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TABLE OF CONTENTS
Item 8. Financial Statements and Supplementary Data

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549



FORM 10-K

(Mark One)  

ý

 

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the Fiscal Year Ended December 31, 20132014

OR

o

 

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the Transition Period From            to            

Commission File Number 1-15525



EDWARDS LIFESCIENCES CORPORATION
(Exact name of registrant as specified in its charter)

Delaware 36-4316614
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. Employer
Identification No.)

One Edwards Way, Irvine, California 92614
(Address of principal executive offices) (ZIP Code)

(949) 250-2500
Registrant's telephone number, including area code

Securities registered pursuant to Section 12(b) of the Act:

 

Name of each exchange on which registered:
Common Stock, par value $1.00 per share New York Stock Exchange

Securities registered pursuant to Section 12(g) of the Act:None



          Indicate by check mark if the registrant is a well-known seasoned issuer, as defined by Rule 405 of the Securities Act.    Yes ý No o

          Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Exchange Act.    Yes o No ý

          Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes ý No o

          Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes ý No o

          Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to the best of the registrant's knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K.    oý

          Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of "large accelerated filer," "accelerated filer," and "smaller reporting company" in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filerý Accelerated filero Non-accelerated filero
(Do not check if a smaller reporting company)
 Smaller Reporting Companyo

          Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes o No ý

          The aggregate market value of the registrant's common stock held by non-affiliates as of June 28, 201330, 2014 (the last trading day of the registrant's most recently completed second quarter): $7,477,512,403$9,013,877,277 based on a closing price of $67.20$85.84 of the registrant's common stock on the New York Stock Exchange. This calculation does not reflect a determination that persons are affiliates for any other purpose.

          The number of shares outstanding of the registrant's common stock, $1.00 par value, as of January 31, 2014,2015, was 107,240,547.107,839,918.

Documents Incorporated by Reference

          Portions of the registrant's proxy statement for the 20142015 Annual Meeting of Stockholders (to be filed within 120 days of December 31, 2013)2014) are incorporated by reference into Part III, as indicated herein.


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EDWARDS LIFESCIENCES CORPORATION
Form 10-K Annual Report—20132014
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PART I

  

Item 1.

 

Business

 1

Item 1A.

 

Risk Factors

 10

Item 1B.

 

Unresolved Staff Comments

 2120

Item 2.

 

Properties

 21

Item 3.

 

Legal Proceedings

 21

Item 4.

 

Mine Safety Disclosures

 21

PART II

 

 

 

PART II


 

Item 5.

 

Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities

 22

Item 6.

 

Selected Financial Data

 24

Item 7.

 

Management's Discussion and Analysis of Financial Condition and Results of Operations

 24

Item 7A.

 

Quantitative and Qualitative Disclosures About Market Risk

 38

Item 8.

 

Financial Statements and Supplementary Data

 4041

Item 9.

 

Changes in and Disagreements With Accountants on Accounting and Financial Disclosure

 9093

Item 9A.

 

Controls and Procedures

 9093

Item 9B.

 

Other Information

 9093

PART III

 

 

 

PART III


 

Item 10.

 

Directors, Executive Officers and Corporate Governance

 9194

Item 11.

 

Executive Compensation

 9194

Item 12.

 

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

 9194

Item 13.

 

Certain Relationships and Related Transactions, and Director Independence

 9194

Item 14.

 

Principal Accounting Fees and Services

 9194

PART IV

 

 

 

PART IV


 

Item 15.

 

Exhibits, Financial Statement Schedules

 9295

 

Signatures

 9699

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PART I

Item 1.    Business

        This report contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. We intend the forward-looking statements contained in this report to be covered by the safe harbor provisions of such Acts. All statements other than statements of historical fact in this report or referred to or incorporated by reference into this report are "forward-looking statements" for purposes of these sections. These statements include, among other things, any predictions of earnings, revenues, expenses or other financial items, plans or expectations with respect to development activities, clinical trials or regulatory approvals, any statements of plans, strategies and objectives of management for future operations, any statements concerning our future operations, financial conditions and prospects, and any statements of assumptions underlying any of the foregoing. These statements can sometimes be identified by the use of the forward-looking words such as "may," "believe," "will," "expect," "project," "estimate," "should," "anticipate," "plan," "goal," "continue," "seek," "pro forma," "forecast," "intend," "guidance," "optimistic," "aspire," "confident," other forms of these words or similar words or expressions or the negative thereof. Investors are cautioned not to unduly rely on such forward-looking statements. These forward-looking statements are subject to substantial risks and uncertainties that could cause our results or future business, financial condition, results of operations or performance to differ materially from the our historical results or experiences or those expressed or implied in any forward-looking statements contained in this report. See "Risk Factors" below for a further discussion of these risks, as well as our subsequent reports on Forms 10-Q and 8-K. These forward-looking statements speak only as of the date on which they are made and we do not undertake any obligation to update any forward-looking statement to reflect events or circumstances after the date of the statement. If we do update or correct one or more of these statements, investors and others should not conclude that we will make additional updates or corrections.

Overview

        Edwards Lifesciences Corporation is focused on technologies that treat structural heart disease and critically ill patients. A pioneer in the development and commercialization of heart valve products,therapies, we are the world's leading manufacturer of heart valvesvalve systems and repair products used to replace or repair a patient's diseased or defective heart valve. We are also a global leader in hemodynamic monitoring systems used to measure a patient's cardiovascular function in the hospital setting.

        Cardiovascular disease is the number-one cause of death in the world, and is the top disease in terms of health care spending in nearly every country. Cardiovascular disease is progressive in that it tends to worsen over time and often affects an individual's entire circulatory system.

        Patients undergoing treatment for cardiovascular disease may be treated using a variety of our products and technologies. For example, an individual with a heart valve disorder may have a faulty valve. A clinician may elect to remove the valve and replace it with one of our bioprosthetic surgical tissue heart valves, surgically re-shape and repair the faulty valve with an Edwards Lifesciences annuloplasty ring, or deploy an Edwards Lifesciences transcatheter valve via a minimally invasive catheter-based system. If a patient undergoes open-heart surgery, our cardiac surgery systems products may be used whilePatients in the patient's heart and lung functions are being bypassed, or during minimally invasive valve surgery. Virtually allhospital setting, including high-risk patients in the operating room or intensive care unit, are candidates for having their cardiac function or fluid levels monitored by our Critical Care products. If the circulatory problems are in the limbs rather than in the heart, the patient's procedure may involve some of our vascular products, which include various types of balloon-tipped catheters that are used to remove blood clots from diseased blood vessels.

Segment and Geographical Information

        We conduct operations worldwide and are managed in the following geographical regions: United States, Europe, Japan, and Rest of World. All regions sell products that are used to treat advanced cardiovascular disease. Additional segment and geographical information is incorporated herein by reference to Note 1718 to


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the "Consolidated Financial Statements." See also the risk factor "Our business is subject to economic, political, and other risks associated with international sales and operations, including risks arising from currency exchange rate fluctuations" in Part I, Item 1A, "Risk Factors,", for information regarding risks involving our international operations.


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Corporate Background

        Edwards Lifesciences Corporation was incorporated in Delaware on September 10, 1999. Unless otherwise indicated or otherwise required by the context, the terms "we," "our," "it," "its," "Company," "Edwards""Edwards," and "Edwards Lifesciences" refer to Edwards Lifesciences Corporation and its subsidiaries.

        Our principal executive offices are located at One Edwards Way, Irvine, California 92614. The telephone number at that address is (949) 250-2500. We make available, free of charge on our website located at www.edwards.com, our annual report on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K, and any amendments to those reports, as soon as reasonably practicable after filing such reports with the Securities and Exchange Commission ("SEC"). The contents of our website are not incorporated by reference into this report.

Edwards Lifesciences' Product and Technology Offerings

        The following discussion summarizes the main areas of products and technologies we offer to treat advanced cardiovascular disease. These are categorized into three main areas: Transcatheter Heart Valve Therapy, Surgical Heart Valve Therapy, Transcatheter Heart Valves, and Critical Care. For more information on net sales from these three main areas, see"Net Sales by Product Group" under "Management's Discussion and Analysis of Financial Condition and Results of Operations."

Surgical Heart Valve Therapy

        We are the global leader in heart valve therapy and the world's leading manufacturer of heart valves and repair products, which are used to replace or repair a patient's diseased or defective heart valve. We produce pericardial valves from biologically inert animal tissue sewn onto proprietary wireform stents.

Transcatheter Heart Valve Therapy

        We have leveraged the knowledge and experience from our Surgical Heart Valve Therapy portfolio to optimize transcatheter heart valve replacement technology, designed for the nonsurgical replacement of heart valves. TheEdwards SAPIEN, Edwards SAPIEN XT, andEdwards SAPIEN 3 transcatheter aortic heart valves, and their respective delivery systems, are used to treat heart valve disease using catheter-based approaches for certain patients deemed at high risk for traditional open-heart surgery. Delivered while the heart is beating, these valves can enable patients to experience a better quality of life sooner than patients receiving traditional surgical therapies. We began offering our transcatheter heart valves to patients commercially in Europe in 2007, in the United States in 2011, and in Japan in 2013. As of December 31, 2014, our transcatheter aortic heart valves were available for sale in more than 65 countries. Supported by extensive customer training and service, and a growing body of compelling clinical evidence, ourSAPIEN family of transcatheter aortic heart valves are the most widely prescribed transcatheter heart valves in the world.

        Sales of our transcatheter heart valves represented approximately 41%, 35%, and 29% of our net sales in 2014, 2013, and 2012, respectively.

Surgical Heart Valve Therapy

        The core of our surgical tissue heart valve product line is theCarpentier-Edwards PERIMOUNT pericardial valve, including the line ofPERIMOUNT Magna Ease valves, the newest generation pericardial valves for aortic and mitral surgical replacement. With their provensignificant clinical data on durability and performance,PERIMOUNT valves are the most widely prescribed tissue heart valves in the world. In addition to its replacement valves, we pioneered and are the worldwide leader in heart valve repair therapies, including annuloplasty rings and systems. We have also developed theEDWARDS INTUITY Valve System, a minimally invasive aortic heart valve system designed to enable a faster procedure, shorter patient time on cardiopulmonary bypass and a smaller incision.


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        Sales of our surgical tissue heart valve products represented approximately 31%, 34%, and 36% of our net sales in 2014, 2013, and 2012, respectively.

        Cardiac surgeons and their patients increasingly are seeking less invasive approaches to aortic or mitral valve surgery, which can offer a number of potential benefits, including smaller incisions, less blood loss, quicker recoveries, and less scarring. Edwards Lifesciences'ThruPortLifesciences offers a variety of systems used to enable minimal incision valve surgery where surgeons perform intricate procedures through small incisions, and allow surgeons to tailor procedures based on their preferred surgical approach.incisions. We are also a global leader in protection cannulae, which are used during cardiac surgery in venous drainage, aortic perfusion, venting and cardioplegia delivery.

        Sales of our surgical tissue heart valve products represented approximately 34%, 36% and 40% of our net sales in 2013, 2012 and 2011, respectively.

Transcatheter Heart Valves

        We have leveraged the knowledge and experience from our Surgical Heart Valve portfolio to optimize transcatheter heart valve replacement technology, designed for the nonsurgical replacement of heart valves.


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TheEdwards SAPIEN, Edwards SAPIEN XT andEdwards SAPIEN 3 transcatheter aortic heart valves are used to treat heart valve disease using catheter-based approaches for certain patients deemed at risk for traditional open-heart surgery. Delivered while the heart is beating, these valves can enable patients to experience a better quality of life sooner than patients receiving alternative therapies. We began offering our Transcatheter Heart Valves to patients commercially in Europe in 2007, in the United States in 2011, and in Japan in 2013. As of December 31, 2013, our transcatheter aortic heart valves were available for sale in over 60 countries. Sales of our Transcatheter Heart Valves represented approximately 35%, 29% and 20% of our net sales in 2013, 2012 and 2011, respectively.

Critical Care

        We are a world leader in hemodynamic monitoring systems used to measure a patient's heart function in surgical and intensive care settings. Hemodynamic monitoring enables a clinician to balance the oxygen supply and demand of a critically ill patient and plays an important role in ensuringenhancing surgical recovery by enabling appropriate tissue and organ perfusion, and ultimately patient outcomes and survival.

Our hemodynamic monitoring technologies are used before, during, and after surgeries, such as open-heart, major vascular, major abdominal, neurological, and orthopedic surgical procedures, as well as for acutely ill patients with conditions such as sepsis, acute respiratory distress syndrome, and multi-organ failure.

        We manufacture products to help clinicians make more informed fluid management decisions for their patients, including the minimally invasiveFloTrac continuous cardiac output monitoring system, a minimally invasive cardiac monitoring technology for goal-directedand the non-invasiveClearSight hemodynamic optimization.monitor that provides real-time, beat-to-beat information. Our hemodynamic monitoring product line also includes theSwan-Ganz line of pulmonary artery catheters, and thePreSep continuous venous oximetry catheter for measuring central venous oxygen saturation. Oursaturation, and theVolumeView sensor-catheter set that measures a critically ill patient's volumetric hemodynamic parameters, while theparameters. OurEV1000 clinical monitoring platform displays a patient's physiologic status and integrates many of our sensors and catheters into one intuitive platform.

        In 2012, we extended our Critical Care product offering with the acquisition of a non-invasive hemodynamic monitoring product line. We plan to integrate this product,ClearSight, into ourEV1000 clinical platform in 2014.

        We are also the global leader in disposable pressure monitoring devices and innovative closed blood sampling systems to help protect both patients and clinicians from the risk of infection.

        Sales of our core hemodynamic monitoring devicesproducts represented approximately 23%15%, 26%17%, and 29%19% of our net sales in 2014, 2013, 2012 and 2011,2012, respectively.

        We manufacture and sell a variety of peripheral vascular products used to treat endolumenal occlusive disease, including balloon-tipped, catheter-based embolectomy products, surgical clips and clamps. OurtheFogarty line of embolectomy catheters, which has been an industry standard for removing blood clots from peripheral blood vessels for more than 40 years.

Competition

        The medical device industry is highly competitive. We compete with many companies, including divisions of companies much larger than us and smaller companies that compete in specific product lines or certain geographies. Furthermore, new product development and technological change characterize the areas in which we compete. Our present or future products could be rendered obsolete or uneconomical as a result of technological advances by one or more of our present or future competitors or by other therapies, including drug therapies. We must continue to develop and acquirecommercialize new products and technologies to remain competitive in the cardiovascular medical device industry. We believe that we compete primarily on the basis of clinical superiority supported by extensive data, and innovative features that enhance patient benefit, product reliability, performance, customerand reliability. Customer and sales support, and cost-effectiveness.cost-effectiveness are additional aspects of competition.

        The cardiovascular segment of the medical device industry is dynamic and subject to significant change due to cost-of-care considerations, regulatory reform, industry and customer consolidation, and evolving


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patient needs. The ability to provide products and technologies that demonstrate value and improve clinical outcomes is becoming increasingly important for medical device manufacturers.


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        We believe that we are globally one of thea leading competitorsglobal competitor in each of our major product lines. In Surgical and Transcatheter Heart Valve therapies, our primary competitors include Medtronic, Inc., St. Jude Medical, Inc., Medtronic, Inc. and Sorin Group. In Critical Care, we compete primarily with a variety of companies in specific product lines including ICU Medical, Inc., PULSION Medical Systems AGSE, a subsidiary of Getinge AB, and LiDCO Group PLC.

Sales and Marketing

        We have a number of broad product lines that require a sales and marketing strategy tailored to our customers in order to deliver high-quality, cost-effective products and technologies to all of our customers worldwide. Our portfolio includes some of the most recognizable product brands in cardiovascular devices today. To help broaden awareness of our products and technologies, we conduct educational symposia and provide training to our customers.

        Because of the diverse global needs of the population that we serve, our distribution system consists of a direct sales force as well as independent distributors. We are not dependent on any single customer and no single customer accounted for 10% or more of our net sales in 2013.2014.

        Where we choose to market our products is also influenced by the existence of, or potential for, adequate reimbursement to hospitals by national healthcare systems. Sales personnel work closely with the customers who purchase our products, which primarily include physicians, nurses, and other clinical personnel, but can also include decision makers such as material managers, biomedical staff, hospital administrators, purchasing managers, and ministries of health. Also, for certain of our products and where appropriate, our sales force actively pursues approval of Edwards Lifesciences as a qualified supplier for hospital group purchasing organizations ("GPOs") that negotiate contracts with suppliers of medical products. Additionally, we have contracts with a number of United States national and regional buying groups.

        United States.    In the United States, we sell substantially all of our products through our direct sales force. In 2013, 46%2014, 45% of our reported sales were derived from sales to customers in the United States.

        International.    In 2013, 54%2014, 55% of our reported sales were derived internationally through our direct sales force and independent distributors. Of the total international sales, 56%58% were in Europe, 22%20% were in Japan, and 22% were in Rest of World. We sell our products in approximately 100 countries, and our major international markets include Australia, Brazil, Canada, France, Germany, Italy, Japan, the Netherlands, Spain, and the United Kingdom. A majority of the sales and marketing approach outside the United States is direct sales, although it varies depending on each country's size and state of development. The international markets in which we choose to market our products are also influenced by the existence of, or potential for, adequate reimbursement to hospitals by national healthcare systems.

Raw Materials and Manufacturing

        We operate manufacturing facilities in various geographies around the world. Our Transcatheter Heart Valve Therapy and Surgical Heart Valve Therapy and Transcatheter Heart Valve products are manufactured in California and Utahprimarily in the United States (California and Utah), Switzerland, and Singapore. Critical Care products are manufactured primarily in our facilities located in Puerto Rico and the Dominican Republic.

        We use a diverse and broad range of raw and organic materials in the design, development, and manufacture of our products. Our non-implantable products are manufactured from man-made raw materials including resins, chemicals, electronics, and metals. Most of our SurgicalTranscatheter Heart Valve Therapy and TranscatheterSurgical Heart Valve Therapy products are manufactured from natural tissues harvested from animal tissue, as well as man-made materials. We purchase certain materials and components used in manufacturing our products from external suppliers. In addition, we purchase certain supplies from single sources for reasons of


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quality assurance, sole source availability, cost effectiveness, or constraints resulting from regulatory requirements.

        We work closely with our suppliers to mitigate risk and assure continuity of supply while maintaining uncompromised quality and reliability. Alternative supplier options are generally considered and identified,


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although we do not typically pursue regulatory qualification of alternative sources due to the strength of our existing supplier relationships and the time and expense associated with the regulatory validation process.

        We follow rigorous sourcing and manufacturing procedures intended to safeguard humans from potential risks associated with diseases such as bovine spongiform encephalopathy ("BSE"). International health and regulatory authorities have given guidance identifying three factors contributing to the control of BSE: source of animals, nature of tissue used, and manufacturing process controls. In the countries in which we sell our products, we comply with all current global guidelines regarding risks for products intended to be implanted in humans. We obtain bovine tissue used in our pericardial tissue valve products only from sources within the United States and Australia, where strong control measures and surveillance programs exist. In addition, bovine tissue used in our pericardial tissue valve products is from tissue types considered by global health and regulatory organizations to have shown no risk of infectibility. Our manufacturing and sterilization processes are designed to render tissue biologically safe from all known infectious agents and viruses, and exceed the worldwide standard for sterile medical products.

Quality Assurance

        We are committed to providing quality products that comply with United States Food and Drug Administration ("FDA") and other applicable regulations to our customers. To meet this commitment, we have implemented modern quality systems and concepts throughout the organization. The quality system starts with the initial product specification and continues through the design of the product, component specification processes, and the manufacturing, sales, and servicing of the product. The quality system is intended to design quality into products and utilizes continuous improvement concepts, including Lean Lean/Six Sigma Principles,principles, throughout the product lifecycle.

        Our operations are certified underinspected by the FDA and comply with all applicable international quality systems standards, such asincluding the International Organization for Standardization ("ISO") 13485. These standards require, among other items, quality system controls that are applied to product design, component material, suppliers, and manufacturing operations. These regulatory approvals and ISO certifications can be obtained only after a complete audit of a company's quality system has been conducted by regulatory or independent outside auditor.auditors. Periodic reexamination by an independent outside auditor is required to maintain these certifications.

Environmental, Health, and Safety

        We are committed to providing a safe and healthy workplace, and the promotion ofpromoting environmental excellence in our own communities, and worldwide.complying with all relevant regulations and medical device industry standards. Through our corporate and site level Environmental, Health, and Safety function,functions, we facilitate compliance with applicable regulatory requirementsestablish and monitor performance against these requirements at all levels of our organization.programs to reduce pollution, prevent injuries, and maintain compliance. In order to measure performance, we monitor and report on a number of metrics, which include the generation of bothincluding regulated and non-regulated waste emissions of air toxics,disposal, energy usage, water consumption, air toxic emissions, and lost time incidents ininjuries from our production activities. Each of our manufacturing sites is evaluated regularly with respect to a broad range of Environmental, Health, and Safety criteria.

Research and Development

        We are engaged in ongoing research and development to deliver clinically advanced new products, to enhance the effectiveness, ease of use, safety and reliability of our current leading products, and to expand the applications of our products as appropriate. We focus on opportunities within specific areas of structural heart disease and critical care monitoring, and we are dedicated to developing novel technologies to better enable clinicians to treat patients who suffer from the disease.patients.


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        We invested $323.0$346.5 million in research and development in 2014, $323.0 million in 2013, and $291.3 million in 2012 (14.9%, 15.8%, and $246.3 million in 2011 (15.8%, 15.3% and 14.7% of net sales, respectively). A significant portionThe majority of our research and development investment has been applied to extend and defendstrengthen our leadership position in transcatheter heart valve replacement technologies, surgical tissue heart valves, heart valve repair therapies, and hemodynamic monitoring products. Additionally, we dedicateWe have also dedicated a sizable portion of our research and development investment to developing advanced technologies designed to address unmet clinical needs within the area of structural heart disease. A considerable portion of our research and development investment includes clinical trials and the collection of evidence that provide data for use in regulatory submissions, and post-market approval studies involving applications of our products.

        We are investing substantially in the development of transcatheter heart valve technologies designed to treat heart valve disease using catheter-based approaches. In the area of transcatheter aortic valve replacement ("TAVR"), we are developing a repositionable, self-expanding transcatheter heart valve system, theEdwards CENTERA transcatheter valve system, in addition to next-generation balloon-expandable valves. We are also making significant investmentinvestments in the development of transcatheter heart valve technologies designed to treat mitral valve disease.

        Surgical Heart Valve Therapy development programs include theEDWARDS INTUITY Elite Valve System, a next-generation minimally invasive aortic heart valve system, andGLXRESILIA, an advanced tissue platform designed to improve tissue valve durability and ease of use. We also plan to broaden our offering of minimally invasive surgical technologies and other products to complement our Surgical Heart Valve Therapy products.

        In our Critical Care product line, we are pursuing the development of non-invasive and minimally invasive hemodynamic monitoring systems, including continuous hemodynamic monitoring, and automated glucose monitoring, and other technologies that collect critical patient information to help clinicians make more informed treatment decisions for larger patient populations.

        Our research and development activities are conducted primarily in facilities located in the United States, Israel, and the Netherlands. Our experienced research and development staff is focused on product design and development, quality, clinical research, and regulatory compliance. To pursue primary research efforts, we have developed alliances with several leading research institutions and universities, and also work with leading clinicians around the world in conducting scientific studies on our existing and developing products. These studies include clinical trials, which provide data for use in regulatory submissions, and post-market approval studies involving applications of our products.

Proprietary Technology

        Patents and other proprietary rights are important to the success of our business. We also rely upon trade secrets, know-how, continuing innovations, and licensing opportunities to develop and maintain our competitive position.

        We own more than 2,500 issued United States patents, pending United States patent applications, issued foreign patents, and pending foreign patent applications. We also have licensed various United States and foreign patents and patent applications that relate to aspects of the technology incorporated in certain of our products, including our heart valves and annuloplasty rings and systems.rings. We also own or have rights in United States and foreign patents and patent applications in the field of transcatheter heart valve repair and replacement. In addition, we own or have rights in United States and foreign patents and patent applications that cover catheters, systems and methods for hemodynamic monitoring, and vascular access products.

        We are a party to several license agreements with unrelated third parties pursuant to which we have obtained, for varying terms, the exclusive or non-exclusive rights to certain patents held by such third parties in consideration for cross-licensing rights and/or royalty payments. We have also licensed certain patent rights to others.

        We monitor the products of our competitors for possible infringement of our owned and/orand licensed patents. Litigation has been necessary to enforce certain patent rights held by us, and we plan to continue to defend and prosecute our rights with respect to such patents.


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        We own certain United States registered trademarks used in our business. Many of our trademarks have also been registered for use in certain foreign countries where registration is available and where we have determined it is commercially advantageous to do so.

Government Regulation and Other Matters

        Our products and technologiesfacilities are subject to regulation by numerous domestic and foreign government agencies, including the U.S. FDA, European Community Notified Bodies, and the Japanese Pharmaceuticals and Medical Devices Agency, to confirm compliance to the various laws and regulations governing the development, testing, manufacturing, labeling, marketing, and distribution of our products and technologies.products. We are also governed by federal, state, local, and international laws of general applicability, such as those regulating employee health and safety and the protection of the environment. Overall, the amount and scope of domestic and foreign laws and regulations applicable to our business is increasing.

        United States Regulation.    In the United States, the FDA has responsibility for regulating medical devices. The FDA regulates design, development, testing, clinical studies, manufacturing, labeling, promotion, and record-keepingrecord keeping for medical devices, and reporting of adverse events, recalls, or other field actions by manufacturers and users to identify potential problems with marketed medical devices. Many of the devices that we develop and market are in a category for which the FDA has implemented stringent clinical investigation and pre-market clearance or approval requirements. The process of obtaining FDA clearance or approval to market a product is resource intensive, lengthy, and costly. FDA review may involve substantial delays that adversely affect the marketing and sale of our products. A number of our products are pending regulatory clearance or approval to begin commercial sales in various markets. Ultimately, the FDA may not authorize the commercial release of a medical device if it determines the device is not safe and effective or does not meet other standards for clearance. Additionally, even if a product is cleared or approved, the FDA may require testing and surveillance programs to monitor the effects of these products once commercialized.

        The FDA has the authority to halt the distribution of certain medical devices, detain or seize adulterated or misbranded medical devices, order the repair, replacement, or refund of the costs of such devices, or preclude the importation of devices that are or appear violative. The FDA also conducts inspections to determine compliance with the quality system regulations concerning the manufacturing and design of devices and current medical device reporting regulations, recall regulations, clinical testing regulations, and other requirements. The FDA may withdraw product clearances or approvals due to failure to comply with regulatory standards, or the occurrence of unforeseen problems following initial approval, and require notification of health professionals and others with regard to medical devices that present unreasonable risks of substantial harm to the public health. Additionally, the failure to comply with FDA or comparable regulatory standards or the discovery of previously unknown product problems could result in fines, delays, or suspensions of regulatory clearances or approvals, seizures, injunctions, recalls, refunds, civil money penalties, or criminal prosecution. Our compliance with applicable regulatory requirements is subject to continual review. Moreover, the FDA and several other United States agencies administer controls over the export of medical devices from the United States and the importationimport of devices into the United States, which could also subject us to sanctions for noncompliance.

        In May 2013, we received a warning letter from the Denver District Office of the FDA resulting from an inspection of our facility in Draper, Utah. The warning letter relates specifically to the execution of our quality systems withinat the Cardiac Surgery Systems business,Utah facility, including design and process validation, corrective and preventive actions, finished device acceptance, and packaging, and indicated that we would not receive pre-market approvals for devices reasonably related to those issues until the issues are resolved. Our Utah facility manufactures devices for the Cardiac Surgery Systems business, such as cannulae and cardioplegia catheters, and also makes devices for our other businesses, including heart valve repair rings, and transcatheter heart valve delivery system components and accessories. We are in the process ofactively implementing the necessary actions to respond to the specificresolve these issues addressedidentified in the letterletter. In June 2014, we were granted a variance from the FDA through June 15, 2015 for theSAPIEN XT delivery systems and remain committed to thoroughly resolving those issues.components that are manufactured at the Draper facility. Under the


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variance, we are complying with an agreed upon action plan for theSAPIEN XT delivery system that verifies the safety and effectiveness of its intended use.

        We are also subject to additional laws and regulations that govern our business operations, products, and technologies, including:

        Failure to comply with these laws and regulations could result in criminal liability, significant fines or penalties, negative publicity, and substantial costs and expenses associated with investigation and enforcement activities. To assist in our compliance efforts, we adhere to many codes of ethics and conduct regarding our sales and marketing activities in the United States and other countries in which we operate. In addition, we have in place a dedicated team to improve our internal business compliance programs and policies.

        International Regulation.    Internationally, the regulation of medical devices is complex. In Europe, our products are subject to extensive regulatory requirements. The regulatory regime in the European Union for medical devices became mandatory in June 1998. It requires that medical devices may only be placed on the market if they do not compromise safety and health when properly installed, maintained, and used in accordance with their intended purpose. National laws conforming to the European Union's legislation regulate our products under the medical devices regulatory system. Although the more variable national requirements under which medical devices were formerly regulated have been substantially replaced by the European Union Medical Devices Directive, individual nations can still impose unique requirements that may require supplemental submissions. The European Union medical device laws require manufacturers to declare that their products conform to the essential regulatory requirements after which the products may be placed on the market bearing the CE Mark. Manufacturers' quality systems for products in all but the lowest risk classification are also subject to certification and audit by an independent notified body. In Europe, particular emphasis is being placed on more sophisticated and faster procedures for the reporting of adverse events to the competent authorities.

        In Japan, pre-market approval and clinical studies are required as is governmental pricing approval for medical devices. Clinical studies are subject to a stringent "Good Clinical Practices" standard. Approval time frames from the Japanese Ministry of Health, Labour and Welfare vary from simple notifications to review periods of one or more years, depending on the complexity and risk level of the device. In addition, importation of medical devices into Japan is subject to the "Good Import Practices" regulations. As with any highly regulated market, significant changes in the regulatory environment could adversely affect future sales.


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        In many of the other foreign countries in which we market our products, we may be subject to regulations affecting, among other things:

        Many of the regulations applicable to our devices and products in these countries are similar to those of the FDA. In some regions, the level of government regulation of medical devices is increasing, which can lengthen time to market and increase registration and approval costs. In many countries, the national health or social security organizations require our products to be qualified before they can be marketed and considered eligible for reimbursement.

        Health Care Initiatives.    Government and private sector initiatives to limit the growth of health care costs, including price regulation and competitive pricing, coverage and payment policies, comparative effectiveness therapies,reviews, technology assessments, and managed-care arrangements, are continuing in many countries where we do business, including the United States, Europe, and Japan. As a result of these changes, the marketplace has placed increased emphasis on the delivery of more cost-effective medical therapies. For example, government programs, private health care insurance, and managed-care plans have attempted to control costs by restricting coverage and limiting the amountlevel of reimbursement they will pay for procedures or treatments, and some third-party payors require their pre-approval before new or innovative devices or therapies are utilized by patients. These various initiatives have created increased price sensitivity over medical products generally and may impact demand for our products and technologies.

        The delivery of our products is subject to regulation by the Department of Health and Human Services Centers for Medicare and Medicaid Services ("CMS"HHS") in the United States and comparable state and foreign agencies responsible for reimbursement and regulation of health care items and services. Foreign governments also impose regulations in connection with their health care reimbursement programs and the delivery of health care items and services. Reimbursement schedules regulate the amount the United States government will reimburse hospitals and doctors for the inpatient care of persons covered by Medicare. CMSHHS' Centers for Medicare & Medicaid Services ("CMS") may also review whether and/or under what circumstances a procedure or technology is reimbursable.reimbursable for Medicare beneficiaries. Several legislative proposals in the United States have been advanced that would restrict future funding increases for government-funded programs, including Medicare and Medicaid. Changes in current reimbursement levels could have an adverse effect on market demand and our pricing flexibility.

        Hospital reimbursement in the United States for TAVR procedures is currently aligned with surgical aortic valve replacement codes. CMS has issued a National Coverage Determination ("NCD") that provides nationwide Medicare coverage of TAVR for patients who either fall within FDA-approved criteria or are part of an approved clinical study. In the United States, physician codes and payment rates have also been established for TAVR procedures.

        Health care cost containment efforts have also prompted domestic hospitals and other customers of medical device manufacturers to consolidate into larger purchasing groups to enhance purchasing power, and this trend is expected to continue. The medical device industry has also experienced some consolidation,


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partly in order to offer a broader range of products to large purchasers. As a result, transactions with customers are larger, more complex and tend to involve more long-term contracts than in the past. These larger customers, due to their enhanced purchasing power, may attempt to increase the pressure on product pricing.


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        Health Care Reform.    In 2010, significant reforms to the health care system were adopted as law in the United States. The law includes provisions that, among other things, reduce or limit Medicare reimbursement, require all individuals to have health insurance (with limited exceptions), and impose increased taxes. Specifically, the law requires the medical device industry to subsidize health care reform in the form of a 2.3% excise tax on United States sales of most medical devices beginning in 2013.devices. The excise tax increased our operating expenses. Because other parts of the 2010 health care law remain subject to continued implementation, the long-term impact on us is uncertain. The newThis law or any future legislation could reduce medical procedure volumes, lower reimbursement for our products, and impact the demand for our products or the prices at which we sell our products.

Seasonality

        Our quarterly net sales are influenced by many factors, including new product introductions, acquisitions, regulatory approvals, patient and physician holiday schedules, and other factors. Net sales in the third quarter are typically lower than other quarters of the year due to the seasonality of the United States and European markets, where summer vacation schedules normally result in fewer medical procedures.

Employees

        As of December 31, 2013,2014, we had approximately 8,6009,100 employees worldwide, the majority of whom were located in the United States, the Dominican Republic, Singapore, and Puerto Rico and Singapore.Rico. Other major concentrations of employees are located in Europe and Japan. We emphasize competitive compensation, benefits, equity participation, and a positive and attractive work environment practices in our efforts to attract and retain qualified personnel, and employ a rigorous talent management system. None of our North American employees are represented by a labor union. In various countries outside of North America, we interact with trade unions and work councils that represent a limited number of employees.

Item 1A.    Risk Factors

        Our business and assets are subject to varying degrees of risk and uncertainty. An investor should carefully consider the risks described below, as well as other information contained in this Annual Report on Form 10-K and in our other filings with the Securities and Exchange Commission. Additional risks not presently known to us or that we currently deem immaterial may also adversely affect our business. If any of these events or circumstances occurs, our business, financial condition, results of operations, or prospects could be materially harmed. In that case, the value of our securities could decline and an investor could lose part or all of his or her investment. In addition, forward-looking statements within the meaning of the federal securities laws that are contained in this Annual Report on Form 10-K or in our other filings or statements may be subject to the risks described below as well as other risks and uncertainties. Please read the cautionary notice regarding forward-looking statements in Item 7, "Management's Discussion and Analysis of Financial Condition and Results of Operations," below.

If we do not introduce new products in a timely manner, our products may become obsolete and our operating results may suffer.

        The cardiovascular products industry is characterized by technological changes, frequent new product introductions, and evolving industry standards. Without the timely introduction of new and improved products, our products could become technologically obsolete or more susceptible to competition and our revenue and operating results would suffer. Even if we are able to develop new or improved products, our ability to market them could be limited by the need for regulatory clearance, restrictions imposed on approved


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indications, entrenched patterns of clinical practice, uncertainty over third-party reimbursement, or other factors. We devote significant financial and other resources to our research and development activities; however, the research and development process is prolonged and entails considerable uncertainty. Accordingly, products we are currently developing may not complete the development process or obtain the regulatory or other approvals required to market such products in a timely manner or at all.


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        Technical innovations often require substantial time and investment before we can determine their commercial viability. We may not have the financial resources necessary to fund all of these projects. In addition, even if we are able to successfully develop new or improved products, they may not produce revenue in excess of the costs of development, and they may be rendered obsolete or less competitive by changing customer preferences or the introduction by our competitors of products with newer technologies or features or other factors.

We may incur product liability losses that could adversely affect our operating results.

        Our business exposes us to potential product liability risks that are inherent in the design, manufacture, and marketing of medical devices. Our products are often used in surgical and intensive care settings with seriously ill patients. In addition, many of the medical devices we manufacture and sell are designed to be implanted in the human body for long periods of time. Component failures, manufacturing flaws, design defects, or inadequate disclosure of product relatedproduct-related risks or product relatedproduct-related information could result in an unsafe condition or injury to, or death of, patients. Such a problem could result in product liability lawsuits and claims, safety alerts, or product recalls in the future, which, regardless of their ultimate outcome, could have a material adverse effect on our business, and reputation, and on our ability to attract and retain customers. Product liability claims may be brought from time to time either by individuals or by groups seeking to represent a class. We may incur charges related to such matters in excess of any established reserves and such charges, including the establishment of any such reserves, could have a material adverse impact on our net income and net cash flows.

We may experience supply interruptions that could harm our ability to manufacture products.

        We use a broad range of raw and organic materials and other items in the design and manufacture of our products. Our Surgical and Transcatheter Heart Valve Therapy products are manufactured from treated natural animal tissue and man-made materials. Our non-implantable products are manufactured from man-made raw materials including resins, chemicals, electronics, and metals. We purchase certain of the materials and components used in the manufacture of our products from external suppliers, and we purchase certain supplies from single sources for reasons of quality assurance, cost-effectiveness, availability, or constraints resulting from regulatory requirements. General economic conditions could adversely affect the financial viability of our suppliers, resulting in their inability to provide materials and components used in the manufacture of our products. While we work closely with suppliers to monitor their financial viability, and to assure continuity of supply, and maintain high quality and reliability, these efforts may not be successful. In addition, due to the rigorous regulations and requirements of the FDA and foreign regulatory authorities regarding the manufacture of our products (including the need for approval of any change in supply arrangements), we may have difficulty establishing additional or replacement sources on a timely basis or at all if the need arises. Although alternative supplier options are considered and identified, we typically do not pursue regulatory qualification of alternative sources due to the strength of our existing supplier relationships and the time and expense associated with the regulatory validation process. A change in suppliers could require significant effort or investment in circumstances where the items supplied are integral to product performance or incorporate unique technology, and the loss of any existing supply contract could have a material adverse effect on us.

        Regulatory agencies in the United States or other international geographies from time to time have limited or banned the use of certain materials used in the manufacture of our products. In these circumstances, transition periods typically provide time to arrange for alternative materials. In addition, the


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SEC enacted disclosure rules regarding products that may contain certain minerals that originate from conflict areas in and around the Democratic Republic of Congo. If our suppliers cannot certifyverify that their components do not originate from these conflict areas, we may need to source components from alternative suppliers. If we are unable to identify alternative materials or suppliers and secure approval for their use in a timely manner, our business could be harmed.


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        Some of our suppliers are located outside the United States. As a result, trade or regulatory embargoes imposed by foreign countries or the United States could result in delays or shortages that could harm our business.

The manufacture of many of our products is highly complex and subject to strict quality controls. If we or one of our suppliers encounters manufacturing or quality problems, including as a result of natural disasters, our business could suffer.

        The manufacture of many of our products is highly complex and subject to strict quality controls, due in part to rigorous regulatory requirements. In addition, quality is extremely important due to the serious and costly consequences of a product failure. Problems can arise during the manufacturing process for a number of reasons, including equipment malfunction, failure to follow protocols and procedures, raw material problems, or human error. If these problems arise or if we otherwise fail to meet our internal quality standards or those of the FDA or other applicable regulatory body, which include detailed record-keeping requirements, our reputation could be damaged, we could become subject to a safety alert or a recall, we could incur product liability and other costs, product approvals could be delayed, and our business could otherwise be adversely affected.

        In addition, our manufacturing facilities in California, Utah, the Dominican Republic, and Puerto Rico could be materially damaged by earthquakes, hurricanes, and other natural disasters or catastrophic circumstances. While we believe that our exposure to significant losses from a catastrophic disaster could be partially mitigated by our ability to manufacture some of our products at our other manufacturing facilities, the losses could have a material adverse effect on our business for an indeterminate period of time before this manufacturing transition is complete and operates without significant disruption.

We may be required, from time to time, to recognize charges in connection with the write-down of our asset or business dispositions, or for other reasons.

        From time to time, we identify businesses and products that are not performing at a level commensurate with the rest of our business. We may seek to dispose of these underperforming businesses or products. We may also seek to dispose of other businesses or products for strategic or other business reasons. If we cannot dispose of a business or product on acceptable terms, we may voluntarily cease operations related to that business or product. Any of these events could result in charges, which could be substantial and which could adversely affect our results of operations.

We may not successfully identify and complete acquisitions or strategic alliances on favorable terms or achieve anticipated synergies relating to any acquisitions or alliances, and such acquisitions could result in unforeseen operating difficulties and expenditures, require significant management resources, and require significant charges or write-downs.

        We regularly explore potential acquisitions of complementary businesses, technologies, services, or products, as well as potential strategic alliances. We may be unable to find suitable acquisition candidates or appropriate partners with which to form alliances. Even if we identify appropriate acquisition or alliance candidates, we may be unable to complete the acquisitions or alliances on favorable terms, if at all. In addition, the process of integrating an acquired business, technology, service, or product into our existing operations could result in unforeseen difficulties and expenditures. Integration of an acquired company often requires significant expenditures as well as significant management resources that otherwise would be available


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for ongoing development of our other businesses. Moreover, we may not realize the anticipated financial or other benefits of an acquisition or alliance.

        We may be required to take charges or write-downs in connection with acquisitions. In particular, acquisitions of businesses engaged in the development of new products may give rise to in-process research and development ("IPR&D") assets. To the extent that the value of these assets declines, we may be required


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to write down the value of the assets. Also, in connection with certain asset acquisitions, we may be required to take an immediate charge related to acquired IPR&D. Either of these situations could result in substantial charges, which could adversely affect our results of operations.

        Future acquisitions could also involve the issuance of equity securities, the incurrence of debt, contingent liabilities, or amortization of expenses related to other intangible assets, any of which could adversely impact our financial condition or results of operations. In addition, equity or debt financing required for such acquisitions may not be available.

General economic and political conditions could have a material adverse effect on our business.

        External factors can affect our profitability and financial condition. Such external factors include general domestic and global economic conditions, such as interest rates, tax rates, and factors affecting global economic stability, and the political environment regarding health care in general. The strength and timing of the current economic recovery remains uncertain, and we cannot predict to what extent the global economic conditions may negatively impact our business. For example, negative conditions in the credit and capital markets could impair our ability to access the financial markets for working capital or other funds, and could negatively impact our ability to borrow. An increase in interest rates could result in an increase in our borrowing costs and could otherwise restrict our ability to access the capital markets. Such conditions could result in decreased liquidity and impairments in the carrying value of our investments, and could adversely affect our results of operations and financial condition. These and other conditions could also adversely affect our customers, and may impact their ability or decision to purchase our products or make payments on a timely basis.

        In 2010, significant reforms to the health care system were adopted as law in the United States. The law includes provisions that, among other things, reduce or limit Medicare reimbursement, require all individuals to have health insurance (with limited exceptions) and impose increased taxes. Specifically, the law requires the medical device industry to subsidize health care reform in the form of a 2.3% excise tax on United States sales of most medical devices beginning in 2013.devices. The excise tax increased our operating expenses. Because other parts of the 2010 health care law remain subject to continued implementation, the long-term impact on us is uncertain. The newThis law or any future legislation, could reduce medical procedure volumes, lower reimbursement for our products, and impact the demand for our products or the prices at which we sell our products. For example, the Budget Control Act of 2011, which provided an increase to the United States debt limit, imposed significant cuts in federal spending over the next decade. This measure and other suchincluding deficit reduction legislation, could adversely affect our results of operations, financial condition, and prospects if they were to impact the demand for our products or pricing, or result in cuts to, or a restructuring of, entitlement programs such as Medicare and Medicaid.

        We do business with governments outside the United States. A number of these countries, including certain European countries, have experienced a deterioration in credit and economic conditions. These conditions have resulted in, and may continue to result in, a reduction in the number of procedures that use our products and an increase in the average length of time that it takes to collect accounts receivable outstanding in these countries. In addition, we have been and may continue to be impacted by declines in sovereign credit ratings or sovereign defaults in these countries.


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Our business is subject to economic, political, and other risks associated with international sales and operations, including risks arising from currency exchange rate fluctuations.

        Because we sell our products in a number of countries, our business is subject to the risks of doing business internationally, including risks associated with United States government oversightanti-corruption and enforcement of the Foreign Corrupt Practices Act as well as with the United Kingdom's Bribery Act and anti-corruption laws in other jurisdictions.anti-bribery laws. Our net sales originating outside of the United States, as a percentage of total net sales, were 54%55% in 2013.2014. We anticipate that sales from international operations will continue to represent a substantial portion of our total sales. In addition, many of our manufacturing facilities and suppliers are located outside of the United States. Accordingly, our future results could be harmed by a variety of factors, including:


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        Substantially all of our sales outside of the United States are denominated in local currencies. Measured in local currency, a substantial portion of our international sales was generated in Europe (and primarily denominated in the Euro) and in Japan. The United States dollar value of our international sales varies with currency exchange rate fluctuations. Decreases in the value of the United States dollar to the Euro or the Japanese yen have the effect of increasing our reported revenues even when the volume of international sales has remained constant. Increases in the value of the United States dollar relative to the Euro or the Japanese yen, as well as other currencies, have the opposite effect and, if significant, could have a material adverse effect on our reported revenues and results of operations. We have a hedging program for certain currencies that attempts to manage currency exchange rate risks to an acceptable level based on management's judgment of the appropriate trade-off between risk, opportunity, and cost; however, this hedging program does not completely eliminate the effects of currency exchange rate fluctuations.

        The United States Foreign Corrupt Practices Act, the United Kingdom Bribery Act, and similar laws in other jurisdictions contain prohibitions against bribery and other illegal payments, or for the failureand make it an offense to fail to have procedures in place that prevent such payments. Recent years have seen an increasing number of investigations and other enforcement activities under these laws. Although we have compliance programs in place with respect to these laws, which may be used as a defense to prove we had adequate procedures, no assurance can be given that a violation will not be found, and if found, the resulting penalties could adversely affect us and our business.


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The stock market can be volatile and fluctuations in our quarterly sales and operating results as well as other factors could cause our financial guidance to vary from actual results and our stock price to decline.

        From time to time, the stock market experiences extreme price and volume fluctuations. This volatility can have a significant effect on the market prices of securities for reasons unrelated to underlying performance. These broad market fluctuations may materially adversely affect our stock price, regardless of our operating results. In addition, the market price of our common stock could fluctuate substantially in response to any of the other risk factors set out above and below, as well as a number of other factors, including the performance of comparable companies or the medical device industry, or changes in financial estimates and recommendations of securities analysts.

        Our sales and operating results may vary significantly from quarter to quarter. A high proportion of our costs are fixed, due in part to significant sales,selling, research and development, and manufacturing costs. Thus, small declines in revenue could disproportionately affect our operating results in a quarter, and the price of our common stock could fall. Other factors that could affect our quarterly sales and operating results include:


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    demand for and clinical acceptance of products;

    the timing and execution of customer contracts, particularly large contracts that would materially affect our operating results in a given quarter;

    the timing of sales of products and of the introduction of new products;

    the timing of marketing, training, and other expenses related to the introduction of new products;

    the timing of regulatory approvals;

    changes in foreign currency exchange rates;

    delays or problems in introducing new products, such as slower than anticipated adoption of transcatheter heart valves;

    changes in our pricing policies or the pricing policies of our competitors;

    the timing of approvals of governmental reimbursement rates or changes in reimbursement rates for our products;

    increased expenses, whether related to sales and marketing, raw materials or supplies, product development, or administration;

    changes in the level of economic activity in the United States or other regions in which we do business;

    costs related to acquisitions of technologies or businesses; and

    our ability to expand our operations and the amount and timing of expansion-related expenditures.

        The quarterly and full-year financial guidance we provide to investors and analysts with insight to our view of our future performance is based on assumptions about our sales and operating results. Due to the nature of our business and the numerous factors that can impact our sales and operating performance, including those described above, our financial guidance may vary from actual results. If we fail to meet any financial guidance that we provide, or if we find it necessary to revise such guidance during the year, the price of our common stock could decline.


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We face intense competition, and if we do not compete effectively, our business will be harmed.

        The cardiovascular medical device industry is highly competitive. We compete with many companies, some of which have longer operating histories, better brand or name recognition, and broader product offerings. Our customers consider many factors when selecting a product, including product reliability, breadth of product line, clinical outcomes, product availability, price, availability and rate of reimbursement, and services provided by the manufacturer. In addition, our ability to compete will depend in large part on our ability to develop and acquire new products and technologies, anticipate technology advances, and keep pace with other developers of cardiovascular therapies and technologies. Our sales, technical, and other key personnel play an integral role in the development, marketing, and selling of new and existing products. If we are unable to recruit, hire, develop, and retain a talented, competitive workforce, our ability to compete may be adversely affected. Our competitive position can also be adversely affected by product problems, physician advisories and safety alerts, reflecting the importance of quality in the medical device industry. Our position can shift as a result of any of these factors. See "Competition" under "Business" included herein.

Consolidation in the health care industry could have an adverse effect on our revenuessales and results of operations.

        The health care industry has been consolidating, and organizations such as GPOs, independent delivery networks, and large single accounts, such as the United States Veterans Administration, continue to consolidate purchasing decisions for many of our health care provider customers. As a result, transactions with


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customers are larger, more complex, and tend to involve more long-term contracts. The purchasing power of these larger customers has increased, and may continue to increase, causing downward pressure on product pricing. If we are not one of the providers selected by one of these organizations, we may be precluded from making sales to its members or participants. Even if we are one of the selected providers, we may be at a disadvantage relative to other selected providers that are able to offer volume discounts based on purchases of a broader range of medical equipment and supplies. Further, we may be required to commit to pricing that has a material adverse effect on our revenues, and profit margins, business, financial condition, and results of operations. We expect that market demand, governmental regulation, third-party reimbursement policies, and societal pressures will continue to change the worldwide health care industry, resulting in further business consolidations and alliances, which may exert further downward pressure on the prices of our products and could adversely impact our business, financial condition, and results of operations.

Our inability to protect our intellectual property or other sensitive company datainformation could have a material adverse effect on our business.

        Our success and competitive position are dependent in part upon our proprietary intellectual property. We rely on a combination of patents and trade secrets to protect our proprietary intellectual property, and we expect to continue to do so. Although we seek to protect our proprietary rights through a variety of means, we cannot guarantee that the protective steps we have taken are adequate to protect these rights. Patents issued to or licensed by us in the past or in the future may be challenged and held invalid. In addition, as our patents expire, we may be unsuccessful in extending their protection through patent term extensions. The expiration of, or the failure to maintain or extend our patents, could have a material adverse effect on us.

        We also rely on confidentiality agreements with certain employees, consultants, and other third parties to protect, in part, trade secrets and other proprietary information. These agreements could be breached, and we may not have adequate remedies for such a breach. In addition, others could independently develop substantially equivalent proprietary information or gain access to our trade secrets or proprietary information.

        Our intellectual property, other proprietary technology, and other sensitive company datainformation is potentially vulnerable to loss, damage, or misappropriation from system malfunction, computer viruses, unauthorized access to our data, or misappropriation or misuse thereofof it by those with permitted access, and other events. While we have invested to protect our intellectual property and other data,information, and continue to work diligently in this area, there can be no assurance that our precautionary measures will prevent breakdowns, breaches, cyber-


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attackscyber-attacks, or other events. Such events could have a material adverse effect on our reputation, financial condition, or results of operations.

        We spend significant resources to enforce our intellectual property rights, sometimes resulting in litigation. Intellectual property litigation is complex and can be expensive and time-consuming. However, our efforts in this regard may not be successful. We may not be able to detect infringement. In addition, competitors may design around our technology or develop competing technologies. Patent litigation can result in substantial cost and diversion of effort. Intellectual property protection may also be unavailable or limited in some foreign countries, enabling our competitors to capture increased market position. The invalidation of key intellectual property rights or an unsuccessful outcome in lawsuits filed to protect our intellectual property could have a material adverse effect on our financial condition, results of operations, or prospects.

Third parties may claim we are infringing their intellectual property, and we could suffer significant litigation or licensing expenses or be prevented from selling products.

        During recent years, we and our competitors have been involved in substantial litigation regarding patent and other intellectual property rights in the medical device industry. From time to time, we have been and may in the future be forced to defend against claims and legal actions alleging infringement of the intellectual property rights of others, and such intellectual property litigation is typically costly and time-consuming. Adverse determinations in any such litigation could result in significant liabilities to third parties or


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injunctions, or could require us to seek licenses from third parties and, if such licenses are not available on commercially reasonable terms, prevent us from manufacturing, selling, or using certain products, any one of which could have a material adverse effect on us. In addition, some licenses may be non-exclusive, which could provide our competitors access to the same technologies.

        Third parties could also obtain patents that may require us to either redesign products or, if possible, negotiate licenses from such third parties. Such licenses may materially increase our expenses. If we are unable to redesign products or obtain a license, we might have to exit a particular product offering.

We and our customers are subject to rigorous governmental regulations and we may incur significant expenses to comply with these regulations and develop products that are compatible with these regulations. In addition, failure to comply with these regulations could subject us to substantial sanctions which could adversely affect our business, results of operations, and financial condition.

        The medical devices we manufacture and market are subject to rigorous regulation by the FDA and numerous other federal, state, and foreign governmental authorities, including regulations that cover the composition, labeling, testing, clinical study, design, sourcing, manufacturing, packaging, marketing, advertising, promotion, and distribution of our products.

        We are required to register with the FDA as a device manufacturer. As a result, we are subject to periodic inspection by the FDA for compliance with the FDA's Quality System Regulation ("QSR") requirements, which require manufacturers of medical devices to adhere to certain regulations, including testing, design, quality control, and documentation procedures. The FDA may also inspect our compliance with requirements related to adverse event reporting, recalls or corrections (field actions), the conduct of clinical studies, and other requirements. In the European Union, we are required to maintain certain CE Mark and ISO certifications in order to sell our products, and are subject to periodic inspections by notified bodies to obtain and maintain these certifications. If we or our suppliers fail to adhere to QSR, CE Mark, ISO, or similar requirements, this could delay or interrupt product production or sales and/or lead to fines, difficulties in obtaining regulatory clearances, recalls, or other consequences, which in turn could have a material adverse effect on our financial condition and results of operations or prospects.

        Medical devices must receive FDA clearance or approval before they can be commercially marketed in the United States. In addition, the FDA may require testing and surveillance programs to monitor the effects of approved products that have been commercialized, and can prevent or limit further marketing of a product


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based upon the results of post-marketing programs. In addition, the federal Medical Device Reporting regulations require us to provide information to the FDA whenever there is evidence that reasonably suggests that a device may have caused or contributed to a death or serious injury or, if a malfunction were to occur, would be likely to cause or contribute to a death or serious injury. Federal regulations also require us to report certain recalls or corrective actions to the FDA. Furthermore, most major markets for medical devices outside the United States require clearance, approval, or compliance with certain standards before a product can be commercially marketed. The process of obtaining regulatory clearances or approvals to market a medical device, particularly from the FDA and certain foreign governmental authorities, can be costly and time-consuming, and clearances or approvals may not be granted for products or product improvements on a timely basis, if at all. Delays in receipt of, or failure to obtain, clearances or approvals for products or product improvements could result in delayed realization of product revenues or in substantial additional costs, which could have a material adverse effect on our business or results of operations or prospects. At any time after approval of a product for commercial sale, the FDA may conduct periodic inspections to determine compliance with QSR requirements, and/or current Medical Device Reporting regulations, or other regulatory requirements. Noncompliance with applicable requirements may subject us or responsible individuals to sanctions including civil money penalties, product seizure, injunction, or criminal prosecution. In addition, the FDA may withhold or delay pre-market approval of our products until the noncompliance is resolved. Product approvals by the FDA can also be withdrawn due to failure to comply with regulatory standards or the occurrence of unforeseen problems following initial approval.


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        Regulatory agencies in the United States or other international geographies from time to time limit or ban the use of certain materials used in the manufacture of our products, require collection and disposal of products at the end of their lifecycle, and require disclosure of the origin of certain raw materials in our products. Noncompliance with applicable requirements could have a material adverse affecteffect on our business.

        The United States Physician Payment Sunshine Act, and similar laws in other jurisdictions, also imposes newimpose reporting and disclosure requirements on device, pharmaceutical, and biologics companies for certain financial relationships with United States health care providers and teaching hospitals. Failure to submit required information or submitting incorrect information may result in significant civil monetary penalties. We will be required to report such aggregate data by March 31, 2014 and detailed data by May 30, 2014.

        We are also subject to various United States and international laws pertaining to health care pricing, anti-corruption, and fraud and abuse, including prohibitions on kickbacks and the submission of false claims laws and restrictions on relationships with physicians and other referral sources. These laws are broad in scope and are subject to evolving interpretation, which could require us to incur substantial costs to monitor compliance or to alter our practices if we are found not to be in compliance. Violations of these laws may be punishable by criminal or civil sanctions against us and our officers and employees, including substantial fines, imprisonment, and exclusion from participation in governmental health care programs.

        Despite our implementation of robust compliance processes, we may be subject, from time to time, to inspections, investigations, and other enforcement actions by governmental authorities. If we are found not to be in compliance with applicable laws or regulations, the applicable governmental authority can impose fines, delay, suspend, or revoke regulatory clearances or approvals, institute proceedings to detain or seize our products, issue a recall, impose marketing or operating restrictions, enjoin future violations and assess civil penalties against us or our officers or employees, and institute criminal prosecution. Moreover, governmental authorities can ban or request the recall, repair, replacement, or refund of the cost of any device or product we manufacture or distribute. Any of the foregoing actions could result in decreased sales as a result of negative publicity and product liability claims, and could have a material adverse effect on our financial condition, results of operations, and prospects. In addition to the sanctions for noncompliance described above, commencement of an enforcement proceeding, inspection, or investigation could divert substantial management attention from the operation of our business and have an adverse effect on our business, results of operations, and financial condition.


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Our industry is experiencing greater scrutiny and regulation by governmental authorities, which may lead to greater governmental regulation in the future.

        In recent years, the medical device industry has been subject to increased regulatory scrutiny, including by the FDA, numerous other federal, state, and foreign governmental authorities, as well as members of Congress. This has included increased regulation, enforcement, inspections, and governmental investigations of the medical device industry and disclosure of financial relationships with health care professionals. We anticipate that the government will continue to scrutinize our industry closely, and that additional regulation by governmental authorities, both foreign and domestic, may increase compliance costs, exposure to litigation, and other adverse effects to our operations.

Unsuccessful clinical trials or procedures relating to products under development could have a material adverse effect on our prospects.

        The regulatory approval process for new products and new indications for existing products requires extensive clinical trials and procedures, including early clinical experiences and regulatory studies. Unfavorable or inconsistent clinical data from current or future clinical trials or procedures conducted by us, our competitors, or third parties, or perceptions regarding this clinical data, could adversely affect our ability to obtain necessary approvals and the market's view of our future prospects. Such clinical trials and procedures are inherently uncertain and there can be no assurance that these trials or procedures will be completed in a timely or cost-effective manner or result in a commercially viable product. Failure to successfully complete


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these trials or procedures in a timely and cost-effective manner could have a material adverse effect on our prospects. Clinical trials or procedures may experience significant setbacks even after earlier trials have shown promising results. Further, preliminary results from clinical trials or procedures may be contradicted by subsequent clinical analysis. In addition, results from our clinical trials or procedures may not be supported by actual long-term studies or clinical experience. If preliminary clinical results are later contradicted, or if initial results cannot be supported by actual long-term studies or clinical experience, our business could be adversely affected. Clinical trials or procedures may be suspended or terminated by us, the FDA or other regulatory authorities at any time if it is believed that the trial participants face unacceptable health risks.

We are subject to risks arising from concerns and/or regulatory actions relating to "mad cow disease."

        Certain of our products, including pericardial tissue valves, are manufactured using bovine tissue. Concerns relating to the potential transmission of BSE, commonly known as "mad cow disease," from cows to humans may result in reduced acceptance of products containing bovine materials. Certain medical device regulatory agencies have considered whether to continue to permit the sale of medical devices that incorporate bovine material. We obtain bovine tissue only from closely controlled sources within the United States and Australia. The bovine tissue used in our pericardial tissue valves is from tissue types considered by global health and regulatory organizations to have shown no risk of infectibility for the suspected BSE infectious agent. We have not experienced any significant adverse impact on our sales as a result of concerns regarding BSE, but no assurance can be given that such an impact may not occur in the future.

If third-party payors decline to reimburse our customers for our products or impose other cost containment measures to reduce reimbursement levels, our ability to profitably sell our products will be harmed.

        We sell our products and technologies to hospitals, doctors, and other health care providers, all of which receive reimbursement for the health care services provided to patients from third-party payors, such as government programs (both domestic and international), private insurance plans, and managed care programs. The ability of customers to obtain appropriate reimbursement for their products from private and governmental third-party payors is critical to the success of medical technology companies. The availability of reimbursement affects which products customers purchase and the prices they are willing to pay. Reimbursement varies from country to country and can significantly impact acceptance of new products.


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        Third-party payors are increasingly attempting to contain health care costs by limiting both coverage and the level of reimbursement for medical products and services. There can be no assurance that levels of reimbursement, if any, will not be decreased in the future, or that future legislation, regulation, or reimbursement policies of third-party payors will not otherwise adversely affect the demand for and price levels of our products. The introduction of cost containment incentives, combined with closer scrutiny of health care expenditures by both private health insurers and employers, has resulted in increased discounts and contractual adjustments to hospital charges for services performed. Hospitals or physicians may respond to such cost-containment pressures by substituting lower cost products or other therapies. In addition, the 2010 United States health care law could adversely affect reimbursement levels for our products, or otherwise adversely affect our product pricing and profitability.

        Initiatives to limit the growth of health care costs, including price regulation, are underway in several countries around the world. In many countries, customers are reimbursed for our products under a government operated insurance system. Under such a system, the government periodically reviews reimbursement levels and may limit patient access. If a government were to decide to reduce reimbursement levels, our product pricing could be adversely affected.

        Third-party payors may deny reimbursement if they determine that a device used in a procedure was not used in accordance with cost-effective treatment methods as determined by such third-party payors, or was used for an unapproved indication. Third-party payors may also deny reimbursement for experimental procedures and devices. We believe that many of our existing products are cost-effective, even though the


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one-time cost may be significant, because they are intended to reduce overall health care costs over a long period of time. We cannot be certain that these third-party payors will recognize these cost savings instead of merely focusing on the lower initial costs associated with competing therapies. If our products are not considered cost-effective by third-party payors, our customers may not be reimbursed for them, resulting in lower sales of our products.

Use of our products in unapproved circumstances could expose us to liabilities.

        The marketing approval from the FDA and other regulators of certain of our products are, or are expected to be, limited to specific indications. We are prohibited by law from marketing or promoting any unapproved use of our products. Physicians, however, can use these products in ways or circumstances other than those strictly within the scope of the regulatory approval. Although the product training we provide to physicians and other health care professionals is limited to approved uses or for clinical trials, no assurance can be given that claims might not be asserted against us if our products are used in ways or for procedures that are not approved.

Our operations are subject to environmental, health, and safety regulations that could result in substantial costs.

        Our operations are subject to environmental, health, and safety laws, and regulations concerning, among other things, the generation, handling, transportation and disposal of hazardous substances or wastes, the cleanup of hazardous substance releases, and emissions or discharges into the air or water. We have incurred and may incur expenditures in the future in connection with environmental, health and safety laws, and regulations. New laws and regulations, violations of these laws or regulations, stricter enforcement of existing requirements, or the discovery of previously unknown contamination could require us to incur costs or could become the basis for new or increased liabilities that could be material.

The success of many of our products depends upon strong relationships with certain key physicians.

        The development, marketing, and sale of many of our products requires us to maintain working relationships with physicians upon whom we rely to provide considerable knowledge and experience. These physicians may assist us as researchers, marketing consultants, product trainers and consultants, inventors, and as public speakers. If new laws, regulations, or other developments limit our ability to maintain strong


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relationships with these professionals or to continue to receive their advice and input, the development and marketing of our products could suffer, which could have a material adverse effect on our business, financial condition, and results of operations.

Item 1B.    Unresolved Staff Comments

        None.


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Item 2.    Properties

        The locations and uses of our major properties are as follows:

North America    
Irvine, California (1) Corporate Headquarters, Research and Development, Regulatory and Clinical Affairs, Manufacturing
Irvine, California (2) Administration
Draper, Utah (2)(1) Administration, Research and Development, Manufacturing
Haina, Dominican Republic (2) Manufacturing
Añasco, Puerto Rico (2) Manufacturing

Europe

 

 

 

 
Horw, Switzerland (2) Manufacturing, Administration
Nyon, Switzerland (1) Administration, Marketing

Asia

 

 

 

 
Tokyo, Japan (2) Administration, Marketing, Distribution
Singapore (1),(2) Manufacturing, Marketing, Distribution, Administration

(1)
Owned property.

(2)
Leased property.

        The Irvine, California lease expires in 2021; the Draper, Utah lease expires in 2024; the Dominican Republic property has one lease that expires in 2016 and one that expires in 2021; the Dominican Republic property leases expire in 2019; the Puerto Rico property has one lease that expires in 2016 and one that expires in 2018; the Horw, Switzerland lease expires in 2015;2016; the Tokyo, Japan lease expires in 2015; and Singapore has one land lease that expires in 2036 and one that expires in 2041. We believe our properties have been well maintained, are in good operating condition, and are adequate for current needs.

Item 3.    Legal Proceedings

        For a description of our material pending legal proceedings, please see Note 1617 to the "Consolidated Financial Statements" of this Annual Report on Form 10-K, which is incorporated by reference.

Item 4.    Mine Safety Disclosures

        Not applicable.


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PART II

Item 5.    Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities

Market Price

        The principal market for our common stock is the New York Stock Exchange (the "NYSE"). The table below sets forth, for the calendar quarters indicated, the high and low salesclosing prices of our common stock as reported by the NYSE.


 2013 2012  2014 2013 

 High Low High Low  High Low High Low 

Calendar Quarter Ended:

                  

March 31

 $94.98 $78.10 $83.96 $67.95  $75.62 $63.04 $94.98 $78.10 

June 30

 86.11 62.34 104.25 67.86  88.19 72.79 86.11 62.34 

September 30

 73.73 65.03 109.88 96.36  104.69 84.05 73.73 65.03 

December 31

 78.89 60.62 110.79 81.29  134.29 97.07 78.89 60.62 

Number of Stockholders

        On January 31, 2014,February 10, 2015, there were 16,51915,961 stockholders of record of our common stock.

Dividends

        We have never paid any cash dividends on our capital stock and have no current plans to pay any cash dividends. Our current policy is to retain any future earnings for use in our business.

Issuer Purchases of Equity Securities

Calendar Month Ended
 Total Number
of Shares
(or Units)
Purchased(a) (c)
 Average
Price Paid
per Share
(or Unit)
 Total Number
of Shares (or
Units) Purchased
as Part of Publicly
Announced Plans
or Programs
 Maximum Number
(or Approximate
Dollar Value) of
Shares that May Yet Be
Purchased Under the
Plans or Programs
(in millions)(b) (c)
 

October 31, 2013

   $   $502.6 

November 30, 2013

  369,802  71.24  369,745  502.5 

December 31, 2013

        502.5 
            

Total

  369,802  71.24  369,745    
            
            

(a)
The difference between the total number of shares (or units) purchased and the total number of shares (or units) purchased as part of publicly announced plans or programs is due to shares withheld by us to satisfy tax withholding obligations in connection with the vesting of restricted stock units issued to employees.

(b)
On May 14, 2013, the Board of Directors approved a stock repurchase program authorizing us to purchase on the open market, including pursuant to a Rule 10b5-1 plan, and in privately negotiated transactions up to $750.0 million of our common stock from time to time until December 31, 2016.

(c)
In October 2013, our August accelerated share On July 10, 2014, the Board of Directors approved a new stock repurchase ("ASR") agreement concluded, and in November 2013, we receivedprogram providing for an additional 0.4$750.0 million sharesof repurchases of our common stock. Shares purchased pursuantWe did not purchase any of our common stock during the fourth quarter of 2014 and, as of December 31, 2014, we had remaining authority to the ASR agreement are presented in the table above in the periods in which they were received.
purchase $952.5 million of common stock.


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Performance Graph

        The following graph compares the performance of our common stock with that of the S&P 500 Index and the S&P 500 Healthcare Equipment Index. The cumulative total return listed below assumes an initial investment of $100 on December 31, 20082009 and reinvestment of dividends.


COMPARISON OF FIVE5 YEAR CUMULATIVE TOTAL RETURN

Total Cumulative Return
 2009 2010 2011 2012 2013  2010 2011 2012 2013 2014 

Edwards Lifesciences

 $158.05 $294.23 $257.32 $328.19 $239.34  $186.16 $162.81 $207.65 $151.43 $293.33 

S&P 500

 126.46 145.51 148.59 172.37 228.19  115.06 117.49 136.30 180.44 205.14 

S&P 500 Healthcare Equipment Index

 120.83 117.02 123.37 145.84 186.00  96.84 102.07 120.66 153.85 194.33 

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Item 6.    Selected Financial Data

        The financial data for the prior years presented in the table below have been restated to reflect our change in accounting principle. For further information, set forth below should be readsee Note 3 to the "Consolidated Financial Statements."

 
  
 As of or for the Years Ended December 31, 
 
  
 2014 2013 2012 2011 2010 
 
  
 (in millions, except per share data)
 

OPERATING RESULTS

 

Net sales

 $2,322.9 $2,045.5 $1,899.6 $1,678.6 $1,447.0 

 

Gross profit

  1,697.3  1,528.9  1,408.6  1,189.2  1,039.5 

 

Net income(a)

  811.1  389.1  291.5  236.6  216.2 

BALANCE SHEET DATA

 

Total assets

 $3,524.3 $2,709.9 $2,209.3 $1,970.0 $1,756.8 

 

Long-term debt(b)

  598.1  593.1  189.3  150.4   

COMMON STOCK INFORMATION

 

Net income per common share(a):

                

 

    Basic

 $7.62 $3.48 $2.54 $2.06 $1.90 

 

    Diluted

  7.48  3.42  2.46  1.98  1.81 

 

Cash dividends declared per common share

           

(a)
The above results include special charges of $70.7 million, $16.3 million, and $16.0 million during 2014, 2013, and 2012, respectively. In addition, the above results include $750.0 million ($487.9 million, net of tax) in conjunction with our2014 for an upfront payment received under a litigation settlement agreement, and $83.6 million ($52.3 million, net of tax) received in 2013 for a litigation award. See"Management's Discussion and Analysis of Financial Condition and Results of Operations"Operations" and"Consolidated Financial Statements" found elsewhere in this Form 10-K. See Note 34 and Note 5 to the"Consolidated Financial Statements" and"Management's Discussion and Analysis of Financial Condition and Results of Operations" for discussions of the effect of certain transactions on our operations.

 
  
 As of or for the Years Ended December 31, 
 
  
 2013 2012 2011 2010 2009 
 
  
 (in millions, except per share data)
 

OPERATING RESULTS

 

Net sales

 $2,045.5 $1,899.6 $1,678.6 $1,447.0 $1,321.4 

 

Gross profit

  1,523.1  1,405.0  1,188.8  1,038.7  922.3 

 

Net income(a)

  391.7  293.2  236.7  218.0  229.1 

BALANCE SHEET DATA

 

Total assets

 $2,724.7 $2,221.5 $1,980.5 $1,767.2 $1,615.5 

 

Long-term debt(b)

  593.1  189.3  150.4    90.3 

COMMON STOCK INFORMATION

 

Net income per common share(a):

                

 

    Basic

 $3.51 $2.55 $2.07 $1.92 $2.04 

 

    Diluted

  3.44  2.48  1.98  1.83  1.95 

 

Cash dividends declared per common share

           

(a)
See Note 3 to the"Consolidated Financial Statements" and"Management's Discussion and Analysis of Financial Condition and Results of Operations"for additional information regarding special (gains) charges of $(67.3) million, $16.0 million and $21.6 million during 2013, 2012 and 2011, respectively.information.

(b)
In October 2013, we issued $600.0 million of 2.875% fixed-rate unsecured senior notes due October 15, 2018 ("the Notes"). A portion of the proceeds from the Notes were used to repay all amounts outstanding under our Four-Year Credit Agreement ("the Credit Facility"). Our previous Five-Year Unsecured Revolving Credit Agreement ("the Credit Agreement") matured on September 29, 2011. Therefore, atAt December 31, 2010, all amounts outstanding under the Credit Agreementcredit agreement in effect at that time were classified as short-term obligations as these obligations were due within one year.

Item 7.    Management's Discussion and Analysis of Financial Condition and Results of Operations

        The following discussion and analysis presents the factors that had a material effect on our results of operations during the three years ended December 31, 2013.2014. Also discussed is our financial position as of December 31, 2013.2014. You should read this discussion in conjunction with the historical consolidated financial statements and related notes included elsewhere in this Form 10-K.

Overview

        We are the global leader in the science of heart valves and hemodynamic monitoring. Driven by a passion to help patients, we partner with clinicians to develop innovative technologies in the areas of structural heart disease and critical care monitoring, enabling them to save and enhance lives. We conduct operations worldwide and are managed in the following geographical regions: United States, Europe, Japan, and Rest of World. Our products are categorized into the following main areas: Transcatheter Heart Valve Therapy, Surgical Heart Valve Therapy, Transcatheter Heart Valves, and Critical Care.

        Effective January 1, 2014, we changed our method of accounting for certain intellectual property litigation expenses related to the defense and enforcement of our issued patents. Under the new method of accounting, these legal costs are expensed in the period incurred; previously, these costs were capitalized and


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then amortized over the life of the related patent. The financial results below reflect the change in accounting principle. For further information, see Note 3 to the "Consolidated Financial Statements."

Financial Results

        The following is a summary of our financial performance (dollars in millions, except per share data):


 Years Ended December 31, Change  Years Ended December 31, Change 

 2013 2012 2011 2013 2012  2014 2013 2012 2014 2013 

Net sales

 $2,045.5 $1,899.6 $1,678.6 7.7% 13.2% $2,322.9 $2,045.5 $1,899.6 13.6% 7.7%

Gross profit as a percentage of net sales

 74.5% 74.0% 70.8% 0.5pts. 3.2pts. 73.1% 74.7% 74.2% (1.6) pts. 0.5pts.

Net income

 $391.7 $293.2 $236.7 33.6% 23.9% $811.1 $389.1 $291.5 108.5% 33.5%

Earnings per share

                      

Basic

 $3.51 $2.55 $2.07 37.6% 23.2% $7.62 $3.48 $2.54 119.0% 37.0%

Diluted

 $3.44 $2.48 $1.98 38.7% 25.3% $7.48 $3.42 $2.46 118.7% 39.0%

        Our sales growth was driven by our Transcatheter Heart Valves product group due to strong growthValve Therapy products which, in Europe, benefited from the launch of theEdwards SAPIEN 3 transcatheter heart valve, and starting in 2013, the United States.States, benefited from the launch of theEdwards SAPIEN XT transcatheter heart valve. Our gross profit margin has benefited from a more profitable product mix, ledwas negatively impacted in 2014 by theforeign currency exchange rate fluctuations, increased Transcatheter Heart Valve sales, but has been tempered byincentive compensation due to our strong performance, and higher manufacturing costs, as we have preparedprimarily for new product launches.our operations in Utah. Net income in 2014 and 2013 also benefited from the $52.3special items. In 2014, we received $750.0 million litigation award,($487.9 million, net of tax,tax) from Medtronic, Inc. ("Medtronic") for an upfront payment due under a litigation settlement agreement, and in 2013, we received from Medtronic Inc. We continue to significantly invest in research and development to extend and defend our leadership position.an $83.6 million ($52.3 million, net of tax) litigation award.

Healthcare Environment, Opportunities and Challenges

        The medical device industry is highly competitive and continues to evolve. Our success is measured both by the development of innovative products and the value we bring to our stakeholders. We are committed to developing new technologies and providing innovative patient care, and we are committed to defending our intellectual property. To strengthen our leadership and enable future growth opportunities, in 20132014 we invested 15.8 percent14.9% of our net sales in research and development. In the coming year,a consolidating industry, we expect increased competition withbelieve our Transcatheter Heart Valves asfocus on innovation and a robust product pipeline will continue to help us compete more effectively, sustain our competitors begin introducing products in the United Statessuccesses, and Europe.build long-term value for our shareholders. The following is a summary of important Transcatheter Heart Valve developments during 2013:2014:

    early clinical evidenceoutcomes in The PARTNER II Trial demonstrated similar outcomes between theEdwards SAPIEN 3 transcatheter heart valveTrial demonstrated outstanding safety, including a low mortality and theEdwards SAPIEN XT transcatheter heart valve in inoperable patients, a positive step toward the approval ofSAPIEN XT and its lower profile delivery system;stroke rate;

    longer-term updates from The PARTNER Trial strengthened the evidence that patients treated with theSAPIEN valve isdemonstrated a safemortality benefit, persistent symptom benefit, and less-invasive alternativea statistically significant reduction in re-hospitalizations compared with standard therapy;

    we received regulatory approval in Europe for patients who needourSAPIEN 3 valve;

    we received regulatory approval in the United States for ourEdwards SAPIEN XT valve, replacement, but are at high surgical risk;and we continued to evaluate theSAPIEN 3 valve as part of the PARTNER II Trial; and

    we received regulatory approval and reimbursementin Europe for ourtheEdwards SAPIEN XTINTUITY Elite Valve System, and in the United States, this valve platform has been studied as part of the TRANSFORM Trial. Three-year clinical outcomes of theEdwards INTUITY valve platform studied in Japanthe TRITON Trial demonstrated improved cardiac and in January 2014, regulatory approval in Europe to launch ourSAPIEN 3 valve. United States studies of theSAPIEN 3 valve were initiated in August 2013.valvular performance, as well as patient functional status.

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        We are dedicated to generating robust clinical and economic evidence increasingly expected by patients, clinicians, and payors in the new healthcare environment, with athe goal of enhancing the value of delivering comprehensive care.


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Results of Operations

    Net Sales by Major Regions
    (dollars in millions)


 Years Ended December 31, Change Percent
Change
  Years Ended December 31, Change Percent
Change
 

 2013 2012 2011 2013 2012 2013 2012  2014 2013 2012 2014 2013 2014 2013 

United States

 $939.6 $812.1 $605.6 $127.5 $206.5 15.7% 34.1% $1,047.3 $939.6 $812.1 $107.7 $127.5 11.5% 15.7%
               

Europe

 616.5 559.7 574.0 56.8 (14.3) 10.2% (2.5)% 744.5 616.5 559.7 128.0 56.8 20.8% 10.2%

Japan

 243.6 294.1 283.7 (50.5) 10.4 (17.2)% 3.7% 257.9 243.6 294.1 14.3 (50.5) 5.9% (17.2)%

Rest of World

 245.8 233.7 ��215.3 12.1 18.4 5.1% 8.5% 273.2 245.8 233.7 27.4 12.1 11.2% 5.1%
               

International

 1,105.9 1,087.5 1,073.0 18.4 14.5 1.7% 1.3% 1,275.6 1,105.9 1,087.5 169.7 18.4 15.3% 1.7%
               

Total net sales

 $2,045.5 $1,899.6 $1,678.6 $145.9 $221.0 7.7% 13.2% $2,322.9 $2,045.5 $1,899.6 $277.4 $145.9 13.6% 7.7%
               
               

        The $107.7 millionincrease in net sales in the United States in 2014 was due primarily to:

    Transcatheter Heart Valve Therapy, which increased net sales by $85.1 million, due primarily to (1) commercial sales of theEdwards SAPIEN XT transcatheter heart valve resulting from the product launch in June 2014, (2) an increase in clinical sales of theEdwards SAPIEN 3 transcatheter heart valve, (3) royalties received under a license agreement with Medtronic (see Note 4 to the "Consolidated Financial Statements"), and (4) the reversal of the sales reserve for estimated Transcatheter Heart Valve Therapy product returns upon delivery of next-generation valves. The introduction of the next-generation valves was completed in 2014. These increases were partially offset by decreased sales of theEdwards SAPIEN transcatheter heart valve as customers converted toEdwards SAPIEN XT, a reduction in net stocking orders as customers converted from direct sales to consignment, and decreased clinical sales ofEdwards SAPIEN XT;

    Critical Care, which increased net sales by $12.9 million, due primarily to enhanced surgical recovery products; and

    Surgical Heart Valve Therapy, which increased net sales by $9.9 million, driven primarily by sales of pericardial aortic tissue valves.

        The $169.7 millionincrease in international net sales in 2014 was due primarily to:

    Transcatheter Heart Valve Therapy, which increased net sales by $152.4 million, driven primarily by the launch of theEdwards SAPIEN 3 transcatheter heart valve in Europe and the ongoing launch of theEdwards SAPIEN XT transcatheter heart valve in Japan, partially offset by lower sales of theEdwards SAPIEN XT transcatheter heart valve in Europe as customers converted toEdwards SAPIEN 3;

    Surgical Heart Valve Therapy, which increased net sales by $25.9 million, driven primarily by sales of pericardial aortic tissue valves andEDWARDS INTUITY Elite valves; and

    Critical Care, which increased net sales by $16.1 million, driven primarily by core hemodynamic products and enhanced surgical recovery products;

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        partially offset by:

    foreign currency exchange rate fluctuations, which decreased net sales by $23.0 million, due to the weakening of various currencies against the United States dollar, mainly the Japanese yen, partially offset by the strengthening of the Euro against the United States dollar.

        The $127.5 millionincrease in net sales in the United States in 2013 was due primarily to:

    Transcatheter Heart Valves,Valve Therapy, which increased net sales by $106.1 million, driven primarily by sales of theEdwards SAPIEN transcatheter heart valve. Procedure volume increased following the FDA action in October 2012 to expand the indicated patient population and access routes compared to the original 2011 approval.

        The $18.4 millionincrease in international net sales in 2013 was due primarily to:

    Transcatheter Heart Valves,Valve Therapy, which increased net sales by $52.4 million, driven primarily by sales of theEdwards SAPIEN XT transcatheter heart valve; and

    surgical heart valve products, which increased net sales by $15.4 million, driven primarily by sales of theCarpentier-Edwards PERIMOUNT Magna Mitral Easepericardial mitral tissue valves andEDWARDS INTUITY Elite valves;

        partially offset by:

    foreign currency exchange rate fluctuations, which decreased net sales by $43.9 million, due primarily to the weakening of the Japanese yen against the United States dollar, partially offset by the strengthening of the Euro against the United States dollar.

        The $206.5 millionincrease in net sales in the United States in 2012 was due primarily to:

    Transcatheter Heart Valves, which increased net sales by $203.5 million, driven primarily by sales of theEdwards SAPIEN transcatheter heart valve which was launched in the fourth quarter of 2011.

        The $14.5 millionincrease in international net sales in 2012 was due primarily to:

    Transcatheter Heart Valves, which increased net sales by $35.9 million, driven primarily by sales of theEdwards SAPIEN XT transcatheter heart valve; and

    Surgical Heart Valve Therapy products, which increased net sales by $19.5 million, driven primarily by sales of theCarpentier-Edwards PERIMOUNT Magna Aortic Ease valve;

        partially offset by:

    foreign currency exchange rate fluctuations, which decreased net sales by $42.4 million, due primarily to the weakening of the Euro against the United States dollar.

        The impact of foreign currency exchange rate fluctuations on net sales is not necessarily indicative of the impact on net income due to the corresponding effect of foreign currency exchange rate fluctuations on international manufacturing and operating costs, and our hedging activities. For more information see"Quantitative and Qualitative Disclosures About Market Risk."


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    Net Sales by Product Group
    (dollars in millions)


 Years Ended December 31, Change Percent
Change
  Years Ended December 31, Change Percent Change 

 2013 2012 2011 2013 2012 2013 2012  2014 2013 2012 2014 2013 2014 2013 

Transcatheter Heart Valve Therapy

 $943.6 $707.7 $552.1 $235.9 $155.6 33.3% 28.2%

Surgical Heart Valve Therapy

 $801.2 $787.5 $784.4 $13.7 $3.1 1.7% 0.4% 826.1 801.2 787.5 24.9 13.7 3.1% 1.7%

Transcatheter Heart Valves

 707.7 552.1 333.8 155.6 218.3 28.2% 65.4%

Critical Care

 536.6 560.0 560.4 (23.4) (0.4) (4.2)% (0.1)% 553.2 536.6 560.0 16.6 (23.4) 3.1% (4.2)%
               

Total net sales

 $2,045.5 $1,899.6 $1,678.6 $145.9 $221.0 7.7% 13.2% $2,322.9 $2,045.5 $1,899.6 $277.4 $145.9 13.6% 7.7%
               
               

    Transcatheter Heart Valve Therapy

        The $235.9 million increase in net sales of Transcatheter Heart Valve Therapy products in 2014 was due primarily to:

    theEdwards SAPIEN 3 transcatheter heart valve, driven primarily by the launch in Europe and clinical sales in the United States; and

    theEdwards SAPIEN XT transcatheter heart valve, driven primarily by the launches in the United States and Japan;

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        partially offset by:

    lower sales of theEdwards SAPIEN transcatheter heart valve, primarily in the United States, and theEdwards SAPIEN XT transcatheter heart valve in Europe, as customers converted to next-generation products.

        The $155.6 million increase in net sales of Transcatheter Heart Valve Therapy products in 2013 was due primarily to:

    theEdwards SAPIEN transcatheter heart valve in the United States, which increased net sales by $97.2 million;

    theEdwards SAPIEN XT transcatheter heart valve, which increased net sales by $61.8 million, due primarily to an increase in international sales; and

    foreign currency exchange rate fluctuations, which increased net sales by $5.2 million, due primarily to the strengthening of the Euro against the United States dollar;

        partially offset by:

    a $14.1 million sales reserve for estimated Transcatheter Heart Valve Therapy product returns expected in 2014 upon introduction of theEdwards SAPIEN 3 transcatheter valve system in Europe and theEdwards SAPIEN XT transcatheter heart valve in the United States.

        During the first quarter of 2014, we completed enrollment in the 500 patient cohort of The PARTNER II Trial studying theEdwards SAPIEN 3 transcatheter valve system in high risk and inoperable patients. In January 2014, we received FDA approval to expand The PARTNER II Trial to include a 1,000 patient single-arm, non-randomized cohort to study theEdwards SAPIEN 3 transcatheter valve system in the treatment of intermediate-risk patients with severe symptomatic aortic stenosis. Enrollment was completed in September 2014. At the end of 2014, we submitted our pre-market approval application forSAPIEN 3 in the United States.

        In January 2014, we received CE Mark for theEdwards SAPIEN 3 transcatheter valve system in Europe. In June 2014, we received FDA approval for theEdwards SAPIEN XT transcatheter heart valve in the United States for the treatment of high-risk and inoperable patients with severe symptomatic aortic stenosis.

    Surgical Heart Valve Therapy

        The $24.9 million increase in net sales of Surgical Heart Valve Therapy products in 2014 was due primarily to:

    surgical heart valve products, which increased net sales by $36.4 million, driven by sales in the United States and Europe of pericardial aortic tissue valves andEDWARDS INTUITY Elite valves;

        partially offset by:

    foreign currency exchange rate fluctuations, which decreased net sales by $10.5 million, due to the weakening of various currencies against the United States dollar, mainly the Japanese yen, partially offset by the strengthening of the Euro against the United States dollar.

        The $13.7 million increase in net sales of Surgical Heart Valve Therapy products in 2013 was due primarily to:

    surgical heart valve products, which increased net sales by $30.1 million, driven by sales of theCarpentier-Edwards PERIMOUNT Magna Aortic Ease, Carpentier-Edwards PERIMOUNT Magna Mitral Ease,pericardial aortic and mitral tissue valves, andEDWARDS INTUITY Elite valves; and

    cardiac surgery systems, which increased net sales by $4.9 million, driven by sales of specialty cannula products;

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        partially offset by:

    foreign currency exchange rate fluctuations, which decreased net sales by $20.2 million, due primarily to the weakening of the Japanese yen against the United States dollar.

        The $3.1 million increase in net sales of Surgical Heart Valve Therapy products in 2012 was due primarily to:

    surgical heart valve products, which increased net sales by $12.5 million, driven by sales of theCarpentier-Edwards PERIMOUNT Magna Aortic Ease        valve; and

    cardiac surgery systems, which increased net sales by $6.0 million, driven by specialty cannula products and minimally invasive surgical products;

        partially offset by:

    foreign currency exchange rate fluctuations, which decreased net sales by $15.3 million, due primarily to the weakening of the Euro against the United States dollar.

        At the end of the first quarter of 2013,In April 2014, we received approval to sellCE Mark for ourCarpentier-Edwards PERIMOUNT Magna Ease valve in China. In the United States, we received approval from the FDA to include advancedEDWARDS INTUITY Elite ourvalve system. This next-generation, minimally invasiverapid deployment system facilitates smaller incisions in surgical aortic valve surgery system,replacement procedures. In the United States, we completed enrollment of patients in our ongoing TRANSFORM Trial a clinical trial designed to support FDA approval for the product. WeEDWARDS INTUITY Elite, and we continued to enrollenrolling patients in our COMMENCE clinical trial, which is studying our next-generationGLX advanced tissue treatment platform applied to theMagna Ease aortic surgical valve and theMagna Mitral Ease valve.

    Transcatheter Heart ValvesCritical Care

        The $155.6$16.6 million increase in net sales of Transcatheter Heart ValvesCritical Care products in 20132014 was due primarily to:

    theEdwards SAPIEN transcatheter heart valve into enhanced surgical recovery products, and core hemodynamic products outside the United States, which increased net sales by $97.2 million;

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      theEdwards SAPIEN XT transcatheter heart valve, which increased net sales by $61.8 million, due primarily to an increase in international sales; and

      foreign currency exchange rate fluctuations, which increased net sales by $5.2 million, due primarily to the strengthening of the Euro against the United States dollar;

    partially offset by:

      a $14.1 million sales reserve for estimated Transcatheter Heart Valve product returns expected in 2014 upon introduction of theEdwards SAPIEN 3 transcatheter valve system in Europe and theEdwards SAPIEN XT transcatheter heart valve in the United States. Additional sales reserves are expected in 2014 for incremental estimated Transcatheter Heart Valve product returns.

            The $218.3 million increase in net sales of Transcatheter Heart Valves in 2012 was due primarily to:

      theEdwards SAPIEN transcatheter heart valve, which increased net sales by $176.7 million, due primarily to the launch in the United States in the fourth quarter of 2011; and

      theEdwards SAPIEN XT transcatheter heart valve, which increased net sales by $63.8 million, due primarily to an increase in international sales;

            partially offset by:

      foreign currency exchange rate fluctuations, which decreased net sales by $16.7$12.0 million, due primarily to the weakening of the EuroJapanese yen against the United States dollar.

            During the fourth quarter of 2013, we completed enrollment in Cohort A, the surgical arm of The PARTNER II Trial, which is evaluating theEdwards SAPIEN XT transcatheter heart valve for the United States market. We submitted our pre-market approval for Cohort B of The PARTNER II Trial to the FDA during the second quarter of 2013 and the FDA's evaluation remains pending. Cohort B is designed for patients with a higher risk profile who are deemed inoperable. Also during the second quarter of 2013, we received approval forSAPIEN XT in Japan, and began commercial sales in October 2013. During the third quarter of 2013, we received approval forSAPIEN in Australia andSAPIEN XT in Canada, and received FDA approval to expand The PARTNER II Trial to include a 500 patient cohort to study theEdwards SAPIEN 3 transcatheter valve system in high risk and inoperable patients. Also, in the third quarter of 2013, the FDA revised the label for ourSAPIEN valve to remove references to specific access points, now making it available for patients who need alternate access points. In January 2014, we received FDA approval to expand The PARTNER II Trial to include a 1,000 patient single-arm, non-randomized cohort to study theEdwards SAPIEN 3 transcatheter valve system in the treatment of intermediate risk patients with severe symptomatic aortic stenosis. In addition, in January 2014, we received CE Mark forSAPIEN 3 in Europe and immediately commenced a launch.

      Critical Care

            The $23.4 million decrease in net sales of Critical Care products in 2013 was due primarily to foreign currency exchange rate fluctuations, which decreased net sales by $28.9 million, due primarily to the weakening of the Japanese yen against the United States dollar.

            In June 2014, we received FDA clearance for theClearSight system, a noninvasive monitor that provides clinicians access to blood volume and blood flow information for patients at moderate or high risk of post-surgical complications, in whom invasive monitoring would not be used. The $0.4 millionClearSight system is part of our enhanced surgical recovery product portfolio. In September 2014, due to a strategic shift of our investment initiatives, we decided to discontinue our automated glucose monitoring program.

      Gross Profit

     
     Years Ended December 31, Change 
     
     2014 2013 2012 2014 2013 

    Gross profit as a percentage of net sales

      73.1% 74.7% 74.2% (1.6) pts. 0.5pts.

            The 1.6 percentage point decrease in gross profit as a percentage of net sales of Critical Care products in 20122014 was due primarily to:driven by:

      a 0.7 percentage point decrease due to the impact of foreign currency exchange rate fluctuations, which decreased net sales by $10.4 million,including the settlement of foreign currency hedging contracts;

      a 0.7 percentage point decrease due primarily to the weakening of the Euro against the United States dollar;higher performance-based incentive compensation; and

      the discontinuation of distributed sales of certain oximetry products and reduced sales ofhigher manufacturing costs, primarily for our Central Venous Access products, which decreased net sales by $6.7 million;operations in Utah;

            partially offset by:

      advanced monitoring products, which increased net salesa 0.8 percentage point increase due to an improved product mix in the United States, driven by $16.7 million, driven byFloTrac systems.Transcatheter Heart Valve Therapy products.

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        Gross Profit

       
       Years Ended December 31, Change 
       
       2013 2012 2011 2013 2012 

      Gross profit as a percentage of net sales

        74.5% 74.0% 70.8% 0.5pts. 3.2pts.

              The 0.5 percentage point increase in gross profit as a percentage of net sales in 2013 was driven by:

        a 1.0 percentage point increase due to an improved product mix in the United States, driven by Transcatheter Heart Valves;Valve Therapy products; and

        a 0.5 percentage point increase in international markets due to a more profitable product mix, primarily higher sales of Transcatheter Heart Valves;Valve Therapy products;

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                partially offset by:

          a 1.3 percentage point decrease due primarily to higher manufacturing costs due to capacity expansion in preparation for multiple Transcatheter Heart Valve Therapy product introductions.

                The 3.2 percentage point increase in gross profit as a percentage of net sales in 2012 was driven by:

          a 2.3 percentage point increase due to the impact of foreign currency exchange rate fluctuations, including the settlement of foreign currency hedging contracts; and

          a 2.3 percentage point increase in the United States due to a more profitable product mix, primarily higher sales of Transcatheter Heart Valves;

                partially offset by:

          the voluntary recalls in the second quarter of 2012 of certain of our heart valves and Critical Care catheters, and manufacturing inefficiencies.

          Selling, General, and Administrative ("SG&A") Expenses
          (dollars in millions)


         Years Ended December 31, Change  Years Ended December 31, Change 

         2013 2012 2011 2013 2012  2014 2013 2012 2014 2013 

        SG&A expenses

         $745.6 $705.3 $642.4 $40.3 $62.9  $858.0 $733.4 $697.4 $124.6 $36.0 

        SG&A expenses as a percentage of net sales

         36.5% 37.1% 38.3% (0.6)pts. (1.2)pts. 36.9% 35.9% 36.7% 1.0pts. (0.8) pts.

                The $40.3$124.6 million increase in SG&A expenses in 2014 was due primarily to (1) higher sales and marketing expenses in the United States, Europe, and Japan, mainly to support the Transcatheter Heart Valve Therapy program, and (2) higher performance-based incentive compensation.

                The $36.0 million increase in SG&A expenses in 2013 was due primarily to (1) higher sales and marketing expenses in the United States and Japan, mainly to support the Transcatheter Heart Valve Therapy program and (2) the 2.3% United States medical device excise tax, or $15.8 million, on United States sales of most medical devices which became effective in 2013. These increases were partially offset by the impact of foreign currency, which reduced expenses by $12.4 million due primarily to the weakening of the Japanese yen against the United States dollar. The decrease in SG&A expenses as a percentage of net sales in 2013 was due primarily to decreased SG&A expenses in Europe as a percentage of net sales.

                The $62.9 million increase in SG&A expenses in 2012 was due primarily to higher sales and marketing expenses in the United States, mainly to support the launch of the Transcatheter Heart Valve program. The decrease in SG&A expenses as a percentage of net sales in 2012 was primarily due to the impact of foreign currency and lower sales and marketing expenses in Europe as a percentage of net sales. The impact of foreign currency reduced SG&A expenses by $17.0 million due primarily to the weakening of the Euro against the United States dollar.


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          Research and Development Expenses
          (dollars in millions)


         Years Ended December 31, Change  Years Ended December 31, Change 

         2013 2012 2011 2013 2012  2014 2013 2012 2014 2013 

        Research and development expenses

         $323.0 $291.3 $246.3 $31.7 $45.0  $346.5 $323.0 $291.3 $23.5 $31.7 

        Research and development expenses as a percentage of net sales

         15.8% 15.3% 14.7% 0.5pts. 0.6pts. 14.9% 15.8% 15.3% (0.9) pts. 0.5pts.

                The increase in research and development expenses in 20132014 was due primarily to new aortic and 2012mitral Transcatheter Heart Valve Therapy product development efforts, additional investments in clinical studies in the Surgical Heart Valve Therapy program, and higher performance-based incentive compensation. The decrease in research and development expenses as a percentage of net sales was due primarily to higher net sales.

                The increase in research and development expenses in 2013 was due primarily to additional investments in clinical studies and new product development efforts in the Transcatheter Heart Valve Therapy program.

          Special (Gains) Charges
          Intellectual Property Litigation (Income) Expense, Net
          (in millions)

         
         Years Ended December 31, 
         
         2013 2012 2011 

        Settlements and litigation

         $(83.6)$ $3.3 

        Realignment expenses

          10.4  9.0  5.5 

        IPR&D impairment

          5.9     

        Licensing of intellectual property

            7.0   

        European receivables reserve

              12.8 
                

        Total special (gains) charges

         $(67.3)$16.0 $21.6 
                
                

          Settlements and Litigation

                In February 2013,May 2014, we entered into an agreement with Medtronic to settle all outstanding patent litigation between the companies, including all cases related to transcatheter heart valves. Pursuant to the agreement, we received $83.6 millionan upfront payment from Medtronic Inc. in satisfactionthe amount of the April 2010 jury award of damages for infringement of the U.S. Andersen transcatheter heart valve patent, including accrued interest.$750.0 million. For further information, see Note 164 to the "Consolidated Financial Statements."

                In December 2011, we recorded a $3.3 million charge related to a litigation settlement.

          Realignment Expenses

                In DecemberFebruary 2013, we recorded a $10.4received $83.6 million charge related primarily to severance expenses associated with a global workforce realignment impacting 118 employees. Asfrom Medtronic in satisfaction of December 31, 2013, our remaining severance obligationsthe initial April 2010 jury award of $9.2 million are expected to be substantially paid bydamages for infringement of the end of 2014.

                In December 2012, we recorded a $9.0 million charge related primarily to severance expenses associated with a global workforce realignment impacting 92 employees. As of December 31, 2013, payments related to the realignment were substantially complete.

                In December 2011, we recorded a $5.5 million charge related primarily to severance expenses associated with a global workforce realignment impacting 49 employees. As of December 31, 2013, payments related to the realignment were complete.

          IPR&D Impairment

                In December 2013, we recorded a $5.9 million write-off of IPR&D assets acquired from Embrella Cardiovascular, Inc. For further information, see Note 5 to the "Consolidated Financial Statements."United States Andersen transcatheter heart valve patent, including accrued interest.


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          Licensing of Intellectual Property

                In April 2012, we obtained an exclusive license to a suturing device for minimally invasive surgery applications. The intellectual property is under development and there is uncertainty as to whether the product will ultimately be approved. We recorded a charge of $2.0 millionincurred external legal costs related to the upfront licensing and royalty fees.

                In June 2012, we obtained a co-exclusive sublicense to intellectual property related to processing tissuelitigation of $9.6 million, $22.1 million, and implanting cardiovascular valves. The intellectual property is under development$14.4 million during 2014, 2013, and there is uncertainty as to whether the product will ultimately be approved. We recorded a charge of $5.0 million related to the upfront licensing fee.2012, respectively.

          European Receivables ReserveSpecial Charges

                During 2011, we recorded a $12.8        Special charges were $70.7 million, charge$16.3 million, and $16.0 million for the years ended December 31, 2014, 2013, and 2012, respectively. For additional details, see Note 5 to reflect the increased risk associated with our southern European receivables, primarily Greece."Consolidated Financial Statements."

          Interest Expense

                Interest expense was $17.2 million, $9.8 million, and $4.4 million in 2014, 2013, and $3.1 million in 2013, 2012, and 2011, respectively. The $5.4 million increase in interest expense for 2013 resulted primarily from a higher average debt balance as compared to the prior year2014 and higher average interest rates due to the issuance in October 2013 of $600.0 million of 2.875% fixed-rate unsecured senior notes. The $1.3 million increase in interest expense for 2012 resulted primarily from higher average interest rates and a higher average debt balance as compared to the prior year.year due to the issuance in October 2013 of $600.0 million of 2.875% fixed-rate unsecured senior notes.

          Interest Income

                Interest income was $6.4 million, $4.6 million, and $4.8 million in 2014, 2013, and $3.4 million in 2013, 2012, and 2011, respectively. The $0.2 millionincrease in interest income for 2014 resulted primarily from higher average investment balances. The decrease in interest income for 2013 resulted primarily from lower average interest rates, partially offset by higher average investment balances. The $1.4 million increase in interest income for 2012 resulted primarily from the recognition of interest income on discounted accounts receivables in southern Europe, partially offset by lower average interest rates.

          Other Expense, (Income), net
          (in millions)


         Years Ended
        December 31,
          Years Ended
        December 31,
         

         2013 2012 2011  2014 2013 2012 

        Promissory note impairment

         $4.0 $ $ 

        Loss on investments

         4.5 0.4 0.7 

        Insurance settlement gain

         (3.7)   

        Foreign exchange losses, net

         $1.5 $1.2 $1.9  2.0 1.5 1.2 

        Loss (gain) on investments in unconsolidated affiliates

         0.4 0.7 (5.4)

        Earn-out payments

           (1.0)

        Lease contract termination costs

         1.0   

        Other

         (0.6) (0.2) (0.3) (0.1) (0.6) (0.2)
               

        Total other expense (income), net

         $1.3 $1.7 $(4.8)
               

        Total other expense, net

         $7.7 $1.3 $1.7 
               

                In December 2014, we recorded a $4.0 million impairment charge related to our promissory note receivable because it was likely that we will be unable to collect the scheduled payments of principal or interest when due according to the contractual terms of the promissory note agreement.

                The loss on investments primarily represents our net share of gains and losses in investments accounted for under the equity method, and realized gains and losses on our available-for-sale and cost method investments. During 2014, we recorded an other-than-temporary impairment charge of $3.5 million related to one of our cost method investments.

                In March 2014, we recorded a $3.7 million insurance settlement gain related to inventory that was damaged in the fourth quarter of 2013.

                The foreign exchange losses relate to the foreign currency fluctuations in our global trade and intercompany receivable and payable balances, offset by the gains and losses on derivative instruments intended as an economic hedge of those exposures.

                The loss (gain) on investments in unconsolidated affiliates primarily represents our net share of gains and losses in investments accounted for under the equity method, and realized gains and losses on our available-for-sale and cost method investments.


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                In September 2009,2014, we soldcommitted to purchase our hemofiltration product line. In connection withDraper, Utah facility for $17.0 million under a purchase option provided in the transaction,lease agreement. Under the terms of the lease agreement, we were entitled to earn-out payments up to $9.0paid $1.0 million based onin December 2014 for certain revenue objectives to be achieved by the buyer over the two years following the sale. As of March 31, 2011, all earn-out payments had been earned.lease contract termination costs.

          Provision for Income Taxes

                Our effective income tax rates for 2014, 2013, 2012 and 20112012 were impacted as follows (in millions):


         Years Ended December 31,  Years Ended December 31, 

         2013 2012 2011  2014 2013 2012 

        Income tax expense at U.S. federal statutory rate

         $180.3 $136.9 $99.2  $400.4 $178.9 $135.9 

        Foreign income taxed at different rates

         (60.6) (41.5) (55.3) (67.1) (60.6) (41.5)

        State and local taxes, net of federal tax benefit

         19.3 5.8 3.7 

        Tax credits, federal and state

         (19.8) (4.9) (10.4) (13.5) (19.8) (4.9)

        Release of reserve for uncertain tax positions for prior years

         (4.8) (3.9) (0.8)

        U.S. tax on foreign earnings, net of credits

         18.9 0.7 9.7  (3.1) 18.9 0.7 

        State and local taxes, net of federal tax benefit

         5.9 3.9 4.6 

        Nondeductible stock-based compensation

         2.6 1.9 1.9  2.1 2.6 1.9 

        Release of reserve for uncertain tax positions for prior years

         (3.9) (0.8) (4.1)

        Other

         0.2 1.7 1.3  (0.4) 0.2 1.7 
               

        Income tax provision

         $123.6 $97.9 $46.9  $332.9 $122.1 $96.7 
               
               

                Certain previously reported amounts in the above table have been reclassified to conform to our current year presentation.

          Reserve for Uncertain Tax Positions

                As of December 31, 20132014 and 2012,2013, the liability for income taxes associated with uncertain tax positions was $127.7$192.3 million and $113.6$127.7 million, respectively. We estimate that these liabilities would be reduced by $30.9$34.3 million and $26.1$30.9 million, respectively, from offsetting tax benefits associated with the correlative effects of potential transfer pricing adjustments, state income taxes, and timing adjustments. The net amounts of $96.8$158.0 million and $87.5$96.8 million, respectively, if not required, would favorably affect our effective tax rate.

                A reconciliation of the beginning and ending amount of unrecognized tax benefits, excluding interest, penalties, and foreign exchange, is as follows (in millions):


         December 31,  December 31, 

         2013 2012 2011  2014 2013 2012 

        Unrecognized tax benefits, January 1

         $113.6 $78.0 $55.1  $127.7 $113.6 $78.0 

        Current year tax positions

         17.8 41.7 26.0  75.9 17.8 41.7 

        Increase prior year tax positions

         5.7 2.6 5.9  0.6 5.7 2.6 

        Decrease prior year tax positions

         (9.0) (4.3) (5.5) (10.5) (9.0) (4.3)

        Settlements

         (0.1) (4.3) (0.1) (1.0) (0.1) (4.3)

        Lapse of statutes of limitations

         (0.3) (0.1) (3.4) (0.4) (0.3) (0.1)
               

        Unrecognized tax benefits, December 31

         $127.7 $113.6 $78.0  $192.3 $127.7 $113.6 
               
               

                We recognize interest and penalties, if any, related to uncertain tax positions in the provision for income taxes. As of December 31, 2014, we had accrued $6.8 million (net of $5.0 million tax benefit) of interest related to uncertain tax positions, and as of December 31, 2013, we had accrued $4.5 million (net of $3.3 million tax benefit) of interest related to uncertain tax positions, and as of December 31, 2012, we had accrued $3.1 million (net of $2.1 million tax benefit) of interest related to uncertain tax positions. During 2014, 2013, 2012 and 2011,2012, we recognized interest expense, net of tax benefit, of $2.3 million, $1.4 million, $1.0 million and $0.4$1.0 million, respectively, in "Provision for Income Taxes" on the consolidated statements of operations.


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                We strive to resolve open matters with each tax authority at the examination level and could reach agreement with a tax authority at any time. While we have accrued for matters we believe are more likely than not to require settlement, the final outcome with a tax authority may result in a tax liability that is more or less than that reflected in the consolidated financial statements. Furthermore, we may later decide to


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        challenge any assessments, if made, and may exercise our right to appeal. The uncertain tax positions are reviewed quarterly and adjusted as events occur that affect potential liabilities for additional taxes, such as lapsing of applicable statutes of limitations, proposed assessments by tax authorities, negotiations between tax authorities, identification of new issues, and issuance of new legislation, regulations, or case law. Management believes that adequate amounts of tax and related penalty and interest have been provided in income tax expense for any adjustments that may result from these uncertain tax positions.

                At December 31, 2013,2014, all material state, local, and foreign income tax matters have been concluded for years through 2006.2008. During the third quarter of 2013, the Internal Revenue Service ("IRS") completed its fieldwork for the 2009 and 2010 tax years. The case is currently in suspense pending finalization of an Advance Pricing Agreement ("APA") and Joint Committee of Taxation approval. The IRS began its examination of the 2011 and 2012 tax years during the fourth quarter of 2013.

                We have also entered into an APA process between the Switzerland and the United States governments for the years 2009 through 20132015 covering transfer pricing matters. These transfer pricing matters are significant to our consolidated financial statements, and the final outcome of the negotiations between the two governments is uncertain.

                During 2014, we also filed with the IRS a request for a pre-filing agreement associated with a tax return filing position on a portion of the litigation settlement payment received from Medtronic in May 2014 (see Note 4 to the "Consolidated Financial Statements").

                Management believes that adequate amounts of tax and related penalty and interest have been provided in income tax expense for any adjustments that may result for our uncertain tax positions. Based upon the information currently available and numerous possible outcomes, we cannot reasonably estimate what, if any, changes in our existing uncertain tax positions may occur in the next 12 months and thus have recorded the gross uncertain tax positions as a long-term liability. However, if the APA and/or pre-filing agreement is finalized in the next 12 months, it is reasonably possible that these events could result in a significant change in our uncertain tax positions within the next 12 months.

                The effective income tax rate for the year ended December 31, 2014 included (1) $262.1 million of tax expense associated with a $750.0 million litigation settlement payment received from Medtronic in May 2014 (see Note 4 to the "Consolidated Financial Statements") and (2) $4.8 million of tax benefits from the remeasurement of uncertain tax positions.

                The federal research credit expired on December 31, 2011 and was not reinstated untilon January 2, 2013. Accordingly,As a result, the effective income tax rate for the year ended December 31, 2012 was calculated without an assumeda benefit for the federal research credit. The effective income tax rate for the year ended December 31, 2013 included (1) an $8.4 million benefit for the full year 2012 federal research credit and (2) $31.3 million of tax expense associated with the $83.6 million litigation award received from Medtronic Inc. in February 2013.2013 (see Note 4 to the "Consolidated Financial Statements").

                We have received tax incentives in Puerto Rico, the Dominican Republic, Singapore, and Switzerland. The tax reductions as compared to the local statutory rates favorably impacted earnings per diluted share for the years ended December 31, 2014, 2013, and 2012 by $0.63, $0.44, and 2011 by $0.44, $0.39, and $0.40, respectively. The Puerto Rico, Dominican Republic, Singapore, and Switzerland grants provide our manufacturing operations partial or full exemption from local taxes until the years 2028, 2030 (subject to review beginning in 2015), 2024, and 2015, respectively.

        Liquidity and Capital Resources

                Our sources of cash liquidity include cash and cash equivalents, short-term investments, amounts available under credit facilities, and cash from operations. We believe that these sources are sufficient to fund the current requirements of working capital, capital expenditures, and other financial commitments for the next twelve months. However, we periodically consider various financing alternatives and may, from time to


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        time, seek to take advantage of favorable interest rate environments or other market conditions. We believe that we have the financial flexibility to attract long-term capital to fund short-term and long-term growth objectives. However, no assurances can be given that such long-term capital will be available to us on favorable terms, or at all.

                We believe that cash held in the United States, in addition to amounts available under credit facilities and cash from operations, are sufficient to fund our United States operating requirements.requirements for the next twelve months. Cash and cash equivalents and short-term investments held outside the United States have historically been used to fund international operations and acquire businesses outside of the United States, although a portion of those amounts may, from time to time, be subject to temporary intercompany loans into the United States. As of December 31, 2013,2014, cash and cash equivalents and short-term investments held in the United States and outside the United States were $811.7 million.$651.7 million and $787.1 million, respectively. The majority of cash and cash equivalents and short-term investments held outside the


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        United States relates to undistributed earnings of certain of our foreign subsidiaries, which are considered by us to be indefinitely reinvested. Repatriations of cash and cash equivalents and short-term investments held outside the United States are subject to restrictions in certain jurisdictions, and may be subject to withholding and other taxes. The potential tax liability related to any repatriation would be dependent on the facts and circumstances that exist at the time such repatriation is made and the complexities of the tax laws of the United States and the respective foreign jurisdictions.

                We have a Five-Year Credit FacilityAgreement ("the Credit Agreement") which provides up to an aggregate of $750.0 million in borrowings in multiple currencies. As of December 31, 2014, there were no borrowings outstanding under the Credit Agreement. In October 2013, we issued $600.0 million of 2.875% fixed-rate unsecured senior notes due October 15, 2018. The proceeds from the Notes of $597.0 million were used to repay all amounts outstanding under our Credit Facility and the remainder will be used for general corporate purposes. For further information on our long-term debt, see Note 89 to the "Consolidated Financial Statements."

                From time to time, we repurchase shares of our common stock under share repurchase programs authorized by the Board of Directors. We consider several factors in determining when to execute share repurchases, including, among other things, expected dilution from stock plans, cash capacity, and the market price of our common stock. The current $750.0 million program provides for repurchases through December 31, 2016. Under this stock repurchase authorization, in November 2013 and FebruaryDuring 2014, we entered into Rule 10b5-1 plans to repurchase, during the period January through April 2014, up to an aggregate total of $300.0 million of our common stock in accordance with certain pre-defined price parameters. During 2013, we repurchased a total of 6.84.4 million shares at an aggregate cost of $495.1$300.0 million, and as of December 31, 2013,2014, had remaining authority to purchase $502.5$952.5 million of our common stock. For further information, see Note 1213 to the "Consolidated Financial Statements."

                Net cash flows provided byoperating activities of $1,022.3 million for 2014 increased $549.6 million from 2013 due primarily to (1) the $750.0 million upfront payment received from Medtronic under a litigation settlement agreement, (2) a lower bonus payout in 2014 associated with 2013 bonuses, and (3) improved operating performance. These increases were partially offset by (1) income tax payments of $224.5 million related to the Medtronic settlement, (2) the prior year receipt of $83.6 million from Medtronic in satisfaction of the initial April 2010 jury award of damages for infringement of the United States Andersen transcatheter heart valve patent, and (3) the $50.0 million charitable contribution to the Edwards Lifesciences Foundation in 2014.

                Net cash flows provided by operating activities of $472.7 million for 2013 increased $110.6 million from 2012 due primarily to (1) the receipt of $83.6 million from Medtronic, Inc. in satisfaction of the April 2010 jury award of damages for infringement of the U.S. Andersen transcatheter heart valve patent, (2) increased collection of accounts receivable, and (3) improved operating performance. These increases were partially offset by (1) a $22.7 million increase in inventory purchases to support future product launches and (2) a $17.0 million impact from excess tax benefits from stock plans, primarily as a result of the realization of excess tax benefits that had been previously unrealized due to credit carryforwards and net operating losses in the United States in 2011 and 2012.

                Net cash flows provided by operating activities of $362.1 million for 2012 increased $53.9 million from 2011 due primarily to (1) improved operating performance, (2) a decrease in inventory builds in comparison to the prior year and (3) increased collection of accounts receivable, particularly a $26.3 million non-recurring collection in Spain and the sale of our Greek bonds. These increases were partially offset by (1) a $50.5 million impact from increased excess tax benefits from stock plans, primarily the realization of excess tax benefits that had been previously unrealized due to credit carryforwards and net operating losses in the United States, and (2) the timing of supplier payments.

                Net cash used ininvesting activities of $633.0 million in 2014 consisted primarily of net purchases of investments of $527.4 million and capital expenditures of $82.9 million.


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                Net cash used in investing activities of $412.7 million in 2013 consisted primarily of net purchases of short-term investments of $296.8$300.9 million and capital expenditures of $109.0 million.

                Net cash used in investingfinancing activities of $78.8$153.0 million in 20122014 consisted primarily of capital expenditurespurchases of $109.0treasury stock of $300.9 million, and a $36.6 million payment associated with the acquisition of BMEYE, B.V. (see Note 5 to the "Consolidated Financial Statements"), partially offset by net proceeds from short-term investmentsstock plans of $69.7 million.$113.3 million, and the excess tax benefit from stock plans of $49.4 million (including the realization of previously unrealized excess tax benefits).

                Net cash provided byfinancing activities of $34.9 million in 2013 consisted primarily of net proceeds from debt of $409.6 million, the excess tax benefit from stock plans of $73.5 million (including the realization of previously unrealized excess tax benefits), and proceeds from stock plans of $45.5 million, partially offset by repurchases of common stock of $496.9 million.


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                Net cash used in financing activities of $155.6 million in 2012 consisted primarily of repurchases of common stock of $353.2 million, partially offset by proceeds from stock plans of $100.1 million, the excess tax benefit from stock plans of $56.5 million (including the realization of previously unrealized excess tax benefits), and net proceeds from debt of $39.5 million.

                A summary of all of our contractual obligations and commercial commitments as of December 31, 20132014 were as follows (in millions):


         Payments Due by Period  Payments Due by Period 
        Contractual Obligations
         Total Less Than
        1 Year
         1-3 Years 4-5 Years After 5
        Years
          Total Less Than
        1 Year
         1-3
        Years
         4-5
        Years
         After 5
        Years
         

        Debt

         $600.0 $ $ $600.0 $  $600.0 $ $ $600.0 $ 

        Operating leases

         103.6 23.5 30.0 15.4 34.7  80.4 20.6 27.7 13.6 18.5 

        Interest on debt

         65.6 15.6 26.9 23.1   53.0 13.8 27.6 11.6  

        Pension obligations(a)

         6.3 6.3     5.8 5.8    

        Contractual development obligations(b)

         1.4 0.9 0.5   

        Capital commitment obligations(c)

         2.3 1.3 1.0   

        Capital commitment obligations(b)

         3.1 0.8 2.3   

        Purchase and other commitments

         6.5 2.5 2.6 0.6 0.8  3.7 2.6 1.1   
                   

        Total contractual cash obligations(d)

         $785.7 $50.1 $61.0 $639.1 $35.5 
                   

        Total contractual cash obligations(c)

         $746.0 $43.6 $58.7 $625.2 $18.5 
                   

        (a)
        The amount included in "Less Than 1 Year" reflects anticipated contributions to our various pension plans. Anticipated contributions beyond one year are not determinable. The total accrued benefit liability for our pension plans recognized as of December 31, 20132014 was $42.7$49.3 million. This amount is impacted by, among other items, pension expense funding levels, changes in plan demographics and assumptions, and investment return on plan assets. Therefore, we are unable to make a reasonably reliable estimate of the amount and period in which the liability might be paid, and did not include this amount in the contractual obligations table. See Note 1112 to the "Consolidated Financial Statements" for further information.

        (b)
        Contractual development obligations consist primarily of cash that we are obligated to pay upon achievement of product development and other milestones.

        (c)
        Capital commitment obligations consist primarily of cash that we are obligated to pay to our limited partnership and limited liability corporation investees. These investees make equity investments in various development stage biopharmaceutical and medical device companies, and it is not certain if and/or when these payments will be made.

        (d)(c)
        As of December 31, 2013,2014, the liability for uncertain tax positions including interest was $135.5$204.1 million. We have entered into an APA process between the Switzerland and the United States governments for the years 2009 through 20132015 covering transfer pricing matters. These transfer pricing matters are significant to our consolidated financial statements, and the final outcome of the negotiations between the two governments is uncertain. Management believes that adequate amounts of tax and related penalty and interest have been provided in income tax expense for any adjustments that may result for our uncertain tax positions. We are unable to make a reasonably reliable estimate of the amount and period in which the liability might be paid, and did not include this amount in the contractual obligations table.

        We acquire assets still in development, enter into research and development arrangements, and sponsor certain clinical trials that often require milestone, royalty, or other future payments to third-parties,


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