0001167379ifrs-full:PensionDefinedBenefitPlansMemberifrs-full:NotLaterThanOneYearMember2021-01-012021-12-31

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C.DC 20549
FORM 20-F

REGISTRATION STATEMENT PURSUANT TO SECTION 12(b) OR (g)or 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934
OR
XOR
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended DECEMBERDecember 31, 20102021
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
OR
For the transition period from __________ to __________
OR
SHELL COMPANY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 Date of event requiring the shell company report __________
Commission file number   number: 001-31269
ALCON, INC.Alcon Inc.
(Exact name of Registrant as specified in its charter)
ALCON, INC.N/A
 (Translation(Translation of Registrant's name into English)
Switzerland
(Jurisdiction of incorporation or organization)
Bösch 69,  P.O. Box 62,  Hünenberg,Rue Louis-d'Affry 6, 1701 Fribourg, Switzerland
(Address of principal executive offices)office)
Elaine E. Whitbeck, General Counsel & Corporate Secretary, Alcon Inc., 6201 South Freeway, TA7-1, Fort Worth, Texas, USA 76134-2099; 817-293-0450; AlconSECContact@Alcon.com
Royce Bedward, Chemin de Blandonnet 8, 1214 Vernier, Geneva, Switzerland; Tel: +1 817 293 0450 ; Fax +1 817 916 2652
(Name, Telephone, E-mailEmail and/or Facsimile number and Address of Company Contact Person)
Securities registered or to be registered pursuant to Section 12(b) of the Act.
Title of each classTrading Symbol(s)Name of each exchange on which registered
CommonOrdinary Shares, parnominal value CHF 0.200.04 per shareThe ALCSIX Swiss Exchange
New York Stock Exchange

Securities registered or to be registered pursuant to Section 12(g) of the Act. None
Securities for which there is a reporting obligation pursuant to Section 15(d) of the Act. None
Indicate the number of outstanding shares of each of the issuer's classes of capital or common stock as of the close of the period covered by the annual report. 302,390,266 Common Shares490,086,981
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes     No
X  Yes  No
If this report is an annual or transition report, indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934. Yes     No 
  YesX  No
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     No 
X  Yes  No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted 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 such files). Yes     No 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, or a non-accelerated filer.filer, or an emerging growth company. See definitions of "large accelerated filer," "accelerated filer," and "emerging growth company" and in Rule 12b-2 of the Exchange Act.
Large Accelerated FilerXAccelerated FilerNon-accelerated FilerEmerging Growth Company 
If an emerging growth company that prepares its financial statements in accordance with U.S. GAAP, indicate by check mark if the registrant has elected not to use the extended period for complying with any new or revised financial accounting standards† provided pursuant to Section 13(a) of the Exchange Act. 
† The term "new or revised financial accounting standard" refers to any update issued by the Financial Accounting Standards Board to its Accounting Standards Codification after April 5, 2012.
Indicate by check mark whether the registrant has filed a report on and attestation to its management's assessment of the effectiveness of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report.
Indicate by check mark which basis of accounting the registrant has used to prepare the financial statements included in this filing.filing:
U.S. GAAPX
International Financial Reporting Standards as issued
OtherOther    
as issued by the International Accounting Standards Board
If ″Other″"Other" has been checked in response to the previous question, indicate by check mark which financial statement item the registrant has elected to follow. Item 17     Item 18 
  Item 17  Item 18
If this report is an annual report, indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes  No 
  Yes
X  No





TABLE OF CONTENTS




SEQUENTIAL
INDEXPAGEPage
INTRODUCTION AND USE OF CERTAIN TERMS
Introduction and Use of Certain Terms
3
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
Market Information
6
PART I
Special Note About Forward-Looking Statements
7
ITEM 1.                   IDENTITY OF DIRECTORS, SENIOR MANAGEMENT AND ADVISORS7PART I
ITEM 2.                   OFFER STATISTICS AND EXPECTED TIMETABLE
Item 1.
7Identity of Directors, Senior Management and Advisers
ITEM 3.                   KEY INFORMATION
Item 2.
8Offer Statistics and Expected Timetable
ITEM 4.                   INFORMATION ON THE COMPANY
Item 3.
22Key Information
ITEM 4A.                UNRESOLVED STAFF COMMENTS
Item 4.
51Information on the Company
ITEM 5.                   OPERATING AND FINANCIAL REVIEW AND PROSPECTS
Item 4A.
52Unresolved Staff Comments
ITEM 6.                   DIRECTORS, SENIOR MANAGEMENT AND EMPLOYEES
Item 5.
82Operating and Financial Review and Prospects
ITEM 7.                   MAJOR SHAREHOLDERS AND RELATED PARTY TRANSACTIONSItem 6.103Directors, Senior Management and Employees
ITEM 8.                   FINANCIAL INFORMATION
Item 7.
110Major Shareholders and Related Party Transactions
ITEM 9.                   THE OFFER AND LISTING
Item 8.
117Financial Information
ITEM 10.                  ADDITIONAL INFORMATION
Item 9.
119The Offer and Listing
ITEM 11.                 QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISKItem 10.135Additional Information
ITEM 12.                  DESCRIPTION OF SECURITIES OTHER THAN EQUITY SECURITIESItem 11.137Quantitative and Qualitative Disclosures About Market Risk
PART II
Item 12.
138Description of Securities Other than Equity Securities
ITEM 13.                  DEFAULTS, DIVIDEND ARREARAGES AND DELINQUENCIES138PART II
    ITEM 14.                 MATERIAL MODIFICATIONS TO THE RIGHTS OF SECURITY HOLDERS AND USE OF PROCEEDS Item 13.    138Defaults, Dividend Arrearages and Delinquencies
ITEM 15.                  CONTROLS AND PROCEDURES
Item 14.
138Material Modifications to the Rights of Security Holders and Use of Proceeds
ITEM 16.                  [RESERVED]
Item 15.
138Controls and Procedures
ITEMItem 16A.              AUDIT COMMITTEE FINANCIAL EXPERT
138Audit Committee and Financial Expert
ITEMItem 16B.               CODE OF ETHICS
138Code of Ethics
ITEMItem 16C.               PRINCIPAL ACCOUNTANT FEES AND SERVICES
139Principal Accountant Fees and Services
    ITEMItem 16D.              EXEMPTIONS FROM THE LISTING STANDARDS FOR AUDIT COMMITTEES140           Exemptions from the Listing Standards for Audit Committees
ITEMItem 16E.               PURCHASES OF EQUITY SECURITIES BY THE ISSUER AND AFFILIATED PURCHASERS140Purchases of Equity Securities by the Issuer and Affiliated Purchasers
ITEMItem 16F.               CHANGES IN REGISTRANT'S CERTIFYING ACCOUNTANT
141Change in Registrant's Certifying Accountant
ITEMItem 16G.               CORPORATE GOVERNANCE
141Corporate Governance
PART III
Item 16H.
143Mine Safety Disclosure
ITEM 17.                  FINANCIAL STATEMENTS
Item 16I.
143Disclosure regarding Foreign Jurisdictions that Prevent Inspections
ITEM 18.                  FINANCIAL STATEMENTS
143PART III
ITEM 19.                  EXHIBITS
Item 17.
144Financial Statements
Item 18.Financial Statements
SIGNATURES155
146Item 19.Exhibits
Consolidated Financial Statements of Alcon Inc.



2


INTRODUCTION AND USE OF CERTAIN TERMS

Trademarks used by Alcon Inc. ("Alcon"publishes Consolidated Financial Statements expressed in US dollars. Our Consolidated Financial Statements responsive to Item 18 of this Annual Report filed on Form 20-F with the US Securities and Exchange Commission (the "Annual Report") appearare prepared in italic typeaccordance with International Financial Reporting Standards ("IFRS") as issued by the International Accounting Standards Board ("IASB"). "Item 5. Operating and Financial Review and Prospects", together with “Item 4.B. Business Overview” and “Item 6.D. Employees”, constitute the Operating and Financial Review ("Rapport annuel"), as defined by the Swiss Code of Obligations.
Unless the context requires otherwise, the words "we", "our", "us", "Alcon", "Company" and similar words or phrases in this reportAnnual Report refer to Alcon Inc. and areits consolidated subsidiaries and the propertywords "Novartis", "Novartis Group" and "Former Parent" refer to Novartis AG and its consolidated affiliates. The term "Alcon Division" means the Alcon business as it was operated under Novartis. The term "Spin-off" refers to the distribution of or are licenseda dividend-in-kind of Alcon shares to Novartis shareholders and American Depository Receipt ("ADR") holders as approved by one of our subsidiaries.

Novartis shareholders at their Annual General Meeting held on February 28, 2019. In this report, the trademark product brand names referAnnual Report, references to the "eye care market" are to the Surgical and Vision Care markets in which we participate, including the sale of ophthalmic surgical devices, contact lenses and ocular health products, noted below.

Product Brand NameReferenced Product
A-OK®
A-OK® ophthalmic knives
Accurus®
Accurus® surgical system
AcrySof®
AcrySof® intraocular lens
AcrySof®CACHET
AcrySof®CACHETphakic lens
AcrySof®IQ
AcrySof®IQ intraocular lens
AcrySof®IQ ReSTOR®
AcrySof®IQ ReSTOR® intraocular lens
AcrySof®IQ ReSTOR®Multifocal Toric
AcrySof®IQ ReSTOR® Multifocal Toric intraocular lens
AcrySof®IQ ReSTOR® +3.0
AcrySof®IQ ReSTOR®+3.0 intraocular lens
AcrySof®IQ Toric
AcrySof®IQ Toric intraocular lens
AcrySof®Natural
AcrySof®Natural intraocular lens
AcrySof® ReSTOR®
AcrySof® ReSTOR® intraocular lens
AcrySof® ReSTOR®Toric
AcrySof® ReSTOR®Toric intraocular lens
AcrySof®Toric
AcrySof®Toric intraocular lens
ALCON®
ALCON® house trademark
ALLEGRETTO
ALLEGRETTO laser system
ALLEGRETTO EX-400
ALLEGRETTOEX-400 laser
ALLEGRETTO EX-500
ALLEGRETTOEX-500 laser
ALLEGRETTO WAVE® Eye-Q
ALLEGRETTO WAVE® Eye-Q 400 Hz laser
ALLEGRO ANALYZER®
ALLEGRO ANALYZER® wavefront system
ALLEGRO
ALLEGRObiometry system
ALLEGRO OCULYZER®
ALLEGRO OCULYZER® pentacam diagnostic device
ALLEGRO TOPOLYZER®
ALLEGRO TOPOLYZER® corneal topography system
AquaLase®
AquaLase® liquefaction device
AZARGA®
AZARGA® ophthalmic suspension
Azopt®
Azopt® ophthalmic suspension
Betoptic S®
Betoptic S® ophthalmic suspension
BSS Plus®
BSS Plus® irrigating solution
CiloDex®
CiloDex® otic solution
CIPRODEX®*
CIPRODEX® otic suspension
Cipro®HC*
Cipro®HC Otic
CONSTELLATION®
CONSTELLATION® vitreoretinal system
Custom Pak®
Custom Pak® surgical procedure packs
DisCoVisc®
DisCoVisc® viscosurgical device
DuoTrav® (EU)
DuoTrav® ophthalmic solution
DuoTrav®APS (EU)
DuoTrav®APS ophthalmic solution
DuoVisc®
DuoVisc® viscoelastic system
DUREZOL®
DUREZOL® ophthalmic emulsion/steroid
EXPRESS®
EXPRESS® contact lens care solutions
EX-PRESS®
EX-PRESS® glaucoma filtration device
Grieshaber®
Grieshaber® surgical instruments
ICAPS®
ICAPS® dietary supplements
Infiniti®
Infiniti® vision system
Laureate®
Laureate® compact phacoemulsification system
LEGACY®
LEGACY® surgical system
LenSx®
LenSx® laser system
Maxitrol®
Maxitrol® ophthalmic suspension or ointment
Moxeza*
Moxeza 0.5% ophthalmic solution
3
Product Brand NameReferenced Product
NEVANAC®
NEVANAC® ophthalmic suspension
Opatanol® (EU)
Opatanol® ophthalmic solution
OPTI-FREE®
OPTI-FREE® contact lens care solutions
OPTI-FREE® EVERMOIST
OPTI-FREE® EVERMOIST multi-purpose disinfecting solution
OPTI-FREE®EXPRESS®No-Rub®
OPTI-FREE®EXPRESS®No-Rub® contact lens care solution
OPTI-FREE®RepleniSH®
OPTI-FREE®RepleniSH® multi-purpose disinfecting solution
OZil®
OZil® torsional hand piece/technology
Pataday
Pataday ophthalmic solution
Patanase®
Patanase® nasal spray
Patanol®
Patanol® ophthalmic solution
Perfluoron®
Perfluoron® perfluoro-n-octane liquid
ProVisc®
ProVisc® ophthalmic viscosurgical device
Silikon®
Silikon® ophthalmic surgical oil
SOFZIA®
SOFZIA® preservative system
Systane®
Systane® lubricant eye drops
Systane®Balance
Systane®Balance lubricant eye drops
Systane®Ultra
Systane®Ultra lubricant eye drops
Tears Naturale®
Tears Naturale® lubricant eye drops
TobraDex®
TobraDex® ophthalmic suspension or ointment
TobraDex®ST
TobraDex®ST ophthalmic suspension
Tobrex®
Tobrex® ophthalmic solution or ointment
TRAVATAN®
TRAVATAN® ophthalmic solution
TRAVATAN®APS
TRAVATAN®APS ophthalmic solution
TRAVATANZ®
TRAVATANZ® ophthalmic solution
TRIESENCE®
TRIESENCE® injectable suspension
Vegamox®* (Japan)
Vegamox® ophthalmic solution
Vigadexa®
Vigadexa® ophthalmic solution
Vigamox®*
Vigamox® ophthalmic solution
VISCOAT®
VISCOAT® ophthalmic viscosurgical device
WaveLight®
WaveLight® refractive suite

*       Cipro® and CIPRODEX® are registered trademarksbut not including the sale of Bayer AG, licensed to Alcon by Bayer Schering Pharma AG.  Moxifloxacin, the primary ingredient in Vigamox®, Vegamox®spectacles and Moxeza, is licensed to Alcon by Bayer Schering Pharma AG.

Avelox® is a trademark of Bayer Schering Pharma AG.  Zaditor® is a trademark of Novartis AG.  Timoptic-XE® is a trademark of Merck & Co., Inc.  Lucentis® is a trademark of Genentech, Inc.

In this report,prescription ophthalmic pharmaceutical products; references to "$", "U.S. $", "U.S. dollars" and "United States dollars", "US dollars", "USD" or "$" are to the lawful currency of the United States of America, and references to "CHF" and "Swiss francs" are to Swiss francs, the lawful currency of the Swiss Confederation,Switzerland; references to "euro""International" are to the lawful currencyentire world except the United States of America, unless the member states ofcontext otherwise requires; references to "associates" are to our employees; references to the European Monetary Union that have adopted or that adopt"SEC" are to the single currency in accordance withUS Securities and Exchange Commission, references to the Treaty establishing"FDA" are to the European Community, as amended by the Treaty on European Union,US Food and Drug Administration, and references to Japanese yen"EMA" are to the lawful currencyEuropean Medicines Agency, an agency of Japan.  Unless otherwise stated, figures providedthe EU; references to the "NYSE" are under United States generally accepted accounting principles ("U.S. GAAP").  Unless we specify otherwise, allto the New York Stock Exchange, and references in this report to "we,"the "SIX" are to the SIX Swiss Exchange; references to "AT-IOL" mean advanced technology intraocular lenses; and references to "Alcon shares" or "our" "us," "the Company" and "our Company" refer shares" are to Alcon Inc. andordinary shares, nominal value CHF 0.04 per share, with ticker symbol "ALC."
All product names appearing in italics are trademarks owned by or licensed to Alcon or its subsidiaries.


4

This report uses certain terms defined below.

TermDefinition
Affordable Care ActHealth Care and Education Reconciliation Act of 2010
AMDAge-related macular degeneration
ANDAAbbreviated New Drug Application
ANDSAbbreviated New Drug Submission
AOMTOtitis media in the presence of tympanostomy tubes
AREDSNational Eye Institute's Age Related Eye Disease Study
ASCAccounting Standards Codification
ASERPAlcon Supplemental Executive Retirement Plan
BACBenzalkonium chloride
CEOChief Executive Officer
CMSThe Centers for Medicare and Medicaid Services
CP ProgramAlcon's Commercial Paper Program
(the) CompanyAlcon, Inc. and its subsidiaries
DCPAlcon Executive Deferred Compensation Plan
DTCDepository Trust Company
EPSEarnings Per Share
ESCPAlcon's Executive Salary Continuation Plan
EUEuropean Union
EUCMSConcerned member state of the European Union
Evaluation DateEnd of the period covered by this annual report
Exchange ActU.S. Securities Exchange Act of 1934
External auditorsThe primary Alcon Group external auditors and additional external auditors specific to the Company subsidiary
FASBFinancial Accounting Standards Board
FDAUnited States Food and Drug Administration
FDAAAFood and Drug Administration Amendments Act of 2007
FTCU.S. Federal Trade Commission
IFRSInternational Financial Reporting Standards
IPOThe initial public offering of approximately 69,750,000 of Alcon, Inc.'s common shares on March 20, 2002
IRBInstitutional Review Board
IRCU.S. Internal Revenue Code
LASIKLaser-Assisted In Situ Keratomileusis
MGDMeibomian gland dysfunction
NDANew Drug Application
Non-U.S. HolderA holder that is not a U.S. Holder (see definition of U.S. Holder below)
NSAIDNon-steroidal anti-inflammatory drug
NYSENew York Stock Exchange
OTCOver-the-Counter drugs available without a prescription
PMAPre-Market Approval
Purchase and Option AgreementPurchase and Option Agreement between Nestlé S.A. and Novartis AG dated as of April 6, 2008
REMSRisk evaluation and mitigation strategies discussed in the FDAAA
RMSReference member state of the European Union
RSU(s)Restricted share unit(s)
SABStaff Accounting Bulletin published by the SEC
SECUnited States Securities and Exchange Commission
Second Stage ClosingThe purchase and sale of Nestlé's remaining Alcon shares to Novartis under the Purchase and Option Agreement
5
TermDefinition
Securities ActU.S. Securities Act of 1933, as amended
Separation AgreementSeparation Agreement between Nestlé and Alcon described in Item 7.B.5
Services AgreementGuarantee Fee and Commercial Paper Program Services Agreement, as described in Item 7.B, "Related Party Transactions."
Shareholders AgreementShareholders Agreement between Nestlé and Novartis dated as of April 6, 2008
SSAR(s)Share-settled stock appreciation right(s)
Swiss HolderSecurity holder as defined in Item 10.E.
TSRTotal shareholder return
U.S. GAAPUnited States generally accepted accounting principles
U.S. HolderSecurity holder as defined in Item 10.E.
VHCAVeterans Health Care Act

References Product names identified by a "®" or a "™" are trademarks that are not owned by or licensed to the ophthalmic industry in this report do not include eyeglassesAlcon or contact lenses.  This report relies on and refers to statistics regarding the ophthalmic industry.  Where specified, these statistics reflect the Company's internal estimates. Otherwise, we obtained these statistics from various third-party sources that we believe are reliable, but we have not independently verified these third-party statistics.  Unless otherwise specified, all market share information was based on units sold.

Statements in this report regarding the Company's market share position are from the following sources:

·  pharmaceutical products--IMS Research;
·  surgical products--internal estimates prepared using industry data;
·  consumer products--AC Nielsen, IMS Research, selected other third party data providers and company estimates.

CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS

This report contains "forward-looking statements" within the meaning of Section 27A of the U.S. Securities Act of 1933, as amended, (the "Securities Act") and Section 21E of the U.S. Securities Exchange Act of 1934, as amended, (the "Exchange Act") relating to our business and the sectors in which Alcon and its subsidiaries and interests operate.  These forward-looking statements are contained principally in the sections entitled "Key Information," "Information on the Company," "Operatingproperty of their respective owners.
MARKET INFORMATION
This Annual Report contains certain industry and Financial Reviewmarket data that were obtained from third-party sources, such as industry surveys and Prospects," "Financial Information," "Additional Information," and "Quantitative and Qualitative Disclosures about Market Risk."  These statements involve known and unknown risks, uncertainties and other factors which may cause our actual results, performance or achievements to be materially different from any future results, performances or achievements expressed or implied by our forward-looking statements.  Forward-looking statements include,industry publications, including, but are not limited to, statements about:publications by Market Scope, GfK and Nielsen. This Annual Report also contains other industry and market data, including market sizing estimates, growth and other projections and information regarding our competitive position, prepared by our management on the progressbasis of such industry sources and our researchmanagement's knowledge of and development programs;experience in the receiptindustry and markets in which we operate (including management's estimates and assumptions relating to such industry and markets based on that knowledge). Our management has developed its knowledge of regulatory approvals; competitionsuch industry and markets through its experience and participation in our industry;these markets.
In addition, industry surveys and industry publications generally state that the impactinformation they contain has been obtained from sources believed to be reliable but that the accuracy and completeness of pending or future litigation; the impact ofsuch information is not guaranteed and that any future product recalls; changes in, or the failure or inability to comply with, governmental regulation; the opportunities for growth, whether through internal development or acquisitions; exchange rate fluctuations; general economic conditions; and trends affecting the ophthalmic industry, our financial condition or results of operations.

Words such as "may," "will," "should," "could," "would," "expect," "plan," "anticipate," "believe," "intend," "estimate," "project," "predict," "potential" and similar expressions are intended to identify forward-looking statements.  These statements reflect our current views with respect to future events andprojections they contain are based on assumptionsa number of significant assumptions. Forecasts, projections and other forward-looking information obtained from these sources involve risks and uncertainties and are subject to risks and uncertainties.  Given these uncertainties, youchange based on various factors, including those discussed in the section "Special Note About Forward-Looking Statements" below. You should not place undue reliance on these statements.
1


SPECIAL NOTE ABOUT FORWARD-LOOKING STATEMENTS
This Annual Report contains, and our officers and representatives may from time to time make, certain “forward-looking statements” within the meaning of the safe harbor provisions of the US Private Securities Litigation Reform Act of 1995. Forward-looking statements can be identified by words such as “anticipate,” “intend,” “commitment,” “look forward,” “maintain,” “plan,” “goal,” “seek,” “target,” “assume,” “believe,” “project,” “estimate,” “expect,” “strategy,” “future,” “likely,” “may,” “should,” “will” and similar references to future periods. Examples of forward-looking statements include, among others, statements we make regarding our liquidity, revenue, gross margin, operating margin, effective tax rate, foreign currency exchange movements, earnings per share, our plans and decisions relating to various capital expenditures, capital allocation priorities and other discretionary items, market growth assumptions, and generally, our expectations concerning our future performance and the effects of the COVID-19 pandemic on our businesses. You should not place undue reliance on these statements.  We discuss
Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties and risks that are difficult to predict such as:
cybersecurity breaches or other disruptions of our information technology systems;
compliance with data privacy, identity protection and information security laws;
our ability to comply with the US Foreign Corrupt Practices Act of 1977 and other applicable anti-corruption laws, particularly given that we have entered into a three-year Deferred Prosecution Agreement with the US Department of Justice;
our success in completing and integrating strategic acquisitions;
the impact of a disruption in our global supply chain or important facilities;
the effect of the COVID-19 pandemic as well as other viral or disease outbreaks;
global and regional economic, financial, legal, tax, political and social change;
the commercial success of our products and our ability to maintain and strengthen our position in our markets;
the success of our research and development efforts, including our ability to innovate to compete effectively;
pricing pressure from changes in third party payor coverage and reimbursement methodologies;
ongoing industry consolidation;
our ability to properly educate and train healthcare providers on our products;
the impact of unauthorized importation of our products from countries with lower prices to countries with higher prices;
our reliance on outsourcing key business functions;
changes in inventory levels or buying patterns of our customers;
our ability to attract and retain qualified personnel;
our ability to service our debt obligations;
the need for additional financing through the issuance of debt or equity;
our ability to protect our intellectual property;
the effects of litigation, including product liability lawsuits and governmental investigations;
our ability to comply with all laws to which we may be subject;
effect of product recalls or voluntary market withdrawals;
the implementation of our enterprise resource planning system;
2


the accuracy of our accounting estimates and assumptions, including pension and other post-employment benefit plan obligations and the carrying value of intangible assets;
the ability to obtain regulatory clearance and approval of our products as well as compliance with any post-approval obligations, including quality control of our manufacturing;
legislative, tax and regulatory reform;
the ability of Alcon Pharmaceuticals Ltd. to comply with its investment tax incentive agreement with the Swiss State Secretariat for Economic Affairs in Switzerland and the Canton of Fribourg, Switzerland;
our ability to manage environmental, social and governance matters to the satisfaction of our many stakeholders, some of which may have competing interests;
the impact of being listed on two stock exchanges;
the ability to declare and pay dividends;
the different rights afforded to our shareholders as a Swiss corporation compared to a US corporation; and
the effect of maintaining or losing our foreign private issuer status under U.S. securities laws.
Some of these factors are discussed in more detail in this Annual Report, including under “Item 3. Key Information—3.D. Risk Factors”, “Item 4. Information on the Company” and “Item 5. Operating and Financial Review and Prospects”. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those described in this reportAnnual Report as anticipated, believed, estimated or expected. We provide the information in greater detail under the subheadings "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations."  These forward-looking statements represent our estimates and assumptions onlythis Annual Report as of the date of this reportits filing. We do not intend, and aredo not intendedassume any obligation, to giveupdate any assurance as to future results.  Factors that might cause future results to differ include, but are not limited to, the following:
6
·  failure to consummate the merger with Novartis AG may cause volatility in our share price;

·  resources devoted to research and development may not yield new products that achieve commercial success;

·  the production and launch of commercially viable products may take longer and cost more than expected;

·  competition may lead to worse than expected financial condition and results of operations;

·  changes in reimbursement procedures and/information or amounts by third-party payors;

·  changes caused by regulatory or market forces in the prices we receive for our products;

·  changes in the global economic environment in which we operate, as well as changes in the economic conditions in our markets;

·  currency exchange rate fluctuations may negatively affect our financial condition and results of operations;

·  the impact of any future events with material unforeseen impacts, including, but not limited to, war, natural disasters, or acts of terrorism;

·  supply and manufacturing disruptions could negatively impact our financial condition or results of operations;

·  inability to attract qualified personnel, which could negatively impact our ability to grow our business;

·  difficulty protecting our intellectual property rights;

·  pending or future litigation may negatively impact our financial condition and results of operations;

·  government regulation or legislation may negatively impact our financial condition or results of operations;

·  product recalls or withdrawals may negatively impact our financial condition or results of operations;

·  the occurrence of environmental liabilities arising from our operations; and

·  the occurrence of any losses from property and casualty, general liability, business interruption and environmental liability risks could negatively affect our financial condition because we self-insure against those risks through our captive insurance subsidiaries.

You should read this report completely and with the understanding that Alcon's actual future results may be materially different from what we expect.  We qualify all of our forward-looking statements by these cautionary statements.  Except to the extent required under the federal securities laws and the rules and regulations promulgated by the United States Securities and Exchange Commission ("SEC"), we undertake no obligation to publicly update or revise anyset out in this Annual Report as a result of these forward-looking statements, whether to reflect new information, or future events or circumstances or otherwise.

3


PART I
ITEM 1.IDENTITY OF DIRECTORS, SENIOR MANAGEMENT AND ADVISORS
ITEM 1.    IDENTITY OF DIRECTORS, SENIOR MANAGEMENT AND ADVISERS

Not Applicable.
1.A. DIRECTORS AND SENIOR MANAGEMENT
Not Applicable.
ITEM 2.OFFER STATISTICS AND EXPECTED TIMETABLE
1.B. ADVISERS
Not Applicable.

1.C. AUDITORS
Not Applicable.

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4



 ITEM 3.KEY INFORMATION
ITEM 2.    OFFER STATISTICS AND EXPECTED TIMETABLE
Not Applicable.
           A.SELECTED FINANCIAL DATA
5



ITEM 3.    KEY INFORMATION
3.A. [RESERVED]
3.B. CAPITALIZATION AND INDEBTEDNESS
Not Applicable.
3.C. REASONS FOR THE OFFER AND USE OF PROCEEDS
Not applicable.
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3.D. RISK FACTORS
You should carefully consider the risks described below, together with all of the other information included in this Annual Report, in evaluating Alcon and our securities. The following tables presentrisk factors could adversely affect our selected historical consolidatedbusiness, financial data in accordance with U.S. GAAP.  This information should be read along with "Management's Discussioncondition and Analysis of Financial Condition and Results of Operations" included in Item 5 of this report and the consolidated financial statements, including the accompanying notes thereto, included in Item 18 of this report.
 Year Ended December 31, 
  2010  2009  2008  2007  2006 
  (in millions, except per share data) 
Statement of Earnings Data:               
Sales
$7,179 $6,499 $6,294 $5,599 $4,897 
Cost of goods sold
 1,675  1,614  1,472  1,398  1,215 
                
Gross profit
 5,504  4,885  4,822  4,201  3,682 
Selling, general and administrative
 2,070  1,935  1,961  1,694  1,399 
Research and development
 747  665  619  564  512 
In process research and development
 --  --  --  9  -- 
Amortization of intangibles
 60  24  29  51  199 
Other operating expenses
 152  --  --  --  -- 
                
Operating income
 2,475  2,261  2,213  1,883  1,572 
Interest income
 29  46  76  69  74 
Interest expense
 (9) (16) (51) (50) (43)
Other, net
 32  22  (155)  27  14 
                
Earnings before income taxes
 2,527  2,313  2,083  1,929  1,617 
Income taxes
 317  306  36  343  269 
                
Net earnings
$2,210 $2,007 $2,047 $1,586 $1,348 
                
Basic weighted-average common shares
   outstanding
 301  299  298  298  304 
Diluted weighted-average common shares
   outstanding
 304  301  301  302  309 
Basic earnings per common share
$7.34 $6.72 $6.86 $5.32 $4.43 
Diluted earnings per common share
$7.27 $6.66 $6.79 $5.25 $4.37 
Dividends paid on common shares
$1,037 $1,048 $750 $613 $417 
Dividends paid per common share: U.S. $
$3.44 $3.50 $2.50 $2.04 $1.38 
Dividends paid per common share: Swiss CHFCHF3.95 CHF3.95 CHF2. 63 CHF2.50 CHF1.68 
                
Cash Flow Data:               
Cash provided by (used in):               
Operating activities
$2,375 $2,416 $2,032 $1,470 $1,406 
Investing activities
 (1,705) (390) (365) (227) (166)
Financing activities
 (1,150) (1,481) (1,333) (607) (1,225)
                
 At December 31, 
  2010  2009  2008  2007  2006 
Balance Sheet Data:(in millions)  
Current assets
$6,069 $5,833 $5,219 $4,825 $3,462  
Working capital
 4,278  3,858  3,029  1,963  1,461  
Total assets
 10,073  8,686  7,551  7,016  5,427  
Long term debt, net of current maturities
 --  56  61  52  49  
Total shareholders' equity
 7,252  5,905  4,691  3,375  2,914  
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Exchange Rates

Fluctuations in the exchange rate between the Swiss franc and the U.S. dollar will affect the conversions into U.S. dollars of any cash dividends paid in Swiss francs on our common shares.  In addition, these and other fluctuations in the exchange rates of the currencies of our various local operations affect our results of operations and the price of our securities.
Risks Related to Our Business Generally
Significant cybersecurity breaches could disrupt business operations, result in the loss of critical and confidential information and adversely impact our reputation and results of operations.
We are heavily dependent on critical, complex and interdependent information technology systems, including Internet-based systems, to support our business processes. We are also increasingly seeking to develop technology-based products to improve patient welfare in a variety of ways, which could also result in us gathering personal information about patients and others electronically. In addition, we rely on the Internet, social media tools and mobile technologies as a means of communication and to gather information, which can include personal information.
The size and complexity of these information technology systems, and, in some instances, their age, make them potentially vulnerable to external or internal security incidents, breakdowns, malicious intrusions, cybercrimes, including state-sponsored cybercrimes, malware, misplaced or lost data, programming or human errors or other similar events. Furthermore, because cyber-threats continue to evolve, it is becoming increasingly difficult to detect and successfully defend against them. Consequently, there is a risk that a cybersecurity breach remains undetected for a period of time.
Like many companies, our technology landscape has become more complex as we also rely on our third party partners to be cyber-resilient. We have experienced certain adverse incidents and expect to continue to experience them in the future and, as the external cyber-attack threat only keeps growing, we may not be able to prevent future breakdowns or breaches in our systems (or those of our third party partners) and we may not be able to prevent such events from having a material adverse effect on our business, financial condition, results of operations or reputation.
A cybersecurity breach could negatively impact important business processes, such as presentedthe conduct of scientific research and clinical trials, the submission of the results of such efforts to health authorities in support of requests for product approvals, the functioning of our financial statements.manufacturing and supply chain processes, our compliance with legal obligations and our other key business activities, including our associates' ability to communicate with one another and with third parties. These risks were heightened during the ongoing pandemic with our office-based associates largely working from home. Such potential information technology issues could also lead to the loss of important information such as trade secrets or other intellectual property and could accelerate the development or manufacturing of competing products by third parties. Furthermore, malfunctions in software or in devices that make significant use of information technology, including our surgical equipment, could lead to a risk of harm to patients.

Cybersecurity breaches, technology disruptions, privacy violations, or similar issues could cause the loss of trade secrets or other intellectual property, expose personal information, interrupt our operations, all of which could result in enforcement actions or liability, including potential government fines, claims for damages and shareholders' litigation. Any such events could require us to expend significant resources beyond those we already invest to further modify or enhance our protective measures, to remediate any damage and to enable the continuity of our business.
The following table sets forth, forData privacy, identity protection and information security compliance may require significant resources, and our failure to comply with applicable law could lead to significant liability.
Our routine business operations, including through the periods indicated,use of information concerningtechnologies such as the exchange rate betweenInternet, social media, mobile technologies and technology-based medical devices like our surgical equipment, increasingly involve our collecting, storing, accessing, and processing personal data and other information about patients, vendors, customers, associates, collaborators and others that are subject to privacy and security laws, regulations and customer-imposed controls. Failure to protect that information could expose such people's personal information to unauthorized persons. Any such event could give rise to significant potential liability and reputational harm, including potentially substantial monetary penalties.
We are subject to certain privacy laws and regulations that continue to evolve, including Swiss francsprivacy laws, the EU's General Data Protection Regulation and U.S. dollars based upon the spot rate atCalifornia Consumer Privacy Act. In addition, there are different and potentially conflicting data privacy laws in effect in the close of market, as published by Bloomberg Finance L.P.:

  Exchange Rate for 1 U.S. Dollar
Fiscal Year Period End (1) Average (1) (2) High Low
         
2006                                                            1.2201 1.2529 1.3228 1.1923
2007                                                            1.1335 1.2000 1.2535 1.0969
2008                                                            1.0687 1.0824 1.2254 0.9844
2009                                                            1.0352 1.0850 1.1852 0.9964
2010                                                            0.9352 1.0423 1.1631 0.9352

(1)  The closing spot rate at each period end and the average rate for each period differed from the exchange rates usedvarious jurisdictions in which we operate and we must understand and comply with each law and standard in the preparation of our financial statements.
(2)  Represents the average of the daily rates as published by Bloomberg Finance L.P. during the period.

The following table sets forth the high and low closing spot rate for the Swiss franc for each of these jurisdictions while ensuring the prior six months:data is secure. In addition, we must make significant efforts to ensure that any international transfers of personal data are done in compliance with applicable law. Failure to comply with these laws could lead to significant liability.


  Exchange Rate for 1 U.S. Dollar
Month Period End Average High Low
         
September 2010                                                           0.9825 1.0011 1.0198 0.9758
October 2010                                                           0.9824 0.9688 0.9904 0.9530
November 2010                                                           1.0034 0.9852 1.0036 0.9584
December 2010                                                           0.9352 0.9670 1.0023 0.9352
January 2011 0.9440 0.9566 0.9737 0.9334
February 2011 0.9289 0.9494 0.9732 0.9264
         
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AlthoughIf we have translated selected Swiss franc amounts in this report into U.S. dollars for convenience, this does not mean thatbreach the Swiss franc amounts referred toDeferred Prosecution Agreement with the US Department of Justice, then resulting actions by the DoJ could have been, or could be, converted into U.S. dollars at these rates or any other rate.

B.  CAPITALIZATION AND INDEBTEDNESS

Not Applicable.

C.  REASONS FOR THE OFFER AND USE OF THE PROCEEDS

Not Applicable.

D.  RISK FACTORS

If the events discussed in these Risk Factors occur,a material adverse effect on our business, financial condition, results of operations or cash flowsflows.
On June 25, 2020, Alcon entered into a three-year Deferred Prosecution Agreement ("DPA") with the US Department of Justice ("DoJ") regarding a charge that Alcon Pte Ltd. conspired to falsify financial books and records in violation of the US Foreign Corrupt Practices Act of 1977, as amended ("FCPA"). The charge relates to payments made by a former distributor to health care providers in Vietnam between 2007 and 2014. Alcon agreed to pay the DoJ a penalty of $8.925 million, for which Novartis has indemnified Alcon.
Under the DPA, the DoJ has agreed to defer prosecution for three years of the facts acknowledged by us that occurred between 2007 and 2014, after which period the charges will be dismissed with prejudice if we do not violate the terms of the DPA. If the DoJ determines that we have breached the DPA, the length of the DPA could be materially adversely affected.  In suchextended, the terms could be modified, a case,monitor could be appointed, and/or we could be subject to prosecution and additional fines or penalties, including the market price of our common sharesdeferred charges. Criminal prosecution or sanctions could decline.  The risks described below are not the only ones that may exist.  Additional risks not currently known by us or that we deem immaterial also may impairhave a material adverse effect on our business, operations.

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Risks Related to Our Business and Industry

Resources devoted to research and development may not yield new products that achieve commercial success.

We devote substantial resources to research and development.  The research and development process is expensive and prolonged, and it entails considerable risk.  Developmentfinancial condition, results of a new product, from discovery through testing and registration to initial product launch, typically takes between eight and fifteen yearsoperations, or more for a pharmaceutical product and between three and seven years or more for a medical device.  Each of these periods varies considerably depending on the product and the country where registration is sought.  Because of the risk associated with our research and development, products we are currently developing may not obtain the regulatory approvals required for us to market such products successfully or they may take longer than we expect to gain necessary governmental, regulatory or other approval.  They may cost more to develop and may be less successful than we currently anticipate, or than other therapies that are presently or soon may be on the market.  We can make no assurances that any of the projects currently in our development pipeline will result in commercially successful products.

If we fail to keep pace with advances in our industry or fail to persuade physicians to adopt new products we introduce, customers may not buy our products and our sales and profits may decline.

The pharmaceutical, medical device and over-the-counter industries are characterized by continual product development, constant innovation in products and techniques, frequent new product introductions and price competition.  Our future growth depends, in part, on our ability to develop products which are more effective in treating diseases and disorders of the eye or that incorporate the latest technologies.  In addition, we must be able to manufacture new products and effectively persuade a sufficient number of eye care professionals and/or consumers to use the new products we introduce.  Sales of our existing products may decline rapidly if a new competing product is introduced by one of our competitors or if we announce a new product that, in either case, represents a substantial improvement over our existing products.  Similarly, if we fail to make sufficient investments in research and development programs, our current and planned products could be surpassed by more effective or advanced products.

cash flows.
We may not successfully developcomplete and launch replacements forintegrate strategic acquisitions to expand or complement our products that lose patent protection.business.

MostAs part of our major products are covered by patents that give us a degree of market exclusivity duringgrowth strategy, we regularly evaluate and pursue external investments, alliances, license arrangements, acquisitions and other transactions, which we collectively refer to as "BD&L" transactions, to expand or complement our business. For example, in 2021, we announced the termacquisition of the patent.  Upon patent expiration,US commercialization rights to Simbrinza and the acquisition of Ivantis. These and other ventures may bring new technologies, products or customers to enhance our prominent position in the ophthalmic industry. We may be unable to identify suitable acquisition candidates at attractive prices or at all. Acquisition activities can be thwarted by overtures from competitors may introduce products usingfor the same technology.  As a result,targeted candidates and governmental regulation (including market concentration limitations and other competition laws).
Further, even if we are successful in completing an acquisition, we could face risks relating to our sales and profits could decline significantlyability to:
successfully integrate the venture due to corporate cultural differences, difficulties in retaining key personnel, customers and suppliers, coordination with other products and changing market preferences;
maintain uniform standards, controls, procedures and policies throughout acquired companies, including effective integration of acquired companies into our internal control over financial reporting;
achieve expected synergies and obtain the desired financial or strategic benefits from acquisitions within the anticipated time periods, if at all; and
successfully enter categories and markets in which we may have limited or no prior experience.
Moreover, acquisitions demand significant company resources and could divert management's attention from our existing business, result in liabilities being incurred that were not known at the time of acquisition or create tax or accounting issues. Furthermore, acquisitions or ventures could also result in potentially dilutive issuances of equity securities, the incurrence of debt, the assumption of contingent liabilities, an increase in expenses related to certain assets and increased competition.operating expenses, all of which could adversely affect our financial condition and results of operations. In addition, to the extent that the economic benefits associated with any of our acquisitions or investments diminish in the future, we may be required to record impairment charges related to goodwill, intangible assets or other assets associated with such transactions, which could adversely affect our financial condition and results of operations.
We often enter into option agreements to acquire early-stage technologies, which may fail in the development process or proof-of-concept stage. Even if such a failure occurs before we exercise our option to acquire the technology, we may have already made a significant investment in the failed technology. Further, if we complete the acquisition, we may not be able to successfully integrate the acquired technology into our business or otherwise use it to develop commercialized products. If we fail to timely recognize or address these matters or to devote adequate resources to them, we may fail to achieve our growth strategy or otherwise not realize the intended benefits of an acquisition.
Disruptions in our global supply chain or important facilities could cause production interruptions, delays and successfully launch more advanced replacementinefficiencies.
We are engaged in manufacturing and sourcing of products before theseand materials on a global scale. Our operations and those of our suppliers could be disrupted by a number of factors, including: disruptions in logistics; strikes and other patents expire.labor disputes; loss or impairment of key manufacturing sites; loss of key suppliers; supplier capacity constraints; raw material and product quality or safety issues; inflation; industrial accidents or other occupational health and safety issues; the impact on our suppliers of tighter credit or capital markets; epidemics and pandemics; and natural and man-made disasters, including climatic events (including any potential effect of climate change), power grid failures, acts of war or terrorism, political unrest, fires or explosions and other external factors over which we have no control.

8


For instance, our successful combination ocular anti-infective/anti-inflammatory product, TobraDex® ophthalmic suspensionIn addition, we single-source or rely on limited sources of supply for some components, raw materials and ointment, lost its exclusive marketing positionproduction services, such as sterilization, used in the United Statesproduction of our products. The loss of one of these suppliers or the inability of any such supplier to meet performance and quality specifications, requested quantities or delivery schedules could cause our sales and profitability to decline and have a negative impact on our customer relations. Moreover, a price increase from a supplier where we do not have a supply alternative could cause our profitability to decline if we cannot increase our prices to our customers. To ensure sufficient supply, we may determine that we need to provide financing to some subset of our supplier base, which could increase our financial exposure to such suppliers.
Semiconductor chips are an essential component to the manufacture of our equipment. Due to our reliance on these semiconductor chips, we are subject to the risk of shortages and long lead times in January 2009.  Boththeir supply. For example, increased demand for semiconductor chips in 2020, due in part to the COVID-19 pandemic and increased demand for consumer electronics that use these chips, resulted in a competitorsevere global shortage of chips in 2021. This shortage may result in delays in the manufacture of our equipment and increased costs to source available semiconductor chips. Further, delays in the manufacture of our Falcon Pharmaceuticals subsidiary launched generic versionsequipment due to a continuing shortage of TobraDex® suspensionsemiconductor chips may harm our reputation and otherwise materially and adversely affect our business and operations.
Finally, in early January 2009.

We dependsome cases, we manufacture our products at a single manufacturing facility. In many cases, regulatory approvals of our products are limited to a specifically approved manufacturing facility. If we fail to produce enough of a product at a facility, or if our manufacturing process at that facility is disrupted, we may be unable to deliver that product to our customers on proprietary technologiesa timely basis. Problems may arise during the manufacturing process for a variety of reasons, including technical, labor or other difficulties, equipment malfunction, contamination, failure to follow specific protocols and procedures, destruction of or damage to any facility (as a result of a natural or man-made disaster, use and storage of hazardous materials or other events), power grid failures, or other reasons. In the event of a quality control issue, we may voluntarily, or our regulators may require us to, close a facility indefinitely. If any such problems arise, we may be unable to purchase substitute products from third-party manufacturers to make up any resulting shortfall in the production of a product, as such third-party manufacturers may only exist in limited numbers or appropriate substitutes may not be able to protect our intellectual property rights adequately.

We currently hold approximately 7,000 patents and have more than 4,000 pending patent applications.  We rely on a combination of contractual provisions, confidentiality procedures and patent, trademark, copyright and trade secrecy laws to protect the proprietary aspects of our technology.  These legal measures afford limited protection and may not prevent our competitors from gaining access to our intellectual property and proprietary information.  Any of our patents may be challenged, invalidated, circumvented or rendered unenforceable.  From time to time, we have faced challenges of our intellectual property rights and face current challenges to some of our key products.  Furthermore, we cannot ensure that any pending patent application held by us will result in an issued patent or that, if patents are issued to us, such patents will provide meaningful protection against competitors or competitive technologies.  Any litigation to protect our intellectual property rights could result in substantial expense, may reduce our profits and may not be successful.  In addition, we may be exposed to future litigation by third parties based on claims that our products infringe their intellectual property rights.available. This risk is exacerbated by the fact that the validity and breadth of patents in our industry frequently involve complex legal issues that are not easily resolved.

10
The Company, either alone or jointly with its commercial partners, has filed fourteen North American patent infringement actions against six different generic drug companies.  With the exception of international generic challenges, all of these generic drug companies are seeking U.S. Food and Drug Administration ("FDA") approval to market generic versions of the Company's products, under what are known as Abbreviated New Drug Applications ("ANDAs").

Each infringement action was filed after the Company received notice that one or more of the generic drug companies had filed an ANDA seeking approval to sell a generic version of a Company product.  As part of its ANDA, each generic drug company challenged one or more patents covering a Company product.  Our products subject to generic challenges include Vigamox® antibiotic ophthalmic solution, Patanol® and Pataday anti-allergy ophthalmic solutions, and TRAVATAN® and TRAVATAN Z® ophthalmic solutions.  In the United States, as a result of filing the lawsuits, the FDA must delay approval of the related ANDAs for 30 months unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  In Canada, filing of the lawsuits secured a 24-month delay in approval from the Minister of Health, which can be shortened if the litigation is earlier resolved or the court modifies the 24-month stay on such approval.  Should any generic drug company succeed in overcoming all applicable patents and secure regulatory approval, it would be entitled to sell a generic product that would compete with the Company's product in the United States or Canada.  Such competition would be expected to impact significantly the Company's sales and profits.  More information on these suits can be found at Item 8.A.7, "Legal Proceedings."

On December 18, 2008, James M. Nielsen, M.D. filed a patent infringement suit against Alcon, Inc. and Alcon Laboratories, Inc. in the U.S. District Court for the Northern District of Texas in Dallas.  Dr. Nielsen is asserting that his U.S. Patent No. 5,158,572 entitled "Multifocal Intraocular Lens" is being infringed by the Company's AcrySof® ReSTOR® intraocular lens.  The patent, which expired at the end of October 2009, was previously licensed to Advanced Medical Optics, Inc.  The Company filed its Answer January 12, 2009.  The Answer included a counterclaim for a declaratory judgment that the patent-in-suit is invalid and not infringed.  The case had been set for trial in August 2010 but has been postponed.  No new trial date has been set.  Summary judgment motions were filed by both parties January 7, 2011.  Alcon is seeking summary judgment on noninfringement, invalidity and laches, while Dr. Nielsen is seeking partial summary judgment on invalidity and laches/estoppels.  On January 10, 2011, the court ordered that both parties' motions be stricken and refiled in a "cross-motion" format, the briefing for which was extended by the court until the end of March 2011.  An adverse ruling by the court, while possible, would not be expected to impact significantly the Company's sales and profits.

On January 22, 2009, Elan Pharma International Ltd. sued two of the Company's subsidiaries, Alcon Laboratories, Inc. and Alcon Research, Ltd., in the U.S. District Court for the Eastern District of Texas in Sherman, alleging infringement of two Elan patents on nanoparticle technology (U.S. Patent Nos. 5,298,262 and 5,429,842).  The complaint claims that the Company's Azopt® product and, potentially, other products infringe the two patents.  The Company answered and counterclaimed on May 12, 2009.  Elan then moved to dismiss certain of the Company's affirmative defenses and counterclaims.  The Company has filed an amended answer and counterclaims providing greater detailparticularly relevant with respect to products for which we represent a substantial portion of the Company's inequitable conduct counterclaims.  The case has been set for trialmarket, such as vitreoretinal equipment and other vitreoretinal-related products. A failure to deliver products on October 17, 2011.  The Company believes that it has strong defensesa timely basis could lead to customer dissatisfaction and intendsdamage to defend itself vigorously.  An adverse ruling byour reputation. Significant delays in the court, however,delivery of our products or a delay in the delivery of a key product could also negatively impact significantly the Company'sour sales and profits.

profitability.
The Company and its subsidiaries are parties to a variety of other legal proceedings arising outeffects of the ordinary course of business, including proceedings relatingongoing COVID-19 pandemic, as well as the mitigation measures, have had, and may continue to product liability and patent infringement.  The Company believes that it has valid defenses and is vigorously defending the litigation pending against it.

While the results of the aforementioned contingencies cannot be predicted with certainty, management believes that the ultimate liability, if any, will not have, a material adverse impact on our business, net sales, profitability, financial condition, liquidity and cash flows.
To stem the spread of COVID-19 disease, in early 2020 nearly all major markets began to implement “stay-at-home” orders, business shutdowns, including offices of eye care professionals, and the deferral of non-urgent surgical procedures, leading to a global economic standstill. Such actions have resulted in disruptions to our supply chain, operations, facilities and associate workforce. While “stay-at-home" orders continued to be implemented sporadically in 2021, if business shutdowns and the deferral of non-urgent surgical procedures are re-implemented broadly to combat the spread of COVID-19, our business, net sales, financial condition, liquidity and cash flows would be adversely affected further.
The magnitude of the continued negative impact of the COVID-19 pandemic on our business, net sales, financial condition, liquidity and cash flows depends on future developments that are unpredictable and most of which are outside of our control, including the duration and scope of the pandemic, related governmental advisories and restrictions to contain COVID-19, how quickly economic conditions improve once the COVID-19 pandemic subsides, the development of therapeutic medicines and vaccines and whether there are subsequent outbreaks.
Moreover, the effects of vaccine mandates are not yet known. A growing number of countries are making vaccination compulsory for workers. Further, certain customers have issued vaccine requirements with respect to our associates who visit their facilities. Our efforts to comply with these mandates, including requiring that some or all of our associates be fully vaccinated against COVID-19, could result in increased labor attrition and disruption, as well as difficulty securing future labor needs, and could adversely impact our ability to deliver services to our customers, which could in turn adversely impact our results of operations.
To the extent COVID-19 continues to adversely affect our operations and global economic conditions more generally, it may also have the effect of heightening many of the other risks described in this “Risk Factors” section including impeding our ability to launch new products and develop innovative products, the inability of our customers or suppliers to operate their businesses, the acceleration of industry consolidation, our inability to forecast demand accurately and our need to obtain additional financing.
9


Changing economic and financial environments in many countries and increasing global political and social instability may adversely impact our business.
We sell our products in more than 140 countries. As a result, local and regional economic and financial environments and political and social conditions throughout the world influence and affect our results of operations and business.
Unpredictable political and social conditions currently exist in various parts of the world, including a backlash against free trade, anti-immigrant sentiment, social unrest, a refugee crisis, food and water shortages, COVID-19 related actions, terrorism and the risk of direct conflicts between nations. In addition, the current trade environment is extremely volatile, including the imposition of trade tariffs, trade or economic sanctions, or other restrictions. Changes in trade policy vis-à-vis countries that we operate in could affect our ability to and/or the cost of doing business in such countries. For example, we expect that the ongoing trade dispute between the United States and China could potentially have an adverse effect on the Company's consolidatedexport of our surgical equipment to China. Similarly, following the UK's "Brexit" and with the rise of nationalist, separatist and populist sentiment in various countries, there is a risk that barriers to free trade and the free movement of people may rise in Europe. As we have a sizable commercial presence in the UK, the continuing uncertainty surrounding the effect of "Brexit" may impact our business in the UK and the rest of Europe, including our costs and the distribution of our products in those markets. Further, significant conflicts continue in parts of the Middle East, including conflicts involving Saudi Arabia and Iran, and with respect to places such as North Korea and Ukraine. Collectively, such difficult conditions could, among other things, disturb the international flow of goods and increase the costs and difficulties of international transactions.
In addition, local economic conditions may adversely affect the ability of payors, as well as our distributors, customers, suppliers and service providers, to pay for our products, or otherwise to buy necessary inventory or raw materials, and to perform their obligations under agreements with us. Although we make efforts to monitor these third parties' financial positioncondition and their liquidity, our ability to do so is limited, and some of them may become unable to pay their bills in a timely manner, or may even become insolvent, which could negatively impact our business and results of operations. Litigation contingencies are subject to change based on settlements and court decisions.

The CompanyThese risks may be subjectelevated with respect to future litigationour interactions with fiscally-challenged government payors, or with third parties with substantial exposure to such payors. For example, we have significant outstanding receivable balances that are dependent upon either direct or indirect payment by various governmental and infringement claims,non-governmental entities across the world. The ultimate payment of these receivables is dependent on the ability of these governments to maintain liquidity primarily through borrowing capacity, particularly in the EU. If certain governments are not able to maintain access to liquidity through borrowing capacity, the ultimate payment of their respective portion of outstanding receivables could be at risk and impact profits and cash flow.
Economic conditions in our markets may also deteriorate due to epidemics or pandemics; natural and man-made disasters, including climatic events (including any potential effect of climate change), power grid failures, acts of war or terrorism, inflation, political unrest, fires or explosions; and other external factors over which could causewe have no control.
To the Company to incur significant expenses or preventextent that economic and financial conditions directly affect consumers, some of our businesses, including the Company from selling its products.  The Company operates in an industry susceptible to significant product liability claims.  Product liability claimselective surgical and contact lens businesses, may be asserted against the Companyparticularly sensitive to declines in the future arising out of events not known to the Company at the present time.

11
Any litigation or claims against us, whether or not successful, could result in substantial costs and harm our reputation.  In addition, intellectual property litigation or claims could force us to do one or more of the following: cease selling or using any of our products that incorporate the asserted intellectual property, which would adversely affect our sales and profits; obtain a license from the holder of the intellectual property right alleged to have been infringed, which license may not be available on reasonable terms, if at all; and redesign or, in the case of trademark claims, rename our products to avoid infringing the intellectual property rights of third parties, which may not be possible and could be costly and time-consuming even if it is possible to do so.

A portion of our sales comes from elective surgical procedures or elections to utilize advanced technology options in surgery.  Economic conditions and price competition may cause sales of our products used in these types of elective surgical procedures to decline and reduce our profitability.

Sales of products used in elective surgical procedures have been and may continue to be adversely impacted by economic conditions.  Generally,consumer spending, as the costs of elective surgical procedures and discretionary purchases of contact lenses are typically borne by individuals with limited reimbursement from their medical insurance providers or government programs. For example, while cataract surgery involving our monofocal IOLs is generally fully covered by medical insurance providers or government reimbursement programs, implantation of certain of our AT-IOL products may only be partially covered, with the individual paying out-of-pocket for the non-covered component. Accordingly, individuals may be less willing to incur the costs of these private pay or discretionary procedures or purchases in weak or uncertain economic conditions thereand may be a decline in the number of theseelect to forgo such procedures there may be a decline in the amount we realize for each procedure and the market for equipment used in such procedure may be negatively impacted.

Inability of users of our products to obtain adequate reimbursement or maintain the current level of reimbursement from third-party payors could limit market acceptance of our products or reduce the prices we receive for our products, which could impact adversely our sales and profits.

The initiatives of managed care organizations and governments to contain healthcare costs in the United States and in other countries are placing an increased emphasis on the delivery oftrade down to more cost-effective medical therapies.  This emphasis has, and in the future could, adversely affect sales and prices of our products.  Patients, consumers, physicians, hospitals and other healthcare providers may be reluctant to purchase our products if they do not receive adequate reimbursement for the cost of our pharmaceutical and surgical products and for procedures performed using our products from both governmental and private third-party payors.  For example:

·  Major third-party payors for hospital services, including government insurance plans, Medicare, Medicaid and private healthcare insurers, have substantially revised their payment methodologies during the last few years, resulting in stricter standards for and lower levels of reimbursement of hospital and outpatient charges for some medical procedures.

·  Increased pressures to reduce government healthcare spending could lower our effective average selling price.  In the United States, the Centers for Medicare and Medicaid Services ("CMS") impose controls on the prices at which medical devices and physician-administered drugs used in ophthalmic surgery are reimbursed for Medicare patients.  Many private third-party payors use CMS guidelines in determining reimbursement levels.  In addition, recent government initiatives, such as the U.S. Medicare Part D outpatient prescription drug benefit and the Affordable Care Act, or future government initiatives may negatively impact the number of units we sell or the price we realize for our pharmaceutical products.

·  Most European Union ("EU") member states impose controls on whether products are reimbursable by national or regional health service providers and on the prices at which medicines and medical devices are reimbursed under state-run healthcare schemes.  Some member states operate reference pricing systems in which they set national reimbursement prices by reference to those in other member states.  Increased pressures to reduce government healthcare spending and increased transparency of prices, following the adoption of the European euro, have meant that an increasing number of governments have adopted this approach.  Ever-tighter budgetary constraints also mean that many jurisdictions are increasingly focusing on health economics-based assessment to determine whether technologies represent an appropriate use of national healthcare budgets.  The major EU economies, such as France, Germany and the United Kingdom, have led the way with the development of sophisticated systems, but in almost every European country there is likely to be some form of health technology assessment before the government issues guidance or grants reimbursement or procurement approval for an expensive new technology.  Furthermore, with increased price transparency, parallel importation of pharmaceuticals from lower price level countries to higher priced markets has grown, and these parallel imports lower our effective average selling price.
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·  Japan also imposes controls on the prices at which medicines and medical devices are reimbursed under the national healthcare schemes.  Due to increased pressures to reduce government healthcare spending, the Japanese government continues to seek cuts where possible, and is actively promoting the use of generic products.

·  Managed care organizations in the United States restrict the pharmaceutical products that doctors in those organizations can prescribe through the use of formularies, the lists of drugs that physicians are permitted to prescribe to patients in a managed care organization.  Exclusion of our pharmaceutical products from these formularies or additional price concessions necessary to be included on formularies could have an adverse effect on our revenues and profits.

·  Competitors may introduce generic products that compete directly or indirectly with our products and such generic products may have preferential positions on formularies or reduce our unit sales and prices.

·  There are proposed and existing laws and regulations governing product prices that may negatively affect the profitability of companies in the healthcare industry.

·  There have been recent initiatives by third-party payors to challenge the prices charged for medical products, which could affect our profitability.

·  Reductions in the prices for our products in response to these trends could reduce our profits.  Moreover, our products may not be covered in the future by third-party payors.  The failure of our products to be so covered could cause our profits to decline.

·  In March 2010, the United States government enacted the Affordable Care Act legislation that is expected to have far reaching implications for the healthcare industry.  This legislation will increase rebates pharmaceutical manufacturers must pay to the Medicaid program, impose new discount obligations on pharmaceutical manufacturers with respect to Medicare Part D, potentially affect reimbursement for pharmaceutical and medical device products through a greater emphasis on comparative effectiveness, impose an annual fee on pharmaceutical manufacturers and an excise tax on medical device products, impose additional reporting requirements surrounding interactions with healthcare providers, and affect the manner in which insurers provide medical coverage.  We expect that these changes will reduce the reimbursement for our products and negatively impact selling prices, increase rebates and fees that we provide to the federal and various state governments, increase the cost of our insurance plans and increase administrative costs associated with compliance activities.  "Overview of Our Business – U.S. Healthcare Reform" in Item 5 provides more discussion of these changes.

The FDA and other regulators may authorize sales of competitive prescription pharmaceuticals on a non-prescription basis, which could reduce the demand for and profitability of our prescription products.

In October 2006 and at the request of the holder of both the patent and the New Drug Application ("NDA"), the FDA revised the status of the allergy drug Zaditor® (Novartis AG) from "prescription only" to "over-the-counter," or "OTC."  The approval by the FDA of the sale of this and other pharmaceutical products without a prescription may reduce demand for our competing prescription products and, accordingly, reduce our profits.  Medicines regulators in other jurisdictions have similar powers to authorize OTC switches, either on their own initiative or in response to an approval-holder's request.  Managed care organizations or other third-party payors may petition the FDA or other medicines regulators to permit sales of some of our pharmaceutical products on a non-prescription basis, which could reduce our profits.

Changes in inventory levels or fluctuations in buying patterns by our large wholesale and large retail customers may adversely affect our sales and earnings and add to their variability from quarter to quarter. We also face additional risks due to the concentration of certain sales with large retail and wholesale customers.

A significant portion of our pharmaceutical and eye care products are sold to major pharmaceutical and healthcare distributors and major retail chains in the United States.  Consequently, our sales and quarterly growth comparisons may be affected by fluctuations in the buying patterns of major distributors, retail chains and other trade buyers.  These fluctuations may result from seasonality, pricing, large retailers' and wholesalers' buying decisions or other
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factors.  We can provide no assurance that large retail and wholesale purchases will not decrease as a result of fluctuations in buying patterns.  Additionally, we are exposed to a concentration of credit risk to these customers that, if affected by financial difficulty, could materially and adversely affect our financial results.

The global nature of our business may result in fluctuations and declines in our sales and profits.

affordable options.
Our products are soldoperations in more than 180 countries.  We have more than 75 local operations worldwide and more than half of our revenues in 2010 came from customers outside the United States.

The results of operations and the financial position of our local operations are generally reported in the relevant local currencies and then translated into U.S. dollars at the applicable exchange rates for inclusion in our consolidated financial statements, exposingemerging markets, particularly China, expose us to currency translation risk.  In 2010, our most significant currency exposures were to the euro, the Japanese yen, the Brazilian real and the Canadian dollar versus the U.S. dollar.

The exchange rates between these and other foreign currencies and the U.S. dollar may fluctuate substantially.  In addition, we are exposed to transaction risk because some of our expenses are incurredheightened risks associated with conditions in a different currency from the currency in which our revenues are received.  Fluctuations in the value of the U.S. dollar against other currencies have had in the past, and may have in the future, a material adverse effect on our operating margins and profitability.

those markets.
Economic, social and political conditions, laws, practices and local customs vary widely among the countries, particularly in emerging markets, in which we sell our products. Our operations outside the United Statesin emerging markets, particularly China, are subject to a number of heightened risks and potential costs, including lower profit margins, less stringent protection of intellectual property, higher risk of violating anticorruption laws and economic, political and social uncertainty in countries in which we operate, especially in emerging markets.  These and other risks may have a material adverse effect on our operations in any particular country and on our business as a whole.uncertainty. For example, many emerging markets have currencies that fluctuate substantially. If currencies devalue and we cannot offset with price increases, our products may become less profitable. Inflation in emerging markets also can make our products less profitable and increase our exposure to credit risks. We have previously experienced currency fluctuations, unstable social and political conditions, inflation and volatile economic conditions in emerging markets, which have impacted our profitability in the pastemerging markets in several marketswhich we operate and we may experience such impacts in the future.

Further, in many emerging markets, average income levels are relatively low, government reimbursement for the cost of healthcare products and services is limited and prices and demand are sensitive to general economic conditions. These challenges may prevent us from realizing the expected benefits of our investments in such emerging markets, which could have an adverse impact on our business, financial condition and results of operations.
The
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We operate in a highly competitive industry and if we fail to innovate, we may be unable to maintain our position in the markets in which we compete and unable to build and expand our markets.
Our industry is highly competitive and, in both our surgical and vision care businesses, we face a mixture of competitors and intense competition from competitors' products. While we currently enjoy leading positions within our industry, our success highly depends on our ability to maintain or build on those leading positions. To compete effectively, we must continue to create, invest in or acquire advanced technology, incorporate this technology into our proprietary products, obtain regulatory approvals in a timely manner where required and manufacture and successfully market our products. We may experience design, manufacturing, marketing or other difficulties that could delay or prevent our development, introduction or marketing of new products or new versions of our existing products. As a result of such difficulties and delays, our development expenses may increase and, as a consequence, our results of operations could suffer. Our failure to respond to competitive pressures in a timely manner could have a material adverse effect on our business, financial condition and results of operations.
For example, in our surgical business, we face a mixture of competitors ranging from large manufacturers with multiple business lines to small manufacturers that offer a limited selection of specialized products. Development by other companies of new or improved products, processes or technologies may make our products or proposed products less competitive or obsolete. We also face competition from providers of alternative medical therapies such as pharmaceutical companies that have the potential to disrupt core elements of our business.
Shifts in industry market share can occur in connection with product issues, physician advisories, safety alerts and publications about our products. In the current economicenvironment of managed care, consolidation among healthcare providers, increased competition and declining reimbursement rates, and absent innovation, we must increasingly compete on the basis of price.
In addition, our vision care business operates within a highly competitive environment. In contact lenses, we face intense competition from competitors' products and may face increasing competition as other new products enter the market, for example, with increased product entries from contact lens manufacturers in Asia. New market entrants and existing competitors are also challenging distribution models with innovation in non-traditional, disruptive models such as direct-to-consumer, Internet and other e-commerce sales opportunities, which could adversely impact the traditional eye care professional ("ECP") channel in which Alcon has a significant presence. Our major competitors in contact lenses offer competitive products and differentiated materials, plus a variety of other eye care products including ophthalmic pharmaceuticals, which may give them a competitive advantage in marketing their lenses. Our vision care business also competes with manufacturers of eyeglasses and providers of other forms of vision correction including ophthalmic surgery. Furthermore, our ocular health product category is also highly competitive. We cannot predict the timing or impact of the introduction of competitive products, including new market entries, "generic" versions of our approved products, or private label products that treat the same conditions as those of our products. In addition, the introduction of alternatives in medical devices and medical prescriptions could also alter the dry eye product market and impede our sales growth. Our ability to respond to these competitive pressures will depend on our ability to decrease our costs and maintain gross margins and operating results, introduce new products successfully and on a timely basis and achieve manufacturing efficiencies and sufficient manufacturing capacity and capabilities for such products.
Finally, our financial crisis appearsperformance also depends on our ability to be affecting manysuccessfully build and expand our markets. For example, while we currently expect our key markets to grow, particularly in multifocal contact lenses and AT-IOLs, the size of the markets in which we operate.compete may not increase above existing levels, we may not be able to regain or gain market share, expand our market penetration or the size of the market for our products or compete effectively, and the number of procedures in which our products are used may not increase above existing levels. Decreases in market sizes or our market share and declines in average selling prices or procedural volumes could materially adversely affect our results of operations or financial condition. Furthermore, our failure to expand our markets beyond existing levels could impact our ability to grow in line with or above current industry standards.
Our research and development efforts may not succeed in bringing new products to market or may fail to do so in a cost-efficient manner or in a manner sufficient to grow our business, replace lost sales or take advantage of new technologies.
Our ability to continue to maintain and grow our business, to replace sales lost due to competition and to bring to market products that take advantage of new and potentially disruptive technologies depends heavily on the success of our research and development activities. Our success relies on our ability to identify and successfully develop cost-effective new products that address unmet medical and consumer needs. To accomplish this, we commit substantial financial, human and capital resources to product research and development, both through our internal dedicated resources and through BD&L transactions. Developing and marketing new products involves a costly, lengthy and uncertain process. Even when our new product development projects make it to market, there have been, and in future may be, instances where projects are subsequently discontinued for technical, clinical, regulatory or commercial reasons. In spite of our investments, our research and development activities and external investments may not produce commercially successful
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new products that will enable us to replace sales lost to our competitors or increase revenue to grow our business. We may not be able to successfully identify and obtain value from our external business development and strategic collaborative efforts. In addition, our new products may cannibalize a portion of the revenues we derive from existing products, therefore driving replacement revenue instead of incremental revenue.
Further, even if we are able to secure regulatory approval and achieve initial commercial success of our products, our products may abruptly cease to be commercially viable due to the discovery of adverse health effects. See "—We may implement product recalls or voluntary market withdrawals of our products."
If we are unable to maintain a cost-effective flow of successful new products sufficient to maintain and grow our business, cover any sales erosion due to competition and take advantage of market opportunities, this lack of innovation could have a material adverse effect on our business, financial condition or results of operations. For a description of the government approval processes which must be followed to market our products, see "—Regulatory clearance and approval processes for our products are expensive, time-consuming and uncertain, and the failure to obtain and maintain required regulatory clearances and approvals could prevent us from commercializing our products" and "Item 4. Information on the Company—4.B. Business Overview—Government Regulation".
Changes in third-party payor coverage and reimbursement methodologies and potential regulatory price controls may adversely impact our ability to sell our products at prices necessary to support our current business strategy.
The prices, sales and demand for some of our products, in particular our surgical products, could be adversely affected by the increased emphasis managed care organizations and governments continue to place on reducing health care costs. In addition, some third-party payors will not provide reimbursement for a new product until we demonstrate the innovative value or improved patient outcomes of the new product, which could impact our ability to grow the market for sales of the product. There have also been recent initiatives by third-party payors to challenge the prices charged for medical products. Physicians, eye care professionals and other healthcare providers may be reluctant to purchase our products if they do not receive adequate reimbursement from third-party payors to cover the cost of those products and for procedures performed using those products. This risk can be heightened in times of higher inflation if reimbursement rates do not keep pace with increasing costs. Reductions in the prices for our products in response to these trends could reduce our profit margins, which would adversely affect our ability to invest and grow our business.
In the US as well as outside the US, governmental programs that typically reimburse at predetermined fixed rates may also decrease or otherwise limit amounts available through reimbursement. For example, in the EU, member states impose controls on whether products are reimbursable by national or regional health service providers and on the prices at which medical devices are reimbursed under state-run healthcare schemes. Some member states operate reference pricing systems in which they set national reimbursement prices by reference to those in other member states. Countries implementing a volume-based procurement process, such as the one initiated in China in 2018, can lead to decreased prices. Other governmental funding restrictions, legislative proposals and interpretations of policy may negatively impact amounts available through reimbursement, including by restricting payment increases to hospitals and other providers through reimbursement systems, or by restricting whether reimbursement is available for our products at all.
We expect that additional health care reform measures will be adopted in the future in the countries in which we operate, including those initiatives affecting coverage and reimbursement for our products, any of which could limit the amounts that governments will pay for health care products and services, which could adversely affect the growth of the market for our products or the demand for our products, or result in additional pricing pressures. We cannot predict the effect such reforms or the prospect of their enactment may have on our business.
Ongoing consolidation among distributors, retailers and healthcare provider organizations could increase both the purchasing leverage of key customers and the concentration of credit risk.
Increasingly, a significant portion of our global sales are made to a relatively small number of distributors, retail chains and other purchasing organizations, as consolidation and vertical integration continue to disrupt existing channels. As a result, there is a risk that consumers may reduce their expenditures on prescription drugs, over-the-counterour customers are gaining additional purchasing leverage, which increases the pricing pressures facing our businesses.
In our surgical business, healthcare productsproviders, physician practices, hospitals and other healthcare spendingsurgery centers around the world continue to help cope with hard economic times.  In addition, governments may come under increasingconsolidate in response to declining reimbursement rates and intensifying pressure to reduce healthcare expenditures as a resultdelivery expenses. In vision care, private label growth and retailer-branded lenses may drive the commoditization of lower revenuecontact lenses and increased demand for other government services during this financial crisis.  Bothfurther boost the bargaining power of these items could have a negative impact on our salesdistributors and profits.

We have significant outstanding receivable balances that are dependent upon either direct or indirect payment by various governmental entities across the world.  The ultimate payment of these receivablesretailers. This consolidation is dependent onincreasing the ability of these governmentslarge groups to maintain liquidity primarily through borrowing capacity, particularlynegotiate price, accelerating the transition of the decision maker from physicians to cost-focused professional buyers and potentially increasing price transparency or price referencing in instances of consolidation across borders.
Further, as our customers consolidate, if one or more of our major customers experienced financial difficulties, the effect on us would be substantially greater than in the European Union.  If certain governments are not able to maintain access to liquidity through borrowing capacity, the ultimate payment of their respective portion of outstanding receivablespast, and could be at risk and impact profits and cash flow.

We single-source many of the active ingredients and components used in our products and interruptions in the supply of these raw materials could disrupt our manufacturing of specific products and cause our sales and profitability to decline.

We single-source active ingredients contained ininclude a majority of our pharmaceutical and consumer eye care products, including ProVisc®, DisCoVisc® and VISCOAT® surgical viscoelastic devices, both Systane® and Systane® Ultra lubricant eye drops, both PatanolÒ and Pataday ophthalmic solutions and Vigamox® moxifloxacin ophthalmic solution.  In these cases, obtaining the required regulatory approvals, including from the FDA, to use alternative suppliers may be a lengthy process.  In many cases, we use single-source suppliers for other components and raw materials used in our products.  Thesubstantial loss of any of these or other significant suppliers or the inability of any such supplier to meet performance and quality specifications, requested quantities or delivery schedules could cause our sales and profitability to decline and have a negative impact on our customer relations.  In addition, a significant price increase from any of our single-source suppliers could cause our profitability to decline if we cannot increase our
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prices to our customers.  In order to ensure sufficient supply, we may determine that we need to provide financing to some of our single-source suppliers, which could increase our financial exposure to such suppliers.

In many cases, we manufacture a product at a single-source facility, and an inability to produce a sufficient quantity of, or any disruption in the manufacturing of, a product at the relevant facility could impair our abilitycollect amounts owed to fill customer orders and could reduce our sales.us.

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In some cases, we manufacture a product, including some of our key products, at a single manufacturing facility.  In many cases, regulatory approvals of our products are limited to a specific approved manufacturing facility.  If we fail to produce enoughproperly educate and train healthcare providers on our products, then customers may not buy our products.
We market our surgical products to healthcare providers, including ECPs, public and private hospitals, ambulatory surgical centers, eye clinics and ophthalmic surgeons' offices and group purchasing organizations and our vision care products to retailers and distributors. We have developed, and strive to maintain, strong relationships with members of each of these groups who assist in product research and development and advise us on how to satisfy the full range of consumer and surgeon needs. We rely on these groups to recommend our products to their patients and to other members of their organizations. Travel restrictions such as those due to the COVID-19 pandemic have increased the difficulty in maintaining these strong relationships.
Contact lens and lens care consumers have a producttendency not to switch products regularly and are repeat consumers. As a result, the success of these products relies on an ECP’s initial recommendation of our products, which may be based on our ability to educate the ECP on our products. Even if we are successful at educating ECPs on our products, ECPs may continue to lose influence in the consumer's selection of contact lenses, which would cause our business to become more dependent upon the success of educating consumers directly. If we had to increase our direct-to-consumer marketing, we could potentially face challenges in maintaining our good relationships with ECPs, who may view our direct-to-consumer marketing as a facility, or ifthreat to their business.
In our manufacturingsurgical business, ophthalmic surgeons play a significant role in determining the course of treatment and, ultimately, the type of products that will be used to treat a patient for cataracts, vitreoretinal conditions, refractive errors and glaucoma, among other things. As a result, it is important for us to properly and effectively market our surgical products to surgeons. Acceptance of our surgical products also depends on our ability to train ophthalmic surgeons and their clinical staff on the safe and appropriate use of our products, which takes time. This training process at that facilitymay take longer than expected and may therefore affect our ability to increase sales. Following completion of training, we rely on the trained ophthalmic surgeons to advocate the benefits of our products in the broader marketplace. Convincing ophthalmic surgeons to dedicate the time and energy necessary for adequate training is disrupted,challenging, and we may not be unable to deliver that product to our customers on a timely basis.  A failure to deliver products on a timely basis could lead to customer dissatisfaction and damage our reputation.  Significant delayssuccessful in these efforts. If we are not successful in convincing ophthalmic surgeons of the deliverymerits of our products or a delay ineducating them on the delivery of a key product also could negatively impact our sales and profitability.

Someuse of our products, are manufacturedthey may not use our products and we will be unable to fully commercialize or assembled by third parties under contract.  Business conditions and regulatory actions may lead to recalls of products assembled or manufactured by these companies, may result in delays in shipments ofprofit from such products or may cause these contractors to abandon their contract manufacturing agreements.  Any of these occurrences could have a negative impact on sales and profitability.

products.
Unauthorized or illegal importation of products from countries with lower prescription drugdistribution may harm our business and medical device prices to countries with higher prescription drug and medical device prices may result in lowering the prices we receive for our products.

reputation.
In the United States and elsewhere, our products are subject to competition from lower priced versions of our products and competing products from Canada, Mexico and other countries where there are government imposed price controls or other market dynamics that make the products lower priced. The ability of patients and other customers to obtain these lower priced imports has grown significantly as a result of regulatory harmonization and common market or trade initiatives, such as those underpinning the European Union, and the internet.  Despite government regulations in some countries aimed at limiting low pricedsuch imports, the volume of imports may continue to rise due to the limited enforcement resources, as well as political pressure to permit the imports as a mechanism for expanding access to lower priced medicines.  In addition, legislative proposals are being considered in the United States at both the federal and state levels to relax U.S. import laws.

Thecertain countries. This importation of foreign productsmay adversely affectsaffect our profitability in the United States and elsewhere.  This impactelsewhere and could become more significant in the future,future.
In addition, our industry continues to be challenged by the vulnerability of distribution channels to counterfeiting. Reports of increased levels of counterfeiting could materially affect consumer confidence in the authentic product and harm our business or lead to litigation.
Our reliance on outsourcing key business functions to third parties heightens the risks faced by our businesses.
We outsource the performance of certain key business functions to third parties and invest a significant amount of effort and resources into doing so. Such outsourced functions can include research and development collaborations, clinical trial activities, manufacturing operations, human resources, warehousing and distribution activities, certain finance functions, submission of regulatory applications, marketing activities, data management and others. Outsourcing of services to third parties could expose us to suboptimal quality of service delivery or deliverables and potentially result in repercussions such as missed deadlines or other timeliness issues, erroneous data, supply disruptions, non-compliance (including with applicable legal or regulatory requirements and industry standards) and/or reputational harm, with potential negative effects on our results.
Ultimately, if the third parties, fail to meet their obligations to us, we may lose our investment in the collaborations and fail to receive the expected benefits of these arrangements. Contractual remedies may be inadequate to compensate us for the damage to our business or lost profits. In addition, many of the companies to which we outsource key business functions may have more limited resources compared to us, and, in particular, may not have internal compliance resources comparable to those within our organization. Should any of these third parties fail to carry out their contractual duties or regulatory obligations or fail to comply with the law, including laws relating to export and trade controls, or should they act inappropriately in the course of their performance of services for us, there is a risk that we could be held responsible for their acts, that our reputation may suffer and that penalties may be imposed upon us. Any such failures by third parties could have a material adverse effect on our business, financial condition, results of operations or reputation.
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Our inability to forecast demand accurately may adversely affect our sales and earnings and add to sales variability from quarter to quarter.
We balance the need to maintain inventory levels that are sufficient to ensure competitive lead times against the risk of inventory obsolescence because of changing customer requirements, fluctuating commodity prices, changes to our products, product transfers or the life cycle of our products. To successfully manage our inventories, we must estimate demand from our customers and produce products in sufficient quantity that substantially corresponds to that demand. If we fail to adequately forecast demand for any product, or fail to determine the optimal product mix for production purposes, we may face production capacity issues in manufacturing sufficient quantities of a given product. In addition, failures in our information technology systems, issues created by the implementation of our new ERP system or human error could also lead to inadequate forecasting of our overall demand or product mix.
As the number of unique products (SKUs) we offer grows, particularly an increasing number of IOL and contact lens styles with varying diopters, the demand forecasting precision required for us to avoid production capacity issues will also increase. Accordingly, the continued proliferation of unique SKUs in our surgical and vision care portfolios could increase the risk of product unavailability and lost sales. Moreover, an increasing number of SKUs could increase global inventory requirements, especially for consigned products such as IOLs, negatively impacting our working capital performance and leading to write-offs due to obsolescence and expired products.
Compounding the risk of inaccurate forecasts, the manufacturing process for our products has lengthy lead times to acquire and install new equipment and product lines to ramp up production. Thus, if we fail to adequately forecast demand, then we may be unable to scale production in a timely manner to meet unexpected higher demand.
Finally, a significant portion of our vision care products are sold to major healthcare distributors and major retail chains in certain markets. Consequently, our sales and quarterly growth comparisons, as well as our estimates for required inventory levels, may be affected by fluctuations in the buying patterns of such buyers. These fluctuations may result from seasonality, pricing, a recall of a competitor’s product, large retailers' and distributors' buying decisions or other factors. If we overestimate demand and produce too much of a particular product, we face a risk of inventory obsolescence, leaving us with inventory that we cannot sell profitably or at all. By contrast, if we underestimate demand and produce insufficient quantities of a product, we could be forced to choose between producing additional unexpected quantities of that product at a higher price or foregoing sales.
We may be unable to attract and retain qualified personnel.
We are highly dependent upon skilled personnel in key parts of our organization, and we invest heavily in recruiting, training and retaining qualified individuals, including significant efforts to enhance the diversity of our workforce. The loss of the service of key members of our organization—including senior members of our scientific and management teams, high-quality researchers and development specialists and skilled personnel in developing countries—could delay or prevent the achievement of major business objectives.
In addition, our ability to hire qualified personnel also depends on the flexibility to reward superior performance and to pay competitive compensation. Laws, regulations and customary practice on executive compensation, including legislation and customary practice in our home country, Switzerland, may restrict our ability to attract, motivate and retain the required level of qualified personnel. For example, pay benchmarks for Swiss and other European companies may be inconsistent with the current market in the United States, making it more difficult to recruit US talent. Further, certain associates will be required to travel frequently between Switzerland and the US. These associates may be unwilling or unable to make such a commitment. Finally, changes to immigration policies in the numerous countries in which we operate, including the United States, as well as restrictions on global travel as a result of local or global public health crises requiring quarantines or other precautions to limit exposure to infectious diseases, may limit our ability to hire or retain talent in, or transfer talent to, specific locations.
Finally, our business, particularly the manufacturing of our products, requires a substantial number of personnel. Any failure to retain stable and dedicated labor by us may lead to disruption to our business operations, including the manufacturing of our products. Although we have not experienced any material labor shortage to date, we have observed an overall tightening and increasingly competitive labor market. We have experienced, and expect to continue to experience, increases in labor costs to remain competitive in retaining talent. If we are unable to manage and control our labor costs, our business, financial condition and results of operations may be materially and adversely affected.
Financial markets, including inflation and volatile exchange rates, are unpredictable, which could lead to unexpected impacts to our earnings, the return on our financial investments and the value of some of our assets.
Financial markets may adversely affect our earnings, the return on our financial investments and the value of some of our assets. For example, inflation could continue to accelerate, which could lead to higher interest rates, increasing our costs of raising capital. Uncertainties around future central bank and other economic policies in the United States and EU, as well as high debt levels in certain other countries, could also impact world trade. Sudden increases in economic, currency or financial market volatility in different countries have also impacted, and may continue to impact, our business and
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results of operations, including the value of our investments in our pension plans. See "—We may be underestimating our future pension and other post-employment benefit plan obligations."
Changes in exchange rates between the US dollar, our reporting currency and other currencies can also result in significant increases or decreases in our reported sales, costs and earnings as expressed in US dollars, and in the reported value of our assets, liabilities and cash flows. Despite any measures we may undertake in the future to reduce, or hedge against, foreign currency exchange risks, because a significant portion of our earnings and expenditures are in currencies other than the US dollar, and the fact that our expenditures in Swiss francs and US dollars are significantly higher than our revenue in Swiss francs and US dollars, respectively, any such exchange rate volatility may negatively and materially impact our business, results of operations and financial condition, and may impact the reported value of our net sales, earnings, assets and liabilities. For more information on the effects of currency fluctuations on our Consolidated Financial Statements and on how we manage currency risk, see "Item 5. Operating and Financial Review and Prospects—5.A. Operating Results—Effects of Currency Fluctuations" and "Item 11. Quantitative and Qualitative Disclosures About Market Risk".
Countries facing financial difficulties, including countries experiencing high inflation rates and highly indebted countries facing large capital outflows, may impose controls on the exchange of foreign currency. Such exchange controls could limit our ability to distribute retained earnings from our local affiliates, or to pay intercompany payables due from those countries.
Our existing debt may limit our flexibility to operate our business or adversely affect our business and our liquidity position.
We have outstanding debt of $4.1 billion as of December 31, 2021, and we may incur additional indebtedness in the future for various reasons, including fluctuations in operating results, capital expenditures and potential acquisitions.
Our indebtedness may:
make it difficult for us to satisfy our obligations, including making interest payments on our debt obligations;
require us to dedicate a portion of our cash flows to payments on our debt, reducing our ability to use our cash flows to fund capital expenditures, BD&L or other strategic transactions, working capital and other general operational requirements, or to pay dividends to our shareholders;
limit our flexibility to plan for and react to changes in our business;
negatively impact our credit rating and increase the cost of servicing our debt;
place us at a competitive disadvantage relative to some of our competitors that have less debt than us;
increase our vulnerability to general adverse economic and industry conditions, including changes in interest rates or a downturn in our business or the economy; and
make it difficult to refinance our existing debt or incur new debt on terms that we would consider to be commercially reasonable, if at all.
The occurrence of any one of these events could have a material adverse effect on our business, financial condition or result of operations or cause a significant decrease in our liquidity and impair our ability to pay amounts due on our indebtedness.
We may need to obtain additional financing, which may not be available or, if it is available, may not be on favorable terms and may result in dilution of our then-existing shareholders.
We may need to raise additional funds to:
finance unanticipated working capital requirements or refinance our existing indebtedness;
develop or enhance our infrastructure and our existing products and services;
engage in mergers and acquisitions or other strategic BD&L transactions;
fund strategic relationships; and
respond to competitive pressures.
If we raise additional funds by issuing equity or convertible debt securities, the percentage ownership of our then-existing shareholders may be diluted, and holders of these securities may have rights, preferences or privileges senior to those of our then-existing shareholders.
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Even if we protect our intellectual property to the fullest extent permitted by applicable law, our competitors and other third parties could develop and commercialize products similar or identical to ours, which could impair our ability to compete.
We rely on a combination of patents, trademarks and copyrights to protect our intellectual property. The scope, strength and duration of those intellectual property rights can vary significantly from product to product and country to country. We also rely on a variety of trade secrets, know-how and other confidential information to supplement these protections. In the aggregate, these intellectual property rights are of material importance to our business.
The protections afforded by these intellectual property rights may limit the ability of competitors to commercialize products covered by the applicable intellectual property rights, but they do not prevent competitors from marketing alternative products that compete with our products. In addition, these intellectual property rights may be challenged by third parties and regulatory agencies, and intellectual property treated as trade secrets and protected through confidentiality agreements may be independently developed by third parties and/or subject to misappropriation by others. Furthermore, in certain countries, particularly in China, due to ambiguities in the law and enforcement difficulties, intellectual property rights may not be as effective as in Western Europe or the United States. Therefore, even if we protect our intellectual property to the fullest extent permitted by applicable law, competitors and other third parties may nonetheless develop and commercialize products similar or identical to ours, which could impair our ability to compete and have an adverse effect on our business, financial condition and results of operations.
Litigation, including product liability lawsuits, and governmental investigations may harm our business or otherwise distract our management.
We, from time to time, are, and may in the future be, subject to various investigations and legal proceedings that arise or may arise.
We also periodically receive inquiries from antitrust and competition authorities in various jurisdictions and, from time to time, are named as a defendant in antitrust lawsuits. For example, since the first quarter of 2015, more than 50 putative class action complaints have been filed in several courts across the US naming as defendants contact lens manufacturers, including Alcon, and alleging violations of federal antitrust law, as well as the antitrust, consumer protection and unfair competition laws of various states, in connection with the implementation of unilateral price policies by the defendants in the sale of contact lenses. The cases have been consolidated in the Middle District of Florida by the Judicial Panel on Multidistrict Litigation and the claims are being vigorously contested. See "Item 8. Financial Information—8.A. Consolidated Statements and Other Financial Information—Legal Proceedings".
In addition, from time to time, we are named as a defendant in product liability lawsuits and, to the extent we are, we may in the future incur material liabilities relating to such product liability claims, including claims alleging product defects and/or alleged failure to warn of product risks. The risk of material product liability litigation is increased in connection with product recalls and voluntary market withdrawals. We have voluntarily taken products off the market in the past. The combination of our insurance coverage, cash flows and provisions may not be adequate to satisfy product liabilities that we may incur in the future. Successful product liability claims brought against us or recalls of any of our products could have a material adverse effect on our business, results of operations or our financial condition.
Because of our extensive international operations, we could be even greater ifadversely affected by violations of worldwide anti-bribery laws, including those that prohibit companies and their intermediaries from making improper payments to government officials or other third parties for the purpose of obtaining or retaining business, such as the FCPA, and laws that prohibit commercial bribery. Our internal control policies and procedures may not always protect us from reckless or criminal acts committed by our associates or agents. Violations of these laws, or allegations of such violations, could disrupt our business and adversely affect our reputation and our business, results of operations, cash flows and financial condition.
Substantial, complex or extended litigation could cause us to incur large expenditures, affect our ability to market and distribute our products and distract our management. For example, intellectual property litigation in which we are named as a defendant from time to time could result in significant damage awards and injunctions that could prevent the manufacture and sale of the affected products or require us to make significant royalty payments to continue to sell the affected products. Lawsuits by associates, shareholders, customers or competitors, or potential indemnification obligations and limitations of our director and officer liability insurance, could be very costly and substantially disrupt our business. Disputes with such companies or individuals from time to time are not uncommon, and we may be unable to resolve such disputes on terms favorable to us.
Even meritless claims could subject us to adverse publicity, hinder us from securing insurance coverage in the future or require us to incur significant legal costs. As a result, significant claims or legal proceedings to which we are a party could have a material adverse effect on our business, prospects, financial condition and results of operations.
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Failure to comply with law, legal proceedings and government investigations may have a significant negative effect on our results of operations.
We are obligated to comply with the laws of all of the countries around the world in which we operate and sell products. These laws cover an extremely wide and growing range of activities. Such legal requirements can vary from country to country and new requirements may be imposed on us from time to time as government and public expectations regarding acceptable corporate behavior change, and enforcement authorities modify interpretations of legal and regulatory provisions and change enforcement priorities. In addition, our associates, independent contractors, consultants, commercial partners and vendors may engage in misconduct or other improper activities, including noncompliance with regulatory standards and requirements, in violation of such laws and public expectations.
For example, we are faced with increasing pressures, including new laws and regulations from around the world, to be more transparent with respect to how we do business, including with respect to our interactions with healthcare professionals and organizations. These laws and regulations include requirements that we disclose payments or other transfers of value made to healthcare professionals and organizations, including by our associates or third parties acting on our behalf, as well as with regard to the prices for our products. We are also subject to certain privacy laws, including Swiss privacy laws, the EU's General Data Protection Regulation and the California Consumer Privacy Act, which include significant penalties for non-compliance.
In addition, we have significant activities in a number of developing countries around the world, both through our own associates and through third parties retained to assist us. In some of these countries, a culture of compliance with law may not be as fully developed as in other countries.
To help us in our efforts to comply with the many requirements that impact us, we have a significant global ethics and compliance program in place, and we devote substantial time and resources to efforts to conduct our business in a lawful and publicly acceptable manner. Nonetheless, our ethics and compliance program may be insufficient or associates may fail to comply with the training they received, and any actual or alleged failure to comply with law or with heightened public expectations could lead to substantial liabilities that may not be covered by insurance, or to other significant losses, and could affect our business, financial position and reputation.
In particular, in recent years, there has been a trend of increasing government investigations, legal proceedings and law enforcement activities against companies and executives operating in our industry. Increasingly, such activities can involve criminal proceedings and can retroactively challenge practices previously considered to be acceptable. For instance, in 2017 and 2018, Alcon and Novartis, as well as certain present and former executives and associates of Alcon and Novartis, received document requests and subpoenas from the DoJ and the SEC requesting information concerning Alcon accounting, internal controls and business practices in Asia and Russia, including revenue recognition for surgical equipment and related products and services and relationships with third-party distributors, both before and after Alcon became part of the Novartis Group. The investigations by the DoJ and the SEC have concluded. Under our final settlement with the DoJ, we are furthersubject to a three-year deferred prosecution agreement. Our failure to comply with the terms of the deferred prosecution agreement with the DoJ could result in resumed prosecution and other regulatory sanctions and could otherwise negatively affect our operations.
For additional information, see "Item 8. Financial Information—8.A. Consolidated Statements and Other Financial Information—Legal Proceedings" and "—If we breach the Deferred Prosecution Agreement with the US Department of Justice, then resulting actions by the DoJ could have a material adverse effect on our business, financial condition, results of operations or cash flows."
Such proceedings are inherently unpredictable, and large judgments or penalties sometimes occur. As a consequence, we may in the future incur judgments or penalties that could involve large cash payments, including the potential repayment of amounts allegedly obtained improperly and other penalties, including enhanced damages. In addition, such proceedings may affect our reputation, create a risk of potential exclusion from government reimbursement programs and may lead to civil litigation. As a result, having taken into account all relevant factors, we may in the future enter into major settlements of such claims without bringing them to final legal adjudication by courts or other such bodies, despite having potentially significant defenses against them, in order to limit the risks they pose to our business and reputation. Such settlements may require us to pay significant sums of money and to enter into corporate integrity or similar agreements intended to regulate company behavior for a period of years, which can be costly to operate under.
Any such judgments or settlements, and any accruals that we may take with respect to potential judgments or settlements, could have a material adverse impact on our business, financial condition or results of operations, as well as on our reputation.
We may implement product recalls or voluntary market withdrawals of our products.
The manufacturing and marketing of medical devices, including surgical equipment and instruments and pharmaceuticals, involve an inherent risk that our products may prove to be defective and cause a health risk. We are also subject to a number of laws and regulations requiring us to report adverse events associated with our products. Such adverse events
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and potential health risks identified in our monitoring efforts or from ongoing clinical studies may lead to voluntary or mandatory market actions, including recalls, product withdrawals or changes to the lawinstructions for using our devices.
Governmental authorities throughout the world, including the FDA, have the authority to require the recall of our commercialized products in the event of material deficiencies or if statedefects in, for example, design, labeling or local governments take further stepsmanufacture.
We may also voluntarily initiate certain field actions, such as a correction or removal of our products in the future as a result of component failures, manufacturing errors, design or labeling defects or other deficiencies and issues. If a correction or removal of one of our devices is initiated to importreduce a health risk posed by the device, or to remedy a violation of the Federal Food, Drug, and Cosmetic Act ("FDCA") caused by the device that may present a risk to health, the correction or removal must be reported to the FDA. Similarly, field actions conducted for safety reasons in the European Economic Area must be reported to the regulatory authority in each country where the field action occurs.
A recall of one of our products from abroad.or a similar competing product manufactured by another manufacturer could impair sales and subsequent regulatory approvals of other similar products we market and lead to a general loss of customer confidence in our products. A product recall could also lead to a health authority inspection or other regulatory action or to us being named as a defendant in lawsuits. See "—Litigation, including product liability lawsuits, and governmental investigations may harm our business or otherwise distract our management."

We may experience difficulties implementing our new enterprise resource planning system.
We are subjectengaged in a multi-year implementation of a new ERP system across our global commercial and manufacturing operations, which is intended to extensive government regulation relatedenhance and streamline our existing ERP system. ERP implementations are inherently complex and time-consuming projects that involve substantial expenditures on system software, implementation activities and business process reengineering. Any significant disruption or deficiency in the design and implementation of our new ERP system could adversely affect our ability to (i)process orders, ship our products, provide services and customer support, fulfill contractual obligations or otherwise operate our business. For additional information, see "Item 4. Information on the reviewCompany—4.A. History and Development of the Company—Significant Acquisitions, Dispositions and other Events".
We may be underestimating our future pension and other post-employment benefit plan obligations.
We sponsor pension and other post-employment benefit plans in various forms. While most of our plans are now defined contribution plans, certain of our associates remain under defined benefit plans. For these defined benefit plans, we are required to make significant assumptions and estimates about future events in calculating the present value of expected future plan expenses and liabilities. These include assumptions used to determine the discount rates we apply to estimated future liabilities and rates of future compensation increases. Assumptions and estimates we use may differ materially from the actual results we experience in the future due to changing market and economic conditions, higher or lower withdrawal rates or longer or shorter life spans of participants, among other variables. For example, in 2021, a decrease in the interest rate we apply in determining the present value of expected future total defined benefit plan obligations (consisting of pension and other post-employment benefit obligations) of one-quarter of one percent would have increased our year-end defined benefit obligation by $38 million. Any differences between our assumptions and estimates and our actual experience could require us to make additional contributions to our pension funds. Further, additional employer contributions might be required if plan funding falls below the levels required by local rules.
Regulatory clearance and approval of drugsprocesses for our products are expensive, time-consuming and medical devices, (ii) ongoing complianceuncertain, and reporting obligations for products with post-approval review and (iii) ongoing pricing and reimbursement reviews for drugs and devices.  These government regulations require internal processes that increase our coststhe failure to secureobtain and maintain market registration of our drugrequired regulatory clearances and device products.  Government regulation alsoapprovals could prevent us from sellingcommercializing our products.

Our businesses are subject to varying degrees of governmental regulation in the countries in which we operate, and the general trend is toward increasingly stringent regulation. The exercise of broad regulatory powers by the FDA continues to result in increases in the amounts of testing and documentation required for the commercialization of regulated products and a corresponding increase in the expense of product introduction. Similar trends are also evident in the EU and in other markets throughout the world. Compliance with these laws and regulations is costly and materially affects our business. Among other effects, health care regulations substantially increase the time, difficulty and costs incurred in obtaining and maintaining approval to market newly developed and existing products.
Most of our products are regulated as medical devices and face difficult development and approval processes in most jurisdictions we operate in, particularly in the US and EU; however other products may be regulated as other categories such as lasers, drug products, dietary supplements and medical foods. We discuss these regulations more thoroughly "Item 4. Information on the Company—4.B. Business Overview—Government Regulation—Product Approval and Monitoring".
The process of developing new products and obtaining necessary FDA clearance or approval, CE marking, or other regulatory marketing authorization is lengthy, expensive and uncertain. Our potential products could take a significantly longer time than we expect to gain marketing authorization or may never gain such marketing authorization. Regulatory authorities may require additional testing or clinical data to support marketing authorization, delaying authorization and
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market entry of our products. Even if the FDA or another regulatory agency or notified body approves a product, the approval may limit the indicated uses for a product, may otherwise limit our ability to promote, sell and distribute a product or may require post-marketing studies or impose other post-marketing obligations. We may be unable to obtain the necessary regulatory clearances or approvals for any product on a timely basis or at all. If a regulatory authority delays authorization of a potentially significant product, our market value and operating results may decline. Similarly, if we are unable to obtain regulatory approval or CE marking of our products, we will not be able to market these products, which would result in a decrease in our sales.
We may be unable to successfully maintain the registrations, licenses, clearances or other authorizations we have received or may receive in the future. We also routinely make minor modifications to our products, labeling, instructions for use, manufacturing process and packaging that may trigger a requirement to notify regulatory authorities or to update such registrations or authorizations. This may subsequently require us to manage multiple versions of individual products around the world, depending on the status of any re-registration approvals. Managing such multiple versions may require additional inventory in the form of "bridging stock", extensive redress operations and inventory increases that could exceed our manufacturing capacity or supply chain ability at the time. This could result in prolonged product shortages that could negatively impact our sales, both in terms of any unavailable products and the potential loss of customers that opt for another supplier.
The manufacture of our products is highly regulated and complex.
The manufacture of our product portfolio is complex and heavily regulated by governmental health authorities around the world, including the FDA. Whether our products are manufactured at our own dedicated manufacturing facilities or by third parties, we must ensure that all manufacturing processes comply with current Good Manufacturing Practices, quality system requirements and other applicable regulations, as well as with our own high quality standards. In recent years, health authorities have substantially intensified their scrutiny of manufacturers' compliance with such requirements.
Any significant failure by us or our third-party suppliers to comply with these requirements or the health authorities' expectations may cause us to shut down our production facilities or production lines or we could be prevented from importing our products from one country to another. Moreover, if we fail to properly plan for manufacturing capacity, the complexity of our manufacturing process could lead to a long lead time to increase capacity. Any of these events could lead to product shortages, or to our being entirely unable to supply products to customers and consumers for an extended period of time. Such shortages or shutdowns have led to, and could continue to lead to, significant losses of sales revenue and to potential third-party litigation. In addition, health authorities have in some cases imposed significant penalties for such failures to comply with regulatory requirements. A failure to comply fully with regulatory requirements could also lead to a delay in the approval of new products to be manufactured at the impacted site.
We may be subject to penalties if we fail to comply with post-approval legal and regulatory requirements and our products could be subject to restrictions or withdrawal from the market.
The research, development, testing, manufacturing, sale and marketing of our products are subject to extensive governmental regulation. Government regulation includes inspection of and controls over testing, manufacturing, safety and environmental controls, efficacy, labeling, advertising, marketing, promotion, record keeping, tracking, reporting, the sale and distribution of pharmaceutical products,distributing, import, export, samples, and electronic records and electronic signatures.  We
Among other requirements, we are also subjectrequired to government regulationcomply with respectapplicable adverse event and malfunction reporting requirements for our products. For example, for our medical device products, in the US, we are required to report to the prices we chargeFDA any incident in which one of our marketed devices may have caused or contributed to a death or serious injury or has malfunctioned and the rebates we offermalfunction of the device or pay to customers, including rebates paid to certain governmental entities.  Government regulation substantially increases the cost of developing, manufacturing and selling our products.

In the United States, we must obtain FDA approval for each pharmaceutical product that we market and FDA approval or clearance for each medicala similar device that we market and additional approvalswould be likely to cause or clearances may be required for product changes.  The FDA approval process is typically lengthy and expensive, and approval is never certain.  Products distributed outside the United States are also subjectcontribute to government regulation, which may be equallydeath or more demanding. Our potential products could take a significantly longer time than we expect to gain regulatory approval or may never gain approval.  If a regulatory authority delays approval of a potentially significant
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product, our market value and operating results may decline.  Evenserious injury if the FDA or another regulatory agency approves a product,malfunction were to recur. In addition, all manufacturers placing medical devices on the approval may limit the indicated uses for a product, may otherwise limit our ability to promote, sell and distribute a product or may require post-marketing studies or impose other post-marketing obligations.  If we are unable to obtain regulatory approval of our products, we will not be able to market these products, which would result in a decrease in our sales.  Currently, we are actively pursuing approval for a number of our products from regulatory authorities and conducting other pre-market procedures in a number of countries, including, among others, the United States, countries in the European Union and Japan.  Continued growth in our sales and profits will depend, in part, on the timely and successful introduction and marketing of some or all of these products.

The clinical trialsEconomic Area are legally required to obtain regulatory approvals are complex and expensive and their outcomes are uncertain.  We incur substantial expense for, and devote significant timereport any serious or potentially serious incidents involving devices produced or sold by the manufacturer to clinical trials, yet we cannot be certain that the trials will resultrelevant authority in the commercial sale of a product.  Positive results from preclinical studies and early clinical trials do not ensure positive results in later clinical trials that form the basis of an application for regulatory approval.  We may suffer significant setbacks in clinical trials, even after earlier clinical trials show promising results.  Any of our products may produce undesirable side effects that could cause us, regulatory authorities or research sites to interrupt, delay or halt clinical trials of a pharmaceutical or medical device candidate.  We, the FDA or another regulatory authority, an Institutional Review Board or a Safety Data Monitoring Committee charged with overseeing the research to protect study subjects may suspend or terminate clinical trials atthose jurisdictions where any time if we or they believe the trial participants face unacceptable health risks.such incident occurred.

Noncompliance with applicable legal regulatory requirements can result in fines, injunctions, penalties, mandatory recalls or seizures, suspensions of production, denial or withdrawal of pre-marketing approvals and criminal prosecution.

The FDA and other regulatory bodies across the world also have authority to request repair, replacement or refund of the cost of any device we manufacture or distribute.

We may be subject to penalties if we fail to comply with post-approval legal and regulatory requirements and our products could be subject to restrictions or withdrawal from the market.

Our manufacturing, sales, promotion and other activities following product approval are subject to regulation by numerous regulatory and law enforcement authorities, including, in the United States, the FDA, the U.S. Federal Trade Commission, the Department of Justice, the CMS, other divisions of the Department of Health and Human Services and state and local governments.  Any product for which we currently have or may obtain marketing approval, or clearance, along with the associated manufacturing processes, any post-approval clinical data that we might be required to collect, any adverse events and malfunctions associated with the products, and any advertising and promotional activities for the product, are subject to continual recordkeeping and reporting requirements, review and periodic inspections by regulatory authorities.  Our advertising and promotional activities are also subject to stringent regulatory rules and oversight. The marketing approvals from the FDA and other regulators of certain of our products are, or are expected to be, limited to specific uses. We are prohibited from marketing or promoting any uncleared or unapproved use of our product, referred to as "off-label" use. In addition to promoting our products in a manner consistent with our clearances and approvals, we must have adequate substantiation for the claims we make for our products. If any of our claims are determined to be false, misleading or deceptive, we could be subject to enforcement action. As Alcon and our associates increasingly use social media to communicate, and given the speed of dissemination of information online, there is a heightened risk that Alcon or one of our associates sends a message that may be deemed inappropriate or prohibited by a regulatory authority. In addition, unsubstantiated claims also present a risk of consumer class action or consumer protection litigation and competitor challenges. In the past, we have had to change or discontinue promotional materials because of regulatory agency requests, and we are exposed to that possibility in the futurefuture.
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Failure to comply with statutes and also toregulations administered by the possibility of new civil monetary penalties that have been established for violative promotion of drug products to consumers.

New requirements and industry guidelines have been adopted to require the posting of ongoing drug and device clinical trials on public registries, and the disclosure of designated clinical trial results.  We must continually review adverse eventFDA and other available safety information that we receive concerningregulatory bodies or failure to adequately respond to any notices of violation or any similar reports could result in, among other things, any of the following enforcement actions:
warning letters or untitled letters issued by the FDA;
fines, civil penalties, in rem forfeiture proceedings, injunctions, consent decrees and criminal prosecution;
detention of imported products;
delays in approving, or refusal to approve, our products;
withdrawal or suspension of approval of our products or those of our third-party suppliers by the FDA or other regulatory bodies;
product recall or seizure;
operating restrictions or interruption of production; and
inability to export to certain countries.
In addition, we are required to comply with various import laws and make expeditedexport control and periodic reports to regulatory authorities.economic sanctions laws, which may affect our transactions with certain customers. In any given situation,certain circumstances, export control and economic sanctions regulations may prohibit the export of certain products or services. In other circumstances, we may consider whether to implement a voluntary product recall.  We might be required to report toobtain an export license before exporting the FDA certain drug and medical device recalls, device malfunctions or product defects and failures to meet federal electronic product standards.  In the United States, any free samples we distribute to physicians must be carefully monitored and controlled, and must otherwise complyitem. Compliance with the requirementsvarious import laws that apply to our businesses can restrict our access to, and increase the cost of obtaining, certain products and at times can interrupt our supply of imported inventory. Any noncompliance by us with applicable laws and regulations or the Prescription Drug Marketing Act, as amended,failure to maintain, renew or obtain necessary permits and FDA regulations.  In addition, certainlicenses could result in criminal, civil and administrative penalties and could have an adverse effect on our results of operations.
If any of these items were to occur, it could result in unanticipated expenditures to address or defend such actions, could harm our products must comply with child-resistant packaging requirements under the Poison Prevention Packaging Actreputation and Consumer Product Safety Commission regulations.could adversely affect our business, financial condition and results of operations.

Our sales, marketing, research and other scientific/educational programs also must comply with rules governing the promotion of medicines and devices, anti-bribery rules and relatedWe are subject to laws such as the anti-kickback andtargeting fraud and abuse provisionsin the healthcare industry.
We are subject to various global laws pertaining to healthcare fraud and abuse, including anti-kickback laws and physician self-referral laws. For example, the US federal healthcare program anti-kickback statute prohibits, among other things, knowingly and willfully offering, paying, soliciting or receiving remuneration to induce, or in return for, purchasing, leasing, ordering, arranging for or recommending the purchase, lease or order of any healthcare item or service reimbursable under Medicare, Medicaid or other federally financed healthcare programs. These US laws have been interpreted to apply to arrangements between manufacturers, on the one hand, and prescribers, purchasers, formulary managers and other healthcare-related professionals, on the other hand. US law provides that a claim for federal healthcare program reimbursement for items or services resulting from a violation of the Social Security Act, as amended, the Foreign Corrupt Practices Act, the False Claims Act, as
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amended, the privacy provisionsfederal anti-kickback statute constitutes a false or fraudulent claim for purposes of the Health Insurance Portability and Accountability Act and similar state laws.false claims statutes. Pricing and rebate programs for covered outpatient drugs reimbursed under federal healthcare programs must comply with the Medicaid drug rebate requirements of the Omnibus Budget Reconciliation Act of 1990, as amended, the Veterans Health Care Act of 1992, as amended, and the Deficit Reduction Act of 2005, as amended. The statutes and regulations governing the various price reporting requirements are complex and have changed over time, and the U.S.US government has not given clear guidance on many issues. In addition, recent statutory and regulatory developments have not yet been applied by the government or courts to specific factual situations. We believe that the Company iswe are in compliance with all applicable government price reporting requirements, but there is the potential that the CMS,Centers for Medicare & Medicaid Services ("CMS"), other regulatory and law enforcement agencies or a court could arrive at different interpretations, with adverse financial or other consequences for the Company.us. If products are made available to authorized users of the Federal Supply Schedule of the General Services Administration, additional laws and requirements apply. All of these activities are also potentially subject to federal and state consumer protection and unfair competition laws. Some European Union bodies and most European Union member states and Japan impose controls and restrictions that are similar in nature or effect to those described above.

In recent years, the US government and several US states in the United States, including California, Connecticut, Maine, Massachusetts, Minnesota, Nevada, New Hampshire, New Mexico, Texas, Vermont and West Virginia, as well as the District of Columbia, have enacted legislation requiring pharmaceuticalmedical device companies to establish marketing compliance programs and file other periodic reports with the state, make periodic public disclosures on sales, marketing, pricing, clinical trials and other activities, and/or register their sales representatives, as well as prohibiting pharmacies and other healthcare entities from providing certain physician prescribing data to pharmaceutical companies for use in sales and marketing.reports. Similar legislation is being considered in other states and at the federal level in the United States.US states. Many of these requirements are new and their breadth and application is uncertain, and most apply onlyavailable guidance is limited. We could face enforcement action, fines and other penalties and could receive adverse publicity, all of which could harm our business, if it is alleged that we have failed to drugs; however, certain legislation (e.g., California, Connecticut, Massachusetts, Nevadafully comply with such laws and Vermont)regulations. Similarly, if the physicians or other providers or entities that we do business with are found to have not complied with applicable laws, they may be subject to sanctions, which could also applies to devices.

have a negative impact on our business.
Depending on the circumstances, failure to meet these applicable legal and regulatory requirements can result in criminal prosecution, fines or other penalties, injunctions, recall or seizure of products, total or partial suspension of production,
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denial or withdrawal of pre-marketing product approvals, private "qui tam" actions brought by individual whistleblowers in the name of the government, or refusal to allow us to enter into supply contracts, including government contracts, any of which could have a material adverse effect on our business, financial condition.condition or results of operations.

Legislative and regulatory reforms may impact our ability to develop and commercialize our products.
The global regulatory environment is increasingly stringent and unpredictable. Unexpected changes can have an adverse impact on our business, financial condition and results of operations.
First, it could be costly and onerous to comply with changes or new requirements relating to the regulatory approval process or postmarket requirements applicable to our products in various jurisdictions. As discussed in "Item 4. Information on the Company—4.B. Business Overview—Government Regulation—Product Approval and Monitoring" the EU has made recent changes to its regulatory regime. In addition, several countries that did not have regulatory requirements for medical devices have established such requirements in recent years, and other countries have expanded, or plan to expand, their existing regulations. While harmonization of global regulations has been pursued, requirements continue to differ significantly among countries. Further, the FDA is also pursuing various efforts to modernize its regulation of devices, including potential changes to the 510(k) pathway such as limiting reliance on older predicate devices and establishing an alternative 510(k) pathway that permits reliance on objective performance criteria. We expect this global regulatory environment to continue to evolve, which could impact the cost of, the time needed to approve and, ultimately, our ability to maintain existing approvals or obtain future approvals for, our products.
Second, new legislation and new regulations and interpretations of existing health care statutes and regulations are frequently adopted, any of which could affect our future business and results of operations. For example, in the US, there have been a number of health care reform legislative and regulatory measures proposed and adopted at the federal and state government levels that affect the health care system generally and that have had significant impact on our business.
Third, changes to current regulations in certain countries, including the United States, requiring a prescription for the purchase of contact lenses could have a significant impact on the way we market and distribute contact lens and contact lens care products, by limiting the role of the ECP as an intermediary in the sale of our vision care products. Such changes could require us to incur significant costs to update our marketing and distribution methodologies and could adversely affect the sales of our vision care products.
Finally, within our surgical business, a considerable portion of our sales and sales growth rely on patient-pay premium technologies, in markets where access to these technologies has been established. For example, in the US, two landmark rulings issued by the CMS established a bifurcated payment system for certain of our AT-IOLs pursuant to which part of the cost of the cataract surgery with such AT-IOLs would be reimbursed under Medicare, with the remaining cost paid out-of-pocket. For more details, see "Item 4. Information on the Company—4.B. Business Overview—Our Products—Surgical". To the extent regulatory bodies in the US, such as CMS, or other health authorities outside the US, decide to amend the regulations governing patient-pay reimbursement for advanced technologies, our sales and sales growth could be negatively impacted.
We are subject to environmental, health and safety laws and regulations.
We are subject to numerous national and local environmental, health and safety laws and regulations, including relating to the discharge of regulated materials into the environment, human health and safety, laboratory procedures and the generation, handling, use, storage, treatment, release and disposal of hazardous materials and wastes. Our operations involve the use of hazardous and flammable materials, including chemicals and biological materials. Our operations also produce hazardous waste products. We generally contract with third parties for the disposal of these hazardous materials and wastes. We cannot eliminate the risk of contamination or injury from these materials. In the event of contamination or injury resulting from our generation, handling, use, storage, treatment, release or disposal of hazardous materials or wastes, we could be held liable for any resulting damages, and any liability could materially adversely affect our business, operating results or financial condition. Our insurance may not provide adequate coverage against potential liabilities. If we fail to comply with applicable environmental, health and safety laws and regulations, we may face significant administrative, civil or criminal fines, penalties or other sanctions. In addition, we may incur substantial costs to comply with current or future environmental, health and safety laws and regulations, which have tended to become more stringent over time, including any potential laws and regulations that may be implemented in the future to address global climate change concerns. Compliance with current or future environmental, health and safety laws and regulations may increase our costs or impair our research, development or production efforts.
We must comply with certain tax incentive agreements in Switzerland.
While operating as a division of Novartis, our subsidiary, Alcon Pharmaceuticals Ltd. (“APL”), benefited from an investment tax incentive granted by the Swiss State Secretariat for Economic Affairs in Switzerland and the Canton of Fribourg, Switzerland in respect of both Swiss federal taxes and Fribourg cantonal / communal taxes for the fiscal years ended December 31, 2007 through December 31, 2017. This tax incentive is subject to a five year "claw-back" period if Alcon does not continue to meet certain requirements related to its operations in Fribourg.
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In connection with the Spin-off, our former parent retained certain assets of APL related to APL’s former pharmaceutical business. As a result, Novartis agreed with the Canton of Fribourg that each of APL and a subsidiary of Novartis (Novartis Ophthalmics AG, Fribourg) will have separate and standalone obligations and potential liabilities in connection with the five year claw-back period relating to the Fribourg investment tax incentive granted to APL. In particular, APL may be required to pay a "claw-back" amount of up to CHF 1.3 billion to the Fribourg tax authorities if APL fails to continue certain business activities in Fribourg and if Alcon Inc., APL and Alcon Services AG fail to (i) remain tax resident in Fribourg, and (ii) employ a certain minimum number of associates in Fribourg. Since December 31, 2018, our "claw-back" obligation has begun to be reduced each year by 20% of the original maximum amount and will expire on December 31, 2022. As of December 31, 2021, the "claw-back" obligation amounted to CHF 260 million.
We intend to conduct APL's operations so as to comply with these requirements in all respects; however, we may be unable to meet, or the Canton of Fribourg may successfully challenge our compliance with, these requirements. If the Canton of Fribourg successfully challenges our compliance with these requirements, we would be required to pay all or a portion of the "claw-back" amount.
We are a multinational business that operates in numerous tax jurisdictions.
We conduct operations in multiple tax jurisdictions, and the tax laws of those jurisdictions generally require that the transfer prices between affiliated companies in different jurisdictions be the same as those between unrelated companies dealing at arm's length and that such prices are supported by contemporaneous documentation. While we believe that we operate in compliance with applicable transfer pricing laws and intend to continue to do so, our transfer pricing procedures are not binding on applicable tax authorities. If tax authorities in any of these jurisdictions were to successfully challenge our transfer prices as not reflecting arm's length transactions, they could require us to adjust our transfer prices and thereby reallocate our income to reflect these revised transfer prices, which could result in a higher overall tax liability to us and possibly interest and penalties.
Additionally, the integrated nature of our worldwide operations can produce conflicting claims from tax authorities in different countries as to the profits to be taxed in the individual countries. The majority of the jurisdictions in which we operate have double tax treaties with other foreign jurisdictions, which provide a framework for mitigating the impact of double taxation on our revenues and capital gains. However, mechanisms developed to resolve such conflicting claims are largely untested, can be expected to be very lengthy and do not always contain a mandatory dispute resolution clause.
In recent years, tax authorities around the world have increased their scrutiny of company tax filings and have become more rigid in exercising any discretion they may have. As part of this, the Organization for Economic Co-operation and Development ("OECD") has proposed certain changes to the International tax standards that have resulted and will continue to result in local tax law changes under its Base Erosion and Profit Shifting ("BEPS") Action Plans to address issues of transparency, coherence and substance. Most recently, the OECD released its plans for proposing further amendments to the international tax standards, including a new attribution of the right to tax corporate profits where customers are located and a mechanism ensuring that all corporate profits would be subject to governmental, regulatorya minimum taxation level. In December 2021, the OECD released preliminary guidance as to how to calculate the minimum 15% tax rate that multinational companies are expected to be subject to in each country they operate in. These rules, when enacted, are likely to lead to an increase of our tax expense and effective tax rate.
Furthermore, Switzerland and the various Swiss cantons in which Alcon is present have adopted their own corporate tax reform. The main elements of the Swiss tax reform became effective in 2020 and have resulted in an increase in Alcon’s tax burden and effective tax rate in Switzerland.
In 2021, substantive modifications to the US corporate tax regulations were proposed as part of the Build Back Better legislation proposal. These regulations, if adopted and when enacted, could have a negative impact on our tax expense, effective tax rate and financial condition.
In general, tax reform efforts, including with respect to tax base or rate, transfer pricing, intercompany dividends, cross border transactions, controlled corporations and limitations on tax relief allowed on the interest on intercompany debt, will require us to continually assess our organizational structure and could lead to an increased risk of international tax disputes, an increase in our effective tax rate and an adverse effect on our financial condition.
Goodwill and other legal proceedings that haveintangible assets on our books may lead to significant noncash impairment charges.
We carry a significant negative effectamount of goodwill and other intangible assets on our Consolidated Balance Sheet, primarily due to the value of the Alcon brand name, but also intangible assets associated with our technologies, acquired research and development, currently marketed products and marketing know-how. As a result, we may incur significant noncash impairment charges if the fair value of the intangible assets and the groupings of cash generating units containing goodwill would be less than their carrying value on our Consolidated Balance Sheet at any point in time. For example, in 2021, we recognized $225 million in impairment charges.
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For a detailed discussion of how we determine whether an impairment has occurred, what factors could result in an impairment and the impact of impairment charges on our results of operations.operations, see "Note 3. Selected Accounting Policies—Goodwill and intangible assets—Impairment of goodwill, Alcon brand name and definite lived intangible assets" to our Consolidated Financial Statements included elsewhere in this Annual Report.

Environmental, social and governance matters may impact our business and reputation.
Increasingly, in addition to the importance of their financial performance, companies are being judged by their performance on a variety of environmental, social and governance ("ESG") matters, which are considered to contribute to the long-term sustainability of companies’ performance.
A variety of organizations measure the performance of companies on such ESG topics, and the results of these assessments are widely publicized. In addition, investment in funds that specialize in companies that perform well in such assessments are increasingly popular, and major institutional investors have publicly emphasized the importance of such ESG measures to their investment decisions. Topics taken into account in such assessments include, among others, the company’s efforts and impacts on climate change and human rights, diversity and inclusion, ethics and compliance with law and the role of the company’s board of directors in supervising various sustainability issues. In addition to the topics typically considered in such assessments, in the healthcare industry, issues of the public’s ability to access our products and solutions are of particular importance.
We are obligated to comply with the laws of each of the many countries in which we operate, coveringactively manage a broad range of activities.  Despite our efforts, any failure to comply with law could lead to substantial liabilities that may not be covered by insurance, and could affectsuch ESG matters, taking into consideration their expected impact on the sustainability of our business and reputation.

As further discussed in Item 8.A.7, "Legal Proceedings," we are subject to various legal proceedings, including legal proceedings relating to Novartis's January 2010 merger proposal.  We may also be subject to additional legal proceedings in the future.  Such proceedings could relate to, among other things, product liability, commercial disputes, employment and wrongful discharge, antitrust, securities, sales and marketing practices, health and safety, environmental, tax, privacy, intellectual property mattersover time and the proposed merger with Novartis.  Such proceedings are inherently unpredictable,potential impact of our business on society and large verdicts sometimes occur.  As a consequence,the environment. However, in light of investors’ increased focus on ESG matters, there can be no certainty that we maywill manage such issues successfully, or that we will successfully meet society’s expectations as to our proper role. Any failure or perceived failure by us in the future incur judgments or enter into settlements of claims thatthis regard could have a material adverse effect on our reputation and on our business, share price, financial condition or results of operations, including the sustainability of our business over time.
Risks related to the Ownership of our Shares
Your percentage ownership in Alcon may be diluted in the future.
In the future, your percentage ownership in Alcon may be diluted because of equity issuances from acquisitions, capital markets transactions or cash flows,otherwise, including equity awards that we may grant to our directors, officers and associates under our associate participation plans. These additional issuances will have a dilutive effect on our earnings per share, which could adversely affect the market price of our commonshares.
Our maintenance of two exchange listings could result in pricing differentials of our ordinary shares between the two exchanges.
Our shares trade on the NYSE in US dollars and on the SIX in Swiss francs, which may result in price differentials between the two exchanges for a variety of factors, including fluctuations in the US dollar/Swiss franc exchange rate and differences in trading schedules.
We may not pay or declare dividends.
Although Alcon expects that it will continue to recommend the payment of a regular cash dividend based upon the prior year’s core net income, we may not pay or declare dividends in the future. The declaration, timing and amount of any dividends to be affectedpaid by speculation concerningAlcon will be subject to the potential outcomeapproval of shareholders at the relevant General Meeting of shareholders. The determination by the Board as to whether to recommend a dividend and the approval of any such proposed dividend by the shareholders will depend upon many factors, including our financial condition, earnings, corporate strategy, capital requirements of our operating subsidiaries, covenants, legal proceedings.requirements and other factors deemed relevant by the Board and shareholders.

In addition, any dividends that we may declare will be denominated in Swiss francs. Consequently, exchange rate fluctuations will affect the US dollar equivalent of dividends received by holders of shares held via DTC or shares directly registered with Computershare Trust Company, N.A. in the US If the value of the Swiss franc decreases against the US dollar, the value of the US dollar equivalent of any dividend will decrease accordingly.
See "Item 8. Financial Information—8.A. Consolidated Statements and Other Financial Information—Dividend Policy" for more information.
As a foreign private issuer, we are subject to different US securities laws and rules than a domestic issuer, which may limit the information publicly available to US shareholders.
We report under the Securities Exchange Act of 1934, as amended ("Exchange Act"), as a non-US company with foreign private issuer status. Because we qualify as a foreign private issuer under the Exchange Act and although we are subject to Swiss laws and regulations with regard to such matters and intend to continue to furnish quarterly financial information to
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the SEC, we are exempt from certain provisions of the Exchange Act that are applicable to US domestic public companies, including (i) the sections of the Exchange Act regulating the solicitation of proxies, consents or authorizations in respect of a security registered under the Exchange Act, (ii) the sections of the Exchange Act requiring insiders to file public reports of their stock ownership and trading activities and liability for insiders who profit from trades made in a short period of time and (iii) the rules under the Exchange Act requiring the filing with the SEC of quarterly reports on Form 10-Q containing unaudited financial and other specified information, or current reports on Form 8-K, upon the occurrence of specified significant events. In addition, foreign private issuers are not required to file their annual report on Form 20-F until four months after the end of each financial year, while US domestic issuers that are large accelerated filers are required to file their annual report on Form 10-K within 60 days after the end of each fiscal year. Foreign private issuers are also exempt from Regulation Fair Disclosure, aimed at preventing issuers from making selective disclosures of material information.
In addition, as a foreign private issuer, we are entitled to rely on exceptions from certain corporate governance requirements of the NYSE. As a result of the above, you may not have the same protections afforded to shareholders of companies that are not foreign private issuers.
Furthermore, we prepare our financial statements under IFRS. There are, and may continue to be, certain significant differences between IFRS and US Generally Accepted Accounting Principles, or US GAAP, including but not limited to potentially significant differences related to the accounting and disclosure requirements relating to associate benefits, nonfinancial assets, taxation and impairment of long-lived assets. As a result, our financial information and reported earnings for historical or future periods could be significantly different if they were prepared in accordance with US GAAP, and you may not be able to meaningfully compare our financial statements under IFRS with those companies that prepare financial statements under US GAAP.
We may lose our foreign private issuer status.
We are subjecta foreign private issuer and therefore we are not required to governmental oversightcomply with all of the periodic disclosure and associated civilcurrent reporting requirements of the Exchange Act applicable to US domestic issuers. To maintain our status as a foreign private issuer, either (a) a majority of our shares must be directly or indirectly owned of record by non-residents of the United States or (b)(i) a majority of our executive officers or directors may not be United States citizens or residents, (ii) more than 50 percent of our assets cannot be located in the United States and criminal enforcement relating(iii) our business must be administered principally outside the United States.
If we were to drug and medical device advertising, promotion and marketing, and such enforcement is evolving and intensifying.  Other parties, includinglose our foreign private plaintiffs, also are commonly bringing suit against pharmaceutical and medical device companies, alleging off-label marketingissuer status, we would be required to comply with the Exchange Act reporting and other violations.  Givenrequirements applicable to US domestic issuers, which are more detailed and extensive than the significant risks associatedrequirements for foreign private issuers. For instance, we would be required to change our basis of accounting from IFRS as issued by the IASB to US GAAP, which we expect would be difficult and costly and could also result in potentially material changes to historical financial statements previously prepared on the basis of IFRS. We may also be required to make changes in our corporate governance practices in accordance with such enforcementvarious SEC and suits,NYSE rules. The regulatory and compliance costs to us under US securities laws could be significantly higher than the costs we have adopted enhanced compliance controls overwill incur as a foreign private issuer. As a result, a loss of foreign private issuer status would increase our advertising, marketing and promotional activities, among other areas.  However, there remains substantial risk in this area given evolving enforcement theories and increasing claims brought by governmental and private parties.

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New legal and regulatory requirementsfinancial compliance costs and would make some activities highly time-consuming and costly. If we were required to comply with the rules and regulations applicable to US domestic issuers, it would make it more difficult and expensive for us to obtain director and officer liability insurance, and we could be required to accept reduced coverage or incur substantially higher costs to obtain coverage. These rules and regulations could also make it more difficult for us to obtain approvalsattract and retain qualified members of our Board.
Our status as a Swiss corporation means that our shareholders enjoy certain rights that may limit our flexibility to raise capital, issue dividends and otherwise manage ongoing capital needs.
Swiss law reserves for approval by shareholders certain corporate actions over which a board of directors would have authority in some other jurisdictions. For example, shareholders must approve the payment of dividends and cancellation of treasury shares. Swiss law also requires that our product candidates and could limitshareholders themselves resolve to, or make more burdensomeauthorize our abilityBoard to, commercialize any approved products.

The Food and Drug Administration Amendments Act of 2007 ("FDAAA") contains significant regulatory requirements affecting pharmaceutical and medical device manufacturers.  These requirementsincrease our share somecapital. While our shareholders may authorize share capital that can be issued by our Board without additional shareholder approval, Swiss law limits this authorization to 50% of the broad themes in recently adopted legal requirements for drugs in the European Union.  For drugs, the FDAAA grants the FDA extensive new authority to impose post-approval clinical study and clinical trial requirements, require safety-related changes to product labeling, review advertising aimed at consumers and require the adoption of risk management plans, referred to in the legislation as risk evaluation and mitigation strategies ("REMS").  The REMS may include requirements for special labeling or medication guides for patients, special communication plans to healthcare professionals and restrictions on distribution and use.  For example, if the FDA makes the necessary findings, it might require that a new product be used only by physicians with certain specialized training, only in certain designated healthcare settings or only in conjunction with special patient testing and monitoring.

The legislation also includes requirements for drugs and devices for providing the public with information on ongoing clinical trials through a clinical trial registry and for disclosing clinical trial results to the public through a clinical trial database, renewed requirements for conducting trials to generate information on the use of products in pediatric patients, new requirements to pay the FDA a fee in order to obtain advisory review of certain drug consumer television advertisements and new penalties, for example, for false or misleading consumer drug advertisements.  Other proposals have been made to impose additional requirements on drug and device approvals, further expand post-approval requirements and restrict sales and promotional activities.

States require the registration of manufacturers and wholesale distributors of pharmaceutical and medical device products in that state, including, in certain states, manufacturers and distributors who ship products into the state even if such manufacturers or distributors have no place of business within the state.  New requirements also have been imposed in some states and certain markets outside the United States and proposed in other states, requiring us to provide paper or electronic pedigrees with the drugs that we distribute to help establish their authenticity and to track their movement from the manufacturer through the chain of distribution.

These new federal and state requirements and additional requirements that have been proposed, and might be adopted, may make the process more difficult or burdensome for us to obtain approval of our product candidates.  In addition, any approvals we receive may be more restrictive or come with onerous post-approval requirements, our ability to commercialize approved products successfully may be hindered and our business may be harmed as a result.

We may implement a product recall or voluntary market withdrawal and could be exposed to significant product liability claims; we may have to pay significant amounts to those harmed and may suffer from adverse publicity as a result.

The manufacturing and marketing of pharmaceuticals and medical devices, including surgical equipment and instruments, involve an inherent risk that our products may prove to be defective and cause a health risk.  In that event, we may voluntarily implement a recall or market withdrawal or may be required to do so by a regulatory authority.  We have recalled products in the past and, based on this experience, believe that the occurrence of a recall could result in significant costs to us, potential disruptions in the supply of our products to our customers and adverse publicity, all of which could harm our ability to market our products.  A recall of one of our products or a product manufactured by another manufacturer could impair sales of other similar products we market as a result of confusion concerning the scope of the recall.  A product recall also could lead to a regulatory agency inspection or other regulatory action.

From time to time, we are named as a defendant in product liability lawsuits, and although we believe we are not currently subject to any material product liability proceedings, we may incur material liabilities relating to product liability claims in the future, including claims arising out of procedures performed using our surgical equipment.  Prior to 2005, we relied on a combination of self-insurance and third-party insurance to cover potential product liability claims.  Since January 1, 2005, we no longer purchase third party product liability insurance coverage for this risk.  The combination of insurance coverage (if any), cash flows and reserves may not be adequate to satisfy product liabilities that we may incur in the future.  Even meritless claims could subject us to adverse publicity, hinder us from
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securing insurance coverage in the future and require us to incur significant legal fees.  Successful product liability claims brought against us could have a material adverse effect on our results of operations or our financial condition.

Our activities involve hazardous materials and may subject us to environmental liability.

Our manufacturing, research and development practices involve the controlled use of hazardous materials.  We are subject to federal, state and local laws and regulations in the various jurisdictions in which we have operations, governing the use, manufacture, storage, handling and disposal of these materials and certain waste products.  Although we believe that our safety and environmental procedures for handling and disposing of these materials comply with legally prescribed standards, we cannot completely eliminate the risk of accidental contamination or injury from these materials.  Remedial environmental actions or compliance with environmental laws could require us to incur substantial unexpected costs which would materially and adversely affect our results of operations or our financial position.  If we were involved in a major environmental accident or found to be in substantial non-compliance with applicable environmental laws, we could be held liable for damages or penalized with fines that could be material.

Prior to 2005, we relied on a combination of self-insurance and third-party insurance to cover potential environmental liability claims.  Since January 1, 2005, we no longer purchase insurance coverage for this risk.  The combination of insurance coverage (if any), cash flows and reserves may not be adequate to satisfy environmental liabilities that we may incur in the future.  Any environmental claims could subject us to adverse publicity, hinder us from securing insurance coverage in the future and require us to incur significant legal fees.  Successful environmental liability claims brought against the Company could have a material adverse effect on our results of operations or our financial condition.

We do not purchase third-party insurance to cover almost all of our property and casualty, business interruption and liability risks.  We continue to purchase insurance from third parties when required by law and for the personal side of directors' and officers' liability insurance.

The pharmaceutical and medical device business involves an inherent risk of product liability and any claims of this type could have an adverse impact on us.  Furthermore, we have all the risks of property and casualty, general liability, business interruption and environmental liability exposures that are typical of a public enterprise with manufacturing and marketing activities.  Prior to 2005, we relied on a combination of self-insurance through our captive insurance subsidiaries and third-party insurance to cover potential claims from these risks.  Since March 31, 2005, we no longer purchase any form of insurance from third parties except for insurance coverage required by law to be purchased from third parties, such as workers' compensation and automobile insurance.  Consequently, we are exposed to all self-insured risks.  However, we purchase the personal side of directors' and officers' liability insurance from a third party.

Although our Company assets, our internally generated cash flows and third-party insurance coverage have been adequate to provide for liability claims in the past, there can be no assurance that future liability claims and other losses from these risks can be covered by our insurance coverage limits for past activities, Company assets and future cash flows.  Any significant losses from these risks could have a material adverse effect on our results of operations or our financial condition.

We may not successfully complete and integrate strategic acquisitions to expand or complement our business.

As part of our growth strategy, we evaluate and pursue strategic business acquisitions to expand or complement our business.  Such ventures may bring new products, increased marketissued share or new customers to Alcon's prominent position in the ophthalmic industry.  We cannot ensure that suitable acquisition candidates will be identified.  Acquisition activities can be thwarted by overtures from competitors for the targeted candidates, governmental regulation (including market concentration limitations) and replacement product developments in our industry.  Further, after an acquisition, successful integration of the venture can be complicated by corporate cultural differences, difficulties in retention of key personnel, customers and suppliers, and coordination with other products and processes.  Also, acquisitions could divert management's attention from our existing business and could result in liabilities being incurred that were not knowncapital at the time of acquisitionthe authorization. The authorization, furthermore, has a limited duration of up to two years and must be renewed by the shareholders from time to time thereafter in order to be available for raising capital. Additionally, Swiss law grants pre-emptive rights to existing shareholders to subscribe for new issuances of shares and advance-subscription rights to subscribe for convertible bonds or similar instruments with conversion or option rights. A resolution adopted at a shareholders' meeting by a qualified majority of two-thirds of the creationvotes represented, and the absolute majority of taxthe nominal value of the shares represented, may restrict or accounting issues.  If we failexclude such pre-emptive or advance-subscription rights in certain limited circumstances. In June 2020, the Swiss Parliament approved certain changes to timely recognizeSwiss corporate law including permitting the payment of interim dividends, subject to shareholders' approval, and providing a board of directors more flexibility to increase share capital. The enactment date for these changes has not yet been determined and may require an amendment to Alcon’s articles of incorporation. Despite these prospective changes, Swiss law also does not provide as much flexibility in the various rights and regulations that can attach to different categories of shares
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as do the laws of some other jurisdictions. These Swiss law requirements relating to our capital management may limit our flexibility, and situations may arise where greater flexibility would have provided benefits to our shareholders.
It may be difficult to enforce US judgments against us.
We are organized under the laws of Switzerland. As a result, it may not be possible for investors to effect service of process within the United States upon us or address these mattersupon such persons or to devote adequate resources toenforce against them we may fail to achieve our growth strategy or otherwise not realizejudgments obtained in US courts, including judgments in actions predicated upon the intended benefitscivil liability provisions of any acquisition.
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We face risks arising from possible union legislation in the United States.

There is a possibility that the proposed Employee Free Choice Act may be enacted infederal securities laws of the United States. If passed,We have been advised by our Swiss counsel that there is doubt as to the Employee Free Choiceenforceability in Switzerland of original actions, or in actions for enforcement of judgments of US courts, of civil liabilities to the extent predicated upon the federal and state securities laws of the United States. Original actions against persons in Switzerland based solely upon the US federal or state securities laws are governed, among other things, by the principles set forth in the Swiss Federal Act on International Private Law. This statute provides that the application of provisions of non-Swiss law by the courts in Switzerland shall be precluded if the result is incompatible with Swiss public policy. Also, mandatory provisions of Swiss law may be applicable regardless of any other law that would make it easier for unions to win electionsotherwise apply.
Switzerland and could result in more labor relations requirements and union activity in our business.  This legislation potentially could increase our costs and couldthe United States do not have a material adverse effecttreaty providing for reciprocal recognition and enforcement of judgments in civil and commercial matters. The recognition and enforcement of a judgment of the courts of the United States in Switzerland are governed by the principles set forth in the Swiss Federal Act on our overall competitive position.Private International Law. This statute provides in principle that a judgment rendered by a non-Swiss court may be enforced in Switzerland only if:
the non-Swiss court had jurisdiction pursuant to the Swiss Federal Act on Private International Law;
the judgment of such non-Swiss court has become final and non-appealable;
the judgment does not contravene Swiss public policy;
the court procedures and the service of documents leading to the judgment were in accordance with the due process of law; and
no proceeding involving the same position and the same subject matter was first brought in Switzerland, or adjudicated in Switzerland, or was earlier adjudicated in a third state and this decision is recognizable in Switzerland.

The March 11, 2011 earthquake
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ITEM 4.    INFORMATION ON THE COMPANY
4.A. HISTORY AND DEVELOPMENT OF THE COMPANY
General Corporate Information
Alcon is a stock corporation (Aktiengesellschaft) organized under the laws of Switzerland in accordance with article 620 et seq. of the Swiss Code of Obligations and tsunamiregistered with the Register of Commerce of the Canton of Fribourg, Switzerland ("Commercial Register") under registration number CHE‑234.781.164. Alcon is registered in Japan may adversely affect our operations in Japan.

On March 11, 2011, a significant portionthe Commercial Register under each of Japan suffered damage from a major earthquakeAlcon AG, Alcon SA and accompanying tsunami.  Our office in Tokyo reported thatAlcon Inc., all of which are stated in Alcon's Articles of Incorporation (our "Articles of Incorporation") as our employees there were safe and that damage tocorporate name. Alcon was formed for an unlimited duration, effective as of September 21, 2018, the Company's physical assets was not significant todate of the Company on a consolidated basis.  However, damage to the country's energy supplies, infrastructure and distribution channels has been significant and may cause adverse consequencesregistration of Alcon in the future.Commercial Register. As a result we expect thatof Novartis’ Spin-off of Alcon and its consolidated subsidiaries on April 9, 2019, Alcon became an independent, standalone corporation. Alcon’s shares are listed on the SIX and the NYSE under the ticker symbol “ALC”.
Alcon is domiciled in Fribourg, Switzerland and our operationsregistered office is located at Rue Louis‑d’Affry 6, 1701 Fribourg, Switzerland. Our headquarters is located in Japan will be adversely affectedGeneva, Switzerland at the following address: Chemin de Blandonnet 8, 1214 Vernier, Geneva, Switzerland. Our telephone number is +41 58 911 20 00. Our principal website is www.alcon.com. The information contained on our website is not a part of this Form 20‑F.
General Development of Business
Alcon was originally founded in 20111945 by factors that may include reduced sales, increased costspharmacists Robert Alexander and expenses,William Conner, who opened a small pharmacy under the “Alcon” name in Fort Worth, Texas. In 1947, Alcon Laboratories, Inc. was first incorporated and disruptionsbegan manufacturing specialty pharmaceutical products to address ocular health needs. In the operationssucceeding years, Alcon began operating internationally with the opening of our suppliersan office in Canada and business partners.  We are unable to determinefirst formed its surgical division.
In 1977, Alcon was acquired by a Swiss subsidiary of Nestlé S.A. and, consequently, Alcon began operating as a wholly owned subsidiary of Nestlé until 2002. In 2001, the extentname of the impactentity was officially changed to Alcon, Inc. and, on March 20, 2002, Nestlé completed an initial public offering of this event on our operations and financial condition in the future with any level of precision at the date of this report.
Risks Related to Our Relationship with Novartis

We will be controlled by Novartis AG as long as it owns a majority of our common shares, and our other shareholders will be unable to affect the outcome of a shareholder vote during that time.

At December 31, 2010, Novartis AG, a Swiss corporation, owned approximately 77% of our outstanding common shares.  Because Novartis's interests may differ from those of our other shareholders, actions Novartis takes with respect to us may be unfavorable to our other shareholders.  Minority holders of common shares will not be able to affect the outcome of most shareholder votes so long as Novartis owns at least a majority of our outstanding common shares.  So long as it owns at least a majority of our common shares, Novartis will be able to control, among other things, the outcome of shareholder votes relating to the following:  the election and removal of all of our directors; amendments to our Articles of Association; payment of dividends; changes to our capital structure; and appointment and removal of our statutory and group auditors.

On December 14, 2010, Alcon's board of directors approved a merger agreement with Novartis, whereby Novartis will pay a total merger consideration valued at $168 per share for the Alcon shares it does not currently own, comprised of a combination of Novartis shares (or American Depositary Shares in lieu thereof) and, if necessary, a cash contingent value amount to result in a total value of $168 per share.  The merger agreement precludes the payment of dividends by Alcon and contains limitations on our ability to take certain actions without the prior consent of Novartis.  Completion is conditional, among other things, on two-thirds approval by the shareholders of Alcon.  At December 31, 2010, Novartis owned more than the required two-thirds25% of the outstanding common shares of Alcon, Inc. From March 20, 2002 until its 2011 merger into Novartis discussed below, Alcon was publicly listed and has agreed, subject to certain conditions, to vote all of its Alcon shares to approve the merger.

For further detailstraded on the proposed merger, please refer to Item 7.B, "Related Party Transactions" and the Merger Agreement dated December 14, 2010 between Novartis AG and Alcon, Inc., included as Exhibit 4.13 to this report.  Additional information concerning the proposed merger is included in the registration statement on Form F-4 filed by Novartis with the United States Securities and Exchange Commission on December 23, 2010 and subsequent amendments thereto.

Because Novartis controls us, conflicts of interest between Novartis and us could be resolved in a manner unfavorable to us.

Various conflicts of interest between Alcon and Novartis could arise.  For example, ownership interests of directors or officers of Alcon in Novartis shares or service as a director or officer of both Alcon and Novartis could create, or appear to create, potential conflicts of interest when a director or officer is faced with decisions that could have different implications for the two companies, such as disagreement over the desirability of a potential acquisition opportunity, employee retention or recruiting or our dividend policy.
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We cannot assure you that all conditions to the merger will be completed and the merger consummated.

The merger is subject to the satisfaction of closing conditions, including the approval of our and Novartis's shareholders, and we cannot assure you that the merger will be completed.  In the event the merger is not completed, we may be subject to many risks, including the costs related to the proposed merger, such as legal, accounting, and advisory fees, which must be paid even if the merger is not completed.  If the merger is not completed, the market price of our common stock could decline.
Sales or distributions of our common shares by Novartis could depress the market price for our common shares.

Novartis may, at any time, sell all or part of our common shares that it owns or it may distribute those common shares to its shareholders.  There can be no assurance that any of our other shareholders will be included in any transaction in the event Novartis sells its interest in us to another party or that any of our shareholders will realize a premium with respect to their common shares as a result of such transaction or any other disposition of our common shares by Novartis.  In addition, sales or distributions by Novartis of substantial amounts of our common shares in the public market or to its shareholders could adversely affect prevailing market prices for our common shares.  Novartis is not subject to any contractual obligation to maintain its respective ownership positions in our shares.

Risks Related to the Securities Markets and Ownership of Our Common Shares

The price of our common shares may fluctuate.

The market price of our common shares may fluctuate significantly in response to factors, both within and outside our control, such as announcements of innovations and discoveries or new products by us or our competitors, developments concerning intellectual property rights and regulatory approvals, changes in estimates of our financial performance, changes in recommendations by securities analysts and developments with respect to the proposed merger with Novartis.  To the extent that there are sales of substantial amounts of common shares in the public market in connection with or immediately following exercise by the holders of employee stock options or share-settled stock appreciation rights, the market price of our common shares may decrease significantly.

The stock market in general sometimes experiences extreme price and volume fluctuations.  The market prices of securities of pharmaceutical and medical device companies have experienced fluctuations that often have been unrelated or disproportionate to the operating results of these companies.  These market fluctuations could result in extreme volatility in the price of our common shares, which could cause a decline in the value of our common shares.  You should be aware also that for the size of our company, Alcon has relatively fewer shares that trade on a daily basis than other similar companies in our industry.  As a result, price volatility of our shares may be greater when the trading volume of our common shares is low.

Risks Related to Our Jurisdiction of Incorporation

We are incorporated in Switzerland and Swiss law governs our internal corporate affairs.

We are a corporation incorporatedNYSE under the laws of Switzerland.  The rights of holders of our common shares are governed by Swiss corporate law and by our Articles of Association.  In particular, Swiss corporate law limits the ability of a shareholder to challenge resolutions or actions of our board of directors in court.  Shareholders generally are not permitted to file a suit to reverse a decision or action by directors but are permitted to seek damages for breaches of fiduciary duty.  Shareholder claims against a director for breach of fiduciary duty would, as a matter of Swiss law, have to be brought at our place of incorporation in the Canton of Zug, Switzerland, or at the domicile of the involved director.  In addition, under Swiss law, any claims by shareholders against us must be brought exclusively at our place of incorporation.

Under Swiss corporate law, we are required to declare dividends in Swiss francs.  As a result, any currency fluctuations between the U.S. dollar and the Swiss franc will affect the dollar value of the dividends we pay.
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In addition, in several instances we follow Swiss corporate governance practices instead of the corporate governance practices applicable to a U.S. company under New York Stock Exchange ("NYSE") listing standards, as permitted by the NYSE.  A summary of the principal areas of difference is provided under Item 16G, "Corporate Governance."
 ITEM 4.INFORMATION ON THE COMPANY
          A.HISTORY AND DEVELOPMENT OF THE COMPANY

General Information

The entity that is now Alcon, Inc. was originally incorporated in Switzerland in 1971 as Société Fromagère Nestlé S.A., and, after a change of our name to Alcon Universal S.A. in 1978, was registered in the Commercial Register of the Canton of Zug on March 13, 1992.  Effective on December 21, 2001, we changed our name to Alcon, Inc.  We are subject to the laws of Switzerland.  Our principal executive offices are located at Bösch 69, P.O. Box 62, 6331, Hünenberg, Switzerland, and our telephone number is +41-41-785-8888.  Our principal United States offices are located at 6201 South Freeway, Fort Worth, Texas 76134-2099.  The telephone number at those offices is (817) 293-0450 and the fax number is (817) 568-7111.

In this document, "IPO" refers to the initial public offering of approximately 69,750,000 of Alcon's common shares on March 20, 2002.  Prior to the IPO, Alcon, Inc. was a wholly owned subsidiary of Nestlésymbol “ACL”.

Important Events in the History of the Company in 2010

Change of Control and Proposed Merger

On April 6, 2008, Nestlé and Novartis executed the Purchase and Option Agreement pursuant to which Nestlé agreed to sell approximately 74 million of its shares of Alcon common stock to Novartis in a cash transaction at a price of $143.18 per share.  This sale was consummated on July 7, 2008, Nestlé sold to Novartis approximately 25% of the then outstanding Alcon shares and granted Novartis acquired a minority stakean option for Novartis to acquire Nestlé’s remaining shares in Alcon of slightly less than 25% of Alcon's outstanding shares, while Nestlé remained Alcon's majority shareholder with approximately 156 million Alcon shares comprisingbeginning in 2010. On August 25, 2010, Novartis purchased the remaining approximately 52% of the Company'stotal outstanding shares.

The Purchase and Option Agreement between Nestlé and Novartis also contained put and call option rights on the balance of approximately 156 million Alcon shares owned by Nestlé. The option rights commenced on January 1, 2010.  As outlined by the two parties, these rights granted (i) Novartis a call option to buy all but 4.1 million (or 2.5%) of Nestlé's remaining Alcon shares at a fixed price of $181 per share and the 4.1 million shares at the first stage price of $143.18 per share, and (ii) Nestlé a put option to sell to Novartis all but 4.1 million of its remaining Alcon shares to Novartis at the lower of Novartis's call price of $181 per share or a premium of approximately 20.5% above the then-market price of Alcon shares, calculated as the average market price of Alcon shares during the five trading days immediately preceding the exercise date of the put option, with the 4.1 million share balance to be sold at the first stage closing price of $143.18 per share.
For further details on the Purchase and Option Agreement, please refer to the following link at the SEC's web site:  http://www.sec.gov/Archives/edgar/data/1114448/000110465908045488/a08-18409_1ex2d1.htm.

On January 4, 2010, Novartis announced that it had exercised its option toFollowing this purchase, the remaining approximately 156 million Alcon shares owned by Nestlé at a weighted average price of $180 per share in cash, pursuant to the Purchase and Option Agreement.  Upon consummation of the purchase on August 25, 2010, Novartis owned an approximate 77% interest in Alcon with the 23% balance being the publicly traded shares.

The consummation triggered certain change of control provisions in certain retirement plans for Company employees, the Company's share-based awards plan (including the vesting of certain outstanding share-based awards) and other agreements.

Alcon. On January 4,December 14, 2010, Novartis also announced that it submittedentered into a definitive agreement to acquire the remaining 23% of Alcon board of directors a proposal forthrough a merger of Alcon, with andInc. into Novartis in consideration for Novartis shares and a contingent value amount. The merger was consummated on April 8, 2011, creating the Alcon Division within Novartis. In connection with the Novartis acquisition of Alcon, Novartis also merged its then‑existing contact lens and contact lens care unit, CIBA Vision, and certain of its ophthalmic pharmaceutical products into Alcon and moved the generic ophthalmic pharmaceutical business conducted by Alcon prior to be effectedthe merger into the Sandoz Division of Novartis. In 2016, Novartis moved the management and reporting of Alcon ophthalmic pharmaceutical and over‑the‑counter ocular health products to the Innovative Medicines Division of Novartis. Subsequently, effective January 1, 2018, Novartis returned to Alcon the management and reporting of over‑the‑counter ocular health products and certain surgical diagnostic medications previously transferred from Alcon in 2016.
On June 29, 2018, Novartis announced its intention to seek shareholder approval for the Spin‑off of its Alcon Division, following the complete legal and structural separation of Alcon into a stand-alone company consisting of Alcon Inc. and its consolidated subsidiaries. Novartis shareholders approved the Spin-off on February 28, 2019, and the Spin-off transaction was consummated on April 9, 2019. Following the Spin-off, Alcon became a stand-alone, independent company.
Significant Acquisitions, Dispositions and other Events
COVID-19 Pandemic
The COVID-19 pandemic continued to have an impact on our financial results and operations in 2021. The 2021 financial impact and risks are discussed in more detail in this Annual Report, including under Swiss merger law.  Under“Item 5. Operating and Financial Review and Prospects”.
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Significant Investments
In 2012, we began a multi‑year software implementation project to standardize our processes, enhance data transparency and globally integrate our fragmented and aging information technology systems across our commercial, supply and manufacturing operations worldwide, through a new foundation of Systems, Applications and Products in Data Processing ("SAP"), which is an ERP software platform. We expect to pay a total of approximately $808 million relating to the termsimplementation of the merger proposal, holdersnew ERP system. We expect to complete the implementation in early 2023. Through December 31, 2021, the total amount paid with respect to the implementation was $768 million.
In addition, we have made significant investments in certain of our manufacturing facilities to enhance our production capabilities. For more information, see “Item 4.D. Property, Plants and Equipment—Major Facilities”.
Acquisitions
In the past three years, we have also entered into certain acquisition transactions, including (i) the exercise of an option to acquire 100% of the Alconoutstanding shares and equity of Ivantis, Inc. on November 5, 2021, (ii) the acquisition of exclusive US commercialization rights to Simbrinza (brinzolamide/brimonidine tartrate ophthalmic suspension) 1%/0.2% from Novartis on June 8, 2021, and (iii) the acquisition of 100% of the outstanding shares and equity of PowerVision, Inc. on March 13, 2019. For further details on certain of our significant transactions in 2021, 2020 and 2019, see “Note 4 to the Consolidated Financial Statements."
Debt Issuances
In connection with the Spin-off, as discussed in greater detail in "Item 10. Additional Information—10.C. Material Contracts," on March 6, 2019 we entered into the Facilities. See "Item 10.C. Material Contracts—Bridge Loan, Term Sheet and Revolving Credit Facilities" for more information.
On September 23, 2019, AFC issued Senior Notes ("Notes") with maturity dates in 2026, 2029 and 2049, which are guaranteed by the Company. The Notes are unsecured senior obligations of AFC issued in a private placement. The total principal amount of the Notes is $2.0 billion. The Notes were issued at a discount totaling $7.0 million, which was recorded as a reduction to the carrying value of the Notes and will be amortized to Interest expense over the term of the Notes. AFC incurred $15 million of debt issuance costs, which were recorded as a reduction to the carrying value of the Notes and will be amortized to Other financial income & expense over the term of the Notes.
The Notes consist of the following:
Series 2026 Notes - $0.5 billion due in 2026 issued at 99.5%, 2.750% interest is payable twice per year in March and September, beginning in March 2020.
Series 2029 Notes - $1.0 billion due in 2029 issued at 99.6%, 3.000% interest is payable twice per year in March and September, beginning March 2020.
Series 2049 Notes - $0.5 billion due in 2049 issued at 99.8%, 3.800% interest is payable twice per year in March and September, beginning March 2020.
The funds borrowed through the issuance of the Initial Notes were used to repay the $1.5 billion Bridge Facility and $0.5 billion Facility A, both of which had been entered into on March 6, 2019. For more information on the Notes, see Note 17 to our Consolidated Financial Statements.
On May 27, 2020, AFC issued senior notes due in 2030 (“Series 2030 Notes”), which are guaranteed by the Company. The Series 2030 Notes are unsecured senior obligations of AFC issued in a private placement and rank equally in right of payment with the Series 2026, Series 2029 and Series 2049 notes. The total principal amount of the Senior 2030 Notes is $750 million. The Senior 2030 Notes were issued at 99.8% with 2.600% interest payable twice per year in May and November, beginning in November 2020. The Series 2030 Notes were issued at a discount totaling $1 million, which was recorded as a reduction to the carrying value of the Series 2030 notes and will be amortized to Interest expense over the term of the Series 2030 Notes. AFC incurred $5 million of debt issuance costs, which were recorded as a reduction to the carrying value of the Series 2030 Notes and will be amortized to Other financial income & expense over the term of the Series 2030 Notes. For more information on the Series 2030 Notes, see Note 17 to our Consolidated Financial Statements.
Transformation Program
On November 19, 2019, we announced a multi-year transformation program to better align our organizational structure with the scope of Alcon's business operations globally. We created four shared business centers designed to create efficiencies for reinvestment into key growth drivers. We estimate that are publicly traded would receive 2.8 Novartis shares for each Alcon share.
the transformation program will result in total
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22charges of approximately $300 million by 2023. Through December 31, 2021, the total expense recognized with respect to the transformation program was $169 million.
Additional Information
The proposed merger would be contingent upon, amongSEC maintains an Internet website at www.sec.gov that contains reports, proxy and information statements and other things, approval byinformation regarding companies that file documents electronically with the Alcon board of directors.  Alcon's Independent Director Committee believes Alcon's Organizational Regulations provide thatSEC. Our Internet website is www.alcon.com. The information included on our internet website or the Alcon board of directors may only approve the proposed merger if a majority of the Independent Director Committee so recommends; however, we cannot predict the outcome of any proceedinginformation that might be initiatedaccessed through such website is not included in this Annual Report and is not incorporated into this Annual Report by reference.
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4.B. BUSINESS OVERVIEW
Overview
Alcon is the global leader in eye care with $8.2 billion in net sales during the year ended December 31, 2021. We research, develop, manufacture, distribute and sell a full suite of eye care products within two key businesses: Surgical and Vision Care. Based on sales for the year ended December 31, 2021, we are the number one company by global market share in the ophthalmic surgical market and in the vision care market. We employ over 24,000 associates from more than 100 nationalities, operating in 60 countries and serving consumers and patients in over 140 countries. We believe our market leading position and global footprint allow us to interpretbenefit from economies of scale, maximize the potential of our commercialized products and pipeline and will permit us to effectively grow the market and expand into new product categories.
Our Surgical business is focused on ophthalmic products for cataract surgery, vitreoretinal surgery, refractive laser surgery and glaucoma surgery. Our broad surgical portfolio includes implantables, consumables and surgical equipment required for these procedures and supports the end-to-end needs of the ophthalmic surgeon. Our Vision Care business comprises daily disposable, reusable and color-enhancing contact lenses and a comprehensive portfolio of ocular health products, including products for dry eye, ocular allergies, glaucoma, and contact lens care, as well as ocular vitamins and redness relievers. Alongside our world-class products, Alcon provides best-in-class service, training, education and technical support for our customers.
Our Surgical and Vision Care businesses are complementary and benefit from synergies in research and development, manufacturing, distribution and consumer awareness and education. This allows us to position ourselves as a trusted partner for eye care products across the continuum of care from retail consumer, to optometry, to surgical ophthalmology. For example, in research and development, we can apply our expertise in material and surface chemistry to develop innovative next-generation products for both our IOL and contact lens product lines. Similarly, our global commercial footprint and expertise as a global organization provide us with product development, manufacturing, distribution and commercial promotion and marketing knowledge that can be applied to both of our businesses.
We are dedicated to providing innovative products that enhance quality of life by helping people see brilliantly. Our strong foundation is based on our longstanding success as a trusted brand, our legacy of industry firsts and advancements, our leading positions in the markets in which we compete and our continued commitment to substantial investment in innovation. With more than 75 years of history in the ophthalmic industry, we believe the Alcon brand name is synonymous with innovation, quality, service and leadership among eye care professionals worldwide.
Our Markets
Overview
We currently operate in the global ophthalmic surgical and vision care markets, which are large, dynamic and growing. As the world population grows and ages, the need for quality eye care is expanding and evolving, and we estimate that the size of the eye care market in which we operate is approximately $27 billion and is projected to grow mid-single digits per year from 2021 to 2026.
Although it is estimated that 90% of all visual impairments are currently preventable, treatable or challenge this position.curable, we operate in markets that have substantial unmet medical and consumer needs. For example, based on market research, it is estimated that there are currently 65 million people with moderate to severe vision impairment due to cataracts, 1.8 billion who suffer from presbyopia, 153 million with uncorrected refractive errors, 146 million with diabetic retinopathy, 103 million living with glaucoma and approximately 1.4 billion who suffer from symptoms of dry eye, among other unaddressed ocular health conditions. In addition, there are 1 billion people living with some form of unaddressed visual impairment, as well as 70% of the global population needing basic vision correction. Below is a brief description of these ocular disorders.

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Our Surgical and Vision Care products are targeted at addressing many of these unmet medical and consumer needs. We expect the surgical and vision care markets to continue to grow, driven by multiple factors and trends, including:
Aging population with growing eye care needs:  A growing aging population continues to drive the increased prevalence of eye care conditions worldwide, as the number of persons aged 60 years or over is expected to more than double by 2050, rising from 962 million globally in 2017 to 2.1 billion in 2050.
Innovation improving the quality of eye care:  Technology innovation in eye care is driving an increased variety of products that more effectively treat eye conditions. The importance of vision correction and preservation, the high return on healthcare spend and the improved patient outcomes are leading to increased coverage and reimbursement opportunities from governmental and private third-party payors, expanding patient access to such eye care products.
Increasing wealth and growth from emerging economies:  It is estimated that by 2030 the global middle class population could exceed 5 billion people with the majority of growth coming in emerging markets. This major demographic shift is generating a large, new customer base with increased access to eye care products and services along with the resources to pay for them. The expansion of training opportunities for eye care professionals in emerging markets is also leading to increased patient awareness and access to premium eye care products and surgical procedures, facilitating their growth.
Increasing prevalence of myopia, progressive myopia and digital eye strain:  It is estimated that by 2050, half of the world's population (nearly five billion people) will be myopic. Further, the modern work environment, along with leisure preferences, have increased the number of hours people spend in front of a screen, adversely impacting vision and increasing the risk of progressive myopia and digital eye strain.
The Independent Director Committee was formedSurgical Market
The surgical market in 2008which we operate is estimated to be $11 billion and is projected to grow mid-single digits per year from 2021 to 2026. The surgical market includes sales of implantables, consumables and surgical equipment, including associated technical, clinical and service support and training. Surgical implantables are medical devices designed to remain in connection with Novartis's initial purchase of slightly less than 25% of the Alcon shares from Nestlé to evaluate transactionseye, such as monofocal and AT-IOLs placed in the merger proposed by Novartis.  The Independent Director Committee engaged independent financial and legal advisors in connection with its evaluation of the proposed merger.  On January 20, 2010, the Independent Director Committee issued its formal response rejecting the Novartis merger proposal.  The committee rejected the merger proposal based on its assessment that the price offeredeye during cataract surgery. Consumables include hand-held instruments, surgical solutions, equipment cassettes, patient interfaces and other terms were not acceptabledisposable items typically used during a single ophthalmic surgical procedure. Finally, surgical equipment includes multi-use surgical consoles, lasers and that Novartis's merger proposal was not in the best interests of Alcondiagnostic instruments used across procedures to enable surgeons to visualize and its minority shareholders.
Merger Agreement of December 14, 2010

On December 15, 2010, Alcon announced that its board of directors approved a merger agreement with Novartis, whereby Novartis will pay a total merger consideration valued at $168 per share for the Alcon shares it does not currently own.  Under the terms of the deal, the merger consideration will be comprised of a combination of Novartis shares (or American Depositary Shares in lieu thereof) and, if necessary, a cash contingent value amount to result in a total value of $168 per share.  The exact exchange ratio and cash contingent value amount will be calculated based upon formulas set forth in the merger agreement.

In accordance with Alcon's Organizational Regulations and after receiving a fairness opinion from its independent financial adviser, Greenhill & Co., the Independent Director Committee unanimously recommended approval of the merger agreement to the Alcon board.  The board also received a separate fairness opinion rendered by Lazard Frères & Co. LLC in connection with the transaction.  After considering these items and other appropriate information and factors, the Alcon board approved the merger proposal.

The merger will be effected under Swiss merger law.  Completion is conditional, among other things, on two-thirds approval by the shareholders of both Novartis and Alcon voting at their respective meetings, and the registration and listing of Novartis shares and American Depositary Shares to be issued as merger consideration on the SIX Swiss Exchange and the New York Stock Exchange, respectively.  At December 31, 2010, Novartis owned more than the required two-thirds of the outstanding common shares of Alcon and has indicated its intention, subject to certain conditions, to vote all of its Alcon shares to approve the merger.  The mergerconduct ophthalmic surgeries. Market growth is expected to be completeddriven mainly by:
An aging population causing increased global demand in cataract and vitreoretinal procedures;
Higher uptake of premium patient-pay technologies, such as where AT-IOL penetration is only 10% outside the US versus 19% in the US;
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Increased adoption of advanced technologies, such as improved diagnostic instruments, surgical options for glaucoma management and the growing use of phacoemulsification during cataract removal, which is utilized in 65% of cases in emerging markets versus over 95% in the US; and
The increasing prevalence of diabetes, the incidence of which has nearly doubled from 4.7% in 1980 to 8.5% in 2014, and for which eye disease is a comorbidity.
The Vision Care Market
The vision care market in which we operate is estimated to be $16 billion and is projected to grow mid-single digits per year from 2021 to 2026. The vision care market is comprised of products designed for use by eye care professionals and consumers. Products are largely categorized across two product lines: contact lenses and ocular health. Market growth is expected to be driven mainly by:
Fast growing daily disposable contact lens and premium reusable lens segment fueled by better material, improved health and comfort and enhanced vision acuity;
Advancements in specialty lenses combined with increasing demand for toric, multifocal and cosmetic lenses, which command an approximately 15-30% pricing premium over spherical lenses, allowing patients to continue wearing contact lenses as they become older and helping to expand the market;
A significant population of approximately 194 million undiagnosed dry eye patients, with an additional 42 million self-diagnosed dry eye patients using unsuitable products for treatment, and advances in diagnostics and ocular health treatments, facilitating the increase in patient awareness of dry eye and treatment;
Growing access and consumption of vision care products in emerging markets such as Asia, which had an estimated single-digit contact lens penetration as compared to double digits in the developed world; and
Increasing consumer access through the expansion of distribution models, including internet sales and other direct-to-consumer channels.
Our Business
Overview
With $8.2 billion in net sales during the first half of 2011.

Upon completion of the merger, Alcon will become the second largest division within Novartis.  Novartis has proposed that its CIBA VISION operations and select Novartis ophthalmic products will be integrated into Alcon.

For further details on the proposed merger, please refer to Item 7.B, "Related Party Transactions" and the Merger Agreement dated December 14, 2010 between Novartis AG and Alcon, Inc., included as Exhibit 4.13 to this report.
Additional information concerning the proposed merger is included in the registration statement on Form F-4 filed by Novartis with the United States Securities and Exchange Commission on December 23, 2010 and subsequent amendments thereto.

Capital Expenditures, Acquisitions and Divestitures for the Last Three Years (January 1, 2008 through December 31, 2010):

The Company's capital expenditures for property, plants and equipment, to expand and upgrade manufacturing facilities, research and development facilities and other infrastructure, for the yearsyear ended December 31, 2010, 2009 and 2008 were $309 million, $342 million and $302 million, respectively.

In 2009,2021, we broke ground to build a facilityare the global leader in Singapore that will manufacture pharmaceuticals to be distributed throughout most of Asia.  Initial construction has been completed, and we plan for the 331,000 square foot facility to be fully functional in 2012.
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LenSx Acquisition

On August 18, 2010, the Company acquired 100% of the outstanding common shares of LenSx Lasers, Inc.  LenSx is a privately held company that has developed the first femtosecond laser to receive U.S. Food and Drug Administration clearance for use as a complementary technology in cataract surgery.  The LenSx® laser enables surgeons to perform specific steps of the traditional cataract procedure with micron-level laser precision, including anterior capsulorhexis, phacofragmentation and the creation of certain corneal incisions.  Without this technology, these steps are done manually with surgical instruments.

The Company paid $367 million in cash at closing to LenSx shareholders for their shares.  The acquisition also provides for maximum contingent payments of $383 million based upon the achievement and over-achievement of future femtosecond unit and procedure fee revenue milestones.  The Company recorded, as part of the purchase price, $72 million for the estimated fair value of the contingent consideration and $12 million in cash paid to a LenSx shareholder for an intangible asset integral to the purchase.

Note 18 to the consolidated financial statements provides more information on this acquisition.

Sirion Asset Purchase

In the first quarter of 2010, we also purchased certain intangible assets from Sirion Holdings, Inc.  The intangible assets included the technology and licenses to manufacture, market and sell DUREZOL® ophthalmic steroid for post-surgical ocular pain and inflammation.

Optonol Acquisition

In January 2010, we acquired Optonol, Ltd., a medical device company that develops, manufactures and markets novel miniature surgical implants used to lower intraocular pressure in patients with glaucoma.  With this acquisition, Alcon acquired Optonol's EX-PRESS® glaucoma filtration device.  This medical device complements Alcon's pharmaceutical products that lower intraocular pressure in patients with glaucoma and ocular hypertension and has been additive to the Company's growth.

The device is currently reimbursed in the U.S by Medicare and other payors, and it is also approved and currently marketed in Europe, Canada, Australia and several other countries.  Because the product is already approved in the United States and other major markets, it began contributing commercially in the first quarter of 2010.

ESBATech Acquisition

On September 15, 2009, the Company acquired ESBATech AG, a Swiss biotechnology company.  The Company paid ESBATech shareholders $150 million in cash at closing and may pay possible contingent payments of up to $439 million based upon the achievement of future research and development milestones that would be expected to create value for Alcon.  The Company recorded, as part of the purchase price, the estimated fair value of $71 million related to the contingent payments.  This valuation was based on the Company's estimates of the probability and timing of these contingent payments.

ESBATech is a clinical-stage biotechnology company that has been developing a pipeline of proprietary single-chain antibody fragment therapeutics for topical and local delivery for safe and convenient therapy.  ESBATech has advanced its antibody fragment technology to preclinical and clinical stages in the eye for various diseases.  The company has several stable and soluble single-chain antibody fragments in development, with its most advanced product candidate progressed into Phase I and II studies relating to the treatment of inflammatory ocular diseases.

The acquisition included all rights to ESBATech's technology for therapeutic application to the eye, including age-related macular degeneration, diabetic macular edema, glaucoma, dry eye and uveitis.  Substantially all of the employees of ESBATech joined Alcon.  The ESBATech acquisition expanded Alcon's research capability outside of small molecules to the field of proteins, antibodies and other large molecules.  This subsidiary has been converted and renamed, "ESBATech, an Alcon Biomedical Research Unit GmbH."
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Note 18 to the consolidated financial statements provides more information on this acquisition.
WaveLight Acquisition

On November 9, 2007, Alcon completed a voluntary tender offer for WaveLight AG, a German company, culminating in Alcon's acquisition of 77.4% of the issued shares of WaveLight.  In the fourth quarter of 2008, Alcon acquired additional shares of WaveLight.  WaveLight develops, manufactures and markets innovative refractive laser and diagnostic systems, including the ALLEGRETTO laser system for refractive eye surgery.

On March 4, 2009, a Domination Agreement was registered and became effective.  The Domination Agreement allowed Alcon to instruct WaveLight with regard to operational and financial matters, as well as the efficient integration of both companies.  Seventy-nine shareholders have filed applications for appraisal proceedings against the Company relative to the cash compensation and guarantee dividend offered in the Domination Agreement.  So far no court hearing has been scheduled.

In October 2009, the German requirements were met to complete the acquisition of the outstanding minority shares of WaveLight by way of a "squeeze-out."  As a result, WaveLight became wholly owned by the Company, and the listing of the shares of WaveLight was terminated.  One hundred shareholders have filed applications for appraisal proceedings against the Company relative to the cash compensation offered in the course of the "squeeze-out."  So far no court hearing has been scheduled.

Before the end of 2009, the Domination Agreement was terminated by way of a mutual agreement between Alcon, Inc. and WaveLight AG.  In addition the shares held in WaveLight were transferred to Alcon Refractive Horizons, LLC.  On April 15, 2010, the legal form of WaveLight AG, a stock corporation under German law (AG), was changed to a limited liability company under German Law (GmbH).

Capital Expenditures, Acquisitions and Divestitures Currently Underway:

In 2010, capital expenditures were made to add manufacturing capacity and upgrades to our Fort Worth, Texas, Puurs, Belgium, Huntington, West Virginia, Cork, Ireland, Kaysersberg, France, Houston, Texas, and Sinking Spring, Pennsylvania, manufacturing facilities and to continue construction of a new manufacturing plant in Singapore.  Capital expenditures were also made to upgrade and expand our research and development facilities and administrative facilities in Fort Worth and in Zurich, Switzerland (ESBATech).  We had capital expenditure commitments of $53 million at December 31, 2010.  We expect to fund these capital projects through operating cash flow and, if necessary, short term borrowings.

The Company has not announced any other acquisitions or divestitures subsequent to December 31, 2010.

B.          BUSINESS OVERVIEW

Alcon is a research and development driven, global medical specialty company predominantly focused on eye care.  We develop, manufacture and market pharmaceuticals, surgical equipment and devices and consumer eye care products to treat primarily diseases and disorders of the eye. Our broad range of products represents one of the strongestmost complete portfolios in the ophthalmic industry.  industry and comprises high-quality and technologically advanced products across all major product categories in the surgical and vision care markets. Our Surgical and Vision Care products are used in treating multiple ocular health conditions and offer leading eye care solutions for patients throughout their lives.
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Our leadership position across most of our product categories enhances our ability to extend our product offering through the launch of new and innovative products and to expand our geographic reach into ophthalmic markets worldwide. Our Surgical business had approximately $4.7 billion in net sales of implantables, consumables and equipment, as well as services and other surgical products, and our Vision Care business had approximately $3.5 billion in net sales of our contact lens and ocular health products, during the year ended December 31, 2021.

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We believe the Alcon brand name is synonymous with innovation, quality, service and leadership among eye care professionals worldwide. In each of our markets, we rely on our strong relationships with eye care professionals and consumers to attract and retain customers and expand the market. We customize our selling efforts with the goal of surrounding eye care professionals with Alcon representatives who can help address each aspect of a customer's needs. Our field force supplements the direct promotion of our products by providing customers with access to clinical education programs, hands on training, data from clinical studies and technical service assistance.
We have 18 state-of-the-art manufacturing facilities that employ our proprietary technologies and know-how. We believe our global footprint, knowledge base in manufacturing, state-of-the-art facilities and capacity planning enable us to handle increased levels of product demand and product complexity. Furthermore, our global manufacturing and supply chain allows us to leverage economies of scale and reduce cost per unit as we ramp up production.
We have also made one of the largest commitmentcommitments to ophthalmic research and development of any surgical and vision care company, with over 1,400 associates worldwide researching and developing treatments for vision conditions and eye diseases, and have sought innovation from both internal and external sources. In 2021, we invested $842 million in research and development. In addition to our in-house research and development capabilities, we also consider external innovation opportunities and routinely screen for companies developing emerging technologies that we believe could enhance our existing product offerings or develop into innovative new products. We intend to continue to pursue acquisition, licensing and collaboration opportunities as part of our goal of remaining a market leader in innovation.
Our Surgical Business
We hold the number one position in the global surgical market, offering implantable products, consumables and equipment for use in surgical procedures to address cataracts, vitreoretinal conditions, refractive errors and glaucoma. Our Surgical business has the most complete line of ophthalmic surgical devices in the industry, creating a "one-stop shop" for our customers that we consider to be a key differentiator for our business. For the year ended December 31, 2021, our Surgical business had $4.7 billion in net sales.
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Our Vision Care Business
Our Vision Care business consists of an extensive portfolio of contact lens and ocular health products, aimed at helping consumers see better. Our product lines include daily disposable, reusable and color-enhancing contact lenses. We also offer a comprehensive portfolio of ocular health products, including products for dry eye, glaucoma, contact lens care and ocular allergies, as well as ocular vitamins and redness relievers. With $3.5 billion in vision care net sales for the year ended December 31, 2021, we aim to continue to innovate across our vision care portfolio to improve the lives of consumers and eye care professionals around the world.
Our Strengths
We have a strong foundation based on robust industry expertise, leading brands and excellence in customer service, backed by more than 75 years of history as a trusted brand. Our strengths include:
Global leader in highly attractive markets with the most complete brand portfolio.  With $8.2 billion in net sales in the year ended December 31, 2021, we are the leader in an attractive eye care market, which is supported by favorable population megatrends and is expected to grow mid-single digits per year from 2021 to 2026. Our Surgical business is the market leader in sales of ophthalmic equipment used in the operating room and is supported by the largest installed base of equipment worldwide, which we use to cross-promote our surgical consumables and IOLs. In our Vision Care business, our extensive portfolio of contact lens and ocular health products includes well-recognized brands such as TOTAL, Precision, Systane, Pataday and Opti-Free. We believe our global leadership position and extensive brand portfolio allow us to benefit and build on the robust fundamentals driving growth in our markets.
Innovation-focused with market leading development capabilities and investment.  We have made one of the largest commitments to research and development in the eye care market, with proven research and development capabilities in the areas of optical design, material and surface chemistry, automation and equipment platforms. Currently, we employ over 1,400 individuals dedicated to our research and development efforts, including physicians, doctors of optometry and PhDs. In addition, we actively seek opportunities to collaborate with third parties on advanced technologies to support our eye care business.
Global scale and reach supported by high-quality manufacturing network.  We have an extensive global commercial footprint that provides us with the scale and reach to support future growth, maximize the potential of new launches, enter new geographies efficiently and to take advantage of the large, dynamic and growing surgical and vision care markets. Our commercial footprint, which includes operations in 60 countries, reaches consumers and patients in over 140 countries and is supported by over 3,500 sales force associates, 18 state-of-the-art manufacturing facilities employing our proprietary technologies and know-how and our extensive global regulatory capability. Our extensive sales and distribution network, supported by our market leadership position and focus on innovation and customer experience, enhances our ability to expand our geographic reach and extend our product offerings through the launch of new and innovative products worldwide.  Currently,
Outstanding customer relationships and a trusted reputation for customer service, training and education. We believe that maintaining the highest levels of service excellence in our customer experience is a critical success factor in our industry. In our Vision Care business, we regularly meet with eye care practitioners to gain feedback and insights on our products and consumers' needs. We also provide training support at over 70 state-of-the-art interactive training centers around the world, as well as through numerous digital and event-based training programs that we provide for practitioners, clinical support staff, students, residents, patients and consumers. In each of our businesses, we have built and maintained our relationships with key stakeholders to establish our trusted reputation in the industry.
World leading expertise in eye care led by a first-class management team.  Our expertise in eye care is driven by our more than 75-year history in the industry and is supported by a high-quality workforce of more than 24,000 associates. We believe our institutional knowledge provides a competitive advantage because our associates' industry expertise, relationships with our customers and understanding of the development, manufacture and sale of our products helps us to better identify new customer needs, assess markets for entry and identify promising technologies. In addition, we believe the diverse experience of our management team in running complex businesses allows them to add significant value to our company. In particular, we benefit from having a management team with an extensive background in the eye care industry. Led by David J. Endicott, our Chief Executive Officer, our management team's deep knowledge of eye care has created excitement among our workforce for our mission.

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Our Strategy
Our going-forward strategy builds on five key pillars in order to generate sustainable and profitable growth:
Maximize the potential of our near-term portfolio by growing key products.  In Surgical, we plan to maintain our leading position in the IOL market as we launch our AT-IOLs on our new Clareon platform. In addition, we expect improved diagnostics and new optical designs will address historical barriers to AT-IOL adoption to further grow this patient-pay market. We will also continue to invest behind our presbyopia-correcting products (e.g., PanOptix, Vivity), execute on the development of our next generation equipment ecosystem for the operating room and office, leading to integration and intra-operability, and expand our reach in surgical glaucoma with the newly acquired Hydrus microstent. In Vision Care, we intend to maintain and grow our leading position in most of our product categories through increased eye care professional and consumer education, supported by continuous production innovation. We intend to expand our position in the daily disposable category behind our DAILIES TOTAL1 and PRECISION1 family of products and trade patients up to a premium offering in the reusable segment with TOTAL30. We also aim to expand the dry eye product market by leveraging our well-recognized Systane family of eye drops and increasing investment in dry eye education and awareness, as well as address the allergy relief market with the Pataday family of products, where we see a significant unmet need and an opportunity for robust market growth.
Accelerate innovation and deliver the next wave of technologies.  We are soldcommitted to accelerating innovation by continuing to be one of the market leaders in over 180 countries,investment in ophthalmic research and development. The research and development activities of our Surgical business are focused on expanding our AT-IOL portfolio to optimize the function of the IOL in restoring vision and reducing outcome variability, including through the use of advanced optics, adjustable materials and accommodating lenses. We are also developing next-generation lasers, robotics and other equipment for cataract, vitreoretinal and laser-refractive surgery, as well as improved visualization equipment. In our Vision Care business, our focus is on developing and launching new contact lens materials, coatings and designs to extend our product lines and improve patient comfort, as well as on new products to expand our portfolio of dry eye diagnostic and treatment, presbyopia and ocular health products. Finally, we expect to continue to supplement our internal innovation investments by identifying and executing on attractive BD&L opportunities with leading academic institutions and early-stage companies.
Capture opportunities to expand markets and pursue adjacencies.  We believe there is a significant opportunity for growth in markets around the world due to under-penetration of both premium surgical devices, such as AT-IOLs, and of our Vision Care portfolio. We intend to facilitate this growth by continued investment in promotion and customer education across all of our markets. In emerging markets in particular, we believe that the growing number of eye care professionals and dedicated eye hospitals, increased levels of affluence, improving technology access and better patient awareness will increase the adoption of our products. By acquiring Ivantis, Inc. in early 2022, we expanded our Surgical portfolio to include the Hydrus microstent, a minimally invasive glaucoma surgery (or MIGS) device for the treatment of mild-to-moderate glaucoma. In addition, we believe we have significant opportunities to expand into adjacent product categories in which Alcon has not significantly participated in the past, through a combination of internal development efforts and potential mergers and acquisitions activity. These opportunities include pharmaceuticals, office-based diagnostics, surgical visualization and consumer driven ocular health products, where we expect our eye care expertise and global commercial footprint will allow us to attract and retain new customers.
Support new business models to expand customer experience.  In Surgical, we intend to continue to identify new business models that benefit healthcare providers and improve access to leading Alcon products and technologies. For example, we are presentpursuing value-based business models that reward improved patient outcomes, as well as models that contract the entire procedure versus individual products. In Vision Care, where e-commerce entries have created some disruption of traditional sales channels, we believe that digital technology can address pain points experienced in everyexisting paths to purchase. We intend to continue investing and innovating in digital capabilities to develop new business models in response to channel shifts and the increase in direct-to-consumer influence.
Leverage infrastructure to improve operating efficiencies and margin profile over time.  With the significant marketorganizational and infrastructure investments we have made over the last several years, we believe we have established a stable foundation that will allow us to continue to enhance the productivity of our commercial resources. We expect to drive significant top line growth and increase operating leverage through improved sales mix, further supply chain efficiency initiatives and support new lower-cost manufacturing platforms to meaningfully improve our core operating income margins over time.

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Our Industry
Selected Conditions that are Treated by Eye Surgery and Surgical Products
Cataracts
A cataract is the progressive clouding of the normally transparent natural lens in the eye. This clouding is usually caused by the aging process, although it can also be caused by heredity, diabetes, environmental factors and, in some cases, medications. As cataracts grow, they typically result in blurred vision and increased sensitivity to light. Cataract formations occur at different rates and may affect one or both eyes. Cataract surgery is one of the most frequently performed surgical procedures. According to the National Eye Institute, cataracts are the leading cause of blindness worldwide even though effective surgical treatment exists. Currently, surgical removal of the clouded lens followed by insertion of a transparent artificial replacement lens, called an IOL, is the preferred treatment for cataracts. The clouded lens is usually removed through a process known as phacoemulsification. During phacoemulsification, an ophthalmic surgeon makes a small surgical incision in the cornea (approximately 2-3 millimeters wide) and inserts an ultrasonic probe that breaks up, or emulsifies, the clouded lens while a hollow needle removes the pieces of the lens. Once the clouded lens is removed, the surgeon inserts an intraocular lens through the same surgical incision. An AT-IOL is a type of IOL that also corrects for refractive errors, like presbyopia and astigmatism.
Retinal Disorders
Vitreoretinal procedures involve surgery on the back portion of the eye, namely the retina and surrounding structures. Vitrectomy is the removal of the gel-like substance, known as vitreous, that fills the back portion of the eye. Removal of the vitreous allows a vitreoretinal surgeon to operate directly on the retina or on membranes or tissues that have covered the retina. These procedures typically treat conditions such as diabetic retinopathy, retinal detachment or tears, macular holes, complications of surgery on the front of the eye, diabetic macular edema, trauma, tumors and pediatric disorders. Vitreoretinal surgery can also involve electronic surgical equipment, lasers and hand-held microsurgical instruments as well as gases and liquids that are injected into the eye.
Refractive Errors
Refractive errors, such as myopia, commonly known as near-sightedness, hyperopia, commonly known as far-sightedness, and astigmatism, a condition in which images are not focused at any one point, result from an inability of the cornea and the lens to focus images on the retina properly. If the curvature of the cornea is incorrect, light passing through it onto the retina is not properly focused and a blurred image results. For many years, eyeglasses and contact lenses were the only solutions for individuals afflicted with common visual impairments; however, they are not always convenient or attractive solutions. Laser refractive surgery offers an alternative to eyeglasses and contact lenses. Excimer lasers, which are low-temperature lasers that remove tissue without burning, are currently used to correct refractive errors by removing small amounts of tissue to reshape the cornea. These lasers remove tissue precisely without the use of heat and without affecting the surrounding tissue. In the LASIK procedure, the surgeon uses either a femtosecond laser or an automated microsurgical instrument, called a microkeratome, to create a thin corneal flap that remains hinged to the eye. The corneal flap is then folded back and excimer laser pulses are applied to the exposed layer of the cornea to change the shape of the cornea. The corneal flap is then returned to its normal position. LASIK has become the most commonly practiced form of laser refractive surgery globally.
Presbyopia
Presbyopia occurs when the natural crystalline lens inside the eye becomes less flexible and loses the ability to focus on close objects. Presbyopia is a vision condition that accompanies the natural aging process of the eye. It cannot be prevented and affects nearly two billion people worldwide. Although the onset of presbyopia among patients may seem to occur suddenly, generally becoming noticeable when patients reach their mid- to late 30s or early to mid-40s, sight reduction typically occurs gradually over time and continues for the rest of the patient's life. Some signs of presbyopia include difficulty reading materials held close to the reader, blurred vision while viewing a computer screen and eye fatigue along with headaches when reading. Presbyopia can be accompanied by other common vision conditions, such as myopia, hyperopia and astigmatism. Presbyopia, while most commonly managed with reading glasses, can be addressed surgically by the implantation of an AT-IOL that allows for the correction of presbyopia at the time of cataract surgery.
Glaucoma
Glaucoma, a group of eye conditions that damage the optic nerve, is the second leading cause of blindness worldwide. While elevated intraocular pressure was historically considered to be synonymous with glaucoma, it is now known that
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many patients with glaucoma have normal intraocular pressure. Treating glaucoma is typically aimed at lowering intraocular pressure for patients with normal or elevated pressure.
Most commonly, glaucoma is managed using medication (e.g., drops). For cases requiring additional intervention, laser-based procedures and conventional surgical techniques, such as filtration surgery and tube shunts, have typically been used to lower IOP. Filtration surgeries, such as trabeculectomy, involve the creation of a new channel to drain aqueous humor from inside the eye. Similarly, tube shunts establish a route for fluid to exit through an implanted device. More recently, a new category of device and procedure-based surgical intervention, known as MIGS, has emerged and is experiencing rapid adoption among both glaucoma and cataract specialists.
Selected Conditions and Eye Care Considerations that are Addressed by Vision Care Products
Refractive Errors
Refractive errors such as myopia, hyperopia, astigmatism and presbyopia are commonly addressed by the use of contact lenses. Presbyopia, for example, can be addressed by the use of multifocal contact lenses.
Dry Eye Disease
Dry eye disease is a ubiquitous, complex and multifactorial condition, and its effect on patients ranges from intermittent and irritating discomfort to a serious, chronic, progressive and irreversible vision-threatening disorder. The incidence of dry eyes rises with age, and longer life spans and aging populations throughout the world where ophthalmologyare key contributors to increased demand for treatment. Evolving patterns of work and play also contribute to increased demand for treatment, as more people spend significant amounts of time working on computers and other digital devices. Wealthier, professional and urban population segments are expanding in rapidly emerging economies and other developing nations, and these populations have greater access to health care and more resources with which to acquire treatment. In addition, more sophisticated diagnostic tools and a greater variety of dry eye products and treatments, such as artificial tear products, are offering improved effectiveness and greater relief as they simultaneously stimulate demand.
Infections and Contamination due to Inadequate Contact Lens Care
Proper care of contact lenses through compliance with disinfection regimens is practiced.important in reducing the risk of infection and irritation associated with the use of reusable contact lenses, as contact lenses are subject to contamination from cosmetics, grease, bacteria, soaps, hand lotions and atmospheric pollutants, and from proteins contained in natural tears. When used properly, contact lens care products remove such contaminants from the surface of the contact lens. In 2010, we had salesaddition, lens rewetting drops may be used to rehydrate the lens during wear and to clear away surface material.
Ocular Allergies
Allergic conjunctivitis occurs when the conjunctiva of $7.2 billion, operating incomethe eye becomes swollen from inflammation due to a reaction to pollen, dander, mold or other allergy-causing substances. When the eyes are exposed to allergy-causing substances, which can vary from person-to-person and are often dependent on geography, a substance called histamine is released by the body and causes blood vessels in the conjunctiva to swell. "Allergy eyes" can become red and itchy very quickly. Seasonal Allergic Conjunctivitis ("SAC") is the most common type of $2.5 billioneye allergy. People affected by SAC experience symptoms during certain seasons of the year. Allergy eye can be treated with various ocular health products including medications, such as antihistamines, and net earningscombinations of $2.2 billion.antihistamines and redness relievers.

Our Products

We research, develop, manufacture, distribute and sell eye care products. Our broad range of products represents one of the strongest portfolios in the ophthalmiceye care industry, with high-quality and technologically advanced products across all major product categories.  Our leadership position across most of our product categories enhances our ability to extend our product offerings, through the launch of newin ophthalmic surgical devices and innovative products, and to expand our geographic reachvision care. We are organized into ophthalmic markets worldwide.  We manage our business through two global business segments: Alcon United StatesSurgical and Alcon International.Vision Care.
Surgical
We hold the number one position in the global ophthalmic surgical market, offering implantable products, consumables and equipment for use in surgical procedures to address cataracts, vitreoretinal conditions, refractive errors and glaucoma. Our Surgical portfolio spans three key ophthalmic categories: pharmaceutical,includes equipment, instrumentation and diagnostics, IOLs and other implantables and a broad line of consumables, including viscoelastics, surgical solutions, incisional instruments, surgical custom packs and consumer eye care products.  See notes 10 and 11 to the consolidated financial statements for a three-year history of our sales by segment and category.

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25other products. For the year ended December 31, 2021, net sales for our implantables, consumables and equipment and other surgical products were $1.5 billion, $2.4 billion and $0.8 billion, respectively.
Cataract, vitreoretinal, refractive and glaucoma surgeries are generally performed in hospitals or ambulatory surgery centers and are supported through a network of eye clinics, ophthalmic surgery offices and group purchasing organizations. The primary ophthalmic surgical procedures for cataract, vitreoretinal and glaucoma surgery are broadly reimbursed in most mature markets. Third-party coverage or patient co-pay options are also available for refractive laser correction and AT-IOLs. Finally, a growing private pay market for premium surgical devices provides a mutually beneficial environment for patients, providers and medical device companies by allowing patients to pay the non-reimbursable cost of a procedure associated with selecting premium devices, such as AT-IOLs.
Our Pharmaceutical Products

We are a global leaderinstalled base of equipment is core to our market leading position in ophthalmic pharmaceuticals.  We develop, manufactureour Surgical business, with best-in-class platforms in cataract and market a broad offeringvitreoretinal equipment and the largest installed base of prescription ophthalmic pharmaceutical products.
The following table lists our principal pharmaceutical products:

Ocular Anti-Infectives/
GlaucomaAnti-InflammatoriesOcular AllergyGenericsOtic/Nasal
TRAVATAN®
TRAVATANZ®
TRAVATAN® APS
DuoTrav®
AZARGA®
Azopt®
Betoptic S®
Vigamox®/Vegamox® (1)
Moxeza(1)
TobraDex®
TobraDex® ST
Tobrex®
NEVANAC®
Maxitrol®
DUREZOL®
Patanol®/Opatanol®
Pataday
Timolol GFS
Pred Acetate
Dorzolamide
Dorzolamide/Timolol
Ciprofloxacin
Brimonidine
Trifluridine
Tobramycin/
    dexamethasone
Cipro® HC Otic (1)
CIPRODEX® (1)
Patanase®

(1)  
Cipro® and CIPRODEX® are registered trademarks of Bayer AG, licensed to Alcon by Bayer Schering Pharma AG.  Moxifloxacin, the primary ingredient in Vigamox®, Vegamox® and Moxeza, is licensed to Alcon by Bayer Schering Pharma AG.

Glaucoma Treatment

In 2010,cataract phacoemulsification consoles, vitrectomy consoles and refractive lasers in the industry. These platforms each have long buying cycles that last approximately seven to ten years and act as anchoring technologies that drive recurring sales of our glaucoma products were $1,277 million, or 41.7% of our total pharmaceutical sales.

TRAVATAN® ophthalmic solution competes in the prostaglandin analogue class of glaucoma treatments.  Prostaglandin analogues are the largest class of compounds currently available to reduce intraocular pressure, which is a primary characteristic of glaucoma.  In 2010, we converted in the United States to the exclusive distribution of a newer formulation of TRAVATAN® called TRAVATAN Z® ophthalmic solution.  TRAVATANZ® replaces the preservative benzalkonium chloride ("BAC") with our proprietary SOFZIA® preservative system.  Outside the United States, we also market DuoTrav® ophthalmic solution, which combines the prostaglandin in TRAVATAN® with a beta blocker, timolol.  We received approvalconsumables and commenced the launch of this product in Japan in 2010 to further expand our glaucoma franchise.  Brands containing our proprietary prostaglandin have been launched in more than 100 countries.  Introduction of TRAVATAN® APS ophthalmic solution, which replaces BAC with a commonly used ocular preservative, is planned in 2011 for Europe.

In late 2008, we received approval from the European Medicines Agency to launch AZARGA® ophthalmic suspension, a fixed combination for the treatment of glaucoma containing a topical carbonic anhydrase inhibitor and a beta blocker.  We have launched AZARGA® in most European markets and several other markets outside the United States.  In addition, we offer Azopt® and Betoptic S® ophthalmic suspensions, both of which utilize separate classes of compounds.  Azopt® is a topical carbonic anhydrase inhibitor that has shown to be an excellent adjunctive therapy when used with other glaucoma therapies, including prostaglandin analogues.

These products are important to our glaucoma franchise and currently make up a majority of our glaucoma products sales.  We expect our glaucoma products to continue to contribute to our sales growth.

Anti-Infectives, Anti-Inflammatories and Combination Therapies

We currently manufacture and market a broad range of drugs to treat bacterial, viral and fungal infections of the eye and to control ocular inflammation.  In 2010, combinedhelp cross-promote sales of our ocular anti-infectives, ocular anti-inflammatoriesimplantable devices.
Sustainable patient access to quality eye care is core to our business. Alcon has invested significant resources to innovate new technologies, expand reimbursement pathways (public and/or private insurance) and combination therapies were $980 million, or 32.0%teach new skills to clinicians around the world to improve patient outcomes and eye care access. Across our Surgical portfolio, we sell a tiered offering of our total pharmaceutical sales.

Our leading ocular anti-infective product is Vigamox® ophthalmic solution, utilizing moxifloxacinproducts intended to treat bacterial conjunctivitis.  During 2006, we received approval andmeet the specific needs of customers in markets around the world at different price points. Newly launched Vigamox® in Japan under the trade name Vegamox® ophthalmic solution.  In November 2010, the FDA approved Moxeza 0.5% ophthalmic solution, using
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the same active ingredient as found in Vigamox®, moxifloxacin, to treat bacterial conjunctivitis.  Moxeza is a new formulationofferings that improves bioavailability, provides an increased concentration of drugbring considerable technology innovation to the conjunctiva, thus allowingmarket are typically introduced at a price premium to offset the cost of research and development. As these products age and/or competitive products advance, prices typically trend downward, requiring continuous innovation cycles to maintain and/or grow our margins. We also develop specific products to match customer needs in different customer segments, for twice-daily treatment.  Launchexample, premium-tier and mid-tier surgical consoles that can be manufactured and sold at different price points in different markets. Likewise, we have introduced the Legion system to help fill the gap in access to phacoemulsification surgery. This affordable system brings some of Moxezain the United States is planned for early 2011.
advanced features of the Centurion system, combined with the greater serviceability, durability and portability to developing markets.

alc-20211231_g4.jpg
During 2005, we launched a topical non-steroidal anti-inflammatory drug ("NSAID") in the U.S. market for the treatmentOur strong installed base of painequipment and inflammation associated with cataract surgery.  NEVANAC® ophthalmic suspension is unique because it is a prodrug where the drug is converted to the active ingredient only after it enters the eye.  NEVANAC® was approved in Japan during 2010.

Our combination ocular anti-infective/anti-inflammatory products, TobraDex® ophthalmic suspension and ointment, combine a broad-spectrum antibiotic with a proven anti-inflammatory.  Our exclusive rights to sell TobraDex® in the United States expired as of January 2009 and in most other countries in March 2009.  Both a competitor and our Falcon Pharmaceuticals subsidiary launched generic versions of TobraDex® suspension in early January 2009.  The generic competition for TobraDex® has resulted in a reduction in sales in the United States due to loss in market share and reduced price.  Sales of TobraDex® outside the United States have not been significantly impacted.

In September 2010, we launched TobraDex® ST suspension, a new formulation of tobramycin and dexamethasone that utilizes a new suspension technology incorporating pharmaceutical-grade xanthan gum and requires only half the amount of dexamethasone as our original TobraDex® suspension.  TobraDex®ST suspension offers dual therapy by providing rapid relief for patients who are suffering from inflammation and infection due to acute blepharitis and other conditions involving ocular inflammation and infection or risk of infection.

In 2010, we acquired the rights in the United States for DUREZOL® emulsion, a topical ophthalmic corticosteroid used to treat postoperative inflammation and pain associated with ocular surgery.  DUREZOL® emulsion received approval from the FDA in 2008 and was the first ophthalmic steroid to be approved for both postoperative inflammation and pain.

Ocular Allergy

We market and manufacture products for the treatment of ocular allergies.  In 2010,extensive clinician relationships drive sales of our ocular allergy pharmaceutical products were $539 million, or 17.6%IOLs and consumables. We consider the quality and breadth of our total pharmaceutical sales.  The allergy market is seasonal, peaking inportfolio to be a key differentiator as a "one-stop-shop" offering for our customers, synonymous with quality, reliability and accessibility. Our Cataract Refractive Suite covers every stage of the springsurgical workflow from clinical planning to cataract removal and again, but to a lesser extent, in the fall.post-operative optimization.

Patanol® ophthalmic solution was the first ocular allergy product with a dual-action active ingredient, which acts as both an antihistamine and a mast-cell stabilizer.  During 2006, we received approval and launched Patanol® in Japan, the second largest ophthalmic allergy market.  We have a co-marketing agreement in Japan with Kyowa Hakko Kirin Co., Ltd., a leading Japanese pharmaceutical company, whereby Kyowa promotes Patanol® to non-eye care physicians and we promote the product to eye care physicians.  In February 2007,2013, we launched in the United States the first once-a-day ocular prescription allergy medicine, Pataday ophthalmic solution, which is a new formulation utilizing an increased concentration of olopatadine, the active ingredient in Patanol®.  According to Wolters Kluwer Health Source Prescription Audit, Patanol® and Pataday were the leading ophthalmic topical anti-allergy prescription products in the United States in 2010.  We currently sell Patanol® in more than 95 countries.

Otic/Nasal Products

We also market combination anti-infective/anti-inflammatory products for ear infections.  CIPRODEX® otic suspension, for the treatment of otitis media in the presence of tympanostomy tubes ("AOMT") and of otitis externa, commonly known as swimmer's ear, is marketed in the United States and a small number of countries outside the United States.  In addition, we market Cipro® HC Otic for the treatment of otitis externa in over 30 countries.  Sales of our otic products are seasonal, with a higher percentage of prescriptions written during the summer months.

Patanase® nasal spray was approved by the FDA in April 2008 and currently is marketed in the United States for the relief of the symptoms of allergic rhinitis in patients six years of age and older.

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Generic Pharmaceuticals

We established Falcon Pharmaceuticals in 1994 to manufacture and market generic ophthalmic and otic pharmaceutical products in the United States.  Falcon's sales in 2010 were $200 million, or 6.5% of our total global pharmaceutical sales.  Falcon currently manufactures and markets approximately 35 generic pharmaceutical products.

Falcon's largest product in 2010 was Brimonidine 0.15% for the treatment of glaucoma and accounted for 27% of Falcon's sales.  Alcon has exclusive rights to manufacture and sell this product, which is the sole generic form of Allergan's branded product, Alphagan® P, through January 2022.  Falcon's second largest product, Timolol GFS, was the sole generic pharmaceutical approved by the FDA as an AB therapeutically equivalent substitute for Merck's Timoptic-XE®.  Merck's patent covering Timoptic-XE® expired in September 2006, allowing other generic competitors to receive approval of a therapeutically equivalent version of Timoptic-XE®.  In December 2009, a competitor launched an authorized generic version of Merck's Timoptic-XE®, which negatively impacted our sales and profits in 2010.

In January 2009, Falcon launched a generic tobramycin/dexamethasone combination drug in response to other competitive generics that were introduced to compete with our TobraDex® branded product.  Our generic version comprised almost 16% of Falcon's sales in 2010.

Falcon's other principal generic products include Prednisolone Acetate (used for the treatment of inflammation of the eye), Timolol Solution (for the treatment of glaucoma), Trifluridine (used to treat viral infections of the eye), Dorzolamide and Dorzolamide/Timolol combination (for the treatment of glaucoma), Ketorolac (used to treat allergy and for the eye), Ciprofloxacin (used to treat infections of the eye) and Neomycin and Polymyxin B Sulfates and Hydrocortisone otic and ophthalmic suspension (sterile antibacterial and anti-inflammatory combination products for the treatment of bacterial infections in the ear and the eye, respectively).

Our Surgical Products

We are the global leader in ophthalmic surgical products and manufacture and market the most comprehensive product offering available today.

The following table lists our principal surgical products:

CataractRefractiveVitreoretinalGeneral Surgical
Infiniti®Centurion vision system
Infiniti®, AquaLase® and
OZil® surgical instruments
Infiniti® consumables
Laureate® compact
      phacoemulsification system
LenSx® laser
AcrySof ® intraocular lenses
    - AcrySof®Natural
    - AcrySof®IQ
    - AcrySof®ReSTOR®
    - AcrySof®IQ ReSTOR®
    - AcrySof®Toric
    - AcrySof®IQ Toric
    - AcrySof® IQ ReSTOR® Multifocal Toric
Viscoelastic devices
    - DuoVisc®
    - DisCoVisc®
    - VISCOAT®
    - ProVisc®
ALLEGRETTO WAVE®
Eye-Q 400 Hz laser
ALLEGRO ANALYZER®
    wavefront system
ALLEGRO TOPOLYZER®
    corneal topography
    system
ALLEGRO OCULYZER®
    pentacam diagnostic device
ALLEGRO
    biometry system
AcrySof ®CACHET
    phakic lens
WaveLight® Refractive Suite    EX 500 Excimer 500 Hz laser
FS200 femtosecond laser
CONSTELLATION® surgical system
Accurus® surgical system
Accurus® cassettes and probes, including 23 gauge and  25 gauge vitreoretinal instrumentation
Grieshaber® microsurgical instruments
Perfluoron® liquid
Silikon® 1000 ophthalmic surgical oil
BSS Plus® surgical irrigating solution
Custom Pak® surgical procedure packs
A-OK® surgical knives
EX-PRESS® glaucoma filtration device
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Cataract Surgery

We support our global market leadership in cataract surgical products by providing a comprehensive offering of surgical equipment, single-use and disposable products.  Sales of our products for cataract surgery in 2010 were $2,604 million, or 80.9% of our total surgical sales.  We currently market products for cataract surgery in substantially all of our markets.

The Infiniti® visionsurgery. This system our most advanced lens removalincludes Active Fluidics technology, an automated system has been widely acceptedthat optimizes anterior chamber stability by allowing surgeons around the globe.  Continued customer interest in the Infiniti® vision systems willto proactively set and maintain or expand our position as the worldwide leader in lens removal systems.  The Infiniti® vision system has been advanced continually since its introduction in 2003, with the latest advancement being the addition of the OZil® torsional handpiece in 2006.  OZil® is a proprietary technology utilizing torsional oscillation and ultrasound to more efficiently emulsify the lens.  Many surgeons who have adopted OZil® torsional technology have reported a more efficient, more effective and safer lens removal procedure.  In addition, many customers with existing Infiniti® vision systems chose to upgrade their units with OZil® torsional technology.

Our portfolio of surgical products allows us to compete effectively in developing as well as developed markets.  In late 2007, we launched the Laureate® compact phacoemulsification system as a replacement for the LEGACY® surgical system in selected markets.  The Laureate® provides excellent fluidics and traditional longitudinal ultrasound capabilities and is designed to support surgical procedures and practices in developing markets.

Our comprehensive line of single-use products for cataract procedures includes the cassettes used in the Infiniti®, Laureate® and LEGACY® surgical systems, a full line of viscoelastics to protect delicate tissues oftarget IOP within the eye during the cataract removal procedure, surgical knives and surgical irrigating solutions.thereby delivering an unprecedented level of intraoperative control.
We also sell the LenSx laser system. The Company holds market-leading positions in each of these product lines.

In 2010, we acquired the LenSx® laser system with LenSx Lasers, Inc.  This laser is the first femtosecond laser to receive FDA clearance for use in cataract surgery.  The surgery, LenSx® system is indicated for anterior capsulotomy, phacofragmentation and the creation of single plane and multi-plane arcused to create incisions in the cornea, during cataract surgery, providingcreate a precise laser alternative to certain manual steps withincapsulorhexis and complete lens fragmentation as part of the traditional cataract procedure. The innovative LenSx® laser platformThis enables surgeons to perform some of the most delicate manual steps of cataract surgery with image-guided visualization and micron level laser precision. The LenSx® laser enhances
Our Verion reference unit and Verion digital marker together form an advanced surgical planning, imaging and guidance technology designed to provide greater accuracy and efficiency during cataract surgery. Our ORA System also provides key intra-operative measurements to improve the placement precision of an implanted IOL during cataract surgery, for example, by aligning the rotation of a surgeon's abilitytoric IOL to predictably createthe axis of astigmatism. Post-operatively, our ORA System aids with outcomes analysis and ongoing optimization for improved outcomes.
In 2019, we launched our Argos biometer, which offers an integrated image-guided solution for every step of the surgical process from post-operative measurement to surgical planning and intra-operative guidance for optimal IOL positioning. Argos biometer provides efficient measurement, simplified workflow, precise measurement via swept-source OCT (SS-OCT), and integration with the rest of our cataract refractive suite.
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Finally, the NGENUITY 3D visualization system provides surgeons improved visualization by combining a well-centered anterior capsulorhexis of exact diameter,high-dynamic 3D camera, advanced high-speed image optimization, polarizing surgeon glasses and to effectively fragmentan ultra-high definition 4K OLED 3D display that offers improved depth perception. Within visualization, we also sell theLuxOR surgical ophthalmic microscope with its proprietary ILLUMIN-i technology, which provides an expanded illumination field with a 6x-larger, highly stable red reflex zone.
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An IOL is a tiny, artificial lens for removal with minimized phaco time and power.  In addition, certain corneal incisions can be made with the LenSx® laser system, reducing or eliminatingeye, which replaces the use of knives in theeye's natural lens that is removed during cataract procedure.

surgery. Our AcrySof® intraocular lenses are IOL is the most frequently implanted intraocular lensesIOL in the world. AcrySof® intraocular lenses IOLs are made of the first material specifically engineered for use in an intraocular lens.  More than 50 million AcrySof® intraocular lenses
We have been implanted since introduction.

Our AcrySof®IQ intraocular lens isa longstanding record of innovation within the first intraocular lens to combine an aspheric design with ultraviolet and blue-light-filtering.  This unique combination of technology allows the AcrySof®IQ to provide improved contrast sensitivity and image quality.

IOL market. In 2005, we introduced a new class of lensIOLs to correct presbyopia calledwith our multifocal AcrySof ReSTOR offering. In 2006, we also launched the AcrySof® ReSTOR® +4.0 diopter add power intraocular lens.  This Toric IOL, designed to correct various levels of preexisting astigmatism in cataract patients. In 2009, the AcrySof IQ Toric lens haswas launched globally, incorporating the aspheric technology into a unique optical system that incorporates an apodized diffractive, refractive design that provides distance, near and intermediate vision for the patient following lens removal surgery, thereby significantly reducing the patient's need for or dependence on eyeglasses.  toric design.
In 2007,recent years, presbyopia correction lenses have evolved to include trifocal designs. In 2015, we launched the next advancementAcrySof IQ PanOptix trifocal IOL in this technology withselect markets outside the US. This novel diffractive optic sends light to three foci to support near, intermediate and distance vision. In 2017, the AcrySof® IQ ReSTOR® aspheric intraocular lens.PanOptix Toric lens was launched in select markets outside the US to address both astigmatism and presbyopia. We launched the AcrySof IQ PanOptix trifocal IOL in the US and Japan in 2019. We also launched the AcrySof IQ Vivity non-diffractive extended depth of focus ("EDoF") IOL in Europe and Australia in 2019, in South America in 2020 and in the US in 2021. This lens incorporates aspheric correction designed specificallyoptic design allows for the AcrySof® ReSTOR® apodized diffractive, refractive design.  In 2009, we further enhanced this product with the launch of the AcrySof® IQ ReSTOR® +3.0 diopter add power intraocular lens, which provides an improved fullextended range of vision and presbyopia correction with the visual disturbance profile of a monofocal IOL.
We have also introduced several innovations to the delivery device used for patients.introducing an IOL into the capsular bag during cataract surgery. Our UltraSert pre-loaded IOL delivery system combines the control of a manually loaded device with the safety and convenience of a disposable, pre-loaded injector to optimize the implantation of the AcrySof IQ Aspheric IOL into the cataract patient's eye.

In late 2005 and early 2006,2017, we received regulatory approvalsa European CE Mark for the AcrySof®Toric intraocular lensClareon IOL with the AutonoMe delivery system followed by FDA approval in several major markets, including2020. AutonoMe is the United States.  The AcrySof®Toric intraocular lens is a lensfirst automated, disposable, pre-loaded IOL delivery system that corrects for various levels of pre-existing astigmatism in cataract patients and was launched globally in 2006.  In 2009, we received
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regulatory approvals and launched the AcrySof® IQ Toric, which incorporates the aspheric technology with a toric design.

In 2010, Alcon launched the AcrySof®IQ ReSTOR®Multifocal Toric intraocular lens outside the U.S.  The AcrySof®IQ ReSTOR®Multifocal Toric intraocular lens brings together the multifocal performanceenables precise delivery of the AcrySof® IQ ReSTOR®IOL into the capsular bag in patients undergoing cataract surgery. The new device is being introduced with the precise astigmatism correction of the AcrySof®Toric intraocular lens.  Alcon completed its CE Mark of the AcrySof® IQ ReSTOR® Toric intraocular lens during the second quarter of 2010,Clareon IOL, a new material with an advanced design that enables sharp, crisp vision, low edge glare and this lens is now available in many major markets that recognize the CE Mark.  The Company plans to file a Pre-Market Application ("PMA") for the lens with the FDA in early 2012.

unsurpassed optic clarity.
Our advanced technology intraocular lensesAT-IOLs (those that correct for refractive errors such as presbyopia and astigmatism) provide significant visual benefits to patients above standard monofocal intraocular lenses.  Our pricing strategyIOLs. Accordingly, the price for advance technology intraocular lenses captures this additional value throughthese AT-IOLs is higher pricing.than the price for monofocal styles. This approach impacts the market penetration of advanced technology intraocular lensesAT-IOLs in the majority of countries, as patients must pay incremental charges above the cost of traditional cataract surgery to obtain an advanced technology intraocular lensAT-IOL and, in some markets, must pay out-of-pocket for the entire surgical procedure and the intraocular lens.AT-IOL.

In the US, our monofocal IOLs are generally fully covered by medical insurance providers or government reimbursement programs, whereas certain of our AT-IOLs may only be partially covered. This payment model was established by two landmark rulings issued by CMS in May 2005 and January 2007. The CMS issuedrulings provide Medicare beneficiaries a ruling that allowschoice between cataract patients in the United States to choose an intraocular lens that provides additional refractive benefits through the treatment of presbyopia suchsurgery with a monofocal IOL, which would be reimbursed as the AcrySof®ReSTOR®.  Under this policy, Medicare will reimburse normal amounts under thea covered benefit forunder Medicare, or cataract surgery with an AT-IOL, which would be partially reimbursed under Medicare and patientspartially paid out-of-pocket. Many commercial insurance plans mirror the CMS rulings, although commercial plans may elect to payvary based on third-party payor. The bifurcated payment for the non-covered charges.  In January 2007, CMS issued a similar ruling allowing Medicare beneficiaries to choose an intraocular lens with the added benefitimplantation of treating astigmatism, such as the AcrySof®Toric lens.  These CMS rulings, which allow for bifurcated payment, haveAT-IOLs has increased the market acceptance of our advanced technology intraocular lensesAT-IOLs in the United States.  Such bifurcated systems areUS. Outside the US, payment and reimbursement models vary widely from country to country, generally depending on the policy adopted by the relevant local healthcare authority on coverage and payment.
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To provide convenience, efficiency and value for ophthalmic surgeons, Alcon offers Custom Pak surgical procedure packs for use in ophthalmic surgery. Unlike conventional surgical procedure packs, our Custom Pak surgical procedure packs allow individual surgeons to customize the products included in their pack, which results in less waste in the environment. Our Custom Pak surgical procedure packs include both our single-use products as well as third-party items not generally availablemanufactured by Alcon. We believe that our Custom Pak offering allows ophthalmic surgeons to improve their efficiency in other countries at this time, but we are pursuing effortsthe operating room, while avoiding the complexity and cost of having to expand them.kit surgical items for each respective procedure. We offer more than 10,000 configurations of our Custom Pak surgical procedure packs globally.

Vitreoretinal Surgery

alc-20211231_g7.jpgOur vitreoretinal surgical product offering is one of the most comprehensive in the industry for surgical procedures for the back of the eye. In 2010, sales of our products for vitreoretinal surgery were $424 million, or 13.2% of our total surgical sales.  We are the global market leader in vitreoretinal products, and we currently market our vitreoretinal surgical products in substantially all of the countries in which we sell products.

The Accurus® surgicalFor vitrectomy procedures, we sell our Constellation vision system integrates all automated, non-laser surgical functions used in vitreoretinal surgery.  Some Accurus® models also can be used for cataract removal.  In late 2008, we introduced the CONSTELLATION® surgicalglobally. We believe this system in the United States and other global markets.  The CONSTELLATION® delivers a higher level of control to the physician and more efficiency through higher vitreous cutting rates.  The CONSTELLATION® is also available withrates and embedded laser technology. On May 6, 2010, we commenced a voluntary corrective action on our CONSTELLATION®The Constellation vision system thatplatform continues to drive our market share in the FDA classified as a Class 1 recall.  We submitted a 510(k) application to the FDA requesting approvalglobal premium segment of software and hardware modifications to the system.  In November 2010, we received a clearance letter from the FDA on our application.  This action did not have a material impact on our financial results.vitrectomy packs.

In addition to the CONSTELLATION® and Accurus®,our Constellation vision system, we also sell a full line of vitreoretinal products, including surgical therapeutics,procedure packs, lasers ultrasound diagnostics and hand-held microsurgical instruments, as well as our Grieshaber and MIVS lines of disposable retinal surgery instruments. We also sell a full line of scissors, forceps and micro-instruments in varying gauge sizes, as well as a range of medical grade vitreous tamponades, which replace vitreous humor during many retinal procedures.
We continue to advance our portfolio with smaller gauge (27+) instruments and higher cut speed vitrectomy probes. We also sell Hypervit high speed vitrectomy probes, which operate at a speed of 20,000 cuts per minute ("cpm"). This increased speed helps reduce traction that can cause iatrogenic tears and post-operative complications.
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Our refractive products include lasers, disposable patient interfaces used during laser vision correction procedures, technology fees and diagnostic devices necessary to plan the refractive procedures. Our WaveLight refractive suite includes the EX500 excimer laser, designed to reshape the cornea, and the FS200 femtosecond laser, designed to create a corneal flap and to deliver laser refractive therapy as part of the LASIK refractive procedure.
We also launched Contoura Vision, a topography-guided LASIK treatment designed to provide surgeons with the ability to perform more personalized laser procedures for patients with near-sightedness, or near-sightedness with astigmatism. This procedure is based on the unique corneal topography of each eye, as measured through the WaveLight Topolyzer VARIO diagnostic device.

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In 2004, we2018, the Hydrus microstent device was launched a series of instruments for use in new small gauge (25 gauge) posterior segment surgical procedures.  We have continued our development in this area by expanding our micro-incision technology product offering in the fourth quarter of 2006US by launching a new 23 gauge system of consumable products for posterior segment procedures.  These new offerings enhanced our Accurus® and CONSTELLATION® consumable products portfolio.

Custom Pak® Surgical Procedure Packs

To provide convenience, efficiency and value for ophthalmic surgeons,Ivantis, which we have developed the Custom Pak® surgical procedure pack.  We market our Custom Pak® for cataract, refractive and vitreoretinal surgical procedures.  Unlike conventional surgical procedure packs, the Custom Pak® allows ophthalmic surgeons and their staff to customize and sequence the products includedacquired in the surgical procedure pack.  For a single price, our Custom Pak®
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includes our single-use products required for the procedure, combined with products not manufactured by Alcon.  We believe that our Custom Pak® allows ophthalmic surgeons to improve their efficiency in the operating room, and this gives us the opportunity to provide access to our single-use products in a value-added package.
Glaucoma Filtration Devices

In early 2010, Alcon finalized its acquisition of Optonol, Ltd., a medical device company that develops, manufactures and markets the EX-PRESS® glaucoma filtration device.  This technology2022. Hydrus is approved and marketed in the United States,US, UK, Germany, Canada, Australia and Signapore. The microstent is implanted into the Schlemm's canal to enhance outflow, reducing eye pressure for the treatment of primary open angle glaucoma (POAG).
Our EX-PRESS glaucoma filtration device is approved and marketed for refractory glaucoma in the US, Europe, Canada, Australia and several other markets. The device is a novel miniature surgical implant designed to lower intraocular pressure in patients with open-angle glaucoma.  With an external diameter of 400 microns and an overall length of just 2.64 mm, theThis shunt is implanted under the scleral flap to enhance outflow of aqueous humor and reduce intraocular pressure.pressure in patients with open-angle glaucoma. The EX-PRESS® glaucoma filtration device creates consistent and predictable outcomes when used as part of trabeculectomy procedures.a trabeculectomy.

Vision Care
Refractive Surgery

In 2010, sales of our laser refractive products and related technology fees were $117 million, or 3.6% of our total surgical sales.  Our refractive sales include all sales related to our ownership of WaveLight.

The WaveLight's ALLEGRETTO WAVE® Eye-Q 400 Hz laser has been widely accepted by surgeons around the globe because it is fast, reliable and precise while offering multiple treatment protocols.  Alcon continues to integrate the WaveLight operations within the global Alcon infrastructure and has established WaveLight as Alcon's Center of Excellence for refractive laser technologies.

In 2010, Alcon launched the WaveLight® Refractive Suite, which includes the new EX500 Excimer 500Hz excimer laser and the FS200 femtosecond laser.  The FS200 technology is designed to create a corneal flap as part of the Laser-Assisted In Situ Keratomileusis ("LASIK") refractive procedure.  This technology represents the next leap forward in exceptional flap customization and patient outcomes.

Our Consumer EyeVision Care Products

We currently market ourportfolio comprises daily disposable, reusable and color-enhancing contact lenses, as well as a comprehensive portfolio of ocular health products, including products for dry eye, glaucoma, contact lens care and ocular allergies, as well as ocular vitamins and redness relievers. For the year ended December 31, 2021, net sales of our contact lens and ocular health products were $2.1 billion and $1.4 billion, respectively.
We serve our customers and patients through optometrists, ophthalmologists and other eye care professionals, retailers, optical chains and pharmacies, as well as distributors that resell directly to smaller retailers and eye care professionals, who sell the products to end-users. The vision care market is primarily private pay, with patients substantially paying for contact lenses and ocular health products out-of-pocket. Partial reimbursement is available in some countries for visits to eye care professionals and a portion of either spectacle or contact lens costs.
Sales of our contact lens and ocular health products are influenced by optometrist and other eye care professional recommendations, our marketing and consumer education efforts and consumer preferences. In addition to price, contact lenses compete on functionality, design and comfort, while ocular health products compete largely on product attributes, brand familiarity and professional recommendations. For our contact lens and ocular health products, we typically compete in the premium price segments of the market and we use improvements in functionality, design and consumer convenience to maintain our pricing position over time.
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Alcon is the number two company in the branded contact lens market based on market share in 2021. This position is driven largely by our core brands TOTAL, PRECISION, DAILIESAquaComfortPLUS and Air Optix.
Our TOTAL product line with its water gradient technology reduces end-of-day dryness, as the water content approaches nearly 100% at the outermost surface of the lens, and is designed to be a super-premium lens positioned to compete at the highest levels across the contact lens market. Our TOTAL product line includes DAILIES TOTAL1, the first and only water gradient disposable contact lens in the market. We launched TOTAL30, our premium offering in the reusable segment, in 2021 to encourage patients to trade up to a next generation, water gradient technology. DAILIES TOTAL1 in the multifocal offering provides a platform for expanding the presbyopia market, which we believe is a potential multibillion dollar opportunity for market participants.
PRECISION1, our new mainstream daily disposable silicone-hydrogel ("SiHy") lens with aqueous extraction and surface treatment, is priced in between the super-premium DAILIES TOTAL1 and the more value-conscious DAILIES AquaComfort PLUS. PRECISION1 is designed for long lasting performance and delivers precise vision, dependable comfort and ease of handling. Following a successful introduction of PRECISION1 spherical lenses, we introduced PRECISION1 for Astigmatism, a toric lens designed for astigmatic patients. In the US and EU, PRECISION1 for Astigmatism features the PRECISIONBALANCE
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8|4 lens design for a stable lens-wearing experience. Studies show that 47% of patients have astigmatism that needs correction, but less than 15% wear toric contact lenses. As a result, we believe the launch of PRECISION1 for Astigmatism provides a significant opportunity to attract new contact lens wearers and maximize retention.
DAILIES AquaComfort PLUS, our most affordable daily disposable contact lens in monofocal, astigmatism-correcting and multifocal options, delivers dependable performance by working with tears to release moisture with every blink. This lens is designed for value-conscious wearers who want the flexibility and simplicity of a daily disposable lens.
Our Air Optix monthly replacement product line features SiHy contact lenses in monofocal, astigmatism-correcting and multifocal options, as well as Air Optix Colors and Air Optix plus HydraGlyde contact lenses. Air Optix plus HydraGlyde brings together two innovative technologies—SmartShield technology and HydraGlyde moisture matrix—for a unique combination of deposit protection and longer-lasting lens surface moisture.
We continue to experience market growth driven by trade-up to premium lenses, expansion of toric and multifocal specialty lenses, as well as increasing penetration in emerging markets.
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Our key brands in our ocular health portfolio include the Systane family of artificial tearstear and related dry eye products, including the SystaneiLux MGD thermal pulsation system, Pataday family of eye allergy products, as well as the Opti-Free and Clear Care lines of multi-purpose and hydrogen peroxide disinfecting solutions, respectively. Select ocular health products include artificial tear and related dry eye products marketed under the Tears Naturale and Genteal brands, Naphcon-A and Zaditor eye drops for the temporary relief of ocular itching due to allergies and vitamins for ocular health marketed under the ICAPS and Vitalux brands.
Alcon currently holds a market leading position in artificial tears. We continue to focus on core product performance while increasing promotion behind a best-in-class innovation portfolio under the brand leadership of Systane artificial tears. The Systane portfolio is a comprehensive offering of ocular health solutions, most of which are indicated for the countries wheretemporary relief of burning and irritation due to dryness of the eye. The Systane portfolio includes products for daily and nighttime relief, as well as products for discomfort associated with contact lens wear. In 2021, we sell products,continued significant international expansion for Systane Ultra multi-dose preservative-free ("MDPF") and Systane Hydration MDPF. By adding the option of MDPF presentations to our portfolio, we address a key need by many eye care practitioners for effective dry eye relief without preservatives. The Systane portfolio also includes the Systane iLux thermal pulsation dry eye device, designed to address the large unmet needs for dry eye and meibomian gland dysfunction patients.
In 2020, we successfully switched from prescription to over-the-counter the Pataday family of allergy relief eye drops. Pataday Twice Daily Relief and Pataday Once Daily Relief eye drops were approved by the FDA and launched in the US in 2020. Pataday Once Daily Extra Strength was approved in 2020 and launched in 2021. The Pataday brand contains olopatadine, the number one doctor-prescribed active ingredient for eye allergy relief.
In 2021, we acquired exclusive US commercialization rights to Simbrinza. a fixed combination of a carbonic anhydrase inhibitor and an alpha-2 adrenergic receptor agonist indicated for the reduction of elevated intraocular pressure ("IOP") in patients with open-angle glaucoma or ocular hypertension. We believe that the acquisition of Simbrinza, combined with our existing over-the-counter ("OTC") eye drops, gives us a strong ophthalmic eye drop portfolio and the opportunity to capitalize on both the large glaucoma market ocular vitaminsand the fast-growing dry eye preservative free and eye allergy markets.
Alcon is also a market leader in selected markets.

The following table lists our principal productscontact lens care in these areas:

Contact Lens CareArtificial TearsOcular Vitamins
OPTI-FREE®RepleniSH® multi-purpose
Systane® lubricant eye drops
ICAPS® dietary supplements
disinfecting solution(multiple formulations)(multiple formulations)
OPTI-FREE® EXPRESS® No Rub® multi-
Systane®Ultra lubricant eye drops
purpose disinfecting solution(multiple formulations)
OPTI-FREE® RepleniSH® rewetting drops
Systane®Balance lubricant eye drops
Tears Naturale® lubricant eye drops
(multiple formulations)
Contact Lensboth multi-purpose (Opti-Free PureMoist) and hydrogen peroxide solutions (Clear Care Products

and AOSEPT PLUS). The vast majority of our contact lens care products isare comprised of disinfecting solutions to remove harmful micro-organisms on contact lenses, with a smaller amount of sales coming from cleaners to remove undesirable film and deposits from contact lenses and lens rewetting drops to improve wearing comfort for contact lenses. Sales ofWe benefit from strong synergies between our contact lens disinfectants in 2010 were $471 million, or 52.7% of our total consumer eye care sales.

In late 2005, we received approval in the United States to market OPTI-FREE® RepleniSH®, our fastest growing multi-purpose disinfecting solution, which is approved for silicone hydrogelbusiness and all other soft contact lenses.  This product utilizes a novel wetting and reconditioning technology to provide lasting comfort and is now our flagship brand in most key markets.  OPTI-FREE® EXPRESS® No Rub® multi-purpose disinfecting solution was the first
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multi-purpose disinfecting solution to obtain FDA approval to make a "no rub" claim.  OPTI-FREE® EXPRESS®No Rub® utilizes a multi-purpose disinfecting solution with high-capacity disinfection and superior protein cleaning benefits, without requiring rubbing of the contact lenses.  We currently market this product in most major markets throughout the world.
Other Vision Care Products

We manufacture and market artificial tears to treat dry eye syndrome and vitamins formulated to promote good ocular health.  We offer a complete line of products for the dry eye sufferer.  Systane® lubricating eye drops has been launched in more than 95 countries.  Systane® has an "in-the-eye" gelling formula that provides long-lasting relief of dry-eye symptoms.  In August 2008, we launched Systane®Ultra lubricating eye drops, which have a unique gel-like network designed to lubricate and protect the ocular surface.  Upon administration to the eye, the artificial tear spreads smoothly over the surface of the eye and provides lasting comfort of a more viscous drop but causes minimal blurring of vision.  In July 2010, we launched in the United States our Systane®Balance lubricant eye drops, designed specifically for dry eye patients with meibomian gland dysfunction ("MGD").  MGD is a significant cause of dry eye signs and symptoms for many patients; Systane®Balance restores the lipid layer and re-establishes the natural tear film helping to prevent tear film evaporation and to provide lubrication in dry eye patients with MGD.  Outside the United States, our second largest selling artificial tears brand is the Tears Naturale® line of products.

We market a variety of formulations of ICAPS® dietary supplements, including an Age Related Eye Disease Study ("AREDS") formula, one with extra Lutein and Zeaxanthin formula and an AREDS-based multi-vitamin that promotes eye health.  In June 2008, we launched an ICAPS® 2 x day, SoftGel with the same ingredients of our original AREDS formula, which is a 4 x day tablet.

Sales and Marketing

We are present in every significant market in the world where ophthalmology and optometry are practiced and currently our products are sold in over 180 countries.  We conduct our sales and marketing activities through more than 55 local operating entities and more than 25 representative/branch offices around the world.  We have a global sales force of approximately 4,000 sales representatives consisting of approximately 1,000 sales representatives in the United States, our largest market, and approximately 3,000 sales representatives outside the United States.  All of our surgical technical service in the United States and a high percentage of that service outside the United States are provided by service technicians employed directly by Alcon.  In countries where we do not have local operations or a scientific office, we use distributors to sell and handle the physical distribution of our products.  Outside the United States, our ten largest markets by sales are Japan, Brazil, France, Canada, Spain, Germany, Italy, Australia, China and the United Kingdom.

We organize our selling efforts around pharmaceutical, surgical and consumer eye care products and customize these efforts to the medical practice needs of each customer.  In addition to direct promotion of our products, our sales representatives provide customers with access to clinical education programs, data from clinical studies and technical service assistance.

In each of our markets, we rely on our strong relationships with eye care professionals to maintain and expand our market share.  Relationships between manufacturers of products paid for by federal and state healthcare programs and healthcare professionals are regulated by a series of federal and state laws and regulations, such as the Federal Anti-Kickback Statute, that restrict the types of financial relationships with referral sources that are permissible.  We engage healthcare professionals to serve as clinical consultants, to participate on advisory boards and to conduct presentations regarding our products.  In addition, we have established or sponsor several long-standing programs that provide training and education to eye care professionals.  We currently have permanent surgical training facilities in several countries around the world on six continents.  These facilities introduce ophthalmologists to our surgical equipment and cataract products through hands-on training in surgical techniques while exposing them to leading ophthalmologists.  If one or more of these activities were found to be in violation of the Federal Anti-Kickback Statute or comparable state laws, we could be subject to government criminal and/or civil enforcement proceedings, and exclusion from Medicare, Medicaid and other federal and state healthcare programs.  Imposition of any of these penalties could have a material adverse effect on our business, financial condition and results of operations.

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Most of our global marketing efforts are supported by advertising in trade publications and by marketing and sales representatives attending regional and national medical conferences.  We reinforce our marketing efforts with targeted and timely promotional materials that our sales force presents to both the eye care and other professionals in the office, hospital or surgery center setting.  We supplement these marketing efforts through direct mailings to eye care professionals and e-detailing.  To coordinate the totality of our sales efforts, including technical service after the sale, we use an integrated customer relationship management system in many markets.  Moreover, in the United States and Japan, we sometimes use direct-to-consumer advertising to promote selected products.

While we market all of our products by calling on medical professionals, our direct customers and distribution methods differ across business lines.  Although physicians write prescriptions, distributors, wholesalers, hospitals, government agencies and large retailers are the main direct customers for our pharmaceutical products.  We primarily sell our surgical products directly to hospitals and ambulatory surgical centers, although we sell through distributors in certain markets outside the United States.  In the United States, over 90% of our contact lens care products, are soldand we expect to large grocery, drug, club and general (mass) merchandise retailers.  Outsidesee our contact lens solution sales benefit from the United States, we sell mostlaunch of our consumernew TOTAL30 reusable lenses.
Finally, our ocular health portfolio also includes artificial tear and related dry eye products marketed under the Tears Naturale and Genteal brands, products for the temporary relief of ocular itching due to ocular allergies marketed under the Naphcon-A and Zaditor brands and vitamins for the maintenance of general ocular health marketed under the ICAPS and Vitalux brands.
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Our ocular health portfolio is typically over the counter but, in a small number of our markets, certain of our ocular health products are regulated as pharmaceuticals and require a prescription.
Principal Markets
Alcon serves consumers and patients in over 140 countries worldwide. The US is our largest market with 44% of our net sales in 2021, see Note 5. Segment information to the Consolidated Financial Statements for net sales by geography. US sales of the vast majority of our products are not subject to material changes in seasonal demand; however, sales of certain of our vision care products, directlyincluding those for allergies and dry eye, are subject to retailers and optical chains, while a smaller amount is sold to distributors for resale directly to smaller retailers and eye care professionals.  No single customer accounted for more than 10%seasonal variation. In addition, sales of our global sales in 2010.

As a result of changes in healthcare economics, managed care organizations have become the largest group of payors for healthcare services in the United States.  In an effortsurgical equipment are also subject to control prescription drug costs, almost all managed care organizations use a formulary that lists specific drugs that can be prescribed and/variation based on hospital or the amount of reimbursement for each drug.  We have a dedicated managed care sales team that actively seeks to optimize formulary positions for our products.clinic purchasing cycles.

Research and Development

We haveAlcon has made one of the largest commitments to research and development commitment to ophthalmology of anyin the eye care company worldwide.  Ourmarket, with proven research and development capabilities in the areas of optical design, material and surface chemistry, automation and equipment platforms. Currently, our research and development organization consists of approximately 1,900 employees,employs over 1,400 individuals dedicated to our research and development efforts, including a significant number of individuals who are either M.D.s,physicians, doctors of optometry or Ph.D.s.and PhDs. Our researchers have extensive experience in the field of ophthalmology and frequently have academic or practitioner backgrounds to complement their commercial experience.  product development expertise.
We organize cross-functional development teams to drive new innovations to our research teamscustomers and our patients around the world. New projects for our pharmaceutical, surgicalSurgical and consumerVision Care pipelines originate either from concepts developed internally by staff scientists and engineers, ideas from eye care products.  Candidates for pharmaceutical, biopharmaceutical and contact lens care product development originate from our internal research, from our extensive relationshipsprofessionals, or through strategic partnerships with academic institutions and from our licensing of molecules and other technologies fromor other companies. Our surgical design concepts are internally developed by staff engineers and scientists who, in addition to their own research, gather ideas from ophthalmic surgeons and clinicians in the involved fields.  OurWe have designed our research and development organization has been designed to driveachieve global registration of products through the efforts of a central research facility in Fort Worth, Texas, combined with regionally basedglobal clinical and regulatory personnel in approximately 40 countries outside the United States.

affairs organization.
We have invested more than $3 billion over the last five yearsapproximately $842 million, $673 million and plan to increase our investment$656 million in research and development as a percent of sales over the next three years.in 2021, 2020 and 2019, respectively. In 2010, we expandedaddition to our ability to conduct internalin-house research and development of biologic molecules for treating ocular diseases by further investing in Alcon ESBATech, an Alcon Biomedical Research Unit GmbH.

We enter into license agreements in the ordinary coursecapabilities, as part of our business for active pharmaceutical ingredientsefforts to pursue strategic research and development technologies.partnerships with third parties, our dedicated business development team has completed over 35 BD&L transactions since 2017. In addition, in 2021, we announced the launch of our first application, SMARTCataract, to our digital health platform, SMART Solutions, which leverages the open, cloud-based infrastructure and services of Philips HealthSuite. We have a number of agreementsbelieve that this new platform furthers our leadership in clinic-to-operating room (OR) integration with pharmaceuticalimage-guided technologies and biotech companies that allow uscloud-based planning. We continually review and refine our operating model to screen compoundsoptimize for potential uses in the eye.  Based on compounds of interest fromefficiency and productivity. Across our screening activities,Surgical and Vision Care pipelines, we have more than 100+ pipeline projects in place a numberprocess as of contracts with companies for developmentDecember 31, 2021, including 30 that have achieved positive proof of new molecular entities for ophthalmic products.

concept or are undergoing regulatory review.
Our research and development departmentorganization maintains an extensive network of relationships with top-tier scientists working in university laboratoriesacademia and with leading ophthalmologists,healthcare professionals, surgeons, inventors and investigatorsclinician-scientists working in the pharmaceutical and surgical products fields.ophthalmology. The principal purpose of these collaborative scientific interactions is to take advantage of leading-edge research from academic investigators and recognized surgeons to complementsupplement our internal technical capabilities.pipeline and leverage technological advancements in academia and the clinical setting.

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WeWhile our primary focus is on delivering new products to our patients and customers, we also fundsupport the advancement of basic science through the Alcon Research Institute, which seeks to encourage, advance and support vision research. ItThe Alcon Research Institute is one of the largest corporately funded research organizationorganizations devoted to eyevision research in the world. The institute'sInstitute's activities are planned and directed by a fullyan autonomous Scientific AdvisoryExecutive Steering Committee that is comprised of distinguished ophthalmologists and vision scientists.researchers. The instituteInstitute has worldwide representation withand operates under the expectationpremise that advancesimprovements in the diagnosis and treatment of ocular diseases are dependent upon advances in basic science and clinical research carried out by independent investigators in institutions throughout the world.

Research and development activities within our Surgical business are focused on expanding intraocular lens capabilities to further improve surgical and refractive outcomes and on developing equipment and instrumentation for cataract, vitreoretinal, refractive and glaucoma surgeries, as well as new platforms for diagnostics and visualization. Our focus within the Vision Care business is on the research and development of new manufacturing platforms and novel contact lens materials, coatings and optical designs for various lens replacement schedules, with the ultimate goal of improving patient outcomes. In addition to our efforts to develop next-generation contact lens technologies, we are strengthening our ocular health portfolio with new products and novel technologies that safely provide relief from symptoms of dry eye and ocular allergies.
Product Development
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We continue to seek opportunities to collaborate with third parties on advanced technologies for various ophthalmic conditions. These include the potential to provide accommodative contact and intraocular lenses for patients living with presbyopia.
Marketing and Sales
Alcon conducts sales and marketing activities throughout the world. During the year ended December 31, 2021, 44% of our sales were in the US. We are developing newpresent in every significant market in the world where ophthalmology and optometry are practiced, with operations in 60 countries supported by over 3,500 associates dedicated to direct sales and with products sold in over 140 countries.
Our global commercial capability is organized around sales and marketing organizations dedicated to treat diseasesour Surgical and conditionsVision Care businesses and we customize these efforts to the medical practice needs of each customer. In addition to direct promotion of our products, our sales representatives provide customers with access to clinical education programs, data from clinical studies and technical service assistance. Our selling models also include focused efforts in all key ophthalmic categories: pharmaceutical, surgicalchannels, including strategic accounts, key accounts and consumerpharmacies.
In each of our markets, we rely on our strong relationships with eye care professionals to attract and retain customers. We engage healthcare professionals to serve as clinical consultants, to participate on advisory boards and to conduct presentations regarding our products. We alsoIn addition, we have targeted development activitiesestablished or sponsor several long-standing programs that provide training and education to eye care professionals, including providing training support at over 70 state-of-the-art interactive training centers around the world. These facilities introduce ophthalmologists to our surgical equipment and cataract products through hands-on training in surgical techniques while exposing them to leading ophthalmologists.
In our Surgical business, our marketing efforts are supported by global advertising campaigns, claims from clinical registration and post-approval studies and by the participation of marketing and sales representatives in regional and global medical conferences. Technical service after the sale is provided using an integrated customer relationship management system in place in many markets. All of our technical service in the otic area specifically focused on leveraging compounds we use for ocular treatments into these areas.

The following table includes additional detail aboutUS, and a numberhigh percentage of these products in development, including their expected regulatory submission dates inthat service outside the European Union (EU), Japan (Jpn) and the United States (U.S.).  We also expect to file for approval of these products in most of theUS, is provided by service technicians employed directly by Alcon. In countries where we currently marketdo not have local operations or a scientific office, we use distributors to sell and handle the physical distribution of our products. We maintainWithin our Surgical business, the practices of our marketing and sales representatives continue to change to meet emerging market trends, namely consolidation of providers, increasing pricing pressures, proliferation of smaller competitors, increasing demands for outcome evidence and a significant regulatory presenceshift from relationship-based selling orientated toward physicians versus professional economic buyers focused on cost.
In our Vision Care business, we support our products with direct-to-consumer marketing campaigns, including advertising, promotions and other marketing materials, and with retailer-focused marketing and promotional materials. The fast-evolving landscape for our Vision Care business varies significantly by country. Three key trends in major countries to supportmarketing and sales help drive the filing processcontinuing evolution of our Vision Care business:
Internet-based purchasing is increasing, as online players grow and the Internet plays a bigger role as a source of consumer information and a platform for price referencing;
Channel consolidation is accelerating, as chains grow in those countries.size and vertically integrate; and
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ExpectedStatus at
NameConditionSubmission DateDecember 31, 2010 (1)
Pharmaceutical
Ophthalmology
DuoTrav® APS
GlaucomaEU FiledFiled
AZARGA®
New combination
Glaucoma
Glaucoma
Jpn 2012
U.S. 2012
EU 2013 or later
Phase III
Phase III
NEVANAC®, new indication
Anti-inflammatoryEU FiledFiled
Nepafenac, new formulation
Anti-inflammatory
U.S. 2012
EU 2012
Phase III
DUREZOL®, new indication
Anti-inflammatoryU.S. 2011Phase III
Pataday
Ocular allergyJpn FiledFiled
AL-43,546Dry eyeJpn 2013 or laterPhase II
TRIESENCE® injectable suspension
Retinal surgeryEU FiledFiled
Otic/Nasal
CiloDex® otic solution
Otic infectionsEU Filed (2)Withdrawn (3)
Moxifloxacin/dexamethasoneOtic infections
U.S. 2012 (4)
EU 2012 or later
Phase III
Surgical
AcrySof ®IQ Toric diopter range expansion
Cataract
U.S. Filed
Jpn Filed
Filed
AcrySof ®IQ Toric low diopter range expansion
CataractU.S. 2012Advanced development
AcrySof ®IQ ReSTOR® Multifocal Toric lens
Cataract
U.S. 2012
Jpn 2011
Advanced development
AcrySof ®IQ ReSTOR®Toric diopter range expansion
CataractU.S. 2012 or laterAdvanced development
AcrySof ®IQ ReSTOR® distant dominant
CataractU.S./EU 2012 or laterAdvanced development
Infiniti® upgrade
Cataract
U.S./EU 2011
Jpn 2012
Advanced development
LenSx laser
CataractEU/Jpn 2011Advanced development
AcrySof®CACHET angle-supported phakic lens
Refractive
U.S. Filed
Jpn 2012
Filed
Advanced development
ALLEGRETTOEX-500 laser
ALLEGRETTOEX-400 laser
Refractive
Refractive
U.S. Filed
Jpn Filed
Filed
Filed
Consumer Eye Care
New formulationDry EyeU.S./EU 2011Advanced development
Lens comfort dropLens solutionU.S./EU 2012Early development
OPTI-FREE® silicone hydrogel
Lens solutionU.S. FiledFiled
New lens solutionLens solutionU.S./EU 2011Advanced development
ICAPS® R2
Ocular vitaminEU 2011Advanced development
ICAPS® AREDS2
Ocular vitaminU.S./EU 2012 or laterEarly development
(1) For a description of the FDA approval process, see "­­– Government Regulation" below. 
(2) This application was filed in Denmark, France, Germany, Italy, Spain and the United Kingdom. 
(3) This application was withdrawn in November 2010 for administrative reasons and will be refiled early in 2011. 
(4) The FDA issued a notice in the fall of 2007 advising companies that they were increasing the requirements for anti-infective clinical studies and that clinical programs previously agreed upon may not be sufficient to support approval.  Review of our NDA confirmed the need for an additional clinical study which was initiated in a timely manner. 
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Pharmaceutical Product Development

Independent eye care professionals vary in influence, as many align more closely with retailers.
We are developing new productssee an opportunity to treat ophthalmic diseasesleverage digital technology to address pain points experienced by consumers and patients in three major therapeutic areas:  glaucoma, retina, and cornea (infection and inflammation, dry eye and allergy).existing paths to purchase. We also have ongoing development activitiesintend to continue investing and innovating in the otic therapeutic area specifically focused on leveraging compounds we use for ocular treatments.

Glaucoma.  Our research into glaucoma seeks to improve patient care and address unmet medical needs in the management of glaucoma.  We continue to investigate novel compounds with new mechanisms of action that may provide new or increased clinical benefits for lowering intraocular pressure or treating glaucoma.  Additionally, we look to provide patient treatment options by (i) combining multiple intraocular pressure lowering medications into a single administration in order to facilitate patient compliance, and (ii) improving the ocular surface health relative to the chronic use of topical ocular medications.

Reformulations of our TRAVATAN® and DuoTrav® formulations to eliminate benzalkonium chloride, a commonly used ocular preservative, are examples of projects intended to provide additional clinical benefit for glaucoma patients by maintaining or improving their ocular surface health.  Both of these projects advanced during 2010 and, assuming regulatory approval, should enter the European markets in 2011.

We have also initiated development of a novel fixed combination glaucoma product designed to provide diurnal adjunctive intraocular pressure lowering benefit when used adjunctively to a prostaglandin.  This novel combination does not contain timolol and thereby improves the potential safety profile for patients with pulmonary or cardiovascular considerations who are in need of an ocular hypertensive medication.

Retina.  We remain committed to addressing the unmet medical needs in the treatment of retinal diseases, including developing treatments for "wet" age-related macular degeneration ("AMD"), "dry" AMD, geographic atrophy, diabetic retinopathy and diabetic macular edema.  In late 2009, we completed enrollment into our first clinical evaluation study of AL-8309b as a topical ocular treatment for geographic atrophy.  We also initiated in 2010 our Phase I/II clinical program for AL-39,324, a potential treatment for "wet" AMD and diabetic retinopathy.  AL-39,324 is a receptor tyrosine kinase inhibitor that acts to block the receptor to which VEGF binds.  Additionally, during 2009, we signed a licensing agreement with Potentia for a compound with a novel mechanism of action that has the potential to be effective in treating "wet" AMD, "dry" AMD and also in preventing the conversion from "dry" AMD to "wet" AMD.  We anticipate initiating a clinical evaluation of this compound during 2011.

Cornea (infection and inflammation, dry eye and allergy).  We initiated our confirmatory development program for a new formulation of nepafenac that is targeted to treat post-surgical ocular inflammation with twice-per-day dosing in 2010.  This development program is expected to be completed in 2011.  We completed in 2010 a clinical program supporting a new indication for NEVANAC® in Europe related to prevention of post-surgical macular edema.  Our clinical development program for AL-43,546 as a dry eye candidate in Japan is progressing.  We also filed during 2010 an NDA in Japan for Pataday, requesting an improved dosing regimen relative to other allergy products currently on the market in Japan.

Otic.  During 2010, we initiated our second confirmatory study of our moxifloxacin/dexamethasone fixed combination product as a potential treatment for otitis media.  This study is expected to complete during 2011.

Surgical Product Development

We currently have products in development in the three primary areas of our surgical markets: cataract, vitreoretinal and refractive surgery.

Cataract Surgery.  We continue to strengthen our AcrySof® intraocular lens and Infiniti® instrumentation franchises.  In 2009, the FDA approved the AcrySof® IQ Toric lens.  This new lens corrects not only for astigmatism, but also for spherical aberrations to provide improved contrast sensitivity and a higher quality of vision. Our research and development efforts are focused on creating new lens models of this design in order to permit a greater number of people to benefit from this new technology.  We also are working on projects that combine the multi-focal, aspheric and toric technologies to correct both pre-existing astigmatism and presbyopia following lens replacement.  We
36
introduced the AcrySof®IQ ReSTOR®Multifocal Toric in Europe during 2010 and are presently conducting clinical studies to support a PMA filing in the United States early in 2012.

In addition to providing new lenses to the market for improving the quality of vision, we remain committed to working with cataract surgeons to help improve the effectiveness and efficiency of their surgical procedures.  As part of this effort, Alcon acquired LenSx® which has developed a femtosecond laser that can be used in cataract surgery for anterior capsulotomy, phacofragmentation and the creation of single plane and multi-plane arc incisions in the cornea.  This new instrument has received regulatory clearance in the United States.  Requests for regulatory clearance in the EU and Japan are expected to be filed in 2011.

We have also advanced the development of our next generation phacoemulsification system to support the surgical needs in the operating room of the future.  As we expect this process to take several years, we continue to introduce enhancements and features to our current surgical platforms and equipment used during cataract surgery.  Key areas of focus continue to be advancements in technology to facilitate lens removal and designing new methods to reduce the potential for the occurrence of posterior capsule opacification.

Vitreoretinal Surgery.  We continuedigital capabilities to develop new micro-incision vitrectomy consumables, handheld accessoriesbusiness models and illumination products designedpractice implementation support in response to respond to the increased needs of ophthalmic surgeons for instrument performance.  Our effortschannel shifts and increases in this area will continue to focus on improving the surgical experience for both the patient and surgeon by the application of new technologies to facilitate the procedure and minimize trauma to the patient.direct-to-consumer influence.

Refractive Surgery.  The Company filed a PMA for the approval of the AcrySof®CACHET angle-supported phakic intraocular lens in the United States during the second half of 2009.  This new lens is made from the biocompatible AcrySof® lens material and provides near-sighted patients with moderate to high degrees of myopia an intraocular lens treatment option that preserves the crystalline lens and has been shown to provide excellent visual results during clinical trials.

Alcon acquired majority control of WaveLight AG in 2007 and has been working to expand the surgical offerings from WaveLight's technology.  We presently are conducting clinical studies to expand the indications for use of WaveLight's ALLEGRETTO WAVE®Eye-Q 400 Hz laser in the United States.  The clinical studies are designed to demonstrate the safety and efficacy of topography-guided laser eye surgery.  Approval of this indication will allow physicians to conduct primary treatments utilizing the topography-guided algorithm or to re-treat patients who may be dissatisfied with their initial LASIK surgery.

Additionally, WaveLight has completed the development of an ALLEGRETTO WAVE® with a 500 Hz laser for refractive surgery, as well as a femtosecond laser (FS-200) for the creation of corneal flaps.  Regulatory clearances for marketing of both have been achieved in Europe and are presently in process in the United States.  Development of WaveLight's next generation excimer laser platform has already been initiated.  This next generation platform will have improved ergonomics and enhanced performance capabilities.

We also look for synergies between the refractive product development and the cataract surgery product development.  We are presently working with technology from the diagnostic group of WaveLight to assist with pre-operative biometry for cataract patients and the selection of intraocular lens power.

Consumer Eye Care Product Development

We currently are developing a variety of products in the areas of contact lens care, OTC dry eye and vitamins that promote ocular health.  Our focus in the contact lens care area is to build on the disinfecting capabilitiesWhile we market all of our existing solutionsproducts by calling on medical professionals, direct customers and distribution methods differ across our business lines. Surgical products are sold directly to hospitals and ambulatory surgical centers, although we sell through distributors in certain markets outside the US where we do not have local operations or a scientific office. In many countries, contact lenses are available only by prescription. Our contact lenses can be purchased from eye care professionals, optical chains and large retailers, subject to country regulation. Our ocular health products can be found in major drugstores, pharmacies, food stores and mass merchandising and optical retail chains globally, with new molecules that optimize disinfecting efficacy while maintaining comfortaccess subject to country regulations, including free-sale, pharmacy-only and convenienceprescription regulations. No single customer accounted for patients.  This focus has resultedmore than 10% of our global sales in the development of OPTI-FREE® EVERMOIST multi-purpose disinfecting solution, which is designed to provide optimum disinfection and prolonged comfortable lens wear time with new contact lens materials, especially the rapidly growing silicone hydrogel lens segment.  This new product was CE Marked and filed with the FDA in the last half of 2010.

Developing new active ingredients and compounds for over-the-counter products that treat dry eye remains a point of focus for addressing the consumer needs in this important area.  In addition to Systane®Balance ocular
2021.
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37
emulsion, which was released to the market in 2010 to help provide ocular comfort to lipid deficient patients, we also have initiated development of a novel formulation to provide prolonged ocular surface protection for the more moderately-severe dry eye patient. These formulations are each designed to address a portion of the spectrum of needs of the various patient segments of the dry eye target population.

In the ocular health area, we continue to develop new formulations for addressing consumer requirements for promoting ocular health.  We plan to release a new omega-3-containing vitamin product in the EU during 2011.  We also continue to support the National Eye Institute's Age-Related Eye Disease Study 2 (AREDS2) study to determine if oral supplementation with omega-3 fatty acids and/or lutein and zeaxanthin reduces the progression to advanced AMD.  The results of this study will be used to guide the development of new formulations of our ICAPS® vitamins that may be more effective in reducing the risk of progression to advanced AMD.

Manufacturing, Quality and Supplies

Manufacturing

We generally organize our manufacturing facilities along product categories, with most plants being primarily dedicated to the manufacture of either our Surgical or Vision Care product offerings. As of December 2021, we employed approximately 4,000 people to manufacture surgical equipmentproducts at 10 facilities in the US, Belgium, Switzerland, Ireland, Germany and surgical medical devices or pharmaceuticalIsrael and contact lens care products.approximately 5,500 people to manufacture Vision Care products at eight facilities in the US, Germany, Singapore, Malaysia and Indonesia. Our functional division of plants reflects the unique differences in regulatory requirements governing the production of surgical medical devices and pharmaceuticals, as well as the different technical skills required of employeesassociates in these two manufacturing environments. Except for our most recently acquired plants, allAll of our manufacturing plants in the United States and Europe are ISO 1348513485:2016 and ISO 14001:20042015 certified. Currently, we manufacture approximately 90% of our products internally and rely on third-party manufacturers for a limited number of products.
The inclusion into ISO 14001goal of the plants from the recent acquisitions of WaveLight, Optonol, ESBATechour supply chain strategy is to efficiently produce and LenSx will be considered in 2011.

Wedistribute high quality products. To that end, we employ cost-reduction programs, known as continuous improvement programs, involving activities such as cycle-time reductions, efficiency improvements, automation, plant consolidations and material negotiationprocurement savings programs as a means to reduce manufacturing and component costs. To comply with good manufacturing practices and to improve the skills of our employees,associates, we train our direct labor manufacturing staff throughout the year. Our professional employeesassociates are trained in various aspects of management, regulatory and technical issues through a combination of in-house seminars, local university classes and trade meetings.

As of December 31, 2010, we employed approximately 2,100 people toThe manufacture our pharmaceutical and contact lens care products at seven facilities in the United States, Belgium, France, Spain, Brazil and Mexico.  Additionally, we are in the commissioning and validation phase for a new pharmaceutical plant in Singapore, which is targeted to start up in late 2012.  As of December 31, 2010, we employed approximately 3,300 people to manufacture surgical equipment and other surgical medical devices at ten facilities in the United States, Belgium, Switzerland, Ireland, Germany and Israel.  Currently, we manufacture substantially all of our products is complex, involves advanced technology and is heavily regulated by governmental health authorities around the world. Risks inherent to the medical device and pharmaceutical contact lens care and surgical products internally and rely onindustries are part of our operations. If we or our third-party manufacturers fail to comply fully with regulations, there could be a product recall or other shutdown or disruption of our production activities. We have implemented a global manufacturing strategy to maximize business continuity in case of such events or other unforeseen catastrophic events.
Quality
Product quality and patient safety are vitally important for only a small number ofAlcon and our industry. Our customers and patients must always feel safe when using our products.

Due to the complexity of certain manufacturing technologies and the costs of constructing Our Quality Management Systems group ("QMS") is responsible for establishing and maintaining duplicate facilities, a numberrobust and compliant quality control system across Alcon. QMS regularly monitors industry trends, as well as global and regulatory changes, and adjusts our processes and procedures to adhere to current standards and best practices. In addition, our Quality Compliance group audits our internal processes and suppliers for compliance with approved processes and procedures.
Supplies
The components used in certain of our keySurgical products, are manufactured at only one ofsuch as viscoelastics, and our facilities.  Some of these keyocular health products, include:

ProductsFacility
U.S. liquid ophthalmic productsFort Worth, Texas
Intraocular lenses (l)Huntington, West Virginia
ProVisc®, VISCOAT®, DuoVisc® and DisCoVisc® viscoelastics
Puurs, Belgium
OPTI-FREE®EXPRESS® No Rub®, OPTI-FREE®RepleniSH® solutions (2)
Fort Worth, Texas
Accurus®, LEGACY®, Infiniti®CONSTELLATION® vision systems
Irvine, California
WaveLight® ALLEGRETTO WAVE® Eye-Q lasers
Pressath, Germany
Cipro® HC, Patanase® products
Barcelona, Spain
Vigadexa® ophthalmic solution
Sao Paulo, Brazil
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(1)  
The Cork, Ireland, facility manufactures certain AcrySof® intraocular lenses for the European markets and certain Latin American markets; the remainder of the world markets continues to be sourced mainly from the Huntington, West Virginia facility.

(2)  The Sao Paulo, Brazil, facility produces contact lens care products for Brazil and other South American markets.

Supplies

The active ingredients used insuch as our pharmaceutical and consumerproducts for dry eye, care products are sourced from facilities that meet the regulatory requirements of the FDA or other applicable health regulatory authorities. Because of the proprietary nature and complexity of the production of these active ingredients,components, a number of them are only available from a single FDA-approved source.or limited number of health regulatory authority-approved sources. The majority of active chemicals, biological raw materials and selected inactive chemicals used in our products are acquired pursuant to long term supply contracts. The sourcingWhen we rely upon a sole source or limited sources of supply for certain components, used in our surgical products differs widely due to the breadth and variety of products. A number of the components used in our medical device products are also single-sourced.  When supplies are single-sourced, we try to maintain a sufficient inventory consistent with prudent practice and production lead-times and to take other steps necessary to ensure our continued supply. The prices of our suppliesraw materials are generally not volatile.stable; however, we continue to monitor established indices for key raw materials and negotiate any price impact with the supplier.

Human Capital Management
Competition

The ophthalmic industryAlcon's culture is highly competitive and subject to rapid technological change and evolving industry requirements and standards.  Companies within our industry compete on technological leadership and innovation, quality and efficacy of their products, relationships with eye care professionals and healthcare providers, breadth and depth of product offering and pricing.  The presence of these factors varies across our product offerings.  We provide a broad line of proprietary eye care products and compete in all major product categoriessummarized in the ophthalmic marketAlcon Blueprint. The Alcon Blueprint includes Alcon's foundational principles and values and behaviors and serves as the bedrock for how we attract, develop and retain top talent. We seek diverse talent and perspectives that embody our values and contribute to our mission to help people to see brilliantly. Our talent acquisition process encompasses all facets of sourcing, attracting, assessing, selecting and onboarding of new associates. Alcon focuses on the care and growth of associates through learning and development, performance feedback, career progression and a focus on associate engagement – all while ensuring competitive compensation and benefits. Our Chief Human Resources Officer, working with the exceptionGlobal Heads of contact lensesTalent Acquisition and eyeglasses.  Even if our principal competitors do not haveTalent Management and Organization Development and Diversity and Inclusion develops systems and processes to support Alcon's ability to attract and retain the best talent and promote diversity and a comparable rangeculture of products, they can, and often do, form strategic alliances and enter into co-marketing agreements to achieve comparable coverage of the ophthalmic market.  We face strong local competitors in some markets, especially in Japan.

Pharmaceutical

Competition in the ophthalmic pharmaceutical market is characterized by category leadership of products with superior technology, including increases in clinical effectiveness (e.g., new compounds, new drug delivery systems, formulations and combination products), the development of therapies for previously untreated conditions (e.g., AMD) and competition based on price from competing brands or generic pharmaceuticals.

Our main competitors in the pharmaceutical market are Allergan, Inc., Bausch & Lomb Incorporated, Pfizer, Inc., Merck & Co., Inc., Daiichi Pharmaceutical Co., Ltd., Inspire Pharmaceuticals Inc., ISTA Pharmaceuticals Inc., Vistakon Pharmaceuticals, LLC (a Johnson & Johnson company), Genentech Inc. and Santen Pharmaceutical Co., Ltd.

Surgical

Superior technology and product performance give rise to category leadership in the ophthalmic surgical market.  Service and long term relationships are also key factors in this competitive environment.  Surgeons rely on the quality, convenience, value and efficiency of a product and the availability and quality of technical service.  While we compete throughout the field of ophthalmic surgery, our principal competitors vary somewhat in each area.  We compete with Bausch & Lomb Incorporated and Abbott Medical Optics, Inc. across most of the ophthalmic surgical market, and with national or regional companies, such as Carl Zeiss Meditec AG and Hoya Corporation, in selected markets.

Consumer Eye Care Products

The consumer eye care business is characterized by competition for market share in a maturing market through the introduction of products that provide superior technology or effectiveness.  Recommendations from eye care
inclusion.
44

39

professionals and customer brand loyalty, as well as our product quality and price, are key factors in maintaining market share in these products. Our principal competitors in contact lens care products are Bausch & Lomb Incorporated, Abbott Medical Optics, Inc., CIBA VISION Corporation (a Novartis company) and, in Japan, Rohto Pharmaceutical Co., Ltd.  We compete with Allergan, Inc., Abbott Medical Optics, Inc., Bausch & Lomb Incorporated, Johnson & Johnson and Novartis in artificial tears products and Bausch & Lomb Incorporated in ocular vitamins.  All consumer eye care markets include significant competition from private label store brands, which generally are less costly to the consumer.

Intellectual Property

We strive to protect our investment in the research, development, manufacturing and marketing of our products through the use of patents, trademarks, copyrights, trade secrets and other intellectual property. We own or have rights to a number of patents, trademarks, copyrights, trade secrets and other intellectual property directly related and important to our businesses.businesses. As of December 31, 2010,2021, we owned more than 1,500 U.S. patents and pending U.S.approximately 1,900 patent applications and approximately 9,500 corresponding patents and patent applications outside the United States.

families.
We believe that our patents are important to our business but that no single patent, or group of related patents, currently is of material importance in relation to our business as a whole. Patents for individual products extend for varying periods of time according to the date a patent application is filed or a patent is granted and the term of patent protection available in the jurisdiction granting the patent.  The scope of protection provided by a patent can vary significantly from country to country.

Our strategy is to develop patent portfolios for our research and development projects in order to obtain market exclusivity for the innovative features of our products in our major markets. AlthoughThe scope and duration of protection provided by a patent can vary significantly from country to country. However, even after the expiration of all patents forcovering a product, normally results in the loss of market exclusivity, we may continue to derive commercial benefits from these products.  such product.
We routinely monitor the activities of our competitors and other third parties with respect to their use of the Company'sour intellectual property. When appropriate, we will enforce our intellectual property rights to ensure that we are receiving the market exclusivityprotections they afford us. Similarly, we will staunchly defend our right to develop and market products against unfounded claims of infringement by others. We will aggressively pursue or defend our position in the appropriate courts if the dispute cannot otherwise be promptly resolved.

In addition to our patents and pending patent applications in the United StatesUS and selected non-U.S.non-US markets, we userely on proprietary know-how and trade secrets in our businesses.businesses and work to ensure the confidentiality of this information, including through the use of confidentiality agreements with associates and third parties. In some instances, we also acquire, or obtain from third parties licenses ofto, intellectual property rights principally patents, whichthat are important to our businesses.businesses from third parties.

Worldwide, allAll of our major products are sold under trademarks that we consider in the aggregate to be important to our businesses as a whole. We consider trademark protection to be particularly important in the protection of our investment in the sales and marketing of our pharmaceutical and contact lens care and general eye careocular health products. The scope and duration of trademark protection varies widely throughout the world. In some countries, trademark protection continues only as long as the mark is used.  Other countries require registration of trademarks and the payment of registration fees.  Trademark registrations are generally for fixed, but renewable, terms.

We also rely on copyright protection in various jurisdictions to protect the exclusivity of the code for thesoftware and printed materials our business relies upon, including software used in our surgical and diagnostic equipment. The scope and duration of copyright protection for computer softwarethese materials also varies widely throughout the world, although itworld.
Competition
The eye care industry is generally forhighly competitive and subject to rapid technological change and evolving industry requirements and standards. We compete with a fixednumber of different companies across our two business segments—Surgical and Vision Care. Companies within our industry compete on technological leadership and innovation, quality and efficacy of their products, relationships with eye care professionals and healthcare providers, breadth and depth of product offerings and pricing. The presence of these factors varies across our Surgical and Vision Care product offerings. Our principal competitors also sometimes form strategic alliances and enter into co-marketing agreements in an effort to better compete. We face strong local competitors in some markets, especially in developed markets, such as the US, Western Europe and Japan.
Surgical
The surgical market is highly competitive. Superior technology and product performance give rise to category leadership in the surgical market. Service and long term which beginsrelationships are also key factors in this competitive environment. Surgeons rely on the datequality, convenience, value and efficiency of copyright registration.a product and the availability and quality of technical service. We primarily compete with Carl Zeiss Meditec AG, Bausch Health Companies Inc., Hoya Corporation, Glaukos Corporation and Johnson & Johnson in the surgical market.

We expect to compete against companies that offer alternative surgical treatment methodologies, including multifocal, tunable and accommodating AT-IOL approaches, and companies that promote alternative approaches for responding to the conditions our products address. At any time, our known competitors and other potential market entrants may develop new devices or treatment alternatives that may compete directly with our products. In addition, they may gain a market advantage by developing and patenting competitive products or processes earlier than we can or by obtaining regulatory approvals / clearances or market registrations more rapidly than we can.
We believe that the principal competitive factors in our surgical market include:
disruptive product technology;
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alternative treatment modalities;
breadth of product lines and product services;
ability to identify new market trends;
acceptance by ophthalmic surgeons;
customer and clinical support;
regulatory status and speed to market;
price;
product quality, reliability and performance;
capacity to recruit engineers, scientists and other qualified associates;
digital initiatives that change business models;
reimbursement approval from governmental payors and private healthcare insurance providers; and
reputation for technical leadership.
Shifts in industry market share can occur in connection with product issues, physician advisories, safety alerts and publications about our products. In the current environment of managed care, with consolidation among healthcare providers, increased competition and declining reimbursement rates, there is also increasing pressure on price.
Vision Care
The vision care market is also highly competitive, and our primary competitors are Johnson & Johnson, Bausch Health Companies, Inc. and The Cooper Companies, Inc. Allergan, Inc. is a competitor in ocular health.
We believe our DAILIES TOTAL1 provides the most advanced daily disposable SiHy contact lens with its advanced "water gradient" technology and PRECISION1 provides a new mainstream daily disposable SiHy lens with aqueous extraction and surface treatment. While daily disposable contact lenses remain appealing to many lens wearers, approximately two-thirds of contact lens wearers globally choose reusable lenses. Despite this preference, innovation within the reusable lens segment has lagged behind daily disposable lenses over the past 10 years. TOTAL30 is designed to change that by delivering a premium offering within the reusable space. We also compete with manufacturers of eyeglasses and with surgical procedures that correct visual defects. We believe that there are opportunities for contact lenses to attract new customers in the markets in which we operate, particularly in markets where the penetration of contact lenses in the vision correction market is low. Additionally, we compete with new market entrants with disruptive distribution models that could potentially innovate to challenge traditional models, including the eye care professional channel in which we have a significant presence. We also believe that laser vision correction is not a significant threat to our sales of contact lenses based on the growth of the contact lens market over the past decade and our involvement in the laser vision correction market through our Surgical business.
In ocular health, the market is characterized by competition for market share through the introduction of products that provide superior effectiveness and reduced burden for treating eye conditions. Recommendations from eye care professionals and customer brand loyalty, as well as our product quality and price, are key factors in maintaining market share in these products.
Government Regulation

Overview

WeOur businesses are subject to comprehensive government controls governing the research, design, clinical and non-clinical development, manufacturing, labeling, advertising, promotion, safety and other reporting, storage, distribution, import, export, sale and marketingvarying degrees of our products in essentially all countries of the world.  National health regulatory agencies generally require pre-approval of pharmaceuticals and medical devices prior to their entry into that country's marketplace.  In addition, European Union Notified Bodies audit and govern applicable Quality Management System requirements, including ISO 13485:2003 and assess devices for compliance with the Medical Device Directive 93/42/EEC and applicable European and international standards.  The certifications obtained are accepted by
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Australia as well.  Japan also has requirements for quality management system regulations for medical device manufacturers.  State and local laws also apply to our activities.  This section summarizes the applicable regulationsgovernmental regulation in the United States, European Unioncountries in which we operate, and Japan.  Please also refer to "Risk Factors – Risks Related to Our Businessthe general trend is toward increasingly stringent regulation. In the US, the drug, device and Industry – We aredietary supplement industries have long been subject to extensive government regulation …."

Pharmaceutical Developmentby various federal and Registration Process in the United States

state agencies, primarily as to product safety, efficacy, manufacturing, advertising, labeling and safety reporting. The pharmaceutical research, development and registration process in the United States is typically intensive, uncertain, lengthy and rigorous and can generally take several years, or more, depending on the product under consideration.  During pre-clinical testing, studies are conducted to demonstrate the activityexercise of the compound against the targeted disease in animal models and to evaluate the effects of the new drug candidate on other organ systems in order to assess its potential therapeutic effectiveness relative to its safety.  This testing includes studies on the chemical and physical stability of candidate formulations, as well as biological testing of the compound.  Pre-clinical testing is subject to good laboratory practice requirements.  Failure to follow these requirements can invalidate the data, among other things.

In order for human clinical studies of a new drug to commence in the United States, an Investigational New Drug Application, or "IND," must be filed with the FDA; similar notifications are required in other countries.  Informed consent also must be obtained from study participants. In general, studies may begin in the United States without specific approvalbroad regulatory powers by the FDA aftercontinues to result in increases in the amounts of testing and documentation required for the commercialization of regulated products and a 30-day review period has passed.  However,corresponding increase in the FDA may prevent studies from moving forward,expense of product introduction. Similar trends are also evident in the EU and may suspend or terminate studies once initiated.  Studiesin other markets throughout the world. In addition to market access regulation, our businesses are also subject to review by independent Institutional Review Boards ("IRB"), responsible for overseeing studies at particular sitesother forms of regulation, such as those relating to anti-bribery, data privacy and protecting human research study subjects.  An IRB may prevent a study from beginning or suspend or terminate a study once initiated.

Clinical testing generally follows a prescribed format that involves initial exposure to normal, non-diseased subjects in Phase I clinical trials, followed by exposure of patients with disease to the new drug candidate in larger Phase IIcybersecurity and Phase III clinical trials.  United States law requires that studies conducted to support approval of a new drug be "adequate and well-controlled" as a way to control possible bias.  This generally means that a control, either a placebo or a drug already approved in the market for the same disease, is used as a reference.  Studies also must be conducted and monitored in accordance with good clinical practice and other requirements.

Following the completion of clinical trials, we thoroughly analyze the data to determine if the clinical trials successfully demonstrate safety and efficacy.  If they do, in the case of a drug product, a New Drug Application, or "NDA," is filed with the FDA along with proposed labeling for the product and information about the manufacturing processes and facilities that will be used to ensure product quality.  Each NDA submission requires a substantial user fee payment for which the FDA has committed generally to review and make a decision concerning approval within 10 months, and of a new "priority" drug within six months.  However, final FDA action on the NDA can take substantially longer and also may involve review and recommendations by an independent FDA advisory committee.  The FDA also can refuse to accept and review an NDA that it deems incomplete or not properly reviewable.

Before final action on a submission, the FDA may conduct a pre-approval inspection of our manufacturing facility to assess conformance to current good manufacturing practice requirements and also may inspect sites of clinical investigators involved in our clinical development program to ensure their conformance to good clinical practices.  The FDA may not approve an NDA, or may require revisions to the product labeling, require that additional studies be conducted prior to or as a condition of approval, or impose other limitations or conditions on product distribution, including, for example, adoption of a special risk management plan.  Following approval, if new information arises related to safety or other issues, the FDA may impose post-approval clinical study and clinical trial requirements, require safety-related changes to product labeling, require the review of advertising or impose a new or modified risk management plan.

A different but similar application is used for biological products, and generally equivalent FDA review, approval and post-approval procedures and requirements apply.

Generic drugs are approved through a different, abbreviated process.  Generally an Abbreviated New Drug Application, or "ANDA", is filed with the FDA.  The ANDA must seek approval of a drug product that has the same active ingredient(s), dosage form, strength, route of administration, and conditions of use (labeling) as a so-called "reference listed drug" approved under an NDA with full supporting data to establish safety and effectiveness.  Only
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limited exceptions exist to this ANDA sameness requirement, including certain limited variations approved by the FDA through a special petition process.  The ANDA also generally contains limited clinical data to demonstrate that the product covered by the ANDA is absorbed in the body at the same rate and to the same extent as the reference listed drug.  This is known as bioequivalence.  In addition, the ANDA must contain information regarding the manufacturing processes and facilities that will be used to ensure product quality, and must contain certifications to patents listed with the FDA for the reference listed drug.

Special procedures apply when an ANDA contains certifications stating that a listed patent is invalid or not infringed, and if the owner of the patent or the NDA for the reference listed drug brings a patent infringement suit within a specified time, an automatic stay bars FDA approval of the ANDA for a specified period of time pending resolution of the suit or other action by the court.  The first complete ANDA filed with the FDA that contains a certification challenging the patents listed with the FDA for a reference listed drug is also eligible to receive 180 days of exclusivity during which the FDA is prohibited from approving subsequent ANDAs.  This period of 180-day exclusivity is subject to certain forfeiture events.

As a general matter, the amount of testing and effort that is required to prepare and submit an ANDA is substantially less than that required for an NDA.  Conducting the necessary formulation development work, performing the bioequivalence testing and preparing the ANDA typically takes one to three years, although the time can be shorter or longer.  FDA review and approval can take from less than one year to two years or longer.

In addition to the NDA and ANDA procedures, there is an additional approval mechanism known as a 505(b)(2) application.  A 505(b)(2) application is a form of an NDA where the applicant does not have a right to reference all or some of the data being relied upon for approval.  Under current regulations and FDA policies, 505(b)(2) applications can be used where the applicant is relying in part on published literature or on findings of safety or effectiveness in another company's NDA.  This might be done, for example, where the applicant is seeking approval for a new use for a drug that has already been approved for a different use or for a different formulation of the same drug that is already approved for the same use.  The use of 505(b)(2) applications is the subject of ongoing legal controversy, and it is thus not clear what the permitted use of a 505(b)(2) application might be in the future.

For biologics licensed under the Public Health Service Act, Congress in March 2010 enacted a new abbreviated approval pathway under which a so-called biosimilar product may be approved based in part on a reference to a previously approved highly similar product of another applicant.  A similar approval pathway has existed in Europe for a number of years.  In the U.S., there are a number of issues of implementation that remain to be developed by the FDA, and it is not clear at this time how the new law will operate or what effects it will have on the biologics market.

Medical Device Development and Registration Process in the United States

Medical devices, including intraocular lenses and surgical equipment used in cataract procedures, vitreoretinal procedures and laser refractive surgery,trade regulation matters. We are also subject to regulationregulations related to environmental and safety matters, which are discussed in greater detail in "Item 4.D. Property, Plants and Equipment—Environmental Matters".
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Product Approval and Monitoring
Most of our products are regulated as medical devices in the United StatesUS and the EU. These jurisdictions each use a risk-based classification system to determine the type of information that must be provided to the local regulatory bodies in order to obtain the right to market a product. In the US, the FDA classifies devices into three classes: Class I (low risk), Class II (moderate risk) and Class III (high risk). Many of our devices are Class II or III devices that require premarket review by the FDA. Approval to market new device products is, in general, achieved by a process not unlike thatThe primary pathway for new pharmaceuticals, requiring submission of extensive pre-clinical and clinical evaluations in a new product application.  The process of developing data sufficient to support a regulatory filing on a new device is costly and generally requires at least several years for completion.

In the United States, medical devices are classified by the FDA as Class I, Class II or Class III based upon the level of risk presented by the device.  Class I devices present the least risk and are generally exempt from the requirement of pre-market review.  Certainour Class II devices are also exempt from pre-market review.  Most Class II devices and certain Class III devices are marketed after submissionis FDA clearance of a pre-marketpremarket notification under a process which is known assection 510(k) of the FDCA. With a 510(k) submission, the manufacturer must submit a notification procedure. The pre-market notification must demonstrateto the FDA that includes performance data that establish that the proposed deviceproduct is "substantially equivalent" to a legally marketed "predicate device" which requires a showing that the device has the same intended use as the predicate device, and either has the same technological characteristics or has different technological characteristics that do not raise different questions of safety and effectiveness than the predicate device.  Clinical study data are sometimes necessary to demonstrate substantial equivalence.  A 510(k) submission is subject to a user fee payment.  Most Class III devices and devices not substantially equivalent to a predicate device are subject to the most stringent regulatory review and cannot be marketed for commercial sale in the United States until the"predicate device", which is typically another Class II previously-cleared device. Our Class III devices require FDA grants approval of a Pre-MarketPremarket Approval ("PMA")application. With a Premarket Approval application, for the device.  The
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PMA filing is subject to a substantial user fee payment, and PMA supplement applications are also subject to user fees.  Modifications of the device or its intended use after 510(k) clearance might require the submission of a new 510(k), and in some cases a change in intended use might require a PMA.

A PMAmanufacturer must contain proposed directions for use of the device, information about the manufacturing processes and facilities, technical information and reports of nonclinical laboratory studies of the device,submit extensive supporting evidence, including clinical data, demonstratingsufficient to demonstrate a reasonable assurance that the device is safe and effective for its intended use, certain information regarding pediatric subpopulations and other information required by the FDA.  The FDA may refer a PMA for review by an advisory panel of outside experts for a recommendation regarding approval of the application.  Clinical trials for a medical device must be conducted in accordance with FDA requirements, including informed consent from study participants, and review and approval by an IRB, and, additionally, FDA authorization of an Investigational Device Exemption application must be obtained for significant risk devices.  The FDA may prevent studies from moving forward, and may suspend or terminate studies once initiated.  The FDA may conduct a pre-approval inspection of our manufacturing facility, and also may inspect clinical investigators and clinical sites involved in our clinical trials program.

If the FDA's evaluation of a PMA is favorable, the FDA typically issues an "approvable letter" requiring the applicant to agree to comply with specific conditions, to supply specific additional data or information or to finalize the labeling, in order to secure final approval of the PMA application.  Once the conditions contained in the approvable letter are satisfied, the FDA will issue a PMA order for the approved indications, which can be more limited than those originally sought by the manufacturer.  The PMA order can include post-approval conditions that the FDA believes are necessary to ensure the safety and effectiveness of the device including, among other things, post-market studies or restrictions on labeling, promotion, sale, distribution and use.  Products manufactured and distributed pursuant to a PMA are subject to extensive, ongoing regulation by the FDA.  The FDA review of a PMA application generally takes one to two years from the date the application is accepted for filing but may take significantly longer.  Supplemental PMA filings may be required prior to implementing product changes or manufacturing changes.

Pharmaceutical and Medical Device Registration Outside the United States

European Union

In the European Union, our products are subjectEU, CE marking is required for all medical devices sold. Prior to extensive regulatory requirements, such asaffixing the CE marking requirement for medical devices which, beyondMark, the European Union, is recognized by markets such as Australia.  As in the United States, the marketing of medicinal products has for many years been subject to the granting of marketing authorizations by regulatory agencies.  Particular emphasis is also being placed on more sophisticated and faster procedures for reporting of adverse events to the competent authorities and on proactive management of risks associated with products.

Pharmaceutical Development and Registration Process in the European Union

In common with the United States, the various phases of pre-clinical and clinical research are subject to significant regulatory controls.  The regulatory controls on clinical trials of medicines in the European Union are now largely harmonized following the implementation of the Clinical Trials Directives 2001/20/EC and 2005/28/EC.  Compliance with the national implementations of Directive 2001/20/EC and Directive 2005/28/EC has been mandatory from May 1, 2004 and January 29, 2006, respectively.  However, variations in the member state regimes continue to exist.

All member states currently require regulatory and institutional or other central or regional ethics review board approval of interventional clinical trials for medicines.  Both regulators and ethics committees also require the submission of adverse event reports during a study and a copy of the final study report.

In the European Union, approval of new medicinal products can be obtained only through one of two processes:
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Mutal recognition or decentralized procedure.  These procedures allow an applicant to submit applications in European Union member states of its choosing.  Companies whose products are ineligible for the centralized
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procedure may choose to use either the mutual recognition procedure or the decentralized procedure.  Unlike the centralized procedure (see below), which results in a single EU-wide approval, these procedures result in individual, national marketing authorizations in each member state that participates.
The mutual recognition procedure and the decentralized procedure are similar in many respects.  The applicant selects a member state that takes primary responsibility for the review and approval of the application: the so-called reference member state ("RMS").  Other states of the applicant's choosing, each a concerned member state ("EUCMS"), are expected to recognize the RMS decision to approve the product and must do so unless they identify a major public health concern.  The procedures differ only in the timing of this EUCMS phase.  In the mutual recognition procedure, it occurs after the RMS has granted a marketing authorization, while in the decentralized procedure it occurs after the RMS has prepared a positive assessment report and drafts of the summary of product characteristics, product labeling and packaging.

In both cases, an EUCMS can only object if it can identify a potential serious risk to public health.  The EUCMS and RMS then have 90 days within which to raise and resolve such issues with the assistance of the Co-ordination Group for the Mutual Recognition and Decentralized Procedures - Human ("CMDH") within the European Medicines Agency.  If any disagreement remains after 90 days, the issue is referred to the Committee for Medicinal Products for Human Use (CHMP) within the European Medicines Agency for an opinion and ultimately a binding European Commission decision.  The mutual recognition/decentralized processes result in separate national marketing authorizations in the RMS and each EUCMS.

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Centralized procedure.  This procedure is mandatory for products developed by means of a biotechnological process, for orphan drugs and for new chemical entities for which the therapeutic indication is the treatment of acquired immune deficiency syndrome, cancer, neurodegenerative disorder, diabetes, auto-immune diseases or other immune dysfunctions or viral diseases.  The procedure is also optional for other new active substances and other products that constitute "a significant therapeutic, scientific or technical innovation."  Under this procedure, an application is submitted to the European Medicines Agency.  Two European Union member states are appointed to conduct an initial evaluation of each application.  These countries each prepare an assessment report; the reports are then used as the basis of a scientific opinion of the Committee for Medicinal Products for Human Use.  If this opinion is favorable, it is sent to the European Commission, which drafts a decision.  After consulting with the member states, the European Commission adopts a decision and grants a marketing authorization, which is valid throughout the European Union and confers the same rights and obligations in each of the member states as a marketing authorization granted by that member state.

The European Union expanded its membership by ten in May 2004 and two more countries joined on January 1, 2007, bringing the total to 27 EU member states.  Several other European countries outside the European Union, particularly the non-European Union members of the European Economic Area, i.e., Norway, Iceland and Liechtenstein, accept European Union review and approval as a basis for their own national approval.

Medical Device Development and Registration Process in the European Union

The European Union regulatory regime for most medical devices became mandatory in June 1998.  Under this regime, a medical device may be placed on the market within the European Economic Area if it conforms to certain "essential requirements."  The most fundamental essential requirement is that a medical device must be designed and manufactured in such a way that it will not compromise the clinical condition or safety of patients, or the safety and health of users and others.  Other requirements include that the device must achieve the performances intended by the manufacturer and be designed, manufactured and packaged in a suitable manner.  To assist manufacturers in satisfying the essential requirements, the European Commission has requested the preparation of standards applicable to medical devices.  These include standards governing common requirements, such as sterilization and safety of medical electrical equipment, and product standards for certain types of medical devices.  There are also harmonized standards relating to design and manufacture.  While not mandatory, compliance with these standards is viewed as the easiest way to satisfy the essential requirements as a practical matter.  Compliance with a standard developed to implement an essential requirement also creates a rebuttable presumption that the device satisfies that essential requirement.

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In order to demonstrate safety and efficacy for their medical devices, manufacturers must conduct clinical investigations in accordance with the requirements of Annex X to the Medical Device Directive 93/42/EEC and applicable European and ISO Standards, as implemented or adopted in the European Union member states.  The resulting data are introduced into the product development cycle for next-generation or new products and considered as a part of design controls and risk management practices in place.  Clinical trials for medical devices usually require the approval of an ethics review board and the prior notification of the study to European regulators.  Both regulators and ethics committees also require the submission of adverse event reports during a study and may request a copy of the final study report.

Manufacturers must demonstrate that their devices conformdevice conforms to the relevant essential requirements of the EU's Medical Device Directive through a conformity assessment procedure. The nature of the assessment depends upon the classification of the device. The method of assessing conformity varies depending on the type and classification rules are mainly based on three criteria:of the length of timeproduct. For most Class I devices, the deviceassessment is in contact witha self-certification process by the body,manufacturer. For all other devices, the degree of invasiveness and the extent toconformity assessment procedure requires review by a "notified body", which the device affects the anatomy.  Medical devices in all but the lowest risk classification are also subject to a notified body conformity assessment.  Notified bodies are often private entities and areis authorized or licensed to perform suchconformity assessments by governmentnational device regulatory authorities. Manufacturers usually have some flexibility to selectThe conformity assessment procedures forrequire a particular classtechnical review of devicethe manufacturer's product and to reflect their circumstances, e.g., the likelihood that the manufacturer will make frequent modifications to its products.  Conformity assessment procedures require an assessment of availablerelevant clinical evidence, literature data for the product and post-market experience in respect of similar products already marketed.data. Notified bodies may also may reviewperform audits of the manufacturer's quality systems.system. If satisfied that the product conforms withto the relevant essential requirements, the notified body issues a certificate of conformity, which the manufacturer uses as a basis for its own declaration of conformity and application of the CE mark.

Manufacturers must complyThe EU published a new Medical Device Regulation in 2017 which will impose significant additional requirements on medical device manufacturers, including with requirements for reporting incidentsrespect to clinical development, labeling, technical documentation and field safety corrective actions associated with medical devices.  In addition,quality management systems. The regulation has a process for reporting certain events has been established betweenthree-year implementation period. Medical devices placed on the Company and its primary Notified Body (TUV PS, Germany, ID # 0123).

Japan

In Japan, our largest market outside the United States, the regulatory process is also quite complex.  Pre-marketing approval and clinical studies are required, as is governmental reimbursement approval for most medical devices and pharmaceuticals.  These requirements are comparable to those in the United States or in Europe.  The introduction of major amendmentsEU after May 2021 will require certification according to these new requirements, except that devices with valid CE certificates, issued pursuant to the pharmaceutical regulationsMedical Device Directives before May 2022, can be placed on the market until those certificates expire, at the latest in 2005 is notableMay 2025, provided there are no significant changes in this respect.  First, they expanded the Japanese regulatory focus to the manufacturing processes of medical devices and pharmaceuticals, both in Japan and overseas.  As a result, demonstration of good manufacturing practicedesign or quality management systems, and disclosureintended purpose of the manufacturing processdevice.
We also market products that are part ofregulated in other product categories, including lasers, drug products, dietary supplements and medical foods. These products are also subject to extensive government regulation, which vary by jurisdiction. For example, in the requirements for marketing approval.  Each of the foreign manufacturers is required toUS, our drug products must either be accredited by the Japanese authorities.

Historically, Japan required that all clinical data submittedmarketed in supportcompliance with an applicable over-the-counter drug monograph or receive FDA approval of a new drug application be performed on Japanese patients.  Since 1998, Japan has accepted overseas patient data when submitted along with a "bridging" study, which demonstrates that Japanese and non-Japanese subjects react comparably to the product.  This approach enables companies like ours to reduce the time to approval and introduction of new drugs into the Japanese market, and we are currently employing these approaches to petition for approval of new ocular drugs in Japan.  More recently, the authorities are intensifying the efforts to speed up the approval process and recommend active use of an "international joint trial" which may enable approval with a limited number of Japanese subjects.

Medical devices are similarly classified into three categories, corresponding to the level of potential risks to the human life and health.  The category with the lowest risk (Class I) may be marketed without product-specific approval or other regulatory action.  The highest risk category products, including most implant devices, are required to file for marketing approval, whereas devices in the middle category can be marketed subject to third-party certification of compliance with applicable Japan Industrial Specifications.  The clinical trial requirement remains ambiguous and the authorities' response varies from time to time.  Generally, devices representing a new technology are required to demonstrate clinical safety and efficacy for approval.

In 2005, Japan introduced theNew Drug Master File, which enables compound developers to protect their confidential data.  The Japanese Drug Master File allows manufacturers of active pharmaceutical ingredients to file in confidence
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manufacturing process and other sensitive information with the authorities to which Japanese licensees may refer in their new drug application.

In a recent development, the Japanese government extended the "exclusivity" period of active pharmaceutical ingredients, which is separate from patent protection, from six to eight years.  No abbreviated generic application will be accepted during this period.  In 2009, the Japanese authorities announced a guideline for approval of "biosimilar" drugs, and approval for these drugs can be granted under a less onerous data requirement.

Other Regulation

Ongoing Reporting and Recordkeeping

Following approval, a pharmaceutical or device company generally must engage in various monitoring activities and continue to submit periodic and other reports to the applicable regulatory agencies, including reporting cases of adverse events and device malfunctions, and maintaining appropriate design control and quality control records.  Some medical devices also may be subject to tracking requirements.  The FDA is in the process of implementing or considering a number of changes to its postmarket requirements for medical devices, including developing a proposed rule for a unique device identification ("UDI") system and other changes to enhance postmarket surveillance for medical devices.  In addition, there are requirements and industry guidelines to require the posting of ongoing drug and device clinical trials on public registries, and the disclosure of designated clinical trial results.

Advertising and Promotion

Drug and medical device advertising and promotion are subject to federal and state regulations.  In the United States, the FDA regulates company and product promotion, including direct-to-consumer advertising.  Violative materials may lead to FDA enforcement action, including, for drugs, the imposition of civil monetary penalties utilizing new authority the FDA has been granted.  The U.S. Federal Trade Commission ("FTC") also has certain authority over medical device advertising.Application. In the European Union,Economic Area, our drug products must receive a marketing authorization from the promotioncompetent regulatory authority before they may be placed on the market. There are various application procedures available, depending on the type of prescription medicines is subjectproduct involved.
Clinical trials may be required to intense regulation and control, including a prohibition on direct-to-consumer advertising.  Some European Union member states also restrictsupport the advertising of medical devices.  The restrictions vary from state to state.  Some subject only those medical devices that are reimbursed under state healthcare systems and/or that are intended for professional use to specific advertising and promotion restrictions.  Others restrict the advertising and promotion of devices for the treatment or diagnosis of certain listed conditions.  In Japan, advertising and marketing of medical devices are subject to a government recommendation and industry self-regulations.  Advertising of unapprovedour drug or uncertified medical devices, for which pre-marketing approval/certification is mandatory, is subject to criminal penalty.

Manufacturing

device products. In the United States,US, clinical trials must be conducted in accordance with FDA requirements, including informed consent from study participants, and review and approval by an institutional review board ("IRB"), among other requirements. Additionally, FDA authorization of an Investigational Device Exemption ("IDE") application must be obtained for studies involving significant risk devices prior to commencing the European Unionstudies. In the EU, clinical trials usually require the approval of an ethics review board and Japan, the prior notification to, or authorization of the study from, the regulatory authority in each country in which the trial will be conducted.
Regulations of the FDA and other regulatory agencies in and outside the US impose extensive manufacturing requirements as well as postmarket compliance and monitoring obligations on our business. The manufacture of our device, drug and dietary supplement products is subject to comprehensiveextensive and continuing regulation.  These regulations require us to manufacture our products in specific approved facilitiescomplex good manufacturing practice and in accordance with their quality system rules and/or current Good Manufacturing Practices, and to list or notify our products and register or authorize our manufacturing establishments withrequirements, which govern the government agencies, such as the FDA.  These regulations also impose certain organizational, procedural and documentation requirements upon us with respect to manufacturing and quality assurance activities.  Our manufacturing facilities are subject to comprehensive, periodic inspections by the FDA and/or other regulatory agencies.

Lasers

In the United States, our lasers are subject to the Electronic Product Radiation Control provisions of the Federal Food, Drug, and Cosmetic Act, previously codified as the Radiation Control for Health and Safety Act, which are administered by the Center for Devices and Radiological Health of the FDA.  This law requires laser manufacturers to file new product and annual reports, comply with performance standards and maintain quality control, product testing and sales records.  In addition, lasers sold to end users must comply with labeling and certification requirements.  Various warning labels must be affixed to the laser depending on the class of the product under the performance standard.

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The FDA undertook various initiativesmethods used in, 2009 with respect to ophthalmic laser devices used for Laser-Assisted In Situ Keratomileusis ("LASIK"), a surgical procedure that uses an excimer laser to permanently change the shape of the cornea.  These initiatives have included FDA letters to eye care professionals with information about advertising and promotion, and letters to ambulatory surgical centers regarding adverse event reporting requirements for device user facilities.  In March 2009, the FDA officially recognized the new LASIK standard from the American National Standards Institute (ANSI) entitled "Laser Systems for Corneal Reshaping."  On October 15, 2009, the FDA announced the launch of a collaborative study with the National Eye Institute and the Department of Defense to examine the potential impact on quality of life from LASIK.  The goal of the LASIK Quality of Life Collaboration Project is to determine the percentage of patients with significant quality of life problems after LASIK surgery and identify predictors of these problems.  One phase of this project is a national, multi-center clinical trial, including evaluation of subpopulations who may be vulnerable to adverse effects from the procedure, expected to end in 2012. The FDA opened a public docket for LASIK so that any interested person can pose comments or concerns regarding LASIK.  In addition, in January 2011, a citizen petition was filed seeking to have the FDA withdraw the PMA approvals for LASIK devices and take certain other regulatory actions with respect to these devices.

 In the European Union, medical device rules regulate lasers intended for medical purposes.  Depending on the class and purpose of each laser, member states also may impose additional restrictions and controls, such as limitations on those entitled to use the products and the facilities where their use is permitted.  Similarly, Japan's medical device regulations cover laser productsand controls used for, medical treatment purposes,the design, manufacture, packaging, storage, handling and the authorities do not allow the useservicing of lasersour products. We are also subject to requirements for aesthetic purposes by non-doctors.

Other

Our manufacturing, sales, promotionproduct labeling and advertising, recordkeeping, reporting of adverse experiences and other activities following product approval are subjectinformation to regulation by numerous regulatory and law enforcement authorities, including, in the United States, the FDA, the FTC, the Department of Justice, CMS, other divisions of the Department of Health and Human Services, the Consumer Product Safety Commission and state and local governments.  Among other laws and requirements,identify potential problems with our post-approval manufacturing and promotion activities must comply with the Federal Food, Drug, and Cosmetic Act and the implementing regulations of the FDA, and we must submit post-approval reports required by these laws.  We must file marketing authorization variations or supplemental applications with the FDA or other regulators and obtain their approval for labeling, manufacturing and other product changes, depending on the nature of the changes.  Our distribution of pharmaceutical samples to physicians must comply with applicable rules, including the Prescription Drug Marketing Act.  We must comply with state laws that require the registration of manufacturers and wholesale distributors of pharmaceutical and medical devicemarketed products, in that state, including, in certain states, manufacturers and distributors who ship products into the state even if such manufacturers or distributors have no place of business within the state.  Some states also impose requirements on manufacturers and distributors to establish the pedigree of product in the chain of distribution, including some states that require manufacturers and others to adopt new technology capable of tracking and tracing product as it moves through the distribution chain.  Certain of our products must comply with child-resistant packaging requirements under the Poison Prevention Packaging Act and Consumer Product Safety Commission regulations.
Our sales, marketing and scientific/educational programs must comply with the medicines advertising and anti-bribery rules and related laws, such as anti-kickback provisions of the Social Security Act, the Foreign Corrupt Practices Act, the False Claims Act, the Veterans Health Care Act ("VHCA") and similar state laws.  Our pricing and rebate programs must comply with pricing and reimbursement rules, including the Medicaid drug rebate requirements of the Omnibus Budget Reconciliation Act of 1990.  If products are made available to authorized users of the Federal Supply Schedule of the General Services Administration, additional laws and requirements apply.  Under the VHCA, we are required to offer certain drugs at reduced prices established by statutory formulas to a number of federal agencies, including the Veterans Administration and the Department of Defense, the Public Health Service and certain private Public Health Service designated entities in order to participate in other federal funding programs, including Medicare and Medicaid.  Participation under VHCA requires submission of pricing data and calculation of discounts and rebates pursuant to complex statutory formulas, as well as the entry into government procurement contracts governed by the Federal Acquisition Regulations.  In addition, legislative changes purportrecalls and field actions. We are also subject to periodic inspections for compliance with these requirements. We expect this regulatory environment will continue to require that discounted prices be offered for certain Department of Defense funded purchases through its TRICARE retail pharmacy program via a rebate system.significant technical expertise and capital investment to ensure compliance.

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Several states have enacted legislation requiring pharmaceuticalMedical device, drug and medical device companiesdietary supplement manufacturers are also subject to establish marketing compliance programs, file periodic reports with the state, make periodic public disclosures on sales, marketing, pricing, clinical trials and other activities and/or register their sales representatives,taxes, as well as to prohibit pharmaciesapplication, product, user, establishment and other healthcare entities from providing certain physician prescribing data to pharmaceutical companies for use in sales and marketing, and to prohibit certain other sales and marketing practices.  All of our activities are potentially subject to federal and state consumer protection and unfair competition laws.  Finally, certain jurisdictions have other trade and export regulations from time to time to which our business is subject, such as technology or environmental export controls and political trade embargoes.  Most European Union member states and Japan impose controls and restrictions that are similar in nature or effect.

Depending on the circumstances, failure to meet these applicable regulatory requirements can result in criminal prosecution, fines or other penalties, injunctions, recall or seizure of products, total or partial suspension of production, denial or withdrawal of pre-marketing product approvals, private "qui tam" actions brought by individual whistleblowers in the name of the government or refusal to allow us to enter into supply contracts, including government contracts.  In addition, even if we comply with FDA and other requirements, new information regarding the safety or effectiveness of a product could lead the FDA to modify or withdraw a product approval.

In March 2010, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 ("Affordable Care Act") was signed into law.  The Affordable Care Act will substantially change the way that health care is financed by both governmental and private insurers and significantly affect the pharmaceutical industry.  The Affordable Care Act contains a number of provisions, including provisions governing enrollment in federal health care programs, reimbursement changes, the increased use of comparative effectiveness research in health care decision-making, and enhancements to fraud and abuse requirements and enforcement, that will affect existing government health care programs and will result in the development of new programs.

A number of provisions contained in the new law may adversely affect our net revenue for our marketed products and any future products.  In 2010, the new law, among other things, increases the minimum basic Medicaid rebate for branded prescription drugs from 15.1% to 23.1% and requires pharmaceutical manufacturers to pay states rebates on prescription drugs dispensed to Medicaid managed care enrollees.  In addition, the Affordable Care Act increases the additional Medicaid rebate on "line extensions" (such as extended release formulations) of solid oral dosage forms of branded products, revises the definition of average manufacturer price by changing the classes of purchasers included in the calculation, and expands the entities eligible for discounted 340B pricing.

Beginning in 2011, the new law will require drug manufacturers to provide a 50% discount on prescriptions for branded products filled while the beneficiary is in the Medicare Part D coverage gap, also known as the "donut hole."  In addition, the Affordable Care Act will impose a significant annual fee on companies that manufacture or import branded prescription drug products.  The fee (which is not deductible for federal income tax purposes) will be based on the manufacturer's market share of sales of branded drugs and biologics (excluding orphan drugs) to, or pursuant to coverage under, specified U.S. government programs.  The new law will also impose an excise tax on medical devices starting in 2013.

The Affordable Care Act also includes substantial new provisions affecting compliance, including reporting provisions that relate to transfers of value to health care providers and to the distribution of product samples to health care providers.  In addition, the federal government has been given additional enforcement authority.

We are unable to predict the future course of federal or state health care legislation and regulations, including regulations that will be issued to implement provisions of the Affordable Care Act.  The Affordable Care Act and further changes in the law or regulatory framework that reduce our revenues or increase our costs could also have a material adverse effect on our business, financial condition and results of operations and cash flows.
Environmental, Health and Safety
We are subject to a wide range of laws and regulations relating to protection of the environment and employee health and safety, both in the United States and elsewhere.  In addition, internal corporate policies and procedures provide a common format for managing these aspects of our business.  Our manufacturing facilities, research and development and other support operations undergo regular internal audits relating to environmental, health and safety requirements.  Our facilities in the United States are required to comply with applicable Environmental Protection
fees.
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Agency and Occupational Safety and Health Administration regulations, as well as state laws and regulations.  Our facilities outside the United States are required to comply with locally mandated regulations that vary by country.  In an effort to ensure ongoing compliance with applicable environmental laws and regulations, we have a program to monitor regulations affecting our products, packaging and operations, as well as ongoing rates of waste, water, air emissions, ozone depletion components and energy consumption.  We also are aware and monitoring issues regarding climate change regulations but have not identified impacts on our operations of a material nature.

Currently we have seven ISO 14001 certifications inclusive of twelve locations.  These include our European pharmaceutical and surgical manufacturing facilities in Puurs, Belgium, Cork, Ireland, and Kaysersberg, France, and our manufacturing and research and development operations in Barcelona, Spain, and Schaffhausen, Switzerland.  North American operations certified under a Corporate Certificate include our manufacturing facilities in Sinking Spring, Pennsylvania, Irvine, California, Houston, Texas, Huntington, West Virginia, and Fort Worth, Texas.  Our manufacturing facilities in Mexico City, Mexico, and Sao Paulo, Brazil, are also ISO 14001 certified.  Certification possibilities for the recent acquisitions of WaveLight, AG, ESBATech AG, Optonol, Ltd. and LenSx Lasers, Inc. will be discussed in 2011.  Based upon our reviews and the outcome of local, state and federal inspections, we believe that our manufacturing facilities are in substantial compliance with all applicable environmental, health and safety requirements.

We are not aware of any pending environmental, health or safety litigation or significant financial obligations arising from current or past operations that are likely to have a material adverse impact on our financial position.  There can be no assurance, however, that environmental health or safety liabilities relating to properties owned or operated by us or waste generated by us will not develop in the future, and we cannot predict whether any such problems, if they were to develop, could require significant expenditures on our part.  In addition, we are unable to predict what legislation or regulations may be adopted or enacted in the future with respect to environmental health and safety protection.

Price Controls

In many of the markets where we operate, theThe prices of pharmaceutical productsour medical devices and drugs that require prescriptions or are reimbursed through payments to providers for services using our devices or drugs are subject to directreimbursement programs and price controls (by law)control mechanisms that vary from country to country. Due to increasing political pressure and governmental budget constraints, we expect these programs and mechanisms to remain robust and to drug reimbursementpotentially even be strengthened or expanded. As a result, such programs with varying price control mechanisms.and mechanisms could have a negative influence on the prices we are able to charge for our products, particularly those used in cataract, vitreoretinal and glaucoma surgeries.

Regulations Governing Reimbursement
In the United States, debate overUS, patient access to our drug and device products that require a prescription or are included in provider service payments is determined in large part by the reformcoverage and reimbursement policies of third-party health insurers, including government programs such as Medicare and Medicaid. Both government and commercial health insurers are increasingly focused on containing health care costs and have imposed, and are continuing to consider, additional measures that exert downward pressure on device and drug prices. Outside the US, global trends toward cost-containment measures likewise may influence prices for our healthcare products in those countries. Adverse decisions relating to either coverage for our products or the amount of reimbursement for our products, could significantly reduce the demand for our products and the prices that our customers are willing to pay for them.
Health Care Fraud and Abuse; Anti-Bribery
We are subject to health care fraud and abuse and anti-bribery laws and regulations in the US and around the world, including state and federal anti-kickback, anti-self-referral and false claims laws in the US. In addition, the FCPA is increasingly used to prosecute relationships between US companies and healthcare providers outside of the healthcare system has resulted in an increased focus on pricing.  Although thereUS. These laws are currently nocomplex and subject to evolving interpretation by government price controls over private sector purchasesagencies and courts. For example, in the United States,US, relationships between manufacturers of products paid for by federal legislation requires pharmaceutical manufacturers to pay prescribed rebates on certain drugs to enable them to be eligible for reimbursement under certain publicand state healthcare programs and proposals have been made to increasehealthcare professionals are regulated by a series of federal and state laws and regulations, such as the rebate levels.  Various states have adopted mechanisms under Medicaid and otherwiseFederal Anti-Kickback Statute (and similar US state laws), that seek to control drug prices, including by disfavoring certain higher priced drugs and by seeking supplemental rebates from manufacturers.restrict the types of permissible financial relationships with referral sources. In the absenceUS, the False Claims Act permits private litigants to pursue lawsuits that can trigger government investigations and result in substantial financial fines and penalties to the defendant, as well as payment of new governmentsignificant financial rewards to the successful private litigants. As discussed in "Item 4.B. Business Overview—Marketing and Sales", we engage in marketing activities targeted at healthcare professionals, which include among others the provision of training programs. If one or more of these activities were found to be in violation of fraud and abuse laws, anti-bribery laws and regulations or any other law or governmental regulation, managed careor there are changes to the interpretation of these laws, we could be subject to, among other things, civil and criminal penalties, damages, fines, exclusion from the Medicare and Medicaid programs and the curtailment or restructuring of our operations.
Data Privacy and Cybersecurity
The regulation of data privacy and security, and the protection of the confidentiality of certain personal information (including patient health information and financial information), is increasing. For example, the EU General Data Protection Regulation contains enhanced financial penalties for noncompliance. Similarly, the US Department of Health and Human Services has become a potent forceissued rules governing the use, disclosure and security of protected health information, and the FDA has issued further guidance concerning cybersecurity for medical devices.
In addition, certain countries have issued or are considering data localization laws, which limit companies' ability to transfer protected data across country borders. Failure to comply with data privacy and cybersecurity laws and regulations can result in enforcement actions, including civil or criminal penalties.
Trade Regulation
The movement of products, services and investment across borders subject us to extensive trade regulations. A variety of laws and regulations in the market placecountries in which we transact business apply to the sale, shipment and provision of goods, services and technology across borders. These laws and regulations govern, among other things, our import, export and other business activities. We are also subject to the risk that increases downward pressure on the prices of pharmaceutical products.  The Medicare Part D outpatient prescription drug benefit is provided primarily through private entities, which attempt to negotiate price concessions from pharmaceutical manufacturers.  The United States government is prohibited by law from interferingthese laws and regulations could change in price negotiations between manufacturers and Medicare drug plan sponsors, but some members of Congress are pursuing legislationa way that would permit the United States governmentexpose us to use its purchasing power to negotiate discounts from pharmaceutical companies, which would likely have a negative impact on the pricing of prescription drugs.  In addition, the law contains triggers for Congressional consideration of cost containment measures for Medicare in the event Medicare cost increases exceed aadditional costs, penalties or liabilities. Some governments also impose economic sanctions against certain level.  These cost containment measures could include certain limitations on prescription drug prices.

This focus on pricing is evidenced in the provisions of the Affordable Care Act, the comprehensive health care reform legislation that was enacted in 2010.  Among other things, the new law imposes greater Medicaid rebates on manufacturers, requires manufacturers to offer a 50% discount to Medicare Part D beneficiaries in the program's coverage gap, expands the entities eligible for discounted 340B pricing, imposes a new annual fee on branded pharmaceutical manufacturers, and lays the foundation for the use of comparative effectiveness research in health care decision-making.  We expect that pressures on pricing and operating results will continue through implementation of the Affordable Care Act and other legislative and administrative developments.

countries, persons or entities.
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In addition to our need to comply with such regulations in connection with our direct activities, we also sell and provide goods, technology and services to agents, representatives and distributors who may export such items to customers and end-users. Failure by us or the European Union, governments influence the pricethird parties through which we do business to comply with applicable import, export control or economic sanctions laws and regulations may subject us to civil or criminal enforcement action and varying degrees of pharmaceutical products and medical devices through their pricing and reimbursement rules and control of national healthcare systems that fund a large part of the cost of such products to consumers.  The approach taken varies from member state to member state.  Some jurisdictions operate positive and/or negative list systems under which products may only be marketed once a reimbursement price has been agreed.  Other member states allow companies to fix their own pricesliability.
4.C. ORGANIZATIONAL STRUCTURE
Organizational Structure
See "Item 4.B. Business Overview” for medicines, but monitor and control company profits.  The downward pressure on healthcare costs in general, particularly prescription drugs, has become very intense.  As a result, increasingly high barriers are being erected to the entry of new products, as exemplified by the National Instituteadditional information.
Significant Subsidiaries
See "Item 6.C. Board Practice” for Health and Clinical Excellence in the United Kingdom, which evaluates the health economics data supporting new medicines and passes reimbursement recommendations to the government.  In addition, in some countries cross-border imports from low-priced markets (parallel imports) exert a commercial pressure on pricing within a country.additional information.

In Japan, reimbursement prices of drug products and medical devices are determined by the National Health Ministry biannually, under the national health insurance.  The Ministry reviews the reimbursement prices of individual products biannually.  In 2010, the Japanese government raised the overall reimbursement of medical service fees by 0.2% for the first time in over 10 years.  However, it reduced the drug reimbursement rates by 5.75% and introduced a new additional rate reduction for the innovative products when generic products are approved.  The downward pressure is likely to remain because of persistent budget deficits.  Compensation for medical devices often takes the form of doctors' fees, which can be modified from time to time with additions of technologies using new medical devices.

C.  ORGANIZATIONAL STRUCTURE

Alcon, Inc. is the parent holding company of the worldwide group of Alcon companies.  Alcon, Inc. owns 100% of the common voting stock in Alcon Holdings Inc., the holding company for our U.S. operations.  The U.S. operations include a diverse group of subsidiaries that perform manufacturing, selling, marketing, distribution and research functions.  Our larger U.S. subsidiaries are:

·  Alcon Laboratories, Inc., which performs selling, marketing and distribution activities in the United States, with physical locations in Texas, California, Maryland and Hawaii; and
·  Alcon Research, Ltd., which is responsible for Alcon's U.S. manufacturing and research and development operations with physical locations in Texas, California, West Virginia and Pennsylvania.

Alcon, Inc. also directly or indirectly owns numerous operating subsidiaries located outside the United States, with substantial presence in Europe, Japan, South America, Canada and Australia.  These international subsidiaries are primarily engaged in selling, marketing and distribution activities; however, several international subsidiaries conduct manufacturing operations and a few maintain small research facilities.  Our larger international subsidiaries, all of which are wholly owned by Alcon, Inc., are:

·  Alcon Pharmaceuticals Ltd. (Switzerland), which operates as our international trading company and European Shared Services Center;
·  S.A. Alcon Couvreur-N.V., our international financing entity, which also operates as a distribution and manufacturing company;
·  Trinity River International Investments (Bermuda) Ltd., which manages Alcon's international portfolio of investments; and
·  Trinity River Insurance Co. Ltd., which provides a wide range of insurance coverage for Alcon affiliates worldwide.

Exhibit 8.1 provides a shorter list of significant subsidiaries, as defined by the SEC.

D.  4.D. PROPERTY, PLANTS AND EQUIPMENT

Our principal executive offices and registered office arecorporate headquarters is located at Bösch 69, P.O. Box 62, 6331 Hünenberg, Canton of Zug,in Geneva, Switzerland. The principal officesoffice for our United StatesSwiss and international operations, arewhich is also our registered office, is located at 6201 South Freeway,in Fribourg, Switzerland, and the principal office for our US operations is located in Fort Worth, Texas 76134.

Texas.
We believe that our current manufacturing and production facilities have adequate capacity for our medium-termmedium‑term needs. To ensure that we have sufficient manufacturing capacity to meet future production needs, we regularly review the capacity and utilization of our manufacturing facilities. The FDA and other regulatory agencies regulate
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the approval for use of manufacturing facilities for pharmaceuticals and medical devices, and compliance with these regulations requires a substantial amount of validation time prior to start-upstart‑up and approval. Accordingly, it is important to our business that we ensure we have sufficient manufacturing capacity to meet our future production needs.  We presently anticipate expanding the capacity of ten of our manufacturing facilities over the next two years.  The "History and Development of the Company" at the beginning of this Item 4 provides additional discussion of capital expenditures underway.

Major Facilities
The following table sets forth by location, approximate sizeour most significant production and principal use of our main manufacturingresearch and other facilities at December 31, 2010:

development facilities:
Location
Approximate Size
Principal Use(s)
Owned/ Leased
United States:Location
Size of Site
(sq. feet)in m2)
Major Activity
Fort Worth, Texas1,668,000315,200 Research and development, administrative buildings, warehouseOwned
Fort Worth, Texas118,000WarehouseLeased
Fort Worth, Texas346,000Pharmaceutical, contact lens care and surgical solutionsOwned
Fort Worth, Texas344,000Pharmaceutical and small volume consumer productsOwned
Houston, Texas391,000
Surgical (Custom Pak® and consumables)
Owned
Irvine, California210,000Surgical (electronic instruments and consumables),Leased
Production, research and development warehousefor Surgical and Vision Care businesses
Johns Creek, Georgia84,825 Production, research and development for Vision Care business
Grosswallstadt, Germany82,300 Production, research and development for Vision Care business
Singapore69,000 Production for Vision Care business
Johor, Malaysia43,900 Production for Vision Care business
Irvine, California40,800 Production, research and development for Surgical business
Houston, Texas37,400 Production for Surgical business
Batam, Indonesia35,000 Production for Vision Care business
Huntington, West Virginia151,00027,500 Production for Surgical (intraocular lenses)Ownedbusiness
Huntington, West Virginia114,000Surgical (advanced optical devices)Owned
Sinking Spring, Pennsylvania165,00021,800 Production for Surgical (hand-held instruments and consumables)Ownedbusiness
Elkridge, MarylandCork, Ireland142,00013,600 Distribution warehouseLeasedProduction for Surgical business
Aliso Viejo, CaliforniaErlangen/Pressath/Teltow, Germany30,00010,700 
Surgical (LenSx® laser equipment)
Leased
Outside the United States:
Barcelona, Spain444,000Pharmaceutical, contact lens care,Production, research and developmentOwned for Vision Care business
Puurs, Belgium594,0008,000 Pharmaceutical, contact lens care, surgicalOwnedProduction for Surgical business
(viscoelastics and Custom Pak®) and administrative
Kaysersberg, France160,000Pharmaceutical and contact lens careOwned
Sao Paulo, Brazil90,000Pharmaceutical and contact lens careOwned
Sao Paulo, Brazil89,000Administrative and warehouseLeased
Cork, Ireland147,000Surgical (intraocular lenses)Owned
Schaffhausen, Switzerland18,0004,100 Production for Surgical (microsurgical instruments)Owned
Schaffhausen, Switzerland26,000Surgical (microsurgical instruments)Leased
Mexico City, Mexico31,000Pharmaceutical and contact lens careOwned
Mexico City, Mexico60,000Administrative building and warehouseOwned
Erlangen, Germany71,000WaveLight administrative, research and developmentLeased
Pressath, Germany28,000
Surgical (WaveLight® refractive equipment)
Leased
Neve Llan, Israel11,000Surgical (glaucoma filtration devices)Leased
Singapore331,000Pharmaceutical plant under constructionOwnedbusiness

In addition to these principal facilities,March 2018, we have office facilities worldwide.  These facilities are generally leased. In three countries, we lease or sublease facilities from Nestlé.  These offices are located in Brazil, Norway and South Africa.  Pursuantcommenced the second phase of expansion of our Grosswallstadt, Germany facility relating to the termsproduction of the Shareholders Agreement, these Shared Site Agreements will continuecontact lenses. The project was completed in effect for the remaindermid-2021 and incurred total costs of their terms and may or may not be renewed.


We believe that all of our facilities and our equipment in those facilities are in good condition and are well maintained.
$449 million. In August
 ITEM 4A.UNRESOLVED STAFF COMMENTS
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2021, an additional expansion project was approved to add three additional contact lens production lines for an anticipated cost of $162 million. Through December 31, 2021, the total amount paid and committed was approximately $114 million. We have no unresolved written comments fromexpect to complete the SEC staff regarding our periodic reports under the Exchange Act received more than 180 days beforeproject by the end of 2023.
In April 2021, we launched a further expansion of our Singapore facility to add four additional production lines for contact lenses. We expect to incur costs of $188 million. Through December 31, 2021, the fiscaltotal amount paid and committed was approximately $152 million. We approved a further expansion in late 2021 to add three additional production lines and a new building for an expected cost of $280.1 million. Through December 31, 2021, the total amount paid and committed for this additional expansion was approximately $74 million. We expect to complete the entire project by October 2024.
In September 2019, we launched an expansion of our Johns Creek, Georgia facility to add four production lines for contact lenses. This project is ongoing and was expanded in 2020. We expect to pay a total amount of approximately $224 million on this project. Through December 31, 2021, the total amount paid and committed was approximately $213 million. In 2021, we launched an additional expansion to add two more production lines for contact lenses for $148 million. Through December 31, 2021, the total amount paid and committed was approximately $108 million. We expect to complete the project by mid-2023. Also, in late 2021, we approved an additional expansion to add one more production line for contact lenses. This additional expansion is expected to cost approximately $73.2 million and be completed by mid-2024. Through December 31, 2021, the total amount paid and committed was approximately $19 million.
We funded each of the projects discussed above from working capital.
Environmental Matters
We integrate core values of environmental protection into our business strategy to protect the environment, to add value to the business, manage risk and enhance our reputation.
We are subject to laws and regulations concerning the environment, safety matters, regulation of chemicals and product safety in the countries where we manufacture and sell our products or otherwise operate our business. As a result, we have established internal policies and standards that aid our operations in systematically identifying relevant hazards, assessing and mitigating risks and communicating risk information. These internal policies and standards are in place to ensure our operations comply with relevant environmental, health and safety laws and regulations and that periodic audits of our operations are conducted. The potential risks we identify are integrated into our business planning, including investments in reducing safety and health risks to our associates and reducing our impact on the environment. We have also dedicated resources to monitor legislative and regulatory developments and emerging issues to anticipate future requirements and undertake policy advocacy when strategically relevant.
Each year, we publish on our website a Corporate Responsibility Report that provides additional details regarding our environmental sustainability strategy and highlights the steps we plan to which this annual report relates.undertake.

ITEM 4A.    UNRESOLVED STAFF COMMENTS
None.

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ITEM 5. OPERATING AND FINANCIAL REVIEW AND PROSPECTS
MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND5.A. OPERATING RESULTS OF OPERATIONS

YouThis operating and financial review should be read together with the following discussionsection captioned "Item 4. Information on the Company—4.B. Business Overview" and analysis in conjunction with our Consolidated Financial Statements and the related notes to those financial statements and notes thereto included elsewhere in this report.Annual Report. Among other things, those financial statements include more detailed information regarding the basis of preparation for the following information. This Management's Discussiondiscussion contains forward-looking statements that involve risks and Analysisuncertainties. As a result of Financial Conditionmany factors, such as those set forth under "Item 3. Key Information —3.D. Risk Factors" and Results of Operations containselsewhere in this Annual Report, Alcon's actual results may differ materially from those anticipated in these forward-looking statements. Please see "Cautionary"Special Note RegardingAbout Forward-Looking Statements" for a discussionStatements" in this Annual Report. “Item 5. Operating and Financial Review and Prospects”, together with “Item 4.B. Business Overview” and “Item 6.D. Employees”, constitute the Operating and Financial Review (“Rapport annuel”), as defined by the Swiss Code of the risks, uncertainties and assumptions relating to these statements.Obligations.

Overview of Our Business

General

Alcon Inc. ("Alcon")researches, develops, manufactures, distributes and its subsidiaries (collectively, the "Company") develop, manufacture and market pharmaceuticals, surgical equipment and devices and consumersells a full suite of eye care products that treat eye diseaseswithin two segments: Surgical and disordersVision Care. The Surgical segment is focused on ophthalmic products for cataract surgery, vitreoretinal surgery, refractive laser surgery and promote the general healthglaucoma surgery, and function of the human eye.  Founded in 1945, we have local operations in over 75 countriesincludes implantables, consumables and our products are sold in more than 180 countries around the world.  In 1977, we were acquired by Nestlé S.A.  Since then, we have operated largely as an independent company, separate from most of Nestlé's other businesses, and have grown our annual sales from $82 million to more than $7 billion primarily as a result of internal development and selected acquisitions.  In March 2002, Nestlé sold slightly less than 25% of its ownership of Alcon through an initial public offering.  In two transactions in 2008 and 2010, Nestlé sold all of its Alcon common shares to Novartis AG, a Swiss corporation that now owns the majority of Alcon's common shares.  The remaining shares continue to be traded on the New York Stock Exchange.  In December 2010, Alcon entered into an agreement to merge with and into Novartis, subject to the approval of each company's shareholders and certain other closing conditions.

We conduct our global business through two business segments: Alcon United States and Alcon International.  Alcon United States includes sales to unaffiliated customers located in the United States of America, excluding Puerto Rico.  Alcon United States operating profit is derived from operating profits within the United States.  Alcon International includes sales to all other unaffiliated customers.

Each business segment markets and sells products principally in three product categories of the ophthalmic market: (i) pharmaceutical (prescription drugs); (ii) surgical equipment required for these procedures. The Vision Care segment comprises daily disposable, reusable and devices (cataract, vitreoretinalcolor-enhancing contact lenses and refractive); and (iii) consumera comprehensive portfolio of ocular health products, including products for dry eye, care (contactglaucoma, contact lens disinfectants and cleaning solutions, artificial tearscare and ocular vitamins).  Business segment operations generally do not include research and development, manufacturing, share-based compensation and other corporate functions.  We market our products to eye care professionalsallergies, as well as ocular vitamins and redness relievers.
We are dedicated to the direct purchasersproviding innovative products that enhance quality of life by helping people see better. Our strong foundation is based on our products, such as hospitals, surgery centers, managed care organizations, health maintenance organizations, government agencies/entities and individuals.

Change of Majority Ownership and Proposed Merger

On April 6, 2008, Nestlé and Novartis executed the Purchase and Option Agreement pursuant to which Nestlé agreed to sell approximately 74 million of its shares of Alcon common stock to Novartis in a cash transaction at a price of $143.18 per share.  That sale was consummated on July 7, 2008, and Novartis acquired a minority stake in Alcon of slightly less than 25% of Alcon's outstanding shares, while Nestlé remained Alcon's majority shareholder with approximately 156 million Alcon shares comprising approximately 52% of the Company's outstanding shares.

The Purchase and Option Agreement between Nestlé and Novartis also contained put and call option rights on the balance of approximately 156 million Alcon shares owned by Nestlé.  The option rights commenced on January 1, 2010.  As outlined by the two parties, these rights granted (i) Novartis a call option to buy all but 4.1 million (or 2.5%) of Nestlé's remaining Alcon shares at a fixed price of $181 per share and the 4.1 million shares at the first stage price of $143.18 per share, and (ii) Nestlé a put option to sell to Novartis all but 4.1 million of its remaining Alcon shares to Novartis at the lower of Novartis's call price of $181 per share or a 20.5% premium above the then-market price of Alcon shares, calculated as the average market price of Alcon shares during the five trading days immediately preceding the exercise date of the put option, with the 4.1 million share balance to be sold at the first stage closing price of $143.18 per share.
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On January 4, 2010, Novartis announced that it had exercised its option to purchase the remaining approximately 156 million Alcon shares owned by Nestlé at a weighted average price of $180 per share in cash, pursuant to the Purchase and Option Agreement.  After consummation of the purchase on August 25, 2010, Novartis owned an approximate 77% interest in Alcon with the 23% balance being the publicly traded shares.

The consummation triggered certain change of control provisions in certain retirement plans for Company employees, the Company's share-based awards (including the vesting of certain outstanding share-based awards) and other agreements.

On January 4, 2010, Novartis also announced that it submitted to the Alcon board of directors a proposal for a merger of Alcon with and into Novartis to be effected under Swiss merger law.  On December 15, 2010, after extensive negotiations between Novartis and the Alcon Independent Director Committee, Alcon announced that its board of directors approved a merger agreement with Novartis, whereby Novartis will pay a total merger consideration valued at $168 per share for the Alcon shares it does not currently own.  Under the terms of the deal, the merger consideration will be comprised of a combination of Novartis shares (or American Depositary Shares in lieu thereof) and, if necessary, a cash contingent value amount to result in a total value of $168 per share.  The exact exchange ratio and cash contingent value amount will be calculated based upon formulas set forth in the merger agreement.

For further details on the proposed merger, please refer to Item 7.B, "Related Party Transactions" and the Merger Agreement dated December 14, 2010 between Novartis AG and Alcon, Inc., included as Exhibit 4.13 to this report.  Additional information concerning the proposed merger is included in the registration statement on Form F-4 filed by Novartis with the United States Securities and Exchange Commission on December 23, 2010 and subsequent amendments thereto.

Statements in the following discussion and analysis relating to our business strategies, operating plans, planned expenditures, expected capital requirements and other forward-looking statements regarding our business do not take into account potential future impacts of our proposed merger with Novartis.

LenSx Lasers Acquisition

On August 18, 2010, the Company acquired 100% of the outstanding common shares of LenSx Lasers, Inc.  LenSx is a privately held company that has developed the first femtosecond laser to receive U.S. Food and Drug Administration clearance for uselongstanding success as a complementary technologytrusted brand, our legacy of industry firsts and advancements, our leading positions in cataract surgery.  LenSx's laser will enable surgeons to perform specific steps of the traditional cataract procedure with micron-level laser precision, including anterior capsulorhexis, phacofragmentation and creation of certain corneal incisions.  Previously these steps were done manually with surgical instruments.
The Company paid approximately $367 million in cash at closing to LenSx shareholders for their shares and agreed to maximum contingent payments of approximately $383 million based upon the achievement and over-achievement of future femtosecond unit and procedure fee revenue milestones.  The Company recorded, as part of the purchase price, $72 million for the estimated fair value of the contingent consideration and $12 million in cash paid to a LenSx shareholder for an intangible asset integral to the purchase.

Between the acquisition date and December 31, 2010, LenSx had no revenues and its costs and expenses were not significant.  Note 18 to the consolidated financial statements provides more information on this acquisition.

ESBATech Acquisition

On September 15, 2009, the Company acquired ESBATech AG, a Swiss biotechnology company.  The Company paid ESBATech shareholders $150 million in cash at closing and may pay possible contingent payments of up to $439 million based upon the achievement of future research and development milestones that would be expected to create value for Alcon.  The Company recorded, as part of the purchase price, the estimated fair value of $71 million related to the contingent payments.  This valuation was based on the Company's estimates of the probability and timing of these contingent payments.

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ESBATech is a clinical-stage biotechnology company that has been developing a pipeline of proprietary single-chain antibody fragment therapeutics for topical and local delivery for safe and convenient therapy.  ESBATech has advanced its antibody fragment technology to preclinical and clinical stages in the eye for various diseases.  The company has several stable and soluble single-chain antibody fragments in development, with its most advanced product candidate progressed into Phase I and II studies relating to the treatment of inflammatory ocular diseases.

The acquisition included all rights to ESBATech's technology for therapeutic application to the eye, including age-related macular degeneration, diabetic macular edema, glaucoma, dry eye and uveitis.  Substantially all of the employees of ESBATech joined Alcon.  The ESBATech acquisition expanded Alcon's research capability outside of small molecules to the field of proteins, antibodies and other large molecules.

Note 18 to the consolidated financial statements provides more information on this acquisition.

U.S. Healthcare Reform

In March 2010, the United States government enacted legislation that is expected to have far reaching implications for the healthcare industry.  The U.S. Department of Health and Human Services has broad discretion to interpret certain sections of these new laws, and numerous regulations are anticipated to follow.  The more significant changes and their estimated effects on the Company for 2010 and future years are discussed below.

·  Beginning January 1, 2010, the legislation increases the Medicaid drug rebate minimum percentage for single source and innovator multiple source drugs from 15.1% to 23.1% of average manufacturer price and for non-innovator multiple source drugs from 11% to 13%.  The legislation further extends this drug rebate to utilization made through risk-based, Medicaid managed care plans.  This portion of the legislation was effective as of the date of enactment (March 23, 2010).  The impact of this legislation has been to increase rebates paid by Alcon.  It also may have an indirect impact on overall rebates paid to managed care organizations.

·  Beginning January 1, 2011, pharmaceutical manufacturers must enter into agreements with the U.S. government to provide a 50% discount on covered brand name Medicare Part D drugs for eligible Part D enrollees in the coverage gap.  The legislation required the U.S. government to establish a model agreement with pharmaceutical manufacturers.  This has been completed and most manufacturers, including the Company, have signed the agreement.  The discounts are excluded from "Best Price" for Medicaid rebate purposes.  This will increase the Company's discounts beginning in 2011.  To the extent patients were foregoing purchasing their medicines once they entered the Medicare Part D coverage gap, this provision could result in a modest increase in prescriptions, although at a lower price.

·  The legislation also expands the section 340B drug discount program eligibility to the outpatient settings of qualified children's hospitals, free-standing cancer centers, critical access hospitals, rural referral facilities, and sole community hospitals with disproportionate share adjustment percentages equal to or greater than 8%.  This will effectively increase volume to those facilities where we offer larger discounts.

·  The legislation imposes a non-deductible pharmaceutical industry fee, requiring brand manufacturers to pay an annual fee in the aggregate of $2.5 billion in 2011, escalating to $4.1 billion in 2018.  The fee is allocated to individual companies based on each manufacturer's proportion of total specified government program sales as a percentage of the entire brand manufacturing industry total of specified government program sales.  There were no fees recognized in 2010.  If the legislation had applied to 2010 and based on our 2009 sales and our assumptions about which sales will be subject to the fee, we estimate its effect on the Company would have been less than $10 million.

·  The legislation imposes a 2.3% excise tax on the sale of medical devices (as defined in section 201(h) of the Federal Food, Drug and Cosmetic Act) intended for humans.  This provision becomes effective for sales after December 31, 2012 and will likely be imposed on a majority of the Company's surgical revenue but will exclude sales of our over-the-counter products such as contact lens disinfectants, artificial tears, and ocular vitamins.  If the legislation had applied to 2010 and based on our 2009 sales
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and our assumptions about which products will be subject to the tax, we estimate its effect on the Company would have been less than $30 million.
·  The legislation likely will increase the population that will have access to drugs by expanding Medicaid eligibility to 133% of the Federal Poverty Level.  It also will create separate health benefit exchanges through which individuals and small businesses can purchase coverage.  Quantifying this impact is not possible at this time.  This portion of the legislation does not go into effect until January 1, 2014.

Finally, the legislation changes the taxation of subsidies received by employers as a result of funding prescription drug benefits for retirees under the Medicare Prescription Drug Improvement and Modernization Act of 2003.  The elimination of this benefit resulted in an initial $25 million charge to income taxes in the first quarter of 2010 and is expected to add an annual income tax cost of approximately $4 million at today's tax rates.

The provisions in the first and third bulleted paragraphs above decreased sales by approximately $20 million in 2010.

Market Environment

Demand for healthcare products and services is increasing in established markets as a result of aging populations and the emergence of new drug therapies and medical devices.  Likewise, demand for healthcare products and services in emerging markets is increasing primarily due to the adoption of medically advanced technologies and improvements in living standards.  As a result of these factors, healthcare costs are rising at a faster rate than macroeconomic growth in many countries.  This faster rate of growth has led governments and other purchasers of healthcare products and services, either directly or through patient reimbursement, to exert pressure on the prices of healthcare products and services.  These cost-containment efforts vary by market.

In the United States, Medicare reimbursement policies and the influence of managed care organizations continue to impact the pricing of healthcare products and services.  The Medicare Prescription Drug, Improvement and Modernization Act of 2003 continues to present opportunities and challenges for pharmaceutical companies.  Many states also have implemented more aggressive price control programs and more liberal generic substitution rules that could result in price reductions.  In addition, managed care organizations use formularies and their buying power to demand more effective treatments at lower prices.  Both governments and managed care organizations support increased use of generic pharmaceuticals at the expense of branded pharmaceuticals.  We are well-positioned to address this market opportunity with Falcon Pharmaceuticals, Ltd., our generic pharmaceutical business.  We also use third-party data to demonstrate both the therapeutic and cost effectiveness of our branded pharmaceutical products.  Moreover, to achieve and maintain attractive positions on formularies, we continue to introduce medically advanced products that differentiate us from our competitors.

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 placed additional pressure on policy makers to offset the cost of the prescription drug benefit by controlling budgets for reimbursement to surgical facilities.  This may affect our industry's ability to maintain current pricing levels.  New technologies for surgical procedures are being challenged to substantiate that their higher costs are accompanied by clinical improvements for Medicare beneficiaries.  We prepare for these challenges by gathering the scientific and clinical data that demonstrate to Medicare that the products in our pipeline are cost-effective when their higher costs are compared to their measurable benefits.

Outside the United States, third-party payor reimbursement of patients and healthcare providers and prices for healthcare products and services vary significantly and, in the case of pharmaceuticals, are generally lower than those in the United States.  In Western Europe, where government reimbursement of healthcare costs is widespread, governments often require price reductions.  The economic integration by European Union members and the introduction of the euro also have impacted pricing in these markets, as more affluent member countries are requesting prices for healthcare products and services comparable to those in less affluent member countries.

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In most of the emerging markets in Latin America and Asia, average income levels are relatively low, government reimbursement for the cost of healthcare products and services is limited and prices and demand are sensitive to general economic conditions.  However, demand for our products in many developing countries has been rising.

In Japan, longer regulatory approval times impact the timing of marketing our pharmaceutical products there in comparison to other markets.  In addition, the Japanese National Health Ministry reviews prices of individual pharmaceutical products and health services biannually.  These reviews have resulted in price decreases, including a 5.75% decline in overall drug reimbursement in 2010.  Reductions in reimbursement levels put downward price pressure on products we supply.

Currency Fluctuations

Our products are sold in over 180 countries and we sell products in a number of currencies in our Alcon International business segment.  Our consolidated financial statements, which are presented in U.S. dollars, are impacted by currency exchange rate fluctuations through both translation risk and transaction risk.  Translation risk is the risk that our financial statements for a particular period are affected by changes in the prevailing exchange rates of the various currencies of our subsidiaries relative to the U.S. dollar.  Transaction risk is the risk that the currency structure of our costs and liabilities deviates to some extent from the currency structure of our sales proceeds and assets.
Our translation risk exposures are principally to the euro, Japanese yen, Brazilian real and Canadian dollar.  With respect to transaction risk, because a significant percentage of our operating expenses are incurred in the currency in which sales proceeds are received, we do not have a significant net exposure.  In addition, most of our assets that are denominated in currencies other than the U.S. dollar are supported by loans or other liabilities of similar amounts denominated in the same currency.  From time to time, we purchase or sell currencies forward to hedge currency risk in obligations or receivables; these transactions are designed to address transaction risk, not translation risk.  More recently, Venezuela has experienced an official currency devaluation and high inflation, but our exposure there is not significant to our consolidated financial condition.

Generally, a weakening of the U.S. dollar against other currencies has a positive effect on our overall sales and, to a lesser extent, profits, while a strengthening of the U.S. dollar against other currencies has a negative effect on our overall sales and, to a lesser extent, profits.  We experienced positive currency impacts during 2010 and 2008.  During these years the U.S. dollar weakened against most major currencies, positively impacting our sales and, to a lesser extent, profits.  However, in 2009, as other major currencies weakened against the dollar, our sales and profits were negatively affected.  We refer to the effects of currency fluctuations and exchange rate movements throughout this Management's Discussion and Analysis of Financial Condition and Results of Operations, which we have computed by applying translation rates from the prior comparative period to the more recent period amounts and comparing those results to the more recent period actual results.

Operating Revenues and Expenses

We generate revenues largely from sales of ophthalmic pharmaceutical products, ophthalmic surgical equipment and devices and consumer eye care products.  Our operating revenues and operating income are affected by various factors, including unit volume, price, currency fluctuations, acquisitions, licensing and the mix between lower-margin and higher-margin products.

Sales of ophthalmic pharmaceutical products are primarily driven by the development of safe and effective products that can be differentiated from competing products in the treatment of ophthalmic diseases and disorders and increased market acceptance of these new products.  Inclusion of pharmaceutical products on managed care formularies covering the largest possible number of patients is another key competitive factor.  We face significant competition in ophthalmic pharmaceuticals, including competition from other companies with an ophthalmic focus and from larger pharmaceutical companies.  In general, sales of our pharmaceutical products are not affected by general economic conditions, although we face pressure from governments and from managed care organizations in the United States to reduce prices.  Alcon has continued to increase market share in most of its major specialties, which has provided some offset to the recent market softness.  We experience seasonality in our ocular allergy medicines, with a large increase in sales in the spring and a lesser increase during the fall and also in our otic
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products, which have significantly larger sales in the summer months than at other times of the year.  Costs of goods sold for our pharmaceutical products include materials, labor, overhead and royalties.
Our surgical product category includes three product lines: cataract, vitreoretinal and refractive.  Sales of our products for cataract and vitreoretinal surgery are driven by technological innovation and aging demographic trends.  The number of cataract and vitreoretinal surgical procedures is not generally affected by economic conditions; however, because cataract patients now have the ability to pay out of their own pockets for certain premium technologies, sales of advanced technology intraocular lenses could be affected by economic conditions.  We believe that our innovative technology and our ability to provide customized (i.e., tailored to each surgeon's preference) surgical procedure packs with a broad range of proprietary products are important to our success in these product categories.  Sales of our refractive surgical equipment and the related technology fees are driven by consumer demand for laser refractive surgery.  We sell lasers and other surgical equipment used to perform laser refractive surgeries and, in the United States, charge a technology fee for each surgery performed (one eye equals one surgery).  Outside the United States, we generally do not charge a technology fee.  Because governments and private insurance companies generally do not cover the costs of laser refractive surgery, sales of laser refractive surgical products and related technology fees are sensitive to changes in general economic conditions and consumer confidence.  There is no significant seasonality in our surgical business.  Costs of goods sold for our surgical products include raw materials, labor, overhead, royalties and warranty costs.  Operating income from cataract and vitreoretinal products is driven by the number of procedures in which our products are used and the types of products used.  Operating income from laser refractive surgical equipment depends primarily on the number of procedures for which we are able to collect technology fees.  In the weaker economy since 2008, the number of refractive procedures in the United States market declined.  Our refractive sales increased as a result of sales of WaveLight® products and procedures following our acquisition of an initial majority interest in WaveLight in late 2007.

Sales of our consumer eye care products are influenced by ophthalmologist, optometrist and optician recommendations of lens care systems, our provision of starter kits to eye care professionals, advertising and consumer preferences for more convenient contact lens care solutions.  Contact lens care products compete largely on product attributes, brand familiarity, professional recommendations and price.  The use of less-advanced cleaning methods, especially outside the United States, also affects demand for our contact lens care products.  There is no seasonality in sales of contact lens care products, but we have experienced some impact from general economic conditions to date, as in low-growth economic environments some consumers may switch to lower-priced brands.  Costs of goods sold for contact lens care products include materials, labor, overhead and royalties.  Operating income from contact lens care products is driven by market penetration and unit volumes.

During the year ended December 31, 2010, advancements in its sales reporting system permitted the Company to better estimate allowable deductions from sales in the calculation of accrued royalties.  This change in estimate resulted in a $24 million addition to U.S. operating income for the year.

On February 11, 2009, the Company announced that it initiated programs to align its operations with the evolving economic conditions and market environment.  These programs included a staffing reduction of approximately 260 employee positions that resulted in a pre-tax charge of $19 million, primarily incurred in the first quarter of 2009.  The staffing reduction is expected to deliver ongoing annualized savings of approximately $40 million, which began in the second quarter of 2009, with the full effect realized thereafter.

Our selling, general and administrative costs include the costs of selling, promoting and distributing our products and managing the organizational infrastructure of our business.  The largest portion of these costs is salaries and commissions for sales and marketing staff.

The Company was self-insured through its captive insurance subsidiary for damages incurred prior to 2006 at one of its sales and distribution facilities and was involved in legal proceedings to seek recovery of its losses and other incremental operating costs from the third parties responsible for the damages.  In December 2008, the captive insurance subsidiary settled its claim against the third parties involved.  Since no recovery had been recorded previously, the Company recognized a gain in the fourth quarter of 2008 related to the settlement of $15 million ($3 million in cost of goods sold and $12 million in selling, general and administrative expenses).

Research and development costs include basic research, pre-clinical development of products, clinical trials, regulatory expenses and certain technology licensing costs.  The largest portion of our research and development
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expenses relates to the research, development and regulatory approval of pharmaceutical products.  As part of the Company's commitment to develop treatments for diseases, disorders and other conditions of the eye, we normally plan to spend approximately 10% to 11% of sales for research and development.  During each of the years 2010, 2009 and 2008, a greater proportion of our research and development expenses were incurred during the second half of the year than during the first half.

Our amortization costs relate to acquisitions and the licensing of intangible assets.  Due to acquisitions and purchases in 2009 and early 2010, annual amortization expense on intangible assets with definite useful lives is estimated to increase to $78 million in 2011 and decrease to $65 million in 2015.

Our other operating expenses of $152 million in 2010 primarily represented costs related to the change of majority ownership arising from Novartis's purchase of its majority interest in Alcon from Nestlé on August 25, 2010, as discussed in note 16 to the consolidated financial statements, and legal and other costs to support Alcon's board of directors in its evaluation of Novartis's merger proposal.  The change of control accelerated the recognition of certain compensation expenses, including pensions ($97 million) and share-based payments ($8 million).

During the third quarter of 2008, the Company reached agreement with the U.S. Internal Revenue Service on all issues surrounding the acquisition and liquidation of its investment in former Summit Autonomous, Inc., the Company's subsidiary responsible for the Company's refractive research and manufacturing activities prior to November 2007.  As a result of this agreement, the Company recognized tax benefits in 2008 totaling $236 million related to losses on the value of this investment.

Material Opportunities, Challenges and Risks

The Company is focused on its ability to bring new products successfully to market in a competitive industry environment.  The Company's long term profitability is dependent upon the ability of its research and development activities to provide a pipeline of new products that are successful in the marketplace.  In general, we are able to generate higher margins from the sales of our products that are under patents or licenses restricting the production or sale of such products by others.  Our goal is to consistently advance the state of our research and development so as to be in a position, as existing products approach the end of their patent or license protection periods, to introduce new products that provide greater efficacy, broader application or more convenience.  Such products under new patents or licenses provide opportunities to maintain and grow our sales.

Part of our strategy is to devote significant resources to research and development efforts.  Development of new products can be a long and expensive process.  Over the past three years, we have invested approximately 10% of annual revenues into research and development.  We strive to be the first to introduce new products in the marketplace or to provide greater efficacy in treatment of ophthalmic conditions.  Being first to the marketplace with a product category can often result in a significant marketing advantage, particularly as larger pharmaceutical companies increase their focus on the ophthalmology field.

Our ability to maintain profit margins on our products may be affected by a number of regulatory activities throughout the world, from restrictive medical reimbursements for managed care to reduced regulation for imports of pharmaceutical products from other countries to the United States.  We monitor these regulatory activities and the effects on product pricing in our major markets.  Where appropriate, we share information with applicable regulatory bodies on the cost of developing new products and the importance of pricing and return of investment as an incentive to develop new and more effective therapeutic treatments.  We also monitor regulatory activities to identify initiatives that could undercut consumer protections by the introduction of nonregulated products into the U.S. distribution chain.

We are aware of and are monitoring issues regarding climate change regulations but have not identified impacts on our operations of a material nature.

We also focus on cost management.  In addition to a strict evaluation of general and administrative expenses, the Company seeks to reduce manufacturing costs through its continuous improvement program.

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As indicated earlier, our industry is dependent on proprietary technology and we vigilantly strive to protect ours.  From time to time, competitors challenge our intellectual property rights.
The Company, either alone or jointly with its commercial partners, has filed fourteen North American patent infringement actions against six different generic drug companies.  With the exception of international generic challenges, all of these generic drug companies are seeking U.S. Food and Drug Administration ("FDA") approval to market generic versions of the Company's products, under what are known as Abbreviated New Drug Applications ("ANDAs").

Each infringement action was filed after the Company received notice that one or more of the generic drug companies had filed an ANDA seeking approval to sell a generic version of a Company product.  As part of its ANDA, each generic drug company challenged one or more patents covering a Company product.  Our products subject to generic challenges include Vigamox® antibiotic ophthalmic solution, Patanol® and Pataday anti-allergy ophthalmic solutions, and TRAVATAN® and TRAVATAN Z® ophthalmic solutions.  In the United States, as a result of filing the lawsuits, the FDA must delay approval of the related ANDAs for 30 months unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  In Canada, filing of the lawsuits secured a 24-month delay in approval from the Minister of Health, which can be shortened if the litigation is earlier resolved or the court modifies the 24-month stay on such approval.  Should any generic drug company succeed in overcoming all applicable patents and secure FDA approval, it would be entitled to sell a generic product that would compete with the Company's product in the United States or Canada.  Such competition would be expected to impact significantly the Company's sales and profits.  More information on these suits can be found at Item 8.A.7, "Legal Proceedings."

On December 18, 2008, James M. Nielsen, M.D. filed a patent infringement suit against Alcon, Inc. and Alcon Laboratories, Inc. in the U.S. District Court for the Northern District of Texas in Dallas.  Dr. Nielsen is asserting that his U.S. Patent No. 5,158,572 entitled "Multifocal Intraocular Lens" is being infringed by the Company's AcrySof® ReSTOR® intraocular lens.  The patent, which expired at the end of October 2009, was previously licensed to Advanced Medical Optics, Inc.  The Company filed its Answer January 12, 2009.  The Answer included a counterclaim for a declaratory judgment that the patent-in-suit is invalid and not infringed.  The case had been set for trial in August 2010 but has been postponed.  No new trial date has been set.  Summary judgment motions were filed by both parties January 7, 2011.  Alcon is seeking summary judgment on noninfringement, invalidity and laches, while Dr. Nielsen is seeking partial summary judgment on invalidity and laches/estoppels.  On January 10, 2011, the court ordered that both parties' motions be stricken and refiled in a "cross-motion" format, the briefing for which was extended by the court until the end of March 2011.  An adverse ruling by the court, while possible, would not be expected to impact significantly the Company's sales and profits.

On January 22, 2009, Elan Pharma International Ltd. sued two of the Company's subsidiaries, Alcon Laboratories, Inc. and Alcon Research, Ltd., in the U.S. District Court for the Eastern District of Texas in Sherman, alleging infringement of two Elan patents on nanoparticle technology (U.S. Patent Nos. 5,298,262 and 5,429,842).  The complaint claims that the Company's Azopt® product and, potentially, other products infringe the two patents.  The Company answered and counterclaimed on May 12, 2009.  Elan then moved to dismiss certain of the Company's affirmative defenses and counterclaims.  The Company has filed an amended answer and counterclaims providing greater detail with respect to the Company's inequitable conduct counterclaims.  The case has been set for trial on October 17, 2011.  The Company believes that it has strong defenses and intends to defend itself vigorously.  An adverse ruling by the court, however, could impact significantly the Company's sales and profits.

The Company and its subsidiaries are parties to a variety of other legal proceedings arising out of the ordinary course of business, including proceedings relating to product liability and patent infringement.  The Company believes that it has valid defenses and is vigorously defending the litigation pending against it.

While the results of the aforementioned contingencies cannot be predicted with certainty, management believes that the ultimate liability, if any, will not have a material adverse effect on the Company's consolidated financial position or results of operations.  Litigation contingencies are subject to change based on settlements and court decisions.

The Company may be subject to future litigation and infringement claims, which could cause the Company to incur significant expenses or prevent the Company from selling its products.  The Company operates in an industry
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susceptible to significant product liability claims.  Product liability claims may be asserted against the Company in the future arising out of events not known to the Company at the present time.
The Company self-insures through captive insurance subsidiaries almost all of its property and casualty, business interruption and liability risks.

On May 6, 2010, we commenced a voluntary corrective action on our CONSTELLATION® vision system that the U.S. Food and Drug Administration ("FDA") classified as a Class 1 recall.  We submitted a 510(k) application to the FDA requesting approval of software and hardware modifications to the system.  In November 2010, we received a clearance letter from the FDA on our application.  This action did not have a material impact on our financial results.

Critical Accounting Estimates

Our discussion and analysis of our financial condition and results of operations are based upon Alcon's consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States ("U.S. GAAP").  The preparation of these financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and costs, and related disclosures of contingent assets and liabilities.  We base our estimates and judgments on historical experience, current conditions and various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities, as well as identifying and assessing our accounting treatment with respect to commitments and contingencies.  Actual results may differ from these estimates and judgments under different assumptions or conditions.

We believe that the following accounting policies involve the more significant estimates and judgments used in the preparation of our financial statements:

Sales Recognition: The Company recognizes sales in accordance with the United States Securities and Exchange Commission ("SEC") Staff Accounting Bulletin ("SAB") No. 104.  Sales are recognized as the net amount to be received after deducting estimated amounts for product returns and rebates.  Product returns are estimated based on historical trends and current market developments.  The Company participates in various sales rebate and other incentive programs, the largest of which relates to Medicaid and Medicare Part D.  Sales rebate and other incentive programs also include chargebacks, which are discounts given primarily to wholesalers for their sales of Alcon products at contractual prices to hospitals, federal government agencies, health maintenance organizations, pharmacy benefits managers and group purchasing organizations.  Sales rebates and incentive accruals reduce revenue in the same period that the related sale is recorded and are included in "Other current liabilities" in our consolidated balance sheets.  Rebates are estimated based on historical analysis of trends and estimated compliance with contractual agreements.  The Company generally offers cash discounts to certain classes of customers for the early payment of receivables.  Those discounts are recorded as a reduction of revenue and accounts receivable in the same period that the related sale is recorded.  While we believe that our reserves for product returns and rebates and for cash discounts are adequate, if the actual results are significantly different than the estimated costs, our sales may be over- or understated.

Inventory Reserves: The Company provides reserves on its inventories for estimated obsolescence or unmarketable inventory equal to the difference between the cost of inventory and the estimated fair market value based upon assumptions about future demand and market conditions.  If actual market conditions become less favorable than those projected by management, additional inventory reserves may be required.

Allowances for Doubtful Accounts:  The Company maintains allowances for doubtful accounts for estimated losses resulting from the inability of its customers to make required payments.  Management regularly assesses the financial condition of the Company's customers and the markets in which these customers participate.  Ifwe compete and our continued commitment to substantial investment in innovation. With more than 75 years of history in the financial conditionophthalmic industry, we believe the Alcon brand name is synonymous with innovation, quality, service and leadership among eye care professionals worldwide. We employ over 24,000 associates from more than 100 nationalities, operating in 60countries and serving consumers and patients in over140countries.
In 2021, Alcon's net sales to third parties amounted to $8.2 billion. The United States accounted for $3.7 billion, or 44%, of total net sales, Japan accounted for $0.6 billion, or 8%, of total net sales, China accounted for $0.5 billion or 6%, of total net sales, Switzerland accounted for $60 million, or 1%, of total net sales, and the rest of the Company's customers were to deteriorate, resulting in an impairment of their ability to make payments on our receivables from them, additional allowances may be required.

Investments:  The majority of the Company's investments are held in funds professionally managed by investment managers.  The net asset values are furnished in statements received from fund custodians whose
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statements reflect valuations conducted according to their respective fund pricing policies and asset types.  The Company uses the net asset values from independent fund custodians as a starting point to value these funds.  On an ongoing basis, management evaluates fund pricing procedures of the fund custodians, their internal controls and their financial statement reports and performs monitoring activities to obtain comfort that the net asset values appropriately represent fair value.

The Company recognizes an impairment charge when the decline in the fair value of our investments below their cost is judged to be other than temporary.  The Company considers various factors in determining whether to recognize an impairment charge, including the length of time and extent to which the fair value has been less than our cost basis, the financial condition and near term prospects of the investment entity, and our intent and ability to hold the investment for a period of time to allow for any anticipated recovery in market value.  Our ongoing consideration of these factors could result in impairment charges in the future, which could adversely affect our net earnings.

The Company determined that, at December 31, 2008, unrealized losses on certain available-for-sale equity securities and a senior secured bank loans fund were other-than-temporarily impaired due to deteriorating general market conditions, particularly during the fourth quarter of 2008, coupled with the unlikely near term prospects for achieving a sustainable recovery, uncertainty about future market conditions, and declines in certain quantitative or qualitative factors.  The other-than-temporary impairment recognized for the senior secured bank loans fund also was deemed appropriate to bring a significant portion of the unrealized losses in line with current market conditions for credit default rates and loss recovery rates.  The Company recognized losses for other-than-temporary impairment during the year ended December 31, 2008 of $37 million.  At December 31, 2010 and 2009, the Company had available-for-sale investments recorded at total fair values of $1,281 million and $530 million with gross unrealized losses totaling $3 million and $2 million, respectively, that were determined to be temporary and were included in accumulated other comprehensive income (loss) on the consolidated balance sheet.

Impairment of Goodwill and Intangible Assets: The Company assesses the recoverability of goodwill and intangible assets upon the occurrence of an event that might indicate conditions for an impairment could exist, or at least annually for goodwill.

Factors we consider important that could trigger an impairment review for intangible assets include the following:

·  significant underperformance relative to expected historical or projected future operating results;
·  significant changes in the manner or extent of our use of the acquired assets or the strategy for our overall business;
·  significant negative industry or economic trends; and
·  significant decline in the market value of the intangible asset for a sustained period.

When we determine the carrying value of intangible assets may not be recoverable from undiscounted cash flows based upon the existence of one or more of the above factors, we measure any impairment based on a projected discounted cash flow method using a discount rate determined by our management to be commensurate with the risk inherent in our current business model.

Management has determined that the reporting units for its annual testing for impairment of goodwill are the operating business segments used for segment reporting.  Management performs its testing using both multiples of quoted market prices to operating profits and present value techniques.  In the most recent testing, the fair values of the Company's reporting units substantially exceeded their respective carrying values.

To the extent that our management determines that goodwill or intangible assets cannot be recovered, such goodwill or intangible assets are considered impaired and the impairment is treated as an expense in the period in which it occurs.

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Tax Liabilities:  We are subject to income taxes in Switzerland, as well as the United States and most other foreign jurisdictions throughout the world and are regularly audited in many of these jurisdictions.  Tax laws throughout the world are complex and the application of these rules to the Company's global business operations can be uncertain.  While we believe we take reasonable positions on the tax returns filed throughout the world, some of these positions may be challenged during income tax audits in Switzerland, the United States and other jurisdictions.  Consequently, significant judgment is required in evaluating our tax positions to determine the Company's ultimate tax liability.  Management records current tax liabilities based on U.S. GAAP, including the more-likely-than-not recognition and measurement standard and the assumption that all material tax risks will be identified in the relevant examination.  Our management believes that the estimates reflected in the consolidated financial statements accurately reflect our tax liabilities under these standards.  However, our actual tax liabilities ultimately may differ from those estimates if we were to prevail in matters for which accruals have been established or if taxing authorities were to successfully challenge the tax treatment upon which our management has based its estimates.  Income tax expense includes the impact of tax reserve positions and changes to tax reserves that are considered appropriate, as well as any related interest.

Our annual effective tax rate will differ from the Swiss statutory rate, primarily because of higher tax rates in the United States and most other non-Swiss jurisdictions.  Our effective tax rate may be subject to fluctuations during the fiscal year as new information is obtained which may affect the assumptions we use to estimate our annual effective tax rate, including factors such as our mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, reserves for tax audit issues and settlements, utilization of research and experimentation tax credits and changes in tax laws in jurisdictions where we conduct operations.

Litigation Liabilities:  Alcon and its subsidiaries are parties to a variety of legal proceedings arising out of the ordinary course of business, including product liability and patent infringement litigation.  By its nature, litigation is subject to many uncertainties.  Management reviews litigation claims with counsel to assess the probable outcome of such claims.  Management records current liabilities for litigation based on their best estimates of what the Company ultimately will incur to pursue such matters to final legal decisions or to settle them.  Our management believes that the estimates reflected in the financial statements properly reflect our litigation liabilities.  However, our actual litigation liabilities may ultimately differ from those estimates if we are unsuccessful in our efforts to defend or settle the claims being asserted.  Legal costs for counsel are expensed during the period incurred.

Pension and Other Employee Benefits:  We must make certain assumptions in the calculation of the actuarial valuation of the Company-sponsored defined benefit pension plans and postretirement benefits.  These assumptions include the weighted average discount rates, rates of increase in compensation levels, expected long term rates of return on assets and increases or trends in healthcare costs.  Furthermore, our actuarial consultants also use subjective factors such as withdrawal and mortality rates.  If actual results are more or less favorable than those projected by management, future periods will reflect reduced or additional pension and postretirement medical expenses.  Upon Novartis's acquisition of the majority of Alcon's common shares, change of control provisions accelerated our expense recognition under certain defined benefit pension plans.  See note 15 to the accompanying consolidated financial statements for additional information regarding assumptions used by the Company.

Fair Values of Contingent Payments:  In connection with the acquisition of businesses, we are required to record liabilities for the estimated fair values of related possible contingent payments.  The possible payments are contingent upon the achievement of future research and development milestones that would be expected to create future value for Alcon.

We engaged a third-party valuation expert to assist us in determining the estimated fair values of contingent payments.  Valuation was based on the Company's estimates of the probability and timing of these contingent payments.  The fair value measurement was based on significant inputs not observable in the market and thus represents a Level 3 measurement, as described in note 5 to the consolidated financial statements.  Each milestone was assigned a probability based on its current status.  The resultant probability-weighted cash flows were then discounted using discount rates between 4.5% and 6%, which the Company
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believes is appropriate and representative of a market participant's assumptions.  The probabilities assigned to payment streams ranged from 5% to 65%.  An increase or decrease of 10 percentage points in the probability assumptions would result in an adjustment to the estimated value of approximately $40 million.
The fair values of these contingent payments will be reviewed on a periodic basis.  Any future changes in this estimated value not associated with the original purchase price valuation will be recorded in the Company's results of operations.

Results of Operations

The following table sets forth, for the periods indicated, selected items from our consolidated financial statements.

           As a % of Total Sales 
  2010  2009  2008  2010  2009  2008 
  (in millions, except percentages) 
Sales:                  
United States                                             $3,177  $2,914  $2,807   44.3%  44.8%  44.6%
International                                              4,002   3,585   3,487   55.7   55.2   55.4 
                         
  Total sales                                              7,179   6,499   6,294   100.0   100.0   100.0 
Costs of goods sold                                              1,675   1,614   1,472   23.3   24.8   23.4 
                         
  Gross profit                                              5,504   4,885   4,822   76.7   75.2   76.6 
Selling, general and administrative  2,070   1,935   1,961   28.8   29.8   31.1 
Research and development                                              747   665   619   10.4   10.2   9.8 
Amortization of intangibles                                              60   24   29   0.9   0.4   0.5 
Other operating expenses                                              152   --   --   2.1   --   -- 
                         
  Operating income                                              2,475   2,261   2,213   34.5   34.8   35.2 
Gain (loss) from foreign currency, net  (3)  (3)  (21)  --   --   (0.4)
Interest income                                              29   46   76   0.4   0.7   1.2 
Interest expense                                              (9)  (16)  (51)  (0.1)  (0.3)  (0.8)
Other, net                                              35   25   (134)  0.4   0.4   (2.1)
                         
  Earnings before income taxes  2,527   2,313   2,083   35.2   35.6   33.1 
Income taxes                                              317   306   36   4.4   4.7   0.6 
                         
  Net earnings                                             $2,210  $2,007  $2,047   30.8%  30.9%  32.5%
                         

This Management's Discussion and Analysis of Financial Condition and Results of Operations discusses several factors affecting the comparability of certain items in the above table.


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The following table sets forth, for the periods indicated, our sales and operating income by business segment.

           As a % of Total Sales 
  2010  2009  2008  2010  2009  2008 
  (in millions, except percentages) 
Alcon United States:                  
Pharmaceutical                                          $1,555  $1,353  $1,321   49.0%  46.4%  47.1%
Surgical                                           1,214   1,167   1,084   38.2   40.1   38.6 
Consumer eye care                                           408   394   402   12.8   13.5   14.3 
                         
  Total sales                                          3,177  $2,914  $2,807   100.0%  100.0%  100.0%
                         
  Segment operating income (1) 1,896  $1,664  $1,554   59.7%  57.1%  55.4%
                         
Alcon International:                        
Pharmaceutical                                          1,511  $1,324  $1,240   37.8%  36.9%  35.6%
Surgical                                           2,006   1,830   1,797   50.1   51.1   51.5 
Consumer eye care                                           485   431   450   12.1   12.0   12.9 
                         
  Total sales                                          4,002  $3,585  $3,487   100.0%  100.0%  100.0%
                         
  Segment operating income (1) $1,728  $1,507  $1,472   43.2%  42.0%  42.2%

(1)Certain manufacturing costs and manufacturing variances are not assigned to business segments because most manufacturing operations produce products for more than one business segment.  Research and development costs, excluding regulatory costs which are included in the business segments, and share-based compensation are treated as general corporate costs and are not assigned to business segments.

The following table sets forth, for the periods indicated, sales by product category for Alcon United States, Alcon International and our consolidated operations and includes the change in sales and change in sales in constant currency calculated by applying rates from the earlier period.  All sales for Alcon United States are recorded in U.S. dollars and, therefore, this business segment does not experience any currency translation gains or losses.

             Change            Change 
          Foreign  in          Foreign in 
          Currency  Constant          Currency Constant 
  2010 2009 Change  Change  Currency(a)  2009  2008 Change Change Currency(a)
  (in millions, except percentages) 
                            
Alcon United States:                           
Pharmaceutical$1,555 $1,353 14.9% --% 14.9% $1,353 $1,321 2.4%--%2.4%
Surgical
 1,214  1,167 4.0  --  4.0   1,167  1,084 7.7 -- 7.7 
Consumer eye care 408  394 3.6  --  3.6   394  402 (2.0)-- (2.0)
                            
  Total sales
$3,177 $2,914 9.0  --  9.0  $2,914 $2,807 3.8 -- 3.8 
                            
Alcon International:                           
Pharmaceutical$1,511 $1,324 14.1  1.7  12.4  $1,324 $1,240 6.8 (6.3)13.1 
Surgical
 2,006  1,830 9.6  2.4  7.2   1,830  1,797 1.8 (4.9)6.7 
Consumer eye care 485  431 12.5  3.7  8.8   431  450 (4.2)(6.0)1.8 
                            
  Total sales
$4,002 $3,585 11.6  2.3  9.3  $3,585 $3,487 2.8 (5.5)8.3 
                            
Total:                           
Pharmaceutical$3,066 $2,677 14.5  0.8  13.7  $2,677 $2,561 4.5 (3.1)7.6 
Surgical
 3,220  2,997 7.4  1.4  6.0   2,997  2,881 4.0 (3.1)7.1 
Consumer eye care 893  825 8.2  1.9  6.3   825  852 (3.2)(3.2)-- 
                            
  Total sales
$7,179 $6,499 10.5  1.3  9.2  $6,499 $6,294 3.3 (3.0)6.3 
                            

(a)  Change in constant currency (as referenced throughout this discussion) is determined by comparing adjusted 2010 reported amounts, calculated using 2009 monthly average exchange rates, to the actual 2009 reported amounts.  The same process was used to compare 2009 to 2008.  Change in constant currency in this table includes sales growth from acquisitions, as discussed later in this Item 5.  Sales change in constant
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currency is not a U.S. GAAP defined measure of revenue growth.  Change in constant currency calculates sales growth without the impact of foreign exchange fluctuations.  Management believes constant currency sales growth is an important measure of the Company's operations because it provides investors with a clearer picture of the core rate of sales growth due to changes in unit volumes and local currency prices.  Sales change in constant currency, as defined and presented by the Company, may not be comparable to similar measures reported by other companies.
Year ended December 31, 2010 Compared to Year ended December 31, 2009

Sales

The Company's global sales increased 10.5% to $7,179 million for the year ended December 31, 2010 from 2009.  The effect of favorable exchange rates increased global sales 1.3%.  Excluding the effect of foreign exchange fluctuations, global sales would have grown 9.2%, including 0.6% combined for additional surgical sales subsequent to the January 2010 acquisition of Optonol Ltd. and pharmaceutical sales of DUREZOL® ophthalmic steroid subsequent to the March 2010 asset purchase.  Sales reflected broad-based sales performance across all product lines and geographic areas with the United States, developed international and emerging international markets growing 9.0%, 7.0% (5.6% in constant currency) and 21.3% (17.1% in constant currency), respectively.  This improvement primarily reflected volume growth and, to a lesser extent, price increases during 2010.

Alcon United States sales increased 9.0% to $3,177 million for 2010, from $2,914 million for 2009.  The majority of the increase was due to volume growth in all major pharmaceutical product categories, in artificial tears and in intraocular lenses, especially our advanced technology intraocular lenses, AcrySof®ReSTOR® and AcrySof® Toric intraocular lenses.  Sales of pharmaceutical products to treat infections and inflammation increased 20.7%, primarily attributable to the strong performance of Vigamox® ophthalmic solution and NEVANAC® ophthalmic suspension.  Sales of surgical glaucoma products subsequent to the January 2010 acquisition of Optonol Ltd. and pharmaceutical sales of DUREZOL® ophthalmic steroid subsequent to the March 2010 asset purchase added 1.3% to the growth.  The overall improvement occurred against the backdrop of U.S. healthcare reform legislation, which reduced U.S. pharmaceutical sales by approximately $20 million.  This reduction included the impact of healthcare reform legislation rebate increases on sales made during the fourth quarter of 2009 that were still in the wholesale and retail distribution channels at the beginning of 2010, as well as sales made during 2010.

Alcon International sales increased 11.6% to $4,002 million in 2010, from $3,585 million in 2009.  The effect of favorable exchange rates increased Alcon International sales 2.3%.  Excluding the effect of foreign exchange fluctuations, Alcon International sales would have grown 9.3%, primarily reflecting volume growth during 2010.  International sales grew on a constant currency basis across all product lines and geographic areas.  Solid pharmaceutical sales growth across all geographic areas, particularly from our infection/inflammation products and our glaucoma franchise, and the sales growth in emerging markets were the main contributors to this performance.  Sales of surgical glaucoma products subsequent to the January 2010 acquisition of Optonol Ltd. were 0.1 percentage points of the growth.

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            Foreign  Change in  
            Currency  Constant  
GLOBAL PRODUCT SALES  2010  2009  Change  Change  Currency(a) 
   (in millions, except percentages)  
                  
Infection/inflammation                                                 $980 $829  18.2 %0.6 %17.6% 
Glaucoma                                                  1,277  1,121  13.9  0.8  13.1  
Allergy                                                  539  486  10.9  1.0  9.9  
Otic/nasal                                                  409  355  15.2  0.3  14.9  
Other pharmaceuticals/rebates                                                  (139) (114) *  *  *  
                  
Total Pharmaceutical                                            3,066  2,677  14.5  0.8  13.7  
                  
Intraocular lenses                                                 1,208  1,133  6.6  1.7  4.9  
Cataract/vitreoretinal/other                                                 1,895  1,759  7.7  1.4  6.3  
Refractive                                                 117  105  11.4  --  11.4  
                  
Total Surgical                                            3,220  2,997  7.4  1.4  6.0  
                  
Contact lens disinfectants                                                 471  448  5.1  1.8  3.3  
Artificial tears                                                 333  283  17.7  2.2  15.5  
Other                                                 89  94  (5.3) 2.1  (7.4) 
                  
Total Consumer Eye Care  893  825  8.2  1.9  6.3  
                  
Total Global Sales                                                $7,179 $6,499  10.5  1.3  9.2  

*Not Meaningful
See (a) on previous table.

Pharmaceutical

Global sales of our pharmaceutical products grew 14.5% during 2010.  The effect of favorable exchange rates increased global sales of our pharmaceutical products 0.8%.  Excluding the effect of foreign exchange fluctuations, our sales of pharmaceutical products would have grown 13.7%.  Sales of key products in all major therapeutic categories reflected volume gains and share growth.

Our prostaglandin family of glaucoma products includes TRAVATAN® ophthalmic solution, TRAVATAN Z® ophthalmic solution and DuoTrav® ophthalmic solution.  Combined sales of our family of TRAVATAN® products grew 12.2% for the year ended December 31, 2010, reflecting volume growth and price increases.  During the year ended December 31, 2010, Azopt® ophthalmic suspension, the Company's topical anhydrase inhibitor, and AZARGA® ophthalmic suspension, a combination formulation of brinzolamide and timolol, posted a 15.8% combined sales increase as a result of market share gains for Azopt® and increasing acceptance of AZARGA® by physicians.

Sales of Vigamox®ophthalmic solution, our leading fluoroquinolone anti-infective drug, increased 15.5% (14.6% excluding the 0.9% positive effect of foreign exchange fluctuations) compared to 2009, reflecting U.S. price increases and volume growth in the International business segment.  (Moxifloxacin, the primary ingredient in Vigamox®, is licensed to Alcon by Bayer Schering Pharma AG.)  NEVANAC® ophthalmic suspension is our non-steroidal anti-inflammatory drug ("NSAID") for the treatment of pain and inflammation associated with cataract surgery.  Sales of NEVANAC® grew 41.2% in the year ended December 31, 2010 over the prior year, due to market share gains, price increases and new product registrations outside the United States.  Sales of DUREZOL® ophthalmic steroid subsequent to the March 2010 asset acquisition provided 3.2 percentage points of the growth in sales of infection and inflammation products.

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Pursuant to a prior legal settlement, a competitor to Alcon launched a generic version of Alcon's branded TobraDex® ophthalmic suspension in the United States on January 1, 2009.  Falcon Pharmaceuticals, our generic pharmaceutical subsidiary, also launched a generic version of TobraDex® ophthalmic suspension on January 2, 2009.  During the year ended December 31, 2010, combined sales of TobraDex® ophthalmic suspension and Falcon's generic version of TobraDex® increased 3.7% globally, including the 2010 rollout of  TobraDex®ST ophthalmic suspension in the United States, over the same period of 2009.

Global sales of our leading allergy products, Patanol® and Patadayophthalmic solutions, grew 11.8% in the year ended December 31, 2010.  Sales of our allergy products benefited from severe spring and fall allergy seasons in the United States during the second and fourth quarters of 2010.

Sales of otic/nasal products increased 15.2% in the year ended December 31, 2010 over 2009.  Sales of CIPRODEX® otic suspension were positively influenced by price increases and volume growth from increased demand due to a severe ear infection season.  (CIPRODEX® is a registered trademark of Bayer AG, licensed to Alcon by Bayer Schering Pharma AG.)  Patanase® nasal spray continued to gain market share in 2010.

Pharmaceuticals rebates grew for the year ended December 31, 2010, compared to 2009, due to increased statutory rebate levels related to the U.S. healthcare reform legislation, increasing utilization of U.S. government programs and higher commercial rebates.  As a result of healthcare reform legislation in the United States, we recognized provisions totaling approximately $20 million for additional rebates primarily related to Medicaid.

Surgical

Global sales of our surgical products grew 7.4% to $3,220 million in the year ended December 31, 2010, compared to 2009.  The effect of favorable exchange rates increased global sales of our surgical products 1.4%.  Excluding the effect of foreign exchange fluctuations, our sales of surgical products would have increased 6.0%.  Higher sales of intraocular lenses and cataract and vitreoretinal products (which include surgical equipment, devices and disposable products) accounted for most of the constant currency growth.

Sales of intraocular lenses increased 6.6% in the year ended December 31, 2010 over 2009.  Excluding the 1.7% positive effect of foreign exchange fluctuations, intraocular lens sales would have increased 4.9%.  Global sales of our advanced technology lenses, such as the AcrySof®ReSTOR® and the AcrySof®Toric, increased 21.4% in the year ended December 31, 2010 and would have grown 19.7% without the 1.7% favorable effect of foreign exchange fluctuations.  Sales of our advanced technology lenses rose with increased adoption by surgeons of the AcrySof®Toric intraocular lens that corrects pre-existing astigmatism and volume gains for the AcrySof®ReSTOR® multifocal intraocular lens that corrects presbyopia.

Alcon received the European CE Mark of approval for the AcrySof® IQ ReSTOR® Toric intraocular lens during the second quarter of 2010.  This lens was introduced to ophthalmologists at the European Society of Cataract and Refractive Surgeons meeting in Paris, France, and became available in the final quarter of 2010 in many major markets that recognize the CE Mark.  The Company plans to file a Pre-Market Application ("PMA") for this lens with the FDA in early 2012.

Solid constant currency sales growth came from most other major product categories within the cataract and vitreoretinal segments.  Sales of these surgical products grew somewhat faster on a constant currency basis in the International business segment due to growth of phaco surgery in emerging markets, increased acceptance of advanced technology products and market share growth.  Sales of surgical glaucoma products subsequent to the January 2010 acquisition of Optonol Ltd. provided 0.7 percentage points of the sales growth in this category.

The increase in refractive sales for the year ended December 31, 2010 reflected global share growth.


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Consumer Eye Care

Our global consumer eye care sales, consisting of contact lens care, artificial tears and other general eye care products, rose 8.2% to $893 million in the year ended December 31, 2010, compared to $825 million in 2009.  The effect of favorable exchange rates increased global sales of our consumer eye care products 1.9%.  Excluding the effect of foreign exchange fluctuations, our sales of consumer eye care products would have grown 6.3% over the prior year.

Sales of our contact lens disinfectants climbed 5.1% in the year ended December 31, 2010 compared to 2009, mostly as a result of volume growth.  The impact of foreign exchange fluctuations increased sales of contact lens disinfectants by 1.8%.

Sales of our artificial tears products grew 17.7% over 2009.  Excluding the 2.2% effect of foreign exchange fluctuations, sales of our artificial tears products would have improved 15.5%, primarily from volume growth in both the United States and International business segments.  Market share growth of the Systane® family of lubricant eye drops drove this performance.

Sales of our other consumer eye care products declined by 5.3% to $89 million in the year ended December 31, 2010 from $94 million in 2009.  Excluding the 2.1% effect of foreign exchange fluctuations, sales of our other consumer eye care products would have decreased 7.4%.  The constant currency decrease reflected growth in retailer and coupon discounts on consumer eye products.

Gross Profit

Gross profit increased 12.7% to $5,504 million in the year ended December 31, 2010 from $4,885 million in 2009.  Gross profit increased as a percent of sales to 76.7% in the year ended December 31, 2010 from 75.2% in 2009.

During the year ended December 31, 2010, advancements in our sales reporting system permitted us to better estimate allowable deductions from sales in the calculation of accrued royalties.  This change in estimate resulted in a $24 million addition to gross profit during the first quarter of 2010.  The remaining gross profit margin reflected differences in foreign currency exchange rates, the effects of price increases in the United States, expiration of a royalty agreement lapping the $3 million of severance charges for the first quarter of 2009 and improvements in product sales mix, which were offset somewhat by increased rebates from the enactment of U.S. healthcare reform legislation.

Operating Expenses

Selling, general and administrative expenses increased 7.0% to $2,070 million in the year ended December 31, 2010 from $1,935 million in 2009, primarily due to foreign exchange impacts and bad debt provisions in Europe, which were partially offset by lapping the 2009 charges for a reduction in force.  In 2009, we experienced in-period costs of $10 million for a reduction in workforce.  Selling, general and administrative expenses decreased as a percentage of sales to 28.8% from 29.8% in 2009.  Although these expenses rose in 2010, disciplined cost management controlled their increase to levels below sales growth.

Research and development expenses increased 12.3% to $747 million (or 10.4% of sales) in the year ended December 31, 2010 from $665 million (or 10.2% of sales) in 2009.  The increase in research and development expenses represented a continued investment across pharmaceutical, surgical and consumer eye care product lines.  The 2009 expense included $6 million of in-period costs for reductions in workforce.  The increase in research and development expenses included operations of our ESBATech biotech laboratories, acquired in September 2009, and our LenSx® laser development, acquired in August 2010.

Amortization of intangibles increased to $60 million in the year ended December 31, 2010, from $24 million in 2009.  The increase arose from amortization of licenses and technology related to ESBATech, acquired in September 2009, and other acquisitions and asset purchases in 2010.

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Other operating expenses of $152 million for the year ended December 31, 2010 represented costs related to the change of majority ownership arising from Novartis's purchase of its majority interest in Alcon from Nestlé on August 25, 2010, as discussed in note 16 to the condensed consolidated financial statements, and legal and other costs to support Alcon's board of directors in its evaluation of Novartis's merger proposal.  The change of control accelerated the recognition of certain compensation expenses, including pension ($97 million) and share-based payments ($8 million).

Operating Income

Operating income increased 9.5% to $2,475 million in the year ended December 31, 2010 from $2,261 million in 2009.  The improvement in 2010 reflected the sales growth, the change in estimating royalties, lapping the 2009 charges for a reduction in force, disciplined cost management discussed above and foreign currency exchange fluctuations.  These were offset somewhat by increases in amortization, effects of the U.S. healthcare reform legislation and the change of majority ownership costs mentioned above.

Alcon United States business segment operating income increased 13.9% to $1,896 million, or 59.7% of sales, in the year ended December 31, 2010 from $1,664 million, or 57.1% of sales, in 2009.  Operating income as a percent of sales improved in 2010 as a result of sales volume growth, price increases, change in the estimating of royalties and disciplined cost management.

Alcon International business segment operating income increased 14.7% to $1,728 million, or 43.2% of sales, in the year ended December 31, 2010 from $1,507 million, or 42.0% of sales in 2009.  In 2010, the operating income margin improved as a result of sales growth, foreign exchange fluctuations, and improved gross margin.

Operating income for the Alcon United States and Alcon International business segments does not include: (1) certain manufacturing costs (e.g., manufacturing operation period costs and manufacturing variances); (2) all research and development costs other than regulatory costs; (3) certain other general corporate expenses; and (4) share-based compensation.  Other operating expenses related to the change in majority ownership and other costs to support Alcon's board of directors in its evaluation of Novartis's merger proposal were included in other general corporate expenses.

Interest and Other Income (Expenses)

Interest income fell 37.0% to $29 million in the year ended December 31, 2010 from $46 million in 2009, primarily as a result of lower short term interest rates, partially offset by higher average balances of cash and cash equivalents in 2010.  Interest expense decreased 43.8% to $9 million in the year ended December 31, 2010 from $16 million in 2009, resulting from decreased borrowings and slightly lower interest rates.

Other, net, included gains (losses) on investments for the year ended December 31, 2010 and 2009 as follows:

 Years ended December 31, 
  2010  2009 
 (in millions) 
Realized gains (losses) on sale of investments                                                                                           $30  $(49)
Unrealized gains (losses) on investments classified as trading securities  6   76 
Other                                                                                            (1)  (2)
         
Total                                                                                     $35  $25 

Alcon and its subsidiaries invest cash generated from operations to fund ongoing operating expenses, research and development and long term corporate liabilities.  The majority of the funds needed to accommodate expenses and liabilities are invested in cash and cash equivalents, the income from which is recorded in interest income.  Despite the significant weighting to cash, the Company does have material exposure to fixed income securities.  Investment gains during the year ended December 31, 2010 reflected the liquidation of the Company's remaining positions in a bank loans fund, a mortgage-backed securities fund and equities.

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The Company had material exposure during the first half of 2009 to the following investment markets:  fixed income securities, hedge funds, senior secured bank loans funds, equities and real estate investment trusts.  The Company sold its investments in real estate investment trusts, a portion of its fixed income securities and a portion of the senior secured bank loans funds portfolio in the first quarter of 2009.  The realized losses on sale of investments in the year ended December 31, 2009 reflected the sale of these instruments, for which the majority of the losses were recognized as unrealized losses on trading securities during fiscal year 2008.  The Company also requested redemption of its investments in hedge funds in 2009 and the balance in hedge funds has declined to $6 million at December 31, 2010.

Income Tax Expense

Income tax expense increased to $317 million in the year ended 2010 from $306 million in 2009.  The effective tax rate was 12.5% in the year ended December 31, 2010, compared to 13.2% in 2009.

The lower effective tax rate for the year ended December 31, 2010 reflected differences in product and geographic earnings mix and period benefits related to change of majority ownership charges, progression on prior year audits and reserve releases from the expiration of statutes of limitations.  These were offset by a $25 million tax charge from the newly enacted provisions of U.S. healthcare reform laws (discussed above).

Net Earnings

Net earnings increased 10.1% to $2,210 million in the year ended December 31, 2010 from $2,007 million in 2009.  This increase resulted from 2010 sales growth, the change in estimating royalties, disciplined cost management, the costs recognized in 2009 for the reduction in workforce and improved financial investment returns.  Together they exceeded the costs related to the U.S. healthcare reform legislation, the change of majority ownership and the Alcon board's evaluation of Novartis's merger proposal.

Year ended December 31, 2009 Compared to Year ended December 31, 2008

Sales

The Company's global sales increased 3.3% to $6,499 million in the year ended December 31, 2009 over $6,294 million in 2008.  The effect of unfavorable exchange rates decreased global sales 3.0 %.  Excluding the effect of foreign exchange fluctuations, global sales would have grown 6.3%, primarily reflecting volume growth during the year ended December 31, 2009.

Alcon United States sales increased 3.8% to $2,914 million in the year ended December 31, 2009 from $2,807 million in 2008.  Our U.S. pharmaceutical sales reflected volume gains in glaucoma products and otic products, as well as growth subsequent to the launch of Patanase® nasal spray during the second quarter of 2008.  These sales gains were partially offset by generic competition to TobraDex® suspension and lower market prescription volumes for some pharmaceutical products.

Surgical sales in the United States benefited from increased sales of intraocular lenses, especially our advanced technology intraocular lenses, AcrySof®ReSTOR® and AcrySof®Toric intraocular lenses, and sales of other cataract and vitreoretinal products.  Despite growth in sales of artificial tears in 2009, our U.S. consumer eye care sales decreased from lower sales of contact lens care and other consumer products, reflecting competition from private label products and changes in retailer purchasing patterns.

Alcon International sales increased 2.8% to $3,585 million in the year ended December 31, 2009, from $3,487 million in 2008.  Excluding the 5.5% unfavorable effect of foreign exchange fluctuations, Alcon International sales would have grown 8.3%, reflecting volume growth during the period.  Solid sales performance in Japan, Brazil, France, Spain and Australia markets led the sales growth in constant currency.

Sales in less developed international markets increased by 1.0%.  Excluding the 10.2% unfavorable effect of foreign currency fluctuation, sales in less developed international markets would have grown 11.2% as a result of
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volume growth.  Sales in the key markets of Brazil, Russia, India and China grew a combined 6.0% and would have grown 16.7% without the 10.7% unfavorable effect of foreign exchange rates.
Pharmaceutical sales outside of the United States grew on a constant currency basis in all major therapeutic areas.  Growth in Surgical sales outside the United States came primarily from advanced technology lenses, such as AcrySof®Toric and AcrySof®ReSTOR®, vitreoretinal equipment and disposable products associated with both cataract and vitreoretinal procedures.  Alcon International sales of Consumer Eye Care products declined due to lower sales of contact lens care and other products, as a result of increased competition in the market.  These declines were somewhat offset by increased sales of artificial tears products.

            Foreign  Change in  
            Currency  Constant  
GLOBAL PRODUCT SALES  2009  2008  Change  Change  Currency(a) 
   (in millions, except percentages)  
                  
Infection/inflammation                                                 $829 $874  (5.1)%(3.2)%(1.9)% 
Glaucoma                                                  1,121  955  17.4  (3.3) 20.7  
Allergy                                                  486  463  5.0  (0.6) 5.6  
Otic/nasal                                                  355  316  12.3  (1.3) 13.6  
Other pharmaceuticals/rebates                                                  (114) (47) *  *  *  
                  
Total Pharmaceutical                                            2,677  2,561  4.5  (3.1) 7.6  
                  
Intraocular lenses                                                 1,133  1,073  5.6  (3.3) 8.9  
Cataract/vitreoretinal                                                 1,759  1,692  4.0  (2.8) 6.8  
Refractive                                                 105  116  (9.5) (3.5) (6.0) 
                  
Total Surgical                                            2,997  2,881  4.0  (3.1) 7.1  
                  
Contact lens disinfectants                                                 448  469  (4.5) (1.7) (2.8) 
Artificial tears                                                 283  272  4.0  (5.6) 9.6  
Other                                                 94  111  (15.3) (3.6) (11.7) 
                  
Total Consumer Eye Care  825  852  (3.2) (3.2) --  
                  
Total Global Sales                                                $6,499 $6,294  3.3  (3.0) 6.3  

*Not Meaningful
See (a) on previous sales table.

Pharmaceutical

Global sales of our pharmaceutical products grew 4.5% in the year ended December 31, 2009 from sales in 2008.  The effect of unfavorable exchange rates decreased global sales of our pharmaceutical products 3.1%.  Excluding the effect of foreign exchange fluctuations, our sales of pharmaceutical products would have grown 7.6%.  Sales of our pharmaceutical products grew faster outside the United States because of several recent product launches in Europe and Japan, as well as faster market growth in emerging markets.  Market share and volume gains for our key products in the major therapeutic categories were the driving forces behind our global sales growth.

Sales growth for our glaucoma products came both from inside and outside the United States with a larger contribution from the international markets.  Even including the negative effects of foreign exchange, combined sales of our family of TRAVATAN® products grew 20.7% for the year ended December 31, 2009 over 2008.  During the year ended December 31, 2009, Azopt® and AZARGA®, a combined formulation that was introduced in Europe subsequent to its approval in late 2008, posted a 15.6% combined sales increase.

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Despite some contraction in the U.S. market, global sales of Vigamox® increased 8.7%, reflecting volume growth and price increases.  Sales of NEVANAC® grew 19.6% in 2009 due to increased use of NSAIDs after cataract surgery, price increases, market share gains and launches in additional countries.

Pursuant to a prior legal settlement, a competitor to Alcon launched a generic version of Alcon's branded TobraDex® ophthalmic suspension in the United States on January 1, 2009.  Falcon Pharmaceuticals, our generic pharmaceutical subsidiary, also launched a generic version of TobraDex® ophthalmic suspension on January 2, 2009.  A U.S. patent related to TobraDex® expired in September 2009.  During the year ended December 31, 2009, the combined sales of TobraDex® ophthalmic suspension and Falcon's generic version of TobraDex® decreased 35.9% globally, primarily within the United States, from 2008.

Despite contraction in the U.S. allergy market, global sales of our leading allergy products, Patanol® and Pataday grew 5.5% for the year ended December 31, 2009 over 2008.  Pataday continued to achieve market share gains in the U.S. ocular allergy market in 2009.  The increase in sales reflected volume growth outside the United States, driven by market share gains and a strong allergy season in Japan, and price growth in the United States.  A contraction in the U.S. allergy market during 2009 was partially offset by expanded market share.

Sales of otic/nasal products increased 12.3% in the year ended December 31, 2009 over 2008, despite contraction in the market for otic products.  Market share gains and price increases positively influenced sales of CIPRODEX®.  In addition, Patanase® gained market share in 2009 subsequent to its 2008 U.S. launch after FDA approval in April 2008.  Patanase® is indicated for patients 6 years of age or older for the relief of seasonal allergic rhinitis.

The change in the other pharmaceuticals/rebates line for the year ended December 31, 2009, compared to 2008, primarily reflects growth in rebates under the U.S. Medicaid program, attributable to increasing utilization rates and higher statutory discounts, and higher commercial rebates attributable to U.S. Medicare Part D sales.

Surgical

Global sales of our surgical products grew 4.0% to $2,997 million in the year ended December 31, 2009, compared to 2008.  The effect of unfavorable exchange rates decreased global sales of our surgical products 3.1%.  Excluding the negative effect of foreign exchange fluctuations, our sales of surgical products would have increased 7.1%.  Higher sales of advanced technology intraocular lenses and cataract and vitreoretinal products accounted for the constant currency growth.remaining $3.4 billion of total net sales.

SalesBasis of intraocular lenses increased 5.6% in the year ended December 31, 2009 over the prior year.  Excluding the 3.3% negative effect of foreign exchange fluctuations, intraocular lens sales would have increased 8.9%.  Global sales of our advanced technology lenses, the AcrySof®ReSTOR® and the AcrySof®Toric, increased 29.3% in the year ended December 31, 2009 and would have grown 32.4% without the 3.1% negative effect of foreign exchange fluctuations.

Sales of other surgical products were adversely impacted by exchange rates but grew faster on a constant currency basis in the International business segment due to growth of phaco surgery in emerging markets, increased acceptance of advanced technology products and market share growth.  The solid constant currency sales growth came from most major product categories within the cataract and vitreoretinal product lines.  Our CONSTELLATION® surgical system continued to gain acceptance globally among vitreoretinal surgeons.

Refractive sales declined 9.5% to $105 million for the year ended December 31, 2009 compared to 2008.  Refractive sales for the period decreased as a result of a weaker economy and a slower market.

Consumer Eye Care

Our global consumer eye care sales, consisting of contact lens care, artificial tears and other general eye care products, declined 3.2% to $825 million in the year ended December 31, 2009, compared to the prior year.  The effect of unfavorable exchange rates caused the 3.2% decrease in global sales of our consumer eye care products.  Excluding the effect of foreign exchange fluctuations, our sales of consumer eye care products would have declined minimally from the prior year.

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Sales of our contact lens disinfectants declined 4.5% in the year ended December 31, 2009 compared to 2008.  Excluding the 1.7% negative impact of foreign exchange fluctuations, sales of contact lens disinfectants would have decreased 2.8%, due to changes in retailer purchasing patterns for our contact lens disinfectants in the United States, declines in the market for branded multi-purpose solutions and competitive pressures.
Sales of our artificial tears products grew 4.0% over 2008.  Higher sales of our Systane® products accounted for most of the growth.  More than half of the sales growth for Systane® and Systane®Ultra lubricant eye drops came from the United States reflecting market share gains.  In July 2008, we launched Systane®Ultra in the United States.

Sales of our other consumer eye care products decreased 15.3% to $94 million in 2009 from 2008.  Excluding the 3.6% negative effect of foreign exchange fluctuations, sales of our artificial tears products would have decreased 11.7%.  The constant currency decrease reflected declines in sales of over-the-counter allergy and redness relief products.

Gross Profit

Gross profit increased 1.3% to $4,885 million in the year ended December 31, 2009 from $4,822 million in 2008.  Gross profit decreased as a percent of sales to 75.2% in the year ended December 31, 2009 from 76.6% in 2008.  Gross profit margin declined as a result of the loss of gross margin on sales of tobramycin/dexamethasone combination products from generic competition to TobraDex®, the effects of differences in foreign currency exchange rates and higher royalty expense, which were partially offset by manufacturing efficiencies and improvements in geographic/product sales mix.

Operating Expenses

Selling, general and administrative expenses decreased 1.3% to $1,935 million in the year ended December 31, 2009 from $1,961 million in 2008.  Selling, general and administrative expense as a percentage of sales decreased to 29.8% in 2009 from 31.1% in 2008.  In 2009, we experienced the costs of sales force additions in selected Asian and European countries, as well as lapping costs of prior year sales force additions that took place progressively after the first quarter of 2008 in the United States, Japan and emerging markets to support new product launches and/or increased direct selling share-of-voice competitiveness, and the in-period costs of $10 million for the 2009 reduction in other workforce.  These costs were more than offset by the favorable effects of foreign currency fluctuations, cost management programs and lower share-based payments expense.

Research and development expenses increased 7.4% to $665 million (or 10.2% of sales) in the year ended December 31, 2009 from $619 million (or 9.8% of sales) in 2008.  The increase in research and development expenses represented a continued investment across pharmaceutical, surgical and consumer eye care product lines.  This investment included ESBATech operations, after the acquisition in September 2009, and new licensing agreements.

Amortization of intangibles decreased to $24 million in the year ended December 31, 2009, from $29 million in 2008.  Certain paid-up licenses became fully amortized in 2009 and 2008, reducing amortization expense.

Operating Income

Operating income increased 2.2% to $2,261 million in the year ended December 31, 2009 from $2,213 million in 2008.  The operating income in 2009 reflected the increase in gross profit (from sales growth and other factors discussed above), as well as reduced selling, general and administrative expenses discussed above.

Alcon United States business segment operating income increased 7.1% to $1,664 million, or 57.1% of sales, in the year ended December 31, 2009 from $1,554 million, or 55.4% of sales, in 2008.  Operating income as a percent of sales improved in 2009 as a result of sales growth and lower operating expenses.

Alcon International business segment operating income increased 2.4% to $1,507 million, or 42.0% of sales, in the year ended December 31, 2009 from $1,472 million, or 42.2% of sales in 2008.  In 2009, the operating income
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margin declined primarily as a result of the effect of unfavorable differences in foreign currency exchange rates, higher royalty expense and lapping costs of sales force additions.

Operating income for the Alcon United States and Alcon International business segments does not include: (1) certain manufacturing costs (e.g., manufacturing operation period costs and manufacturing variances); (2) all research and development costs other than regulatory costs; (3) certain other general corporate expenses; and (4) share-based compensation.

Interest and Other Income (Expenses)

Interest income decreased 39.5% to $46 million in the year ended December 31, 2009 from $76 million in 2008, primarily as a result of declining short term interest rate yields in 2009.  Interest expense declined 68.6% to $16 million in the year ended December 31, 2009 from $51 million in 2008, resulting from decreased borrowings and lower interest rates.

Other, net, included gains (losses) on investments for the year ended December 31, 2009 and 2008 as follows:

  Years ended December 31, 
  2009  2008 
  (in millions) 
Realized gains (losses) on sale of investments                                                                                           $(49) $(12)
Unrealized gains (losses) on investments classified as trading securities  76   (85)
Other-than-temporary impairment on available-for-sale investments  --   (37)
Other                                                                                            (2)  -- 
         
Total                                                                                     $25  $(134)

Alcon and its subsidiaries invest cash flow generated from operations to fund ongoing operating expenses, research and development and long term corporate liabilities.  The majority of the funds needed to accommodate expenses and liabilities are invested in cash and cash equivalents, the income from which is recorded in interest income.  The Company's long term liabilities are evaluated with the help of outside consultants and are offset by a portfolio of investments with appropriate durations and expected returns.  Despite the significant weighting to cash, the Company had material exposure to the following investment markets:  fixed income securities, a senior secured bank loans fund and equities.  The realized and unrealized gains and losses on investments in the year ended December 31, 2009 reflected the volatility in the public markets in line with market indices.

Income Taxes

In the year ended December 31, 2009, the Company recognized net income tax expense totaling $306 million compared to income tax expense of $36 million in 2008.  During the third quarter of 2008, the Company reached agreement with the U.S. Internal Revenue Service on all issues surrounding the acquisition and liquidation of its investment in former Summit Autonomous, Inc., the Company's subsidiary responsible for the Company's refractive research and manufacturing activities prior to November 2007.  As a result of this agreement, the Company recognized tax benefits in 2008 totaling $236 million related to losses on the value of this investment.

In the year ended December 31, 2009, increased income tax expense included a net increase of $22 million for period items related to audit settlements, advance pricing agreement negotiations, recent case law, the elimination of net operating loss carryforwards, lapses of statutes of limitation and other minor items.  The Company continued to recognize Swiss tax benefits associated with the expansion of the Company's global administration operations.

preparation
The net tax expense for the year ended December 31, 2008 reflected the combined effects of (i) a net reduction of $271 million for period items described below, (ii) product and geographic earnings mix and (iii) the Swiss tax benefits associated with the expansion of the Company's global administration operations.  The reduction for period items includes (i) a reduction of $236 million for losses associated with the Company's Pre-Filing Agreement with the U.S. Internal Revenue Service related to losses associated with the Company's investmentConsolidated Financial Statements included elsewhere in Summit Autonomous, Inc. described above and (ii) reductions related to the progress on audit settlements, advance pricing agreement negotiations, the lapse of statutes of limitation and other minor items.

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Net Earnings

Net earnings decreased 2.0% to $2,007 million in the year ended December 31, 2009 from $2,047 million in 2008.  This decrease resulted from increased income taxes in 2009, compared to 2008this Annual Report, which included $271 million of period reductions of income taxes.  This income tax increase was partially offset by 2009 sales growth, disciplined cost management programs and improved financial investment returns.

Sales by Quarter

The following table sets forth our sales by quarter for the last three years.

  Unaudited 
  2010  2009  2008 
  (in millions) 
          
First                                                                            $1,721  $1,493  $1,536 
Second                                                                             1,886   1,677   1,736 
Third                                                                             1,760   1,614   1,524 
Fourth                                                                             1,812   1,715   1,498 
             
Total                                                                            $7,179  $6,499  $6,294 
             

Our quarterly sales trends reflect seasonality in several products, including ocular allergy and otic products, in the form of increased sales during the spring months, which occur during the second quarter in the northern hemisphere.

Liquidity and Capital Resources

Cash, Debt and Liquidity

At December 31, 2010, the Company reported cash and cash equivalents of $2,525 million, total short term borrowings and debt of $399 million and consolidated shareholders' equity of $7,252 million.  As part of our cash management strategy, the Company maintains large balances of cash and cash equivalents in Switzerland and Bermuda, while the Company's debt is borrowed in subsidiary operating companies located elsewhere.

The Company continued to generate significant cash flow from operations in 2010 and used $306 million to repay short term debt.  In addition, the Company used $1,037 million to pay dividends on common shares and $33 million to purchase treasury shares, as discussed below.  Acquisitions and financing activities led to a decrease of $482 million in cash and cash equivalents at December 31, 2010 from the prior year.

The Company maintains an irrevocable Rabbi trust to be held and invested in an unfunded arrangement for the payment of benefits to participants under certain defined benefit pension plans of the Company.  The assets of the trust are restricted to the payment of pension benefits except under certain conditions, such as the Company's insolvency or termination of the trust.  The Alcon Executive Retirement Plans Grantor Trust Agreement provides for the Company to fund the current actuarially determined present value of the aggregate accrued pension benefits of all participants upon the change of control (discussed in note 16 to the consolidated financial statements).  Based on actuarially determined pension benefit projections and market conditions, the Company contributed $152 million during the third quarter of 2010 to satisfy this requirement.  The assets of the trust were primarily the cash surrender value ($279 million as of December 31, 2010) of company owned life insurance policies purchased from a related captive insurance company subsidiary and cash equivalents ($152 million as of December 31, 2010).

Withholding taxes of approximately $107 million have not been provided on approximately $2,133 million of unremitted earnings of certain subsidiaries since such earnings are, or will be, reinvested in operations indefinitely.  Taxes of approximately $17 million have not been provided on temporary differences of approximately $212 million for permanent investments in certain subsidiaries that will be taxable upon liquidation.  Management believes that
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investing indefinitely in these operations will not adversely affect the Company's ability to meet its current and long term working capital and liquidity needs.

In order to receive an expedited return in 2009 of assets held by Lehman Brothers International (Europe) (in administration) as discussed in note 14 to the consolidated financial statements, Alcon has agreed to return any assets which the Joint Administrators determine should not have been disbursed in settlement.  The amount of funds to be returned, if any, would result from the determination by the Joint Administrators that the rights of another claimant in the proceeding have precedence over the Company's claim.

Cash Flows

During the year ended December 31, 2010, the Company generated operating cash flow of $2,375 million, compared to $2,416 million in 2009.  The decrease primarily reflected the Company's working capital requirements.

The operating cash flow was used for payment of dividends on common shares, the purchase of Alcon common shares, the repayment of short term borrowings, acquisitions and capital expenditures, including improvements and upgrades to our manufacturing plants and certain other facilities.

Financing Activities

During the year ended December 31, 2010, short term borrowings decreased by $270 million.  Our short term borrowings are discussed more fully under "Credit Facilities and Debt" below.

Since 2002, the Company's board of directors has authorized the purchase on the open market of up to 27 million Alcon common shares, to, among other things, satisfy the exercise of equity awards granted to employees that became or are scheduled to become exercisable in 2007 through 2012.  To the extent such share purchases are not required for employee awards, the board may present the shares for approval of cancellation at future shareholders' meetings.  Through December 31, 2010, we cumulatively have purchased approximately 25.6 million Alcon common shares (including approximately 207,000 shares in 2010) for $2,740 million (including $33 million in 2010).

In December 2008, as a result of the agreement between Novartis and Nestlé discussed in note 16 to the consolidated financial statements, the Company discontinued the purchase of Alcon common shares in the open market under all share repurchase programs.  However, the Company continues to acquire shares withheld from employees' exercises of share-based awards to cover their taxes.

We intend to issue new common shares from conditional capital for the exercise of stock options held by employees that became exercisable in 2006 and 2005, as well as for share-based awards granted after December 31, 2007.  In February 2010, approximately 1.3 million share-settled stock appreciation rights and approximately 168,000 stock options granted to employees in 2007 became exercisable.  In connection with the change in control, on August 25, 2010, almost 1.0 million employee share-settled stock appreciation rights and approximately 145,000 employee stock options became exercisable.  In addition, over 1,000 restricted shares and approximately 234,000 restricted share units vested at that time.  During 2010, approximately 2.4 million options were exercised, providing proceeds of $169 million to the Company, and more than 1.5 million share-settled stock appreciation rights were exercised.

In June 2010, we paid our shareholders cash dividends of $1,037 million (CHF 3.95 per common share, or approximately $3.44 per common share).  The merger agreement with Novartis dated December 14, 2010 precludes the payment of dividends by Alcon.

Investing Activities

Net cash used in investing activities in the year ended December 31, 2010 and 2009 was $1,705 million and $390 million, respectively.  The Company increased its investing activities in 2010 through two acquisitions, the purchase of intangible assets and adjustments to the investment portfolio.  In 2010, more cash was used to acquire financial investments than in 2009, as certain adjustments were made in the investment portfolio.  Capital expenditures decreased slightly in 2010, when compared to 2009, but the decrease was more than offset by purchases of intangible assets.

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Our annual capital expenditures over the last three years were $309 million in 2010, $342 million in 2009 and $302 million in 2008, principally to expand and upgrade our manufacturing and research and development facilities and other infrastructure.  In 2010, capital expenditures were made to add manufacturing capacity and upgrades to our Fort Worth, Texas, Puurs, Belgium, Huntington, West Virginia, Cork, Ireland, Kaysersberg, France, Houston, Texas, and Sinking Spring, Pennsylvania, manufacturing facilities and to continue construction of a new manufacturing plant in Singapore.  In 2009, we broke ground to build the facility in Singapore that will manufacture pharmaceuticals to be distributed throughout most of Asia.  We plan for the 331,000 square foot facility to be fully functional in 2012.  Capital expenditures in 2010 were also made to upgrade and expand our research and development facilities and administrative facilities in Fort Worth and in Zurich, Switzerland (ESBATech).

We had capital expenditure commitments of $53 million at December 31, 2010.  We expect to fund these capital projects through operating cash flow and, if necessary, short term borrowings.

In January 2010, we acquired Optonol, Ltd., a medical device company that develops, manufactures and markets novel miniature surgical implants used to lower intraocular pressure in patients with glaucoma.  With this acquisition, Alcon acquired Optonol's EX-PRESS® glaucoma filtration device.  This medical device will complement Alcon's pharmaceutical products that lower intraocular pressure in patients with glaucoma and ocular hypertension, and will be additive to the Company's growth opportunities.

The device is currently reimbursed in the U.S by Medicare and other payors, and it is also approved and currently marketed in Europe, Canada, Australia and several other countries.  Because the product is already approved in the United States and other major markets, it began contributing commercially in the first quarter of 2010.

In the first quarter of 2010, we also purchased certain intangible assets.  The intangible assets included the technology and licenses to manufacture, market and sell DUREZOL® ophthalmic steroid for post-surgical ocular pain and inflammation.

On August 18, 2010, the Company acquired 100% of the outstanding common shares of LenSx Lasers, Inc.  LenSx is a privately held company that has developed the first femtosecond laser to receive U.S. Food and Drug Administration clearance for use as a complementary technology in cataract surgery.  LenSx's laser enables surgeons to perform specific steps of the traditional cataract procedure with micron-level laser precision, including anterior capsulorhexis, phacofragmentation and the creation of certain corneal incisions.  Without this technology, these steps must be performed manually with hand-held surgical instruments.

The Company paid $367 million in cash at closing to LenSx® shareholders for their shares.  The acquisition also provides for maximum contingent payments of $383 million based upon the achievement and over-achievement of future femtosecond unit and procedure fee revenue milestones.

During 2010, although we sold portions of our investments receiving proceeds of $2,149 million, we added to our financial portfolio, investing $2,881 million.  Total investments (short term and long term) were included in the consolidated balance sheets at a fair value of $1,287 million as of December 31, 2010, as compared with $552 million as of December 31, 2009.  These investments were primarily denominated in U.S. dollars.  The Company has invested in mostly debt investments primarily to plan for obligations under certain deferred compensation arrangements and to generate additional returns within established risk parameters.  More information on our investments is provided in notes 4 and 5 to the consolidated financial statements.
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Contractual Obligations

 Payments Due by Period 
     1 Year   2-3   4-5  More than 
  Total  or Less  Years  Years  5 Years 
 (in millions) 
Long term debt                                             $62  $62  $--  $--  $-- 
Operating leases                                              280   67   87   45   81 
Purchase obligations                                              76   41   30   3   2 
Income tax liabilities                                              77   1   76   --   -- 
Other long term liabilities                                              920   85   189   152   494 
   Total contractual obligations $1,415  $256  $382  $200  $577 
During the year ended December 31, 2010, we increased net unrecognized tax benefits by $1 million, resulting in net unrecognized tax benefits of $77 million at December 31, 2010.  Total unrecognized tax benefits for which payments were expected within one year were $1 million.  A reasonably reliable estimate of the timing of future payments relating to noncurrent unrecognized tax benefits could not be determined.

Additional information about the amounts included in the above table was provided in notes 3, 5, 8, 9, 13, 15, 17 and 18 to the consolidated financial statements.

Off-Balance Sheet Arrangements

The Company has obligations under certain guarantees, letters of credit, indemnifications and other contracts that contingently require the Company to make payments to guaranteed parties upon the occurrence of specified events.  The Company believes that any payments required under these contingencies would not pose potential material risk to the Company's future liquidity, capital resources and financial condition.  See the notes to the consolidated financial statements for further descriptions and discussions regarding the Company's obligations.

We acquire assets still in development and enter into research and development arrangements with third parties that often require milestone and royalty payments to such third party contingent upon the occurrence of certain future events linked to the success of the asset in development.  Milestone payments may be required contingent upon the successful achievement of an important point in the development life cycle of the pharmaceutical product (e.g., approval of the product for marketing by the appropriate regulatory agency).  If required by the arrangement, we may have to make royalty payments based upon a predetermined percentage of the sales of the pharmaceutical product in the event that regulatory approval for marketing such product is obtained.  Because of the contingent nature of these payments, except for contingent payments recorded in business acquisitions, they are not included in the table of contractual obligations.

These arrangements are not individually material to the Company's future liquidity, capital resources and financial condition.  However, if milestones for multiple products covered by such arrangements would happen to be reached in the same accounting period, the aggregate charge to expense could be material to theposition, results of operations, in any one period.  These arrangements often give us the discretion to unilaterally terminate development of the product, which would allow us to avoid making the contingent payments; however, we are unlikely to cease development if the potential product successfully achieves clinical testing objectives.

Capital Resources

We expect to meet our current working capital and liquidity needs principally through cashcomprehensive income/(loss), and cash equivalents, the liquidation of short term investments and, to the extent necessary, short term borrowings. We expect to meet future liquidity requirements through our operating cash flows the liquidation of short term investments and, to the extent necessary, issuance of short term or long term debt.  We believe this combination would be sufficient to meet our liquidity requirements, even if our sales were adversely affected as compared to expectations.

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Credit Facilities and Debt

During 2010, the Company repaid and terminated its commercial paper facility.  An Alcon subsidiary had an available commitment of $12 million under an unsecured line of credit with a subsidiary of Novartis; at December 31, 2010, $4 million was outstanding under this credit facility.  Alcon's subsidiaries had third-party lines of credit, including bank overdraft facilities, totaling approximately $845 million under which there was an aggregate outstanding balance of $333 million at December 31, 2010.  These third-party credit facilities are arranged or provided by a number of international financial institutions, the most significant of which had the following aggregate limits:  Citibank ($395 million); Mitsui-Sumitomo Bank ($105 million); Mizuho Bank ($99 million); and Bank of Tokyo – Mitsubishi UFJ ($61 million).  Most of the credit facilities have terms of less than one year and accrue interest at a rate consistent with local borrowing rates.  In aggregate, these facilities had a weighted average interest rate of 2.5% at December 31, 2010.

As of December 31, 2010, the Company had a bank loan for Japanese yen 5.0 billion ($62 million) maturing in January 2011 arranged by ABN AMRO for our subsidiary in Japan.  The balance of the loan was repaid in January 2011.
Valuation of Financial Instruments

The Fair Value Measurements and Disclosures Topic of the Accounting Standards Codification ("ASC") defines fair value, establishes a framework for measuring fair value, establishes a fair value hierarchy based on the inputs used to measure fair value and enhances disclosure requirements for fair value measurements.

The Company has hired investment managers to invest funds primarily in liquid, short term high-quality fixed income investments.  The investments are held at a global custodian and priced using the custodian's pricing matrix, which primarily includes broker/dealer quotes in active markets.  The pricing on these securities has not been adjusted by the Company.  We have reviewed our global custodian's pricing source hierarchy, which details the preferred pricing source and method for each asset class.  Due to the nature of the pricing sources, the Company has classified these investments as Level 2.

As indicated in note 5 to the consolidated financial statements, financial assets presented at fair value and categorized as Level 3 were corporate investments held in funds professionally managed by investment managers.  These Level 3 financial assets were marked to net asset values furnished in statements received from fund custodians, whose statements reflect valuations conducted according to their respective fund pricing policies and asset types.  The Company evaluated these pricing policies utilized by the investment advisors and validated certain fair value measurements.

As discussed in note 5 to the consolidated financial statements, in connection with certain acquisitions, the Company agreed to potential contingent payments, with estimated fair values totaling $160 million, upon the achievement of certain future research and development milestones and/or certain revenue objectives.  These contingent liability payments were classified as Level 3 under the fair value hierarchy and were valued using discounted probability weighted cash flow models.   The sensitivities of the estimates to the assumed probabilities are discussed in that same note.

The Company's financial assets and liabilities presented at fair value and categorized as Level 3 as of December 31, 2010 and 2009 were summarized in the table presented below:
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  December 31,  December 31, 
  2010  2009 
  (in millions) 
       
Level 3 assets
 $6  $22 
         
Total assets
 $10,073  $8,686 
         
Total financial assets measured at fair value
 $1,287  $559 
         
Level 3 assets as a percent of total assets
 Less than 1 %  Less than 1 % 
Level 3 assets as a percent of total financial assets measured at        
fair value
 Less than 1 %   4%
         
         
Level 3 liabilities $160  $71 
         
Total liabilities $2,821  $2,781 
         
Total financial liabilities measured at fair value (including short term        
borrowings) $571  $736 
      ��  
Level 3 liabilities as a percent of total liabilities  6%  3%
Level 3 liabilities as a percent of total financial liabilities measured        
at fair value  28%  10%
         

For a further discussion regarding the measurement of financial instruments, see note 5 to the consolidated financial statements.
Market Risk

Interest Rate Risks

We are exposed to interest rate risks through short term floating rate investments that exceed our short term floating rate loans.  Rising interest rates will increase net interest income, while falling rates will reduce it.  We evaluate the use of interest rate swaps and periodically use such agreements to manage our interest rate risk on selected debt instruments.

Credit Risks

In the normal course of our business, we incur credit risk because we extend trade credit to our customers.  We believe that these credit risks are well diversified, and our internal staff actively manages these risks.  Our principal concentrations of trade credit are generally with large and financially sound corporations, such as large retailers and grocery chains, drug wholesalers and governmental agencies.  It is not unusual for our five largest customers in the United States to represent in the aggregate approximately 16% of the outstanding balance of our gross accounts receivable; however, no single customer accounted for more than 10% of the Company's consolidated sales in the year ended December 31, 2010.

In connection with our sales of surgical equipment, we frequently finance the purchase of our equipment and enter into leases and other financial transactions with our customers.  In general, these loans and other transactions range in duration from one to five years and in principal amount range from $15,000 to $500,000.  We conduct credit analyses of the customers to whom we extend credit and secure the loans and leases with the purchased surgical equipment.  Over the last 24 years, we have offered financing programs for surgical equipment and losses have not been material to our operations.  In countries that may be subject to high inflation, the credit risks to which we are exposed can be larger and less predictable.

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We conduct some of our business through export operations and are exposed to country credit risk.  This risk is mitigated by the use, where applicable, of letters of credit confirmed by large commercial banks in Switzerland and the United States.

In certain countries in the European Union, many of our government customers have significantly delayed payment of amounts owed to us for their purchase of our products.  This has increased our exposure to credit risk in these countries.  We regularly review these risks and take appropriate actions related to them.

We have significant outstanding receivable balances that are dependent upon either direct or indirect payment by various governmental entities across the world.  The ultimate payment of these receivables is dependent on the ability of these governments to maintain liquidity primarily through borrowing capacity, particularly in the European Union.  If certain governments are not able to maintain access to liquidity through borrowing capacity, the ultimate payment of their respective portion of these outstanding receivables could be at risk and impact profits and cash flow.

Currency Risks

We are exposed to market risk from changes in currency exchange rates that could impact our results of operations and financial position.  We manage our exposure to these currency risks through our regular operating and financing activities and, when appropriate, through the use of derivative financial instruments.  We use foreign currency derivative financial instruments as risk management tools.

We use foreign currency forward contracts and options to manage the volatility of non-functional currency cash flows resulting from changes in exchange rates.  Foreign currency forward contracts are primarily used to hedge intercompany purchases and sales.  The use of these derivative financial instruments allows us to reduce our overall exposure to exchange rate fluctuations, since the gains and losses on these derivative contracts substantially offset losses and gains on the assets and liabilities being hedged.

New Accounting Standards

In October 2009, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update No. 2009-13, "Multiple-Deliverable Revenue Arrangements-a consensus of the FASB Emerging Issues Task Force."  This update provides amendments to ASC Topic 605, "Revenue Recognition" to address the accounting for multiple-deliverable arrangements to enable vendors to account for products or services (deliverables) separately rather than as a combined unit.  The update is effective prospectively for revenue arrangements entered into or materially modified in fiscal years beginning on or after June 15, 2010.  The Company does not expect this update to have any impact on the Company's consolidated financial statements upon adoption on January 1, 2011.

In January 2010, the FASB issued Accounting Standards Update No. 2010-06, "Improving Disclosures about Fair Value Measurements."  This update provides amendments to ASC Topic 820-10, "Fair Value Measurements and Disclosures" by requiring additional disclosures regarding financial instruments.  The update is effective for interim and annual reporting periods beginning after December 15, 2009, except for the disclosures about purchases, sales, issuances, and settlements in the roll forward of activity in Level 3 fair value measurements.  Those disclosures are effective for fiscal years beginning after December 15, 2010, and for interim periods within those fiscal years.  The Company implemented the applicable portions of this update in 2010 and does not expect the remaining provisions of this update to have a significant impact on the Company's consolidated financial statements.
In July 2010, the FASB issued Accounting Standards Update No. 2010-20, "Disclosures about the credit quality of Financing Receivables and the Allowance for Credit Losses."  This update amends ASC Topic 825, "Accounting for Financial Instruments" by requiring additional disclosures regarding financing receivables.  The update is effective for interim and annual reporting periods beginning after December 15, 2010.  The Company does not expect this update to have any impact on the Company's consolidated financial statements upon adoption on January 1, 2011.
In December 2010, the FASB issued Accounting Standards Update No. 2010-27, "Fees Paid to the Federal Government by Pharmaceutical Manufacturers."  This update responded to certain provisions in the "Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act".  The update is
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effective for calendar years beginning after December 31, 2010.  There were no applicable fees incurred in 2010.  In accordance with the guidance, applicable fees in 2011 will be recognized in operating expenses.  See further discussion of these fees in this Item 5, under "U.S. Healthcare Reform."

ITEM 6.                         DIRECTORS, SENIOR MANAGEMENT AND EMPLOYEES
A.  DIRECTORS AND SENIOR MANAGEMENT

Below is information with respect to our current directors and officers and their ages as of February 1, 2011.  Unless otherwise indicated, the business address of all of our directors and officers is c/o Alcon, Inc., Bösch 69, P.O. Box 62, 6331, Hünenberg, Switzerland.

NameAgeTitle
Daniel Vasella, M.D.57Chairman and Director
Cary R. Rayment                                             63Vice Chairman and Director
Kevin J. Buehler                                             53President, Chief Executive Officer and Director
Urs Bärlocher, Ph.D.                                             68Director
Paul Choffat, Ph.D.                                             61Director
Lodewijk J.R. de Vink                                             65Director
Joan W. Miller, M.D.                                             52Director
Thomas G. Plaskett                                             67Director
Jacques Seydoux, M.D.                                             59Director
Enrico Vanni, Ph.D.                                             59Director
Norman Walker                                             58Director
Patrick Bachmann                                             43
Attorney-in-Fact (Prokurist)
Stefan Basler                                             56
Attorney-in-Fact (Prokurist)
Joanne Beck                                             53
General Manager (Direktor)
Wes Brazell                                             44
Attorney-in-Fact (Prokurist)
Robert Karsunky                                             48Senior Vice President, Finance, Chief Financial Officer and Corporate Strategy Officer
Elaine E. Whitbeck                                             56General Counsel and Corporate Secretary

Effective with the change of majority ownership on August 25, 2010, Werner Bauer, Paul Bulcke, Francisco Castañer, James Singh and Herman Wirz resigned from our board of directors.

Effective November 1, 2010, Robert Karsunky was appointed as Senior Vice President, Finance, Chief Financial Officer, and Corporate Strategy Officer of Alcon, Inc.  Mr. Karsunky succeeded Richard J. Croarkin who served in that role since August 2007.

Alcon entered into a service agreement with Cary Rayment commencing April 1, 2009 under which he served as a director and the non-executive chairman of the board.  Effective October 24, 2010, Cary Rayment ceded his chairman position and the board appointed Daniel Vasella as chairman and Mr. Rayment as vice chairman of the board.

Directors

Daniel Vasella, M.D.  Dr. Vasella is the chairman of the board for Alcon, Inc.  He was appointed to this position on October 24, 2010.  Dr. Vasella joined the Alcon, Inc. board in July 2008.  He served 14 years as Chief Executive Officer and 11 years as Chairman and Chief Executive Officer of Novartis AG.  The board of directors of Novartis accepted Dr. Vasella's proposal to complete the Chief Executive Officer succession process by appointing Joe Jimenez as Novartis's Chief Executive Officer as of February 1, 2010.  Dr. Vasella continues in his role as Chairman of the Board of Novartis concentrating on strategic priorities.  After holding a number of medical positions in Switzerland, he joined Sandoz Pharmaceuticals Corporation in the United States in 1988.  From 1993 to 1995, Dr. Vasella advanced from Head of Corporate Marketing to Senior Vice President and Head of Worldwide Development to Chief Operating Officer of Sandoz Pharma Ltd.  In 1995 and 1996, Dr. Vasella was a member of the Sandoz Group Executive Committee and Chief Executive Officer of Sandoz Pharma Ltd.  Dr. Vasella is a member of the board of directors of PepsiCo, Inc., United States.
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Cary R. Rayment.  Mr. Rayment has been the vice chairman of the board for Alcon, Inc. since October 24, 2010.  Following his retirement as President and Chief Executive Officer on April 1, 2009, he served in the role as non-executive chairman and director of Alcon, Inc. until October 24, 2010.  He also served as Chairman, President and Chief Executive Officer of Alcon Laboratories, Inc. from October 1, 2004 to March 31, 2009.  Prior to these promotions, Mr. Rayment served as Senior Vice President, Alcon United States from 2001 to 2004 (adding responsibility for Alcon Japan in 2004); Vice President and General Manager, Surgical, and Area Vice President Japan in 2000; Vice President, International Marketing & Area Vice President Japan from 1997-1999; Vice President and General Manager, Managed Care in 1996; Vice President and General Manager, U.S. Surgical Products from 1991-1995; and Vice President Marketing, Surgical Products from 1989-1990.  Mr. Rayment joined Alcon in 1989, following the acquisition of CooperVision, Inc. where his position had been Vice President of Marketing.
Kevin J. Buehler.  Mr. Buehler was appointed President and Chief Executive Officer of Alcon, Inc. effective April 1, 2009 and elected as a member of the board on May 5, 2009.  He served as Senior Vice President, Global Markets and Chief Marketing Officer of Alcon Laboratories, Inc. from January 1, 2007 to March 31, 2009.  He served as Senior Vice President, Alcon United States and Chief Marketing Officer from February 2006 through December 2006.  From 2004 to 2006, he was Senior Vice President, Alcon United States.  From 2002 to 2004, Mr. Buehler was International Area Vice President with responsibility for the Company's operations in Latin America, Canada, Australia and the Far East.  In 1999, he led the U.S. Consumer Products Division as Vice President and General Manager and in 1998 was promoted to a Vice President position.  In 1996, after holding a series of sales management positions with increasing responsibility in the U.S. Consumer Products Division, Mr. Buehler expanded his experience into the pharmaceutical and surgical business areas, leading the Company's U.S. Managed Care and Falcon Generic Pharmaceutical groups.  Mr. Buehler joined the Company in 1984.

Urs Bärlocher, Ph.D.  Dr. Bärlocher joined the Alcon, Inc. board in August 2010.  He earned his J.D. from the University of Basel and was admitted to the bar in 1970.  After working as a tax lawyer, he joined Sandoz Ltd., Basel, Switzerland, in 1973.  After the formation of Novartis, Basel, Switzerland, in 1996, he was appointed Head of Legal, Tax and Insurance.  From 1999 until 2005, he served as General Counsel and Head of General Affairs and thereafter, until his retirement in summer 2007, he served as Head of Legal and Tax Affairs of the Novartis Group.  He is currently a member of the board of directors of Habasit AG, Habasit Holding AG and Victoria-Jungfrau Collection AG, as well as vice president of the Windler Foundation.

Paul Choffat, Ph.D.  Dr. Choffat joined the Alcon, Inc. board in August 2010.  He holds a J.D. from the University of Lausanne, Switzerland, and an M.B.A. from the International Institute for Management Development (IMD) in Lausanne, Switzerland.  He started his professional career with Nestlé in Zurich, Switzerland, and London, UK.  From 1981 to 1985, he was project manager at McKinsey & Company in Zurich.  He held a number of senior positions at Landis & Gyr in Zug, Switzerland, before he moved to Von Roll in Gerlafingen as CEO.  He joined Sandoz Ltd., Basel, Switzerland, in 1995.  During the merger which created Novartis, he headed the Integration Office.  In 1996, he returned to line management as CEO of Fotolabo SA, Montpreveyres-sur-Lausanne, Switzerland, where he remained for three years before becoming an entrepreneur and private investor in 1999.  From 2002 to April 2007, Dr. Choffat served as Head of Novartis Consumer Health.  He is currently a member of the board of directors of HSBC Private Bank (Suisse) SA and de Rham SA.

Lodewijk J.R. de Vink.  Mr. de Vink joined the Alcon, Inc. board in March 2002.  Mr. de Vink has served as Founding Partner of Blackstone Health Care Partners since April 2003.  Prior to that, he was Chairman, International Health Care Partners from November 2002 to 2003, and Chairman, Global Health Care Partners, Credit Suisse First Boston, from November 2000 to September 2002.  Mr. de Vink was formerly Chairman, President and CEO of Warner-Lambert Company.  He joined Warner-Lambert as President of International Operations in 1988, was elected President in 1991, and then Chairman and CEO in May 1999.  Before Warner-Lambert, Mr. de Vink spent twenty years at Schering-Plough where he held many international assignments, leaving there as President of Schering International.  Mr. de Vink is a member of the board of directors of Roche Holding AG and Flamel Technologies S.A.  Mr. de Vink is also a member of the European Advisory Council, Rothschild & Cie, as well as a member of Sotheby's International Advisory Board.

Joan W. Miller, M.D.  Dr. Miller joined the Alcon, Inc. board in May 2009.  Dr. Miller is Chief and Chair of Ophthalmology and Henry Willard Williams Professor of Ophthalmology at the Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital and Harvard Medical School.  Dr. Miller's research interests are focused on ocular neovascularization, particularly as it relates to macular degeneration and diabetic retinopathy, including the
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role of growth factors, the development of antiangiogenic therapy, and photodynamic therapy.  Dr. Miller has received numerous awards, including the Rosenthal Award, Don Gass Medal and the Henkind Lecture of the Macula Society, the Retina Research Award from the Club Jules Gonin, the Founders Award of ASRS (American Society of Retina Specialists), the Alcon Research Institute Award and the Suzanne Veronneau-Troutman Award.  Dr. Miller's professional affiliations include American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, Inc. (ARVO) and the New England Ophthalmological Society (NEOS).
Thomas G. Plaskett.  Mr. Plaskett joined the Alcon, Inc. board in May 2003.  In September 2003, the board affirmed Mr. Plaskett as the "audit committee financial expert."  Since 1991, Mr. Plaskett has served as Chairman of Fox Run Capital Associates, a private consulting firm, focusing on financial advisory and consulting services for emerging companies. Previously, he was Chairman, President and Chief Executive Officer of Pan Am Corporation from 1988 to 1991, and President and Chief Executive Officer of Continental Airlines from 1986 to 1987.  Also, during the period from 1974 to 1986, he held several senior management positions at American Airlines and AMR Corporation, including Senior Vice President of Marketing and Senior Vice President of Finance and Chief Financial Officer.  He also was Vice-Chairman of Legend Airlines from 1996 to 2000.  Mr. Plaskett is a director of RadioShack Corporation; director of Signet Jewelers, Ltd.; and a director of several privately held companies.

Jacques Seydoux, M.D.  Dr. Seydoux joined the Alcon, Inc. board in August 2010.  He graduated with an M.D. from the University of Berne, Switzerland, in 1979.  After holding a number of medical positions, he was appointed medical director and chair of the department of Obstetrics and Gynecology of the Regional Hospital of Delémont, Switzerland, in 1998.  After the merger of the regional hospitals of Delémont and Porrentruy that created the State Hospital of Jura in 2004, he was named medical director and chair of the department of Obstetrics and Gynecology Service.  He is a member of numerous professional associations such as vice president of the Swiss National Obstetrics and Gynecology Society, president of the Groupment Romand de la Société Suisse Gyn/Ob, and member of the European Society for Gyn Endoscopy, the American Gynecological and Obstetrical Society, the Society of Obstetrics and Gynecology of Canada as well as of the North American Menopause Society.

Enrico Vanni, Ph.D.  Dr. Vanni joined the Alcon, Inc. board in August 2010.  He is a chemical engineer graduated from the Federal Polytechnic School of Lausanne, Switzerland and holds a Ph.D. (Doctorate in Science) from the University of Lausanne.  His background also includes an MBA from INSEAD in Fontainebleau, France.  He started his career in 1977 with IBM in San Jose, California, and after his MBA in 1980, joined McKinsey & Company in Zurich, Switzerland.  He managed the Geneva Office from 1988 to 2004.  His consulting activities mostly covered companies in the pharmaceutical, consumer and finance sectors.  He was head of the European pharmaceutical practice and served as member of the Partner review committee of the firm over many years.  He retired as Director of McKinsey at the end of 2007.  Since 2008, he is an independent consultant and a member of several company boards of directors such as Eclosion (private equity for biotechs), Denzler & Partners (management resources) and MBCP (private banking).

Norman Walker.  Mr. Walker joined the Alcon, Inc. board in August 2010.  He earned a degree in Business Studies at the University of Brighton, UK, in 1975 and attended the Harvard International Senior Management Program in 1994.  He started his professional career with Ford Motor Co in London, UK, in 1975.  Over a period of 9 years he held a number of positions in human resources management before he joined GrandMet in London, UK, in 1984 where he assumed human resources responsibilities in several of its business units.  Mr. Walker subsequently joined Kraft Foods in 1991 and held a number of leading human resources positions in Germany, the United States and Switzerland.  From 1998 to 2003, he served as the Head of Corporate Human Resources of the Novartis Group.  Mr. Walker is a senior advisor to TPG Capital LLP, Chair of Vita Cayman, advisor to CMi and a visiting professor at Bocconi.

Part C of this Item 6 includes information about the staggered terms of office for our board of directors and re-election limits for non-executive directors.

Alcon, Inc. is a holding company which operates principally through its operating subsidiaries.  Our board of directors is responsible for the ultimate direction of Alcon, Inc., as a holding company, and will determine our business strategy and policies and those of our operating subsidiaries.  The executive officers of Alcon, Inc. are responsible for certain administrative, regulatory and oversight matters, the exercise of shareholder rights with
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respect to our subsidiaries, the funding of research and development projects, the administration and purchase of intellectual property rights and the collection of related license income.

Senior Management

Our principal subsidiary in the United States is Alcon Laboratories, Inc. Under the supervision of our board of directors, the executive officers of Alcon, Inc. and Alcon Laboratories, Inc. provide global management services with
respect to the ongoing business and operations of our operating subsidiaries, including research and development, manufacturing, sales and distribution, marketing, financing and treasury.

Below is information with respect to the current executive officers of Alcon Laboratories, Inc. and their ages as of February 1, 2011.  Unless otherwise indicated, the business address of all of these officers is c/o Alcon Laboratories, Inc., 6201 South Freeway, Fort Worth, Texas 76134-2099.

NameAgeTitle
Kevin J. Buehler
53Chairman, President and Chief Executive Officer
Robert Karsunky
48Senior Vice President, Finance, Chief Financial Officer and Corporate Strategy Officer
William K. Barton
57Senior Vice President, International Markets
Sabri Markabi, M.D.52Senior Vice President, Research & Development and Chief Medical Officer
Merrick McCracken
48Senior Vice President, Human Resources
Ed McGough
50Senior Vice President, Global Manufacturing and Technical Operations
Elaine E. Whitbeck
56Senior Vice President, Chief Legal Officer/General Counsel and Corporate Secretary

Effective November 1, 2010, Robert Karsunky was appointed as Senior Vice President, Finance, Chief Financial Officer and Corporate Strategy Officer of Alcon Laboratories, Inc.  Mr. Karsunky succeeded Richard J. Croarkin who served as Alcon's chief financial officer since August 2007.

Kevin J. Buehler.  See "-Directors" above.

Robert Karsunky.  Mr. Karsunky was named Senior Vice President, Finance, Chief Financial Officer and Corporate Strategy Officer of Alcon Laboratories, Inc. effective November 1, 2010.  His global responsibilities include management of all financial functions for the Company as well as Information Technology, Investor Relations, Business Development and coordination of the development and execution of corporate strategy.

Mr. Karsunky joined Novartis in 2006 as chief financial officer in the Consumer Health Division of Novartis.  In this role, he was responsible for the division's finance, information technologies, procurement and merger and acquisition activities.  Prior to joining Novartis, he served for four years as the vice president of finance for the international division of Medtronic, Inc.  He began his career with Eli Lilly in 1991 where he held a variety of increasingly responsible financial positions to become the executive director of finance for Intercontinental and Japan from 2000 to 2002.

William K. Barton.  Mr. Barton was named Senior Vice President, International Markets of Alcon Laboratories, Inc., effective April 1, 2009.  In this role, Mr. Barton is responsible for the management of International Markets and the Global Marketing Committee.  Mr. Barton joined Alcon in 1989 (following the acquisition of CooperVision) as Group Product Director, Marketing, Surgical Products.  Since that time, he has held positions of increasing responsibility in all divisions including Vice President of Marketing for Surgical from 1991 to 1995, Vice President of Marketing in Pharmaceutical from 1996 to 1998, and Vice President of Sales for Primary Care from 1999 to 2000.  In 2001, he returned to the Surgical Division as Vice President and General Manager.  He gained international experience from 2004 to 2007 as Vice President/Area President of Canada, Australia and Far East.  Most recently he served as Vice President/Area President of U.S. and Global Marketing, a position he has held since 2007.

Mr. Barton began his career in ophthalmology in 1978 and worked for Allergan Pharmaceuticals, Syntex Ophthalmics and CooperVision, which was later acquired by Alcon.


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Sabri Markabi, M.D.Dr. Markabi joined Alcon Laboratories, Inc. as Senior Vice President of Research and Development on March 27, 2008 and was further appointed Chief Medical Officer of Alcon Laboratories, Inc. on July 1, 2008.  He served as a staff neurologist on the faculty of the University Hospital in Tours, France.  In 1991, he joined CIBA-GEIGY and assumed positions of increasing responsibilities in France, Switzerland, and most recently, New Jersey.  In 2004 he was appointed Vice President, Global Head of Development for the Ophthalmic Business Unit of Novartis AG, where he oversaw the Development organization including research and development strategy, experimental medicine, clinical development and regulatory affairs.
Merrick McCracken.  Mr. McCracken joined Alcon Laboratories, Inc. as Senior Vice President, Human Resources on January 18, 2010.  Mr. McCracken leads Alcon's global Human Resources organization and is responsible for the development and implementation of human resources (″HR″) strategies, processes and solutions in support of the Alcon business.  He plays a central role in advancing efforts and initiatives in alignment with Alcon's Global Strategic Priorities, with particular emphasis on Organizational Effectiveness and Development. Mr. McCracken joined Alcon from Wyeth where he held several senior-level HR leadership roles, most recently serving as VP HR, Global Manufacturing, overseeing HR for 18,000 employees across 30 sites in 16 countries.  Other roles while with Wyeth include VP, Corporate HR, Talent Management & Leadership Development, VP HR North America, VP HR, Europe/Middle East/Africa and VP HR Intercontinental Region.  Prior to Wyeth, he was with Bristol-Myers Squibb for 11 years, during which time he held various senior HR leadership roles in Research & Development and International Commercial Operations.  He began his career in 1987 in the airline industry in Canada.

Ed McGough.  Mr. McGough was appointed Senior Vice President, Global Manufacturing and Technical Operations of Alcon Laboratories, Inc. in January 2008.  In this position, Mr. McGough has responsibility for global manufacturing operations, global quality assurance and compliance, various supply chain functions including U.S. Customer Service and Distribution, Corporate Engineering, Safety and Environmental Affairs and the Operational Excellence group.  He joined Alcon in 1991 as Manager, Quality Assurance and Regulatory Affairs at Alcon's precision device facility in Sinking Spring, Pennsylvania.  Since that time, Mr. McGough has gained leadership experience through positions of increasing responsibility across manufacturing, including senior managerial roles at our Puerto Rico, Houston and Fort Worth facilities.  Additionally, Mr. McGough has had global responsibility for the Company's pharmaceutical manufacturing operations.

Elaine E. Whitbeck.  Ms. Whitbeck has served as Corporate Secretary and General Counsel of Alcon, Inc. since February 18, 2003.  Ms. Whitbeck is Senior Vice President, Chief Legal Officer/General Counsel and Corporate Secretary for Alcon Laboratories, Inc. and its affiliates.  Ms. Whitbeck has been with the Company for over 24 years.  Ms. Whitbeck is responsible for all legal matters of the Company.  Prior to joining the Company, Ms. Whitbeck was the Director of Legal Operations and Shareholder Services for Mary Kay Cosmetics, Inc.  Prior to joining Mary Kay Cosmetics, Inc., Ms. Whitbeck was a trial attorney with the Dallas law firm of Vial, Hamilton, Koch & Knox.  Ms. Whitbeck was a board member of WaveLight AG, Prevent Blindness America-Texas Chapter and the Lena Pope Home (child protection and adoption) and currently serves on the board of ORBIS INTERNATIONAL (the "Flying Eye Hospital").

B.  COMPENSATION

We provide our board of directors with compensation and benefits that will attract and retain qualified directors.  In 2010, all members of our board of directors, except for our President and Chief Executive Officer, received an annual cash retainer of $100,000 with an additional $15,000 for the audit committee chairperson and an additional $10,000 each for the chairpersons of the compensation, nominating/corporate governance and independent director committees.  We refer to a director who is not a full-time employee of Alcon as a non-employee director.  The non-employee directors also receive a meeting fee of $2,000 per non-regularly scheduled meeting, not to exceed $50,000 in a board year.  The additional meeting fee is in consideration of their attendance at meetings beyond the regularly scheduled board and committees meetings.

In accordance with the service contract discussed below, Mr. Rayment also received additional cash compensation for serving as non-executive chairman of our board from January 1, 2010 through October 24, 2010.  At the December 2010 meeting, the board approved renewing Mr. Rayment's pay through the next annual general meeting of shareholders for his service as vice chairman of the board.  The board also determined to pay Dr. Vasella

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the same chairman retainer of $290,000 per year through the next annual general meeting of shareholders.  For the year ended December 31, 2010, Mr. Rayment received $290,000 for fees as chairman and vice chairman, and Dr. Vasella received a lump sum of $169,166 in December 2010 for chairman fees from November 2010 through the next annual general meeting of shareholders.

At the February 2011 board meeting, additional payments of $100,000 each were awarded to Messrs. de Vink, Plaskett and Dr. Miller in recognition of their extraordinary service in their capacity as members of the Independent Director Committee to consider and evaluate the merger transaction.
In 2010, restricted share units ("RSUs") were awarded to non-employee directors in the amount of $125,000.  The number of RSUs was determined using the value of one common share on the date of grant.  Each of the non-employee directors on the board after the May 2010 Annual General Meeting was awarded 850 RSUs.  In August 2010, Mr. Walker and Drs. Bärlocher, Choffat, Seydoux and Vanni were elected as non-employee directors.  After Board approval at the September 2010 meeting, each of the new directors were granted 775 RSUs.  In the fiscal years ended December 31, 2010, 2009 and 2008, our directors did not receive any other compensation or benefits-in-kind from Alcon, Inc. except as noted above and, with respect to Mr. Rayment and Mr. Buehler, as noted below.

We had service contracts with two of our directors.  Alcon entered into a service agreement with Mr. Rayment that commenced April 1, 2009, after his retirement as President and Chief Executive Officer of Alcon, Inc. effective March 31, 2009, under which he served as a director and the non-executive chairman of the board.  The service agreement automatically renews on an annual basis until termination.  On October 24, 2010, the board approved extending the agreement with the same remuneration on a monthly basis for his service as vice chairman of the board.  Mr. Buehler was named President and Chief Executive Officer of Alcon, Inc. and Alcon Laboratories, Inc. effective April 1, 2009 and has an employment agreement with Alcon Laboratories, Inc.  Additional information pertaining to these agreements has been provided under Item 10.C, "Material Contracts," of this annual report.  In addition, Timothy R.G. Sear, our former Chairman and Chief Executive Officer, was provided an office by the Company through May 2010.  Mr. Sear vacated the office space on April 30, 2010.

During 2010, the executive officers received RSUs from Alcon, Inc. as indicated in this Compensation section.  In 2011, we expect to grant our executive officers 100% RSUs for the equity portion of their compensation.

The following compensation table sets forth information regarding compensation and benefits-in-kind paid during the fiscal years ended December 31, 2010, 2009 and 2008 to the executive officers of Alcon Laboratories, Inc.

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Summary Compensation Table
           
  Annual Compensation Long Term Compensation Awards   
              Per-   
          Restricted Securities formance All 
        Other Share Under- Share Other 
        Compensa- Unit Lying Unit Compensa- 
    Salary Bonus tion Awards SSARs Awards ion 
Name Year ($) ($) (1) ($) (2) ($) (3) 
(#) (4)
 
(#) (5)
 ($) (6) 
                  
Kevin J. Buehler(7)
  2010  1,027,500  1,455,000 32,074  5,527,314  --  --  689,914 
   2009  866,250  460,000  30,500  1,269,250  131,857  14,574  328,170 
   2008  570,833  390,000  31,580  446,751  22,191  3,028 (123,447) 
                  
Richard J. Croarkin (8)
  2010  563,333  1,020,800  21,436 1,909,490  --  --  1,412,825 
   2009  585,000  430,000  20,641 470,896  48,919  5,407  144,044 
   2008  550,000  170,000  21,580 383,014  19,021  2,596  64,822 
                  
Robert Karsunky (9)
  2010  95,833  --  2,500  3,468,497  --  -- 70,548 
                  
William K. Barton(10)
  2010  533,333  438,000  31,861  1,507,492  --  --  418,622 
   2009  490,000  245,000  31,861  355,414  36,920  4,081  175,384 
   2008  431,667  235,000  32,519  210,687 10,462  1,428  5,370 
                  
Sabri Markabi, M.D.(11)
  2010  591,667  470,000  20,824  2,110,489 --  --  151,246 
   2009  541,667  298,000  19,250  507,735 52,743 5,830  124,528 
   2008  380,769  --  15,573  668,865 16,916  --  42,562 
                  
Elaine E. Whitbeck  2010  541,667  380,000  35,412  1,457,164 --  --  439,123 
   2009  520,833  335,000  35,769  365,517 37,975  4,197  218,811 
   2008  492,500  300,000  35,474  357,489 17,753  2,423  44,691 
                  
Ed McGough(12)
  2010  412,500  305,000  30,123  1,004,995 --  --  272,591 
  2009  396,667  255,000  27,822  253,867 26,371  2,915  123,145 
   2008  380,000  190,000  27,732  204,195 10,145  1,384  43,481 
                  
Merrick R. McCracken(13)
  2010  383,334 --  65,781  1,201,017  --  --  95,603 

(1)  Bonus paid in 2010 was for 2009 performance.  Bonus paid in 2009 was for 2008 performance.  Bonus paid in 2008 was for performance in 2007.  Mr. Croarkin's bonus for 2010 performance was also paid in 2010 in the pay period following his separation from employment with Alcon, Inc. and is included in the 2010 bonus section of the summary compensation table.

(2)  Includes payments made for car allowance, financial consulting services, executive physicals and other allowances.  Also included are additional payments related to relocation for Mr. McCracken in 2010.

(3)  Restricted share units were granted in 2010, 2009 and 2008.  The value shown is as of the grant date.  Summarized below are the total restricted share units outstanding at December 31, 2010 and the value by vesting date.  The value is based on the closing price of the shares on the NYSE on December 31, 2010.  Due to change of control provisions in the 2008 restricted stock unit grant agreement, the vesting of 2008 restricted stock units was accelerated and vested at the change of control rather than the scheduled vesting in 2011.  The holders of restricted share units do not have voting rights but have the right to receive a dividend equivalent thereon.
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The number of restricted share units and their value for Mr. Karsunky reflects two sign-on grants made to him on December 3, 2010.  The grants were 100% restricted share units.  The first sign-on grant had a grant date fair market value of $2,400,000 and will vest at the same rate as his forfeited equity from Novartis (40% after one year, 40% after the second year and 20% after the third year).  The second sign-on grant had a grant date fair market value of $1,100,000 and will vest at the end of two years.  This vesting aligns with the 2010 Novartis performance long term incentive grants that were forfeited when he terminated service with Novartis.  Alcon has charged back 75% of this grant value to Novartis.

  Total Restricted  Total Restricted  Value  Value  Value 
  Shares  Share Units  Vesting  Vesting  Vesting 
Name at 12/31/10 (#)  at 12/31/10 (#)  in 2011 ($)  in 2012 ($)  in 2013 ($) 
                
Kevin J. Buehler                                        --   49,608   --   2,381,392   5,724,556 
Richard J. Croarkin                                        --   --   --   --   -- 
Robert Karsunky                                        --   21,363   957,459   2,054,526   478,729 
William K. Barton                                        --   13,636   --   666,835   1,561,287 
Sabri Markabi, M.D.                                        --   19,207   --   952,622   2,185,802 
Elaine E. Whitbeck                                        --   13,433   --   685,790   1,509,162 
Ed McGough                                        --   9,285   --   476,311   1,040,858 
Merrick R. McCracken  --   7,551   --   --   1,233,833 

(4)  Share-settled stock appreciation rights ("SSARs") were granted in 2009 and 2008.

(5)  No performance share units were granted in 2010. The 2009 performance share unit awards have three consecutive performance targets during a three-year service period from 2009 through 2011.  The 2008 performance share unit awards have a cumulative three-year performance period from 2008 through 2010.  The awards represent 25% of each participant's total equity award value granted in 2009 and 2008, respectively.  The table below represents the potential number of performance share units to be paid in Alcon shares at minimum, target and maximum.

    Estimated Future Performance Share Unit Payout
Name Grant Date Minimum # Target # Maximum #
         
Kevin J. Buehler
 02/17/2009 -- 14,574 29,148
  02/11/2008 -- 3,028 6,056
Richard J. Croarkin
 02/17/2009 -- -- --
  02/11/2008 -- -- --
William K. Barton
 02/17/2009 -- 4,081 8,162
  02/11/2008 -- 1,428 2,856
Sabri Markabi, M.D. 02/17/2009 -- 5,830 11,660
  02/11/2008 -- -- --
Elaine E. Whitbeck
 02/17/2009 -- 4,197 8,394
  02/11/2008 -- 2,423 4,846
Ed McGough
 02/17/2009 -- 2,915 5,830
  02/11/2008 -- 1,384 2,768

The 2008 performance share units vested on December 31, 2010 and became payable at 118.4% of target based on the 2008 through 2010 cumulative performance and final approval at theboard of directors meeting in February 2011.  In addition, due to the pending merger of Alcon and Novartis, the 2009 performance share units were approved by the board to pay out at 178.5% in February 2012 based on two years' actual performance and one year at 100% of target performance level.  Mr. Croarkin vested his 2009 and 2008 performance share units upon his separation from Alcon and received 8,003 Alcon common shares for them at 100% of target as approved by the board of directors.

(6)  Provides the aggregate amount of employer contributions to the Alcon 401(k) and Retirement Plans, including Company contributions and earnings on allocations made to the Excess 401(k) Plan, additional compensation for
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premiums paid for Executive Universal Life Insurance and the Umbrella Liability Insurance, hire-on bonus (Mr. McCracken) and payout of grandfathered sick leave (Messrs Buehler, Barton, McGough and Ms. Whitbeck). Mr. Karsunky's other compensation includes payment of Swiss taxes on pension benefits made by the Company on his behalf due to his relocation to the United States.  Mr. Croarkin's other compensation includes severance and   accrued vacation time received upon his separation from Alcon and a deposit of golden parachute (IRC §280G) excise taxes that are not taxable, if at all, until 2011.
(7)  On January 8, 2009, Mr. Buehler was named Chairman, President and Chief Executive Officer of Alcon Laboratories, Inc. effective April 1, 2009.

(8)  Mr. Croarkin's compensation reflects his compensation for the time he served as Senior Vice President, Finance and Chief Financial Officer of Alcon, Inc. during 2010.  Mr. Croarkin separated from service with Alcon, Inc. on November 30, 2010.

(9)  Mr. Karsunky was named Senior Vice President, Finance and Chief Financial Officer of Alcon, Inc. on November 1, 2010.

(10)  Mr. Barton was named Senior Vice President, International Markets of Alcon Laboratories, Inc., effective April 1, 2009.

(11)  Dr. Markabi joined Alcon in March 2008 and was appointed Senior Vice President, Research and Development and Chief Medical Officer of Alcon Laboratories, Inc. in July 2008.

(12)  Mr. McGough was appointed Senior Vice President, Global Manufacturing and Technical Operations of Alcon Laboratories, Inc. effective January 1, 2008.

(13)  Mr. McCracken was named Senior Vice President, Global Human Resources of Alcon, Inc. in January 2010.

SSAR Grant Table

No SSARs were granted during 2010.

Aggregated Option/SSAR Exercises in Last Fiscal Year and Fiscal Year End Option/SSAR Value Table

  Shares    Number of Securities Underlying  Value of Unexercised In-the- 
  Acquired  Value Unexercised Options/SSARs  Money Options/SSARs 
  On  Realized at 12/31/10 (#)  at 12/31/10 ($) 
Name Exercise  ($) Exercisable  Unexercisable  Exercisable  Unexercisable 
                  
Kevin J. Buehler                                --   --  122,801   131,857   6,902,894   10,062,008 
Richard J. Croarkin  77,912   4,304,074  --   --   --   -- 
William K. Barton  45,432   1,852,280  --   36,920   --   2,817,365 
Sabri Markabi, M.D.  --   --  16,916   52,743   313,453   4,024,818 
Elaine E. Whitbeck  --   --  58,769   37,975   1,761,744   2,897,872 
Ed McGough                                16,327   1,538,399  18,883   26,371   473,165   2,012,371 

Pension Plans

Messrs. Buehler, Barton and McGough and Ms. Whitbeck participate in the nonqualified Executive Salary Continuation Plan ("ESCP").  The ESCP is unfunded and non-contributory and provides for a retirement benefit based on the participant's years of participation service under the plan, using the average of the annual base compensation in effect in the year of separation from service and for the two years preceding such year of separation.  Benefits are payable upon retirement after the accumulated participation of at least 10 years of service and upon reaching age 55 (with penalties) or at the normal retirement age of 62.  Annual compensation includes the amount shown as annual base salary in the Summary Compensation Table.

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The ESCP benefit formula is 3% of a participant's final three-year average annual base compensation times years of participation, up to a maximum of 20 years.  A participant must attain at least 10 years of participation service in order to have a vested benefit.

In December 2003, the board of directors approved a new nonqualified Alcon Supplemental Executive Retirement Plan ("ASERP").  If certain conditions are met, the ASERP provides for a maximum benefit of up to 30% of the final three-years' average base salary and bonus at retirement, less an offset for Social Security benefits, payable for the remaining life of the participant.  Effective January 1, 2004, all new participants began to participate in the ASERP instead of the ESCP.  Existing ESCP participants continued to accrue benefits under the ESCP through December 31, 2008; thereafter, ESCP participants began to accrue benefits for future service under the provisions of the ASERP; however, the normal form of payment for benefits accrued under ASERP by current ESCP participants will be a single life annuity with a 50% surviving spouse's benefit.  Mr. Croarkin and Dr. Markabi participate in the ASERP. At the September 2010 meeting, the board of directors approved one additional year of ASERP participation credit subject to an early retirement penalty post change of control for Mr. Croarkin as a part of his separation package.  Messrs. Karsunky and McCracken will be eligible to participate in the ASERP beginning in 2011.  ESCP participants with the maximum participation of 20 years service at December 31, 2008 were not eligible to participate in the ASERP.  Participants are limited to 20 years participation service credit under the ESCP and the ASERP.

As previously stated, due to Alcon's change of control in 2010, the change of control provisions in the ESCP apply.  All plan participants became immediately vested in their accumulated benefit (if the participant had 10 years of participation service or more) or at the minimum benefit percentage of 30% (10 years of participation service times 3%) and, in accordance with plan provisions, early retirement reductions were waived and payouts began in the second month following the month of the change of control.  For those employees subject to section 409A of the IRC code, including the executive officers named above, payment is delayed for 6 months.  Individuals in ASERP also became 100% vested at the change of control and early retirement reductions were waived for benefits accrued as of August 25, 2010.  Future accruals will be subject to the early retirement reductions.  However, ASERP benefit payments begin on the later of the first day of the month after the participant turns age 50 or the first day of the month after the termination of the participant's employment.

The Company maintains an irrevocable Rabbi trust to hold and invest amounts for the payment of benefits to participants under the ESCP and ASERP.  The assets of the trust are restricted to the payment of ESCP and ASERP benefits except under certain conditions, such as the Company's insolvency.  The Alcon Executive Retirement Plans Grantor Trust Agreement provided for the Company to fund the current actuarially determined present value of the aggregate accrued pension benefits of all participants in the ESCP and ASERP upon the change of control in the ownership of Alcon.  Based on a range of actuarially determined pension benefit projections and current market conditions, management contributed $152 million to the trust during the third quarter of 2010 to satisfy this requirement.

    Number of Years Present Value of 
Name Plan Name 
Credited Service
(#)
 Accumulated Benefit ($) 
        
Kevin J. Buehler                                               ESCP/ASERP  20  10,241,047 
Richard J. Croarkin                                               ASERP  8  2,055,156 
Robert Karsunky  --  --  -- 
William K. Barton                                               ESCP/ASERP  19  5,197,204 
Sabri Markabi, M.D.                                               ASERP  2  201,368 
Elaine E. Whitbeck                                               ESCP/ASERP  20  6,040,705 
Ed McGough                                               ESCP/ASERP  15  3,712,259 
Merrick R. McCracken  --  --  -- 
           
The plans have been operated in "good faith compliance" with Section 409A of the Code and the guidance thereunder from the period January 1, 2005 to January 1, 2008.  The ESCP and ASERP were amended to comply with Section 409A of the Internal Revenue Code effective January 1, 2008.

The Company provides for all U.S. employees (i) the Alcon 401(k) Plan under which Alcon will match dollar-for-dollar the first 5% of base salary (including commissions) and bonus contributed by each employee, and (ii) the
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Alcon Retirement Plan, into which Alcon automatically contributes an amount equal to 7% of each employee's compensation.  Contributions to both plans are subject to the applicable legal limits.

Amended 2002 Alcon Incentive Plan

The Amended 2002 Alcon Incentive Plan is intended to help us retain and motivate our key employees.  Through this plan, we are able to grant our employees' stock options, stock appreciation rights, restricted shares, restricted share units and other awards based on our common shares, in addition to performance-based annual and long term incentive awards.  Through this share ownership, we are able to align employee and shareholder interests, by directly linking incentive awards to our profitability and increases in shareholder value.

Amendments

Pursuant to Swiss law, shareholder approval is not required to make material amendments to employee equity incentive plans.  Our board of directors has the authority to amend the Amended 2002 Alcon Incentive Plan at any time.  However, shareholder approval is required to increase conditional capital if the number of shares required to satisfy the Amended 2002 Alcon Incentive Plan exceeds the existing conditional capital and the treasury shares available.

In February 2005, our board of directors amended the Amended 2002 Alcon Incentive Plan effective as of January 1, 2005 to clarify that the board's compensation committee may accelerate the vesting, exercise or payment of an award upon a participant's termination of employment without cause (as determined in accordance with this plan's provision), and to allow for the award of restricted shares and restricted share units to non-employee directors.  To effect the foregoing, Sections 3.2(9), 4.2 and 4.5 of the Amended 2002 Alcon Incentive Plan were amended.

In December 2005, our board of directors amended the Amended 2002 Alcon Incentive Plan effective as of January 1, 2006 to allow the award of Stock Appreciation Rights to non-employee directors.  To effect the foregoing, Section 4.2 of the Amended 2002 Alcon Incentive Plan was amended.

In December 2006, our board of directors amended the Amended 2002 Alcon Incentive Plan to provide for mandatory equitable adjustments in the event of any equity restructuring.  This amendment is effective as of January 2007 and applies to all outstanding awards.

In December 2008, our board of directors amended the Amended 2002 Alcon Incentive Plan to remove the requirement for board consent for retirements under this plan.  This amendment is effective as of January 1, 2009.  In addition, a provision was added stating that no change to the definition of "retirement," as provided under this plan, relative to an executive officer or director of the Company shall occur without prior approval of the board.  The board amended the award agreements to provide for a "double trigger" upon a change-of-control.  For awards after January 1, 2009, vesting will accelerate upon the occurrence of both a change-of-control and either involuntary termination, other than "for cause," or voluntary termination for "good reason" within six months preceding or during the two years following the change-of-control.

In September 2009, our board of directors amended the Amended 2002 Alcon Incentive Plan to increase the shares available for awards from 30 million to 40 million.  In addition, the plan was amended to clarify share counting rules for SSARs that upon exercise only net shares are counted.  These amendments were effective January 1, 2010.

In December 2010, our board of directors amended the Amended 2002 Alcon Incentive Plan to change the definition of the "Non-Employee Director" to account for the change of majority shareholder from Nestlé to Novartis.  In addition, an administrative technical change was made to the definition of "Change of Control" to reflect the change in majority ownership.  Lastly, the plan was modified to allow for remuneration to be paid to Alcon board members who are also employees of Novartis.


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Eligibility and Award Limits

Our employees, non-employee directors and employees of our subsidiaries and affiliates are eligible to receive awards under the Amended 2002 Alcon Incentive Plan.  Employees of Novartis and its subsidiaries other than Alcon entities are not eligible to receive awards under this plan.

Under the Amended 2002 Alcon Incentive Plan, limits are placed on the maximum award amounts that may be granted to any employee in any plan year.  The maximum number of shares subject to stock options/stock appreciation rights that may be issued to any participant during any calendar year shall not exceed 750,000.  The maximum number of shares that may be issued to any participant as restricted shares during any calendar year shall not exceed 200,000.

Administration

The Amended 2002 Alcon Incentive Plan is administered by the compensation committee of our board of directors, which has the authority to recommend and set the terms and conditions of the grant awards.  Our board of directors is responsible for approving the recommendations of the compensation committee.

For our employees who are not considered executive officers, the compensation committee may delegate its authority under the Alcon Incentive Plan to our executive officers, subject to certain guidelines.

Shares Reserved for Awards

Under the Amended 2002 Alcon Incentive Plan, a total of up to 40 million common shares may be issued for awards.  Through December 31, 2010, approximately 20.4 million of these common shares had been issued under this plan.

Of the total shares available to grant, the board of directors has allocated a small portion to the President and CEO to award at his discretion.  These shares are to be used for awards beyond the annual long term incentive awards and may be awarded to recognize increased responsibilities or special contributions, to attract new hires, to retain executives or to recognize certain other special circumstances.  The amounts of these awards are set to provide strong additional retention incentive.  Generally, these share-based awards are subject to a three-year vesting schedule.  Although the awards are at the discretion of the President and CEO, he must report any awards granted to the compensation committee at its quarterly meetings.  As of December 31, 2010, there are 110,909 shares available for the President and CEO's discretionary awards under the plan.

Our board of directors has the authority to make appropriate adjustments to the limits described above, as well as to the terms of outstanding awards, in the event of any transaction that affects our common shares such as share splits, share dividends or other similar events.

Awards of stock options that expire unexercised, stock appreciation rights or restricted shares that are forfeited under the terms of this plan or stock appreciation rights that are exercised for cash are not included in applying the maximum limit for our common shares available for grant under this plan.

Annual and Long Term Incentive Awards

Annual and long term incentive awards may be granted under the Amended 2002 Alcon Incentive Plan.  The awards are considered earned only if corporate, business segment or performance goals over the performance period satisfy the conditions established by the compensation committee and approved by our board of directors.  The performance objectives, which may vary from employee to employee, are based on one or more financial measures and additional non-financial measures.

Our board of directors determines whether awards are paid in the form of cash, common shares or any combination of these items.  Under the Amended 2002 Alcon Incentive Plan, selected executive officers may be awarded performance-based incentive awards, subject to a maximum limit.


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Stock Options

Under the Amended 2002 Alcon Incentive Plan, we may grant to eligible employees stock options that are either incentive stock options or nonqualified stock options.  To date, the stock options granted have been nonqualified stock options, which do not and will not qualify as incentive stock options for federal income tax purposes under Section 422 of the U.S. Internal Revenue Code of 1986.

The compensation committee will recommend to our board of directors for approval the number and type of stock options to grant, as well as the exercise price, applicable vesting schedule, option term and any applicable performance criteria. Unless otherwise decided by our board of directors, stock options will vest in full on the third anniversary of the date of grant, or on an option holder's death, permanent disability or retirement (as defined in the Amended 2002 Alcon Incentive Plan and/or award agreements).  Beginning with awards granted in 2006, vesting of stock option awards will not be accelerated upon the option holder's retirement, but will vest according to the regular vesting schedule.  Upon the involuntary termination of an option holder's employment with us, all vested options will be exercisable for 30 days; provided, however, that where the termination of employment is due to (i) retirement or (ii) death or disability, they may be exercisable for their remaining term, or for 60 months not to exceed the remaining term, respectively.  Some vesting requirements have been modified in accordance with local laws and the approval of the board.  Upon voluntary termination of employment, all options (vested and unvested) forfeit on the date of termination.  The grant price for any stock option will be not less than the fair market value of our common shares on the grant date.  Unless our board of directors provides for a different period, stock options will have a term of ten years.

Stock Appreciation Rights
We may grant stock appreciation rights, which will entitle the holder to receive an amount equal to the difference between the fair market value and the grant price.  The compensation committee will recommend to our board of directors for approval the number of stock appreciation rights to grant, as well as the exercise price, applicable vesting schedule, term and any applicable performance criteria.  The amount may be settled either in stock or in cash, as designated by the award agreement.

Unless determined otherwise by our board of directors, stock appreciation rights will vest in full on the third anniversary of the date of grant or on a holder's death, permanent disability or retirement (as defined in the Amended 2002 Alcon Incentive Plan and/or award agreements).  Beginning with awards granted in 2006, vesting of stock appreciation rights will not be accelerated upon the holder's retirement, but will vest according to the regular vesting schedule.  Upon the involuntary termination of a holder's employment with us, all vested stock appreciation rights will be exercisable for 30 days; provided, however, that where the termination is due to (i) retirement or (ii) death or disability, they may be exercisable for the remaining term, or for 60 months not to exceed the remaining term, respectively.  Some vesting requirements have been modified in accordance with local laws and the approval of the board.  Upon voluntary termination of employment, all stock appreciation rights (vested and unvested) forfeit on the date of termination.  Stock appreciation rights granted in tandem with stock options can be exercised only if the related stock option is exercisable at that time. Unless our board of directors provides for a different period, stock appreciation rights will have a term of ten years.

Restricted Shares/Restricted Share Units

The Company may grant restricted shares/restricted share units.  Restricted shares are common shares granted to a participant subject to restrictions determined by the board of directors.  Restricted share units entitle the recipient to receive a specified number of common shares or the cash equivalent equal to the fair market value of such shares on the date of vesting.  A restricted share or restricted share unit will vest and become transferable upon satisfaction of the conditions set forth in the restricted share/restricted share unit award agreements.  Restricted share/restricted share unit awards will be forfeited if a recipient's employment terminates prior to vesting of the award.  The compensation committee will recommend to our board of directors for approval the number of restricted share/restricted share unit awards to grant, applicable vesting schedule, term and any applicable performance criteria.

Unless otherwise specified in the restricted share/restricted share unit award agreements, restricted share/restricted share unit awards will vest upon a holder's death or permanent disability or retirement at or after age 62.  Restricted share awards/restricted share unit awards granted in 2009 do not vest automatically upon a holder's retirement after
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age 55 with 10 years of service and prior to age 62.  For each year of service, 33% of the award will become non-forfeitable and will continue to vest as if there had been no termination of service.  Restricted share unit awards granted in 2010 do not vest automatically upon a holder's retirement after age 55 with 10 years of service and prior to age 62.  In the first twenty-three months following the grant, the individual will forfeit 100% of the award upon termination.  In the twenty-fourth month until the normal vesting date, 33% of the award will forfeit upon termination. The non-forfeited, unvested portion of the award will continue to vest as if there had been no termination of service.  Upon three full years of service after the date of the award, the grant will become 100% vested.  Holders of restricted shares will have voting rights and receive dividend equivalents prior to vesting.  Holders of restricted share units have no voting rights and receive dividend equivalents prior to vesting.

During 2010, the Company made a special retention grant of restricted share units to 201 individuals for a total accounting value of $30 million.  This special retention grant was made at the date of the change of majority ownership to enhance the retention of employees with key talent and/or in business critical positions.  The actual provisions for this award were modified from the annual award guidelines to remove retirement vesting.  In order to receive the full award amount, the recipients must stay with the Company for three years.  However, if the employee is terminated due to position elimination or the employee resigns for "good reason," then the award may vest on a pro-rata basis.

Performance Share Units

Performance share units vest upon a service requirement and achievement of specific Alcon business objectives as selected by the compensation committee in its discretion and approved by Alcon's board of directors.

The metrics for the 2009 grant consist of three one-year earnings per share ("EPS") growth targets during a three-year service period with a cumulative three-year relative total shareholder return ("TSR") as a modifier.  At the beginning of the performance period, the compensation committee establishes a total equity award value for each participant.  The performance share unit portion reflects 25% of the established total value for 2009 recipients.  The actual values of the units awarded to the employee have been adjusted based on Alcon's three one-year EPS targets and cumulative TSR during the three-year service period.  The adjustment was accomplished by multiplying the target award by the applicable EPS award percentage for 2009 and 2010, by 100% for the year 2011 and the maximum TSR multiplier, which was 200% based on the Company's historical performance.  On that basis, in February 2011, Alcon's board of directors approved a final settlement of 178.5% of the original units that will be paid in February 2012 to participants that meet the service requirements.

The metrics for the 2008 grant consist of a cumulative three-year EPS growth target for the three-year service period with a cumulative three-year relative TSR as a modifier.  At the beginning of the performance period, the compensation committee establishes a total equity award value for each participant.  The performance share unit portion reflects 25% of the established total value for 2008 recipients.  The actual value of the units awarded to the employee was adjusted based on Alcon's cumulative three-year EPS target and cumulative TSR during the three-year service period.  The adjustment was accomplished by multiplying the target award by the applicable EPS award percentage and the TSR multiplier, which resulted in board approval of a final settlement of 118.4% of the original units.

The compensation committee will recommend to our board of directors for approval the number of performance share units to grant, applicable vesting schedule, term and any applicable performance criteria.  Unless otherwise specified in the award agreement, the performance share unit awards will vest upon a holder's death or permanent disability.  Vesting of performance share unit awards upon a holder's retirement after age 62 will continue as if there was no termination of employment.  If the employee's termination of employment is voluntary and after age 55 with not less than 10 years of service but prior to retirement, the employee will forfeit unvested performance share units (have his/her target award reduced) by 33% for each year remaining in the vesting schedule of the award.  If an employee's termination is a result of a change of control due to position elimination or for "good reason" as defined in the award agreements, the employee will vest 100% in the award and will be paid out with an EPS award percentage of 100% and a TSR multiple of 1.0.  Unvested non-forfeited performance share units will continue to vest according to the award agreement as if there had been no termination of employment.  Holders of performance share units have no voting rights and do not receive dividend equivalents prior to vesting.
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Other Share-Based Awards

The Amended 2002 Alcon Incentive Plan also allows us to provide awards that are denominated in or valued by reference to our common shares.  The grant price for the award will not be less than the fair market value of our common shares on the grant date.  The compensation committee will recommend to our board of directors for approval the number and type of award to grant, applicable vesting schedule, term and any applicable performance criteria.

Change-of-Control Provisions

Upon the change-of-control (as defined under the Amended 2002 Alcon Incentive Plan) in August 2010, the following events occurred for annual share-based awards granted prior to December 31, 2008, if the agreement covering the award so provided:

·  all stock options and stock appreciation rights became fully vested and exercisable;

·  all restrictions on outstanding restricted shares and restricted share units lapsed;

·  all outstanding cash incentive awards vested and will be paid out on a prorated basis; and

·  all performance share unit awards will continue to vest under their original terms unless achievement of performance goals can no longer be measured, in which case 100% of each employee's awards vest upon completion of the individual service requirements.

For share-based awards granted on or after January 1, 2009, the board approved modifications to the change-of-control provisions.  Vesting of future awards will accelerate upon the occurrence of  both a change-of-control and either involuntary termination, other than "for cause," or voluntary termination for "good reason" within six months preceding or during the two years following the change-of-control.  Therefore, awards made in 2010 and 2009 did not vest on the change-of-control.

Upon the completion of the merger with Novartis, management expects that Novartis common shares would be substituted for Alcon common shares under the outstanding share-based awards at the merger date.  The substitution ratio would be based on the price of a Novartis share in the merger relative to $168 for an Alcon share, but no cash would be paid.

Corporate Transactions

In the event of certain corporate transactions described in the Amended 2002 Alcon Incentive Plan, our board of directors may:

·  require the exercise of all outstanding awards during a specified time period, after which the awards shall be terminated;

·  cancel all outstanding awards in exchange for a cash payment equal to the value of the awards; or

·  immediately vest all outstanding stock options and stock appreciation rights, remove all restrictions on restricted share awards, performance-based awards and other share-based awards, and vest and pay pro rata (based on when the corporate transaction occurs in the applicable performance cycle) all outstanding incentive awards.

Transferability and Other Terms

Options or awards granted to an employee under the Amended 2002 Alcon Incentive Plan may not be transferred except by will or the laws of descent and distribution.  In addition, only the employee may exercise options or awards during his or her lifetime.

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In the case of nonqualified stock options, however, the board has the authority to permit all or any part of a nonqualified stock option to be transferred to members of the employee's immediate family and certain family trusts or partnerships, subject to prior written consent of the compensation committee.

Alcon Executive Deferred Compensation Plan

The Company adopted the Alcon Executive Deferred Compensation Plan (the "DCP") effective October 25, 2002.  The DCP allows certain U.S. employees the opportunity to defer the receipt of salary, bonus and restricted shares.  The DCP further provides that restricted shares deferred by eligible executives can only be invested in Alcon common shares and distributed as Alcon common shares at the end of the deferral period.

The DCP was amended in 2005 for compliance with IRC Section 409A, which was created as part of The American Jobs Creation Act of 2004.  The DCP has been operated in "good faith compliance" with Section 409A of the Code and the guidance thereunder from the period January 1, 2005 to January 1, 2008.  The DCP was further amended to comply with Section 409A of the Internal Revenue Code effective January 1, 2008.

Alcon Excess 401(k) Plan

The Company adopted the Alcon Excess 401(k) Plan effective January 1, 2004.  This plan provides deferral of excess employer contributions that cannot be made to the Alcon 401(k) and Alcon Retirement Plans because of limitations under the U.S. Internal Revenue Code of 1986.

The Alcon Excess 401(k) Plan has been operated in "good faith compliance" with Section 409A of the Code and the guidance thereunder from the period January 1, 2005 to January 1, 2008.  The Alcon Excess 401(k) Plan was amended to comply with Section 409A of the Internal Revenue Code effective January 1, 2008.

Alcon Directors

The share-based awards to non-employee directors under the Amended 2002 Alcon Incentive Plan will promote greater alignment of interests between our non-employee directors, our shareholders and Alcon.  It will assist us in attracting and retaining highly qualified non-employee directors, by giving them an opportunity to share in our future success.  Non-employee directors are eligible to receive awards under the Amended 2002 Alcon Incentive Plan.

Shares Reserved for Awards

Approximately 60,000 of the 40 million common shares under the Amended 2002 Alcon Incentive Plan were allocated for awards to non-employee directors.

Annual Awards

Every year, each non-employee director will receive share-based awards with a current value of $125,000.

C.  BOARD PRACTICES

Board Composition

Our board of directors currently consists of eleven members including three independent directors; six directors that were designated by Novartis; the vice chairman of the board of directors; and the chief executive officer of Alcon Laboratories, Inc.

On April 6, 2008, Nestlé S.A. and Novartis AG entered into a Purchase and Option Agreement and a Shareholders' Agreement.  Under the terms of the Shareholders Agreement, the parties agreed to use their reasonable best efforts to cause the number of our board of directors to be ten; subject to election and the due qualification of such individuals as directors, our board of directors should be comprised of (A) one individual designated by Novartis, (B) five individuals designated by Nestlé, (C) three individuals nominated by the Nominating/Corporate Governance Committee that qualify as independent directors and who are not Novartis or Nestlé  designees and (D) the Chief Executive Officer of Alcon, Inc.  Upon consummation of the purchase by Novartis of the remaining
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approximately 52% of Alcon, Inc. common shares, the parties agreed to use their reasonable best efforts to cause the five individuals designated by Nestlé to resign from office and to have five replacement directors nominated by Novartis elected at an extraordinary or an annual general meeting of shareholders of the Company.
At the annual general meeting held on May 5, 2009, the shareholders elected Kevin Buehler to the board of directors.  With Mr. Buehler's election, our board of directors expanded from ten to eleven members.
On August 16, 2010, an extraordinary general meeting of shareholders was held to conditionally elect the Novartis designated directors to replace the five Nestlé designated directors upon the consummation of the acquisition by Novartis of all common shares of Alcon, Inc. that were beneficially owned by Nestlé as of such time, pursuant to the Purchase and Option Agreement.  On August 25, 2010, Novartis and Nestlé completed the purchase and sale of approximately 156 million shares of Alcon, Inc.  With the completion of this transaction, Novartis became Alcon's majority shareholder with approximately 77 percent of Alcon's outstanding shares. Effective August 25, 2010, the five Nestlé-designated members of the Alcon board of directors tendered their resignations and the August 16, 2010 election of the five Novartis-designated directors became effective.
Members of our board of directors generally are elected to serve three-year terms.  Members of our board of directors whose terms of office have expired shall be eligible for re-election.  Non-executive directors may only be appointed for up to four terms of office.  Our board of directors is divided into three classes serving staggered terms.  As a result, some of our directors will serve terms that are less than three years.  As their terms of office expire, the directors of one class will stand for election each year as follows:

·  Class I directors have terms of office expiring at the annual general meeting of shareholders in 2012.  These directors are Kevin Buehler (director since 2009), Paul Choffat, Ph.D. (director since 2010) and Joan W. Miller, M.D. (director since 2009).

·  Class II directors have terms of office expiring at the annual general meeting of shareholders in 2013.  These directors are Urs Bärlocher, Ph.D. (director since 2010), Lodewijk J.R. de Vink (director since 2002), and Jacques Seydoux, M.D. (director since 2010); and

·  Class III directors have terms of office expiring at the annual general meeting of shareholders in 2011.  These directors are Thomas G. Plaskett (director since 2003), Cary R. Rayment (director since 2005), Enrico Vanni, Ph.D. (director since 2010), Daniel Vasella, M.D. (director since 2008) and Norman Walker (director since 2010).

Our Organizational Regulations provide that directors will retire from office no later than the annual general meeting after their 72nd birthday.

Service Contracts

Cary Rayment and Kevin Buehler are the only directors on our board that have a service contract with the Company or any of its subsidiaries.  The contract with Mr. Rayment does not provide for benefits upon termination.  On October 24, 2010, Mr. Rayment ceded his position of chairman of the board of Alcon, Inc. and was appointed as vice chairman.  At the December 2010 meeting, the board approved extending Mr. Rayment's agreement with the same remuneration on a monthly basis for his service as vice chairman of the board until the next annual general meeting of the shareholders.  The board also determined to pay Dr. Vasella the same chairman retainer of $290,000 per year through the next annual general meeting of the shareholders.

A discussion of the material terms of Mr. Buehler's employment agreements with the Company and certain benefits upon termination is set forth in Item 10.C, "Material Contracts," of this annual report.

Board Committees

Our board of directors has appointed an audit committee, a nominating/corporate governance committee, a compensation committee and an independent director committee.

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Audit Committee

The audit committee consists of six directors of which three directors are not otherwise affiliated with Novartis or Alcon.  Our board of directors has determined that all members of the audit committee are independent as defined by the rules of the SEC and the listing standards of the NYSE.  The audit committee is currently comprised of Thomas G. Plaskett (Chairman), Urs Bärlocher, Ph.D., Paul Choffat, Ph.D., Lodewijk J.R. de Vink, Joan W. Miller, M.D. and Enrico Vanni, Ph.D.  In September 2003, the board affirmed that Mr. Plaskett was the "audit committee financial expert" within the meaning of applicable SEC regulations.  The functions of this committee include ensuring proper implementation of the financial strategy as approved by the board of directors, reviewing periodically the financial results as achieved, overseeing that the financial performance of the group is properly measured, controlled and reported, and recommending any share repurchase program for approval by our board of directors, as well as:

·  review of the adequacy of our system of internal accounting procedures;

·  recommendations to the board of directors as to the selection of independent auditors, subject to shareholder approval;

·  discussion with our independent auditors regarding their audit procedures, including the proposed scope of the audit, the audit results and the related management letters;

·  review of the audit results and related management letters;

·  review of the services performed by our independent auditors in connection with determining their independence;

·  review of the reports of our internal and outside auditors and the discussion of the contents of those reports with the auditors and our executive management;

·  oversight of the selection and the terms of reference of our internal and outside auditors;

·  review and discussion of our quarterly financial statements with our management and our outside auditors; and

·  ensure our ongoing compliance with legal requirements, accounting standards and the provisions of the NYSE.

Nominating/Corporate Governance Committee

The nominating/corporate governance committee shall consist of at least two directors who are not otherwise affiliated with Novartis or Alcon, at least one director designated by Novartis as long as Novartis remains as Alcon, Inc.'s majority shareholder.  The nominating/corporate governance committee is currently comprised of Daniel Vasella, M.D.  (Chairman), Urs Bärlocher, Ph.D., Lodewijk J. R. de Vink, Joan W. Miller, M.D,  Thomas G. Plaskett, Jacques Seydoux, M.D. and Enrico Vanni, Ph.D.  The functions of this committee include:

·  subject to certain nomination rights of Novartis as provided in our Organizational Regulations, identifying individuals qualified to become members of our board of directors and recommending such individuals to the board for nomination for election by the shareholders;

·  making recommendations to the board concerning committee appointments;

·  developing, recommending and annually reviewing corporate governance guidelines for Alcon;

·  reviewing proposals of the chief executive officer for appointment of members of our executive management, to the extent such members are appointed by the board, and making recommendations to the board regarding such appointments;

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·  overseeing corporate governance matters; and

·  coordinating an annual evaluation of Alcon's board.

Compensation Committee

The compensation committee shall consist of at least two members of our board of directors who are not otherwise affiliated with Novartis or Alcon, at least one member of our board of directors nominated by Novartis as long as Novartis remains as Alcon's majority shareholder.  The compensation committee is currently comprised of Lodewijk J.R. de Vink (Chairman), Thomas G. Plaskett, Daniel Vasella, M.D. and Norman Walker.  The functions of this committee include:

·  review of our general compensation strategy;

·  recommendations for approval by our board of directors of compensation and benefits programs for our executive officers;

·  review of the terms of employment between Alcon and any executive officer or key employee;

·  administration of our long term incentive plan and recommendations to our board of directors for approval of individual grants under this plan; and
·  
decisions with respect to the compensation of members of our board of directors.
Independent Director Committee

In accordance with our Organizational Regulations, the Alcon board of directors established an Independent Director Committee of the Alcon board of directors in 2008 in connection with Novartis's initial purchase of slightly less than 25% of the Alcon shares from Nestlé, in order to protect the interests of the minority holders of publicly held Alcon shares in certain transactions.  The Independent Director Committee is currently comprised of Thomas G. Plaskett (Chairman), Lodewijk J.R. de Vink and Joan W. Miller, M.D.  The Independent Director Committee shall be responsible for protecting the interests of our minority shareholders and shall make recommendations to the board of directors with respect to:

·  a proposed merger, takeover, business combination or related party transaction of Alcon, Inc. with the majority shareholder or any group company of the majority shareholder;

·  a proposed bid for the shares of Alcon, Inc. by any entity owning a majority of our outstanding voting rights;

·  a proposed repurchase by us of all our shares not owned by an entity owning a majority of the outstanding voting rights of Alcon; or

·  any change to the powers and duties of the Independent Director Committee.

The Independent Director Committee believes that our board of directors may only approve a decision with respect to any of these matters if a majority of the members of the Independent Director Committee so recommends; however, we cannot predict the outcome of any proceeding that might be initiated to interpret or challenge this position.

Executive Sessions of Non-Management Directors

The vice chairman presides at the regularly scheduled executive sessions of the non-management directors.  Interested parties may communicate directly with the presiding director or with the non-management directors as a group by writing to the following address:  Alcon, Inc., Attention: Non-Management Directors, P.O. Box 1821, Radio City Station, New York, New York 10101-1821.


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D.  EMPLOYEES

As of December 31, 2010, we employed approximately 16,700 full-time employees, including approximately 1,900 research and development employees, approximately 5,400 manufacturing employees and approximately 6,500 marketing, sales and customer support employees.  Currently, we believe that approximately 700 of our workers in Belgium are represented by a union.  In other European countries, our workers are represented by works councils. We believe that our employee relations are good.

The following table indicates the approximate number of employees by location:

December 31, Total United States International
       
2010
 16,700 7,300 9,400
2009
 15,700 7,100 8,600
2008
 15,400 7,300 8,100

E.  SHARE OWNERSHIP

As of December 31, 2010, all of the officers and directors listed below had direct or beneficial ownership of less than 1% of the outstanding shares.  The following tables set forth the total number of vested and unvested shares and share options and share-settled stock appreciation rights owned by officers, directors and persons closely linked to them as of December 31, 2010.

      Total Number of 
  Restricted Beneficially Owned Shares  Owned 
Name Shares Units (1) Shares Direct or Indirectly 
        
Daniel Vasella, M.D.                                              1,550 375 1,925 
Cary R. Rayment                                              15,281 52,989 68,270 
Kevin J. Buehler                                              67,210 8,753 75,963 
Urs Bärlocher, Ph.D.                                              775 25 800 
Paul J. Choffat, Ph.D. .                                              775 10 785 
Lodewijk J.R. de Vink                                              1,550 5,000 6,550 
Joan W. Miller, M.D.                                              1,550 - 1,550 
Thomas G. Plaskett                                              1,550 2,485 4,035 
Jacques Seydoux, M.D.                                              775 10 785 
Enrico Vanni, Ph.D.                                              775 1 776 
Norman Walker                                              775 100 875 
Patrick Bachmann                                              1,599 236 1,835 
Joanne Beck                                              2,164 200 2,364 
Wes Brazell                                              2,726 - 2,726 
Robert Karsunky                                              21,363 - 21,363 
Elaine E. Whitbeck                                              20,053 - 20,053 
William K. Barton                                              19,145 - 19,145 
Sabri Markabi, M.D.                                              25,037 3,375 28,412 
Merrick R. McCracken                                              7,551 - 7,551 
Ed McGough                                              13,584 1,978 15,562 
        
(1)Restricted share units include restricted share units and performance share units, both settleable solely in shares.

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Options and Share-Settled Stock Appreciation Rights Held by Officers and Directors

    Outstanding Grant Vesting Term
Name 
Year (2)
 (#) Price ($) Year (Years)
           
Daniel Vasella, M.D. 2009 3,150 96.02 2012 10
  2008 1,350 167.95 2010 10
           
Cary R. Rayment
 2009 3,150 96.02 2012 10
  2008 100,621 147.54 2010 10
  2007 125,211 130.56 2010 10
  2006 95,652 122.90 2009 10
  2005 152,400 79.00 2008 10
  2004 22,000 63.32 2007 10
  2004 25,000 80.20 2007 10

Kevin J. Buehler
 2009 131,857 87.09 2012 10
  2008 22,191 147.54 2010 10
  2007 28,350 130.56 2010 10
  2006 14,783 122.90 2009 10
  2005 30,477 79.00 2008 10
  2004 12,000 63.32 2007 10
  2004 15,000 80.20 2007 10
           
Lodewijk J. de Vink 2009 3,150 96.02 2012 10
  2008 1,500 154.65 2010 10
  2007 2,000 132.91 2010 10
  2006 2,200 100.00 2009 10
  2005 3,000 97.89 2008 10
  2004 4,000 75.30 2007 10
  2003 4,500 41.71 2006 10
  2002 6,000 33.00 2005 10
           
Joan W. Miller, M.D. 2009 3,150 96.02 2012 10
           
Thomas G. Plaskett
 2009 3,150 96.02 2012 10
           
Patrick Bachmann
 2009 791 87.09 2012 10
  2008 533 147.54 2010 10
           
Stefan Basler(1) 
 2007 1,063 130.56 2010 10
  2006 704 122.90 2009 10
  2005 1,751 79.00 2008 10
  2004 2,420 63.32 2007 10
  2003 3,000 36.39 2006 10
  2002 2,550 33.00 2005 10
           
Joanne Beck
 2009 4,615 87.09 2012 10
           
Wes Brazell
 2009 5,158 87.09 2012 10

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    Outstanding Grant Vesting Term
 Name
 
Year (2)
 (#) Price ($) Year (Years)
Elaine E. Whitbeck
 2009 37,975 87.09 2012 10
  2008 17,753 147.54 2010 10
  2007 23,625 130.56 2010 10
  2006 17,391 122.90 2009 10

William K. Barton.
 2009 36,920 87.09 2012 10
           
Sabri Markabi, M.D.,
 2009 52,743 87.09 2012 10
  2008 5,667 144.87 2010 10
  2008 5,667 144.87 2010 10
  2008 5,582 144.87 2009 10
Ed McGough
 2009 26,371 87.09 2012 10
  2008 10,145 147.54 2010 10
  2007 5,434 130.56 2010 10
  2006 3,304 122.90 2009 10
           


(1)  Mr. Basler's 2002 and 2003 outstanding stock appreciation rights will be settled in cash.

(2)  Outstanding stock appreciation rights for shares granted in 2008 became vested upon the change of control in August 2010.

Information on common shares, stock options and share-settled stock appreciation rights granted to officers and directors and on incentive compensation plans is included in Item 6.B "Compensation."


 ITEM 7.MAJOR SHAREHOLDERS AND RELATED PARTY TRANSACTIONS

A.  MAJOR SHAREHOLDERS
Alcon is currently a majority owned subsidiary of Novartis AG.  During July 2008, Nestlé S.A. sold approximately 74 million, or almost 25%, of the outstanding Alcon common shares to Novartis.  At December 31, 2009 and 2008, Nestlé owned 156,076,263, or approximately 52%, of the outstanding common shares of Alcon.  In January 2010, Novartis exercised its call option under the Purchase and Option Agreement for Nestlé's remaining Alcon common shares and proposed a merger of Alcon with and into Novartis.  In August 2010, Novartis acquired Nestlé's remaining Alcon shares.  As of December 31, 2010, Novartis had purchased cumulatively 231,352,279, or approximately 77%, of the outstanding shares of Alcon.

The common shares owned by Novartis carry the same voting rights as other outstanding Alcon common shares.  Novartis is not subject to any contractual obligation to retain its interest in us.  However, pursuant to a merger agreement dated December 14, 2010, Novartis and Alcon have agreed, subject to certain conditions, to merge Alcon with and into Novartis.

See additional discussion of Novartis's purchase of its controlling interest from Nestlé, agreements between Novartis and Nestlé and the proposed merger under "Risk Factors-Risks Related to Our Relationship with Novartis."

Other than Novartis, no shareholder reported beneficial ownership of 5% or more of Alcon's outstanding common shares at December 31, 2010.

At December 31, 2010, excluding treasury shares held by Alcon, three shareholders of record in Switzerland, including Novartis, held 231,352,419, or approximately 77%, of the outstanding common shares of Alcon.

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B.  RELATED PARTY TRANSACTIONS

1.  Purchase and Option Agreement between Nestlé and Novartis

On April 6, 2008, Nestlé and Novartis executed the Purchase and Option Agreement pursuant to which Nestlé agreed to sell approximately 74 million of its shares of Alcon common stock to Novartis in a cash transaction at a price of $143.18 per share.  This sale was consummated on July 7, 2008, and Novartis acquired an ownership stake in Alcon of slightly less than 25% of Alcon's outstanding shares, while Nestlé remained Alcon's majority shareholder with approximately 156 million Alcon shares comprising approximately 52% of the Company's outstanding shares.

The Purchase and Option Agreement between Nestlé and Novartis also contained put and call option rights on the balance of approximately 156 million Alcon shares owned by Nestlé.  These option rights commenced on January 1, 2010.  As outlined by the two parties, these rights granted (i) Novartis a call option to buy all but 4.1 million (or 2.5%) of Nestlé's remaining Alcon shares at a fixed price of $181 per share and the 4.1 million shares at the first stage price of $143.18 per share, and (ii) Nestlé a put option to sell to Novartis all but 4.1 million of its remaining Alcon shares to Novartis at the lower of Novartis's call price of $181 per share or a 20.5% premium above the then-market price of Alcon shares, calculated as the average market price of Alcon shares during the five trading days immediately preceding the exercise date of the put option, with the 4.1 million share balance to be sold at the first stage closing price of $143.18 per share.
For further details on the Purchase and Option Agreement, please refer to the following link at the SEC's web site:  http://www.sec.gov/Archives/edgar/data/1114448/000110465908045488/a08-18409_1ex2d1.htm.

On January 4, 2010, Novartis announced that it had exercised its option to purchase the remaining approximately 156 million Alcon shares owned by Nestlé at a weighted average price of $180 per share in cash, pursuant to the Purchase and Option Agreement.  After consummation of the purchase on August 25, 2010, Novartis owned an approximate 77% interest in Alcon, with the 23% balance being the publicly traded shares.

The consummation triggered certain change of control provisions in certain retirement plans for Company employees, the Company's share-based awards plan (including the vesting of certain outstanding share-based awards) and other agreements.

On January 4, 2010, Novartis also announced that it submitted to the Alcon board of directors a proposal for a merger of Alcon with and into Novartis to be effected under Swiss merger law.  Under the terms of the merger proposal, holders of the Alcon shares that are publicly traded would receive 2.8 Novartis shares for each Alcon share.  The proposed merger would be contingent upon, among other things, approval by the Alcon board of directors.  As more fully discussed in Item 6.C, "Board Practices," the Company believes that Alcon's Organizational Regulations provide that the Alcon board of directors may only approve the proposed merger if a majority of the Independent Director Committee so recommends; however, management cannot predict the outcome of any proceeding that might be initiated to interpret or challenge this position.

The Independent Director Committee was formed in 2008 in connection with Novartis's initial purchase of slightly less than 25% of the Alcon shares from Nestlé to evaluate transactions such as the merger proposed by Novartis.  The Independent Director Committee engaged independent financial and legal advisors in connection with its evaluation of the proposed merger.  On January 20, 2010, the Independent Director Committee issued its formal response rejecting the Novartis merger proposal.  The committee rejected the merger proposal based on its assessment that the price offered and other terms were not acceptable and that Novartis's merger proposal was not in the best interests of Alcon and its minority shareholders.

2.  Merger Agreement of December 14, 2010

On December 15, 2010, Alcon announced that its board of directors approved a merger agreement with Novartis, whereby Novartis will pay a total merger consideration valued at $168 per share for the Alcon shares it does not currently own.  Under the terms of the deal, the merger consideration will be comprised of a combination of Novartis shares (or American Depositary Shares in lieu thereof) and, if necessary, a cash contingent value amount to result in a
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total value of $168 per share.  The exact exchange ratio and cash contingent value amount will be calculated based upon formulas set forth in the merger agreement.

In accordance with Alcon's Organizational Regulations and after receiving a fairness opinion from its independent financial adviser, Greenhill & Co., the Independent Director Committee unanimously recommended approval of the merger agreement to the Alcon board.  The board also received a separate fairness opinion rendered by Lazard Frères & Co. LLC in connection with the transaction.  After considering these items and other appropriate information and factors, the Alcon board approved the merger proposal.

The merger will be effected under Swiss merger law.  Completion is conditional, among other things, on two-thirds approval by the shareholders of both Novartis and Alcon voting at their respective meetings, and the registration and listing of Novartis shares and American Depositary Shares to be issued as merger consideration on the SIX Swiss Exchange and the New York Stock Exchange, respectively.  At December 31, 2010, Novartis owned more than the required two-thirds of the outstanding common shares of Alcon and has agreed, subject to certain conditions, to vote all of its Alcon shares to approve the merger.  The merger is expected to be completed during the first half of 2011.

Upon completion of the merger, Alcon will become the second largest division within Novartis.  Novartis has proposed that its CIBA VISION operations and select Novartis ophthalmic products will be integrated into Alcon.

The merger agreement has been incorporated by reference as Exhibit 4.13 to this Form 20-F.  Additional information concerning the proposed merger is included in the registration statement on Form F-4 filed by Novartis with the United States Securities and Exchange Commission on December 23, 2010 and subsequent amendments thereto.

3.  Litigation Trust

On July 8, 2010, the Independent Director Committee announced the creation and funding of the Alcon Litigation Trust, an irrevocable trust established under New York law pursuant to a resolution of the Alcon board of directors.  The members of the Independent Director Committee were the trustees of the trust.  The trust was created and funded on July 7, 2010 with $50 million.  The trust was created to provide the financial means to commence, defend or maintain litigation relating to any transaction between Alcon and a majority shareholder, including the transaction contemplated by the merger proposal announced by Novartis on January 4, 2010, and ensure the protection of the interests of Alcon and its minority shareholders in connection with any such transaction.

In connection with the merger agreement of December 14, 2010, the trust was terminated and the trust property was returned to Alcon in December 2010.  The trust agreement has been filed as Exhibit 4.12 to this Form 20-F.

4.  Minority Shareholder Class Action Lawsuits

As further discussed in Item 8.A.7, "Legal Proceedings," certain Alcon minority shareholders filed several class action lawsuits related to Novartis's January 2010 merger proposal to acquire the remaining publicly held minority interest.  The claims varied among the cases, but include allegations of: (i) breach of contract against Alcon; (ii) tortious interference with contract against Novartis and Nestlé; (iii) breach of fiduciary duties against the Alcon board of directors, Nestlé and Novartis; (iv) aiding and abetting breaches of fiduciary duties against the Alcon board of directors, Nestlé and Novartis; (v) breach of Section 13(d) of the Exchange Act against Novartis and Nestlé for an alleged failure to disclose that they were acting as a "group;" and (vi) breach of Section 14(d) of the Exchange Act against Novartis and Nestlé for an alleged failure to file with the U.S. Securities and Exchange Commission the materials required in connection with a "tender offer."

Eight cases filed in the U.S. District Courts for the Southern District of New York and the Northern District of Texas were consolidated into one class action case in the Southern District of New York.  A ninth case, which did not name Alcon, Inc. and its board of directors as parties, was filed in the Eastern District of New York but was voluntarily dismissed by the plaintiffs on March 18, 2010.
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On April 14, 2010, plaintiffs in the consolidated action dismissed their claims against Nestlé and the five Alcon directors designated by Nestlé.  On May 24, 2010, the court granted a motion by Novartis and dismissed the action in its entirety on the ground of the Forum Non Conveniens doctrine.  On July 14, 2010, the plaintiffs appealed the district court's dismissal to the U.S. Court of Appeals for the Second Circuit.  Plaintiffs moved to dismiss the appeal on January 5, 2011, and the Second Circuit granted their motion the next day.
Two cases filed in District Court, Tarrant County, Texas and two cases filed in the County Court at Law, Dallas County, Texas were consolidated for pre-trial purposes by the Texas Multidistrict Litigation Panel in the Texas District Court, Dallas County.  In November 2010, the court granted Novartis's motion seeking dismissal of these actions on the ground of the Forum Non Conveniens doctrine.  The plaintiffs appealed the court's dismissal, and the appeal is pending.

5.  Separation Agreement with Nestlé

Alcon, Inc. entered into a Separation Agreement with Nestlé (the "Separation Agreement") prior to the initial public offering in March 2002.  This Separation Agreement governs certain pre-offering transactions, as well as the relationship between Alcon and Nestlé following this offering.  The Separation Agreement was filed as an exhibit to the initial registration statement.  The Separation Agreement is governed by and will be construed in accordance with the laws of Switzerland.  The Separation Agreement with Nestlé governs the business and legal relationship between Nestlé and Alcon.

In accordance with Section 6.2 of the Shareholders Agreement between Nestlé and Novartis, upon the closing of Novartis's purchase of the remaining Alcon shares held by Nestlé pursuant to the Purchase and Option Agreement ("Second Stage Closing"), the Separation Agreement was terminated on August 25, 2010.  However, certain provisions of the Separation Agreement shall survive for a period of time thereafter.

For further details about the Shareholders Agreement and the Purchase and Option Agreement, please refer to the following link at the SEC's web site:  http://www.sec.gov/Archives/edgar/data/1167379/000110465908045488/0001104659-08-045488-index.htm.
Included in this Section 7.B.5 is a summary of certain material provisions that are included in the Shareholders Agreement and the Purchase and Option Agreement.  Also included in this section are references to the Separation Agreement between Alcon and Nestlé, which was terminated as of August 25, 2010, subject to the survival of certain sections, which are not material from Alcon's perspective.

(a)  Corporate Governance

The Shareholders Agreement between Nestlé and Novartis provided for the expansion of the Alcon board of directors from eight to ten members, with one of the additional members designated by Nestlé and one designated by Novartis.  Alcon's shareholders voted to expand the Alcon board and elected two new directors at Alcon's annual general meeting held on May 6, 2008 in Zug, Switzerland.  James Singh, Nestlé's Executive Vice President and Chief Financial Officer and Nestlé's designee, and Daniel Vasella, M.D., chairman of Novartis and Novartis's designee, were elected to these two director positions and joined Alcon's board upon the closing of the 74 million share sale transaction on July 7, 2008.

On January 8, 2009, Kevin Buehler was named President and Chief Executive Officer of Alcon, Inc. effective April 1, 2009.  At the annual general meeting on May 5, 2009, the shareholders elected Mr. Buehler to the board of directors.  With Mr. Buehler's election, our board of directors expanded from ten to eleven members.

Pursuant to provisions of the Purchase and Option Agreement and the Shareholders Agreement, on August 16, 2010, Novartis AG conditionally designated five directors to replace directors designated by Nestlé, which designation became effective upon the Second Stage Closing.  Accordingly, Enrico Vanni, Ph.D., Mr. Norman Walker, Paul Choffat, Ph.D., Urs Bäerlocher, Ph.D., and Jacques Seydoux, M.D., were designated by Novartis and subsequently elected to director positions by the shareholders.  The Nestlé directors who resigned from the Board as of the Second Stage Closing include Francisco Castañer, Dr. Werner J. Bauer, Paul Bulcke, James Singh and Hermann A. Wirz.

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For further details about corporate governance issues, please refer to Section 6.B of this report and to the Shareholders Agreement at:
http://www.sec.gov/Archives/edgar/data/1167379/000110465908045488/0001104659-08-045488-index.htm.

(b)         Dividend Policy

Under the terms of the Separation Agreement, which terminated as of the Second Stage Closing, if our board of directors proposed to pay a dividend to shareholders, Nestlé agreed to vote all of its shares in favor of such proposal so long as Nestlé held at least a majority of our outstanding common shares.  Under the merger agreement with Novartis dated December 14, 2010, Alcon has agreed not to pay dividends pending completion of the merger.

(c)Intercompany Debt and Future Financings

The Separation Agreement contained provisions governing the refinancing of intercompany debt prior to the initial public offering in March 2002.  During 2002, Nestlé's role in our debt structure changed from being the largest direct lender to providing primarily indirect support of our third-party debts.  In connection with the change of majority ownership, all direct borrowings from Nestlé were repaid in 2010.

In 2002, we entered into a $2.0 billion U.S. commercial paper program (the "CP Program"), which had $286 million outstanding as of December 31, 2009.  Nestlé served as the guarantor of the CP Program, for which they received a fee as discussed in note 8 to the consolidated financial statements.  In October 2005, the parties executed a Guarantee Fee and Commercial Paper Program Services Agreement (the "Services Agreement"), effective as of October 28, 2002.  Through this Services Agreement, the parties more formally documented the pre-existing CP Program.  The Services Agreement stated that Nestlé will: (i) provide a guarantee in favor of the holders of notes issued by Alcon Capital Corporation, Alcon, Inc.'s indirect wholly owned subsidiary, as part of the CP Program and (ii) manage the CP Program.  Pursuant to the Shareholders Agreement, the Guarantee Fee and Commercial Paper Program Services Agreement was terminated on August 13, 2010, and all commercial paper borrowings were repaid.

The Company participated with certain Nestlé affiliates in specific cash pooling accounts under which overdraft lines of credit were available and were jointly and severally guaranteed by all participants, including the Company.  At December 31, 2009, the total maximum permitted under these lines of credit was approximately $305 million.   The Company no longer participates in these accounts or lines of credit.

Under the terms of the Shareholders Agreement between Nestlé S.A. and Novartis, the parties agreed upon the Second Stage Closing to (a) terminate the Separation Agreement subject to the survival of certain provisions; (b) use reasonable best efforts to cause Alcon to terminate the Commercial Paper Program Services Agreement and ensure that no new commercial paper notes that benefit from the Commercial Paper Guarantee would be issued following the Second Stage Closing; (c) cause Alcon to repay any Indebtedness owed to Nestlé; (d) cause Alcon to use its reasonable best efforts to cause any Guarantees issued by Nestlé on behalf of Alcon  to be extinguished as soon as reasonably practicable after the Second Stage Closing with no further liability to Nestlé; and (e) cause Alcon to (i) terminate the cash pooling arrangements (the "Cash Pooling Arrangements") between Alcon and Nestlé and (ii) cause any Guarantees issued by Alcon on behalf of Nestlé relating to the lines of credit associated with the Cash Pooling Arrangements to be extinguished as soon as reasonably practicable after the Second Stage Closing with no further liability to Alcon.  Nestlé and Novartis also agreed that they shall, and shall use their reasonable efforts to cause Alcon to, terminate the Services Agreement (as defined in the Shareholders Agreement as the "Investment Services Agreement"), provided that certain sections shall survive such termination for a period of 18 months after the Second Stage Closing Date.  Nestlé S.A. and Novartis also agreed that they shall, and shall use their reasonable efforts to cause their Affiliates (including Alcon), to terminate all other Shared Arrangements (other than the Remaining Shared Agreements), with certain provisions surviving such termination for a period of 18 months after the Second Stage Closing Date.  Alcon and Nestlé have complied with the obligations referenced in this paragraph.  As discussed above, the Separation Agreement terminated as of the Second Stage Closing.

For further details about these terms and the definitions of the defined terms used above, please refer to Section 6.2 of the Shareholders Agreement at:
http://www.sec.gov/Archives/edgar/data/1167379/000110465908045488/0001104659-08-045488-index.htm.

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(d)Cash Management, Investment and Treasury Services

The Separation Agreement provided that Nestlé would continue to perform the cash management and treasury functions that it performed for us on the date of the Separation Agreement.  Since January 1, 2004, under a Services Agreement, Nestec S.A., an affiliate of Nestlé, provided certain additional treasury and investment services for the Company for a fee that is comparable to fees that would be paid in an arm's length transaction.  The Services Agreement could be terminated with 60 days' written notice.  This Services Agreement replaced a prior agreement with Nestlé to provide similar treasury and investment services during 2003.  Total fees paid for these services to Nestec S.A. for the years ended December 31, 2010, 2009 and 2008 were $1 million or less annually.

During 2008, Lehman Brothers International (Europe) London filed for administration in England.  At that time the Company's cash and cash equivalents included $707 million of short term securities held in a segregated custodial account of Lehman Brothers International (Europe) London pursuant to a Custody Agreement.  Nestlé invoiced the Company in December 2008, and in 2009 the Company reimbursed Nestlé, for a total of $5 million in fees paid by Nestlé to the Joint Administrators of Lehman Brothers International (Europe) (in administration) related to the release of the short-term securities held in the custodial account.  This amount of fees is subject to adjustment depending on the final costs incurred to settle the administration of Lehman Brothers International (Europe).

As discussed above, the Separation Agreement terminated as of the Second Stage Closing, subject to the survival of certain sections.

(e)Accounting and Reporting

Our consolidated financial statements are prepared in accordance with U.S. GAAP; Nestlé's consolidated accounts, consistent with past practice, continue to be prepared in accordance with International Financial Reporting Standards ("IFRS") as issued by the International Accounting Standards Board ("IASB").
The Separation Agreement providedpreparation of the Consolidated Financial Statements requires management to make certain estimates and assumptions, either at the balance sheet date or during the year, that we establish adequate procedures allowingaffect the reported amounts of assets and liabilities as well as revenues and expenses. Actual outcomes and results could differ from those estimates and assumptions.
The businesses of Alcon did not form a separate legal group of companies prior to the Spin-off in 2019. For the period in 2019 prior to the Spin-off, the financial statements were prepared on a combined basis for carve-out financial statements and were derived from Novartis’ Consolidated Financial Statements and accounting records, which were prepared in accordance with IFRS.
For further information on the timely conversionbasis of preparation of the Consolidated Financial Statements, see Note 2 to the Consolidated Financial Statements included elsewhere in this Annual Report.
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Items you should consider when evaluating our Consolidated Financial Statements
COVID-19
In March 2020, the World Health Organization declared the outbreak of COVID-19 as a pandemic. The pandemic triggered widespread shelter-in-place orders, business shutdowns and the deferral of non-urgent surgical procedures. Outbreaks of COVID-19 cases continued to occur in 2021 and localized responses remain unpredictable. The COVID-19 pandemic continued to have an impact on our financial statementsresults and operations in 2021, and it may continue to IFRS for inclusion in Nestlé's financial statements.  Alcon has complied with this obligation.

Sincehave an adverse effect on our net sales, operating results and cash flow. The extent to which the Separation Agreement was terminated uponCOVID-19 pandemic and the Second Stage Closing, Alcon is no longer obligatedrelated economic impact may continue to convertaffect our financial statements to IFRS for inclusion in Nestlé's financial statements.  However, Novartis reports itscondition or results of operations in accordance with IFRSis uncertain.
Use of estimates and Alcon will continue to convert itsassumptions
The preparation of financial statements requires management to IFRSmake certain estimates and assumptions, either at the balance sheet date or during the period that affects the reported amounts of assets and liabilities as well as revenues and expenses. In particular, due to the unknown future impacts of the ongoing COVID-19 pandemic, actual outcomes and results could differ from those estimates and assumptions as indicated in the "Critical accounting policies and estimates" section of this document. See Note 3 to the Consolidated Financial Statements included elsewhere in this Annual Report and in the "Critical accounting policies and estimates" section within this Item 5.A.
Segment description
Alcon has two identified reportable segments: Surgical and Vision Care. Both segments are supported by Research and Development and Manufacturing and Technical Operations, whose results are incorporated into the respective segment contribution. Segment contribution excludes amortization and impairment charges for Novartis.acquired product rights or other intangibles, general and administrative expenses for corporate activities, spin readiness and separation costs, transformation costs, fair value adjustments of contingent consideration liabilities, past service costs primarily for post-employment benefit plan amendments, and certain other income and expense items. See Note 5 to the Consolidated Financial Statements included elsewhere in this Annual Report.

In Surgical, Alcon researches, develops, manufactures, distributes and sells ophthalmic products for cataract surgery, vitreoretinal surgery, refractive laser surgery and glaucoma surgery. The surgical portfolio also includes implantables, consumables and surgical equipment required for these procedures and supports the end-to-end procedure needs of the ophthalmic surgeon. Alcon also provides services, training, education and technical support for the Surgical business. In 2021, the Surgical segment accounted for $4.7 billion, or 57%, of Alcon net sales to third parties, and contributed $1.2 billion, or 66%, of Alcon operating income (excluding unallocated income and expenses).
(f)Allocation of Liabilities
In Vision Care, Alcon researches, develops, manufactures, distributes and sells daily disposable, reusable, and color-enhancing contact lenses and a comprehensive portfolio of ocular health products, including products for dry eye, glaucoma, contact lens care and ocular allergies, as well as ocular vitamins and redness relievers. Alcon also provides services, training, education and technical support for the Vision Care business. In 2021, the Vision Care segment accounted for $3.5 billion, or 43%, of Alcon net sales to third parties, and contributed $604 million, or 34%, of Alcon operating income (excluding unallocated income and expenses).

Opportunity and risk summary
The Separationsurgical and vision care markets in which Alcon operates are large, dynamic and growing. As the world population grows and ages, the need for quality eye care is expanding and evolving. In addition, although it is estimated that 90% of all visual impairments are currently preventable, treatable or curable, we operate in markets that have substantial unmet medical and consumer needs. Our surgical and vision care products are targeted at addressing many of these unmet medical and consumer needs through products that are used in treating multiple ocular health conditions and offer leading eye care solutions for patients throughout their lives.
The surgical market in which we operate includes sales of implantables, consumables and surgical equipment, including associated technical, clinical and service support and training, and is projected to grow mid-single digits per year from 2021 to 2026. Growth drivers in the surgical market include: global growth of cataract and vitreoretinal procedures, driven by an aging population; increased access to care; higher uptake of premium patient-pay technologies; increased adoption of advanced technologies; and eye disease as a comorbidity linked to the global prevalence of diabetes.
The vision care market in which we operate is comprised of products designed for ocular care and consumer use, and is projected to grow mid-single digits per year from 2021 to 2026. Growth drivers in the vision care market include: better contact lens material, improved health and comfort and enhanced visual acuity; a significant population of approximately
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194 million undiagnosed dry eye patients, with an additional 42 million self-diagnosed dry eye patients using unsuitable products for treatment; growing access and consumption of vision care products in emerging markets; and increasing consumer access through the expansion of distribution models.
In each of our markets, we rely on our strong relationships with eye care professionals and consumers to attract and retain customers and expand the market. We have also made one of the largest commitments to research and development in the eye care market, which we expect to continue through internal innovation investments and identifying and executing on attractive acquisition, licensing and collaboration opportunities.
Alcon's future expectations are subject to various risks and uncertainties, including market dynamics in the surgical and vision care markets, general economic conditions, the effects of the ongoing COVID-19 pandemic and the pace of innovation in our industry, as well as successfully achieving our growth strategies and efficiency initiatives. These expectations were, in the view of management, prepared on a reasonable basis, reflect the best currently available estimates and judgments and present, to the best of management's knowledge and belief, the expected future financial performance of Alcon. However, this information is not fact and should not be relied upon as necessarily indicative of future results, and you are cautioned not to place undue reliance on the prospective financial information. There will likely be differences between Alcon expectations and the actual results and those differences could be material. Alcon's expectations may not be achieved and we do not undertake any obligation to release publicly the results of any future revisions we may make to our expectations. When considering Alcon's expectations, you should keep in mind the risk factors and other cautionary statements in "Item 3. Key Information—3.D Risk Factors" and "Special Note About Forward-Looking Statements" in this Annual Report.
Our financial results are affected to varying degrees by internal and external factors. For example, cybersecurity breaches or other disruptions of our information technology systems or our inability to comply with data privacy, identity protection or information security laws would significantly impact our business. Given the three-year Deferred Prosecution Agreement providedwe entered into with the US Department of Justice, our compliance with anti-corruption laws is of heightened significance to our business. Litigation risk, including intellectual property and product liability lawsuits, and government investigations are additional risks our business faces.
Further, our ability to grow depends on the commercial success of our products and our ability to maintain our position in the highly competitive markets in which we operate. Our ability to grow also depends on the success of our research and development efforts and BD&L activities in bringing new products to market, as well as the commercial acceptance of our products. The effect of a disruption in our global supply chain or important facilities and the COVID-19 pandemic (or other viral or disease outbreaks) would further impact our business.
Even if we protect our intellectual property to the fullest extent permitted by applicable law, competitors may market products that compete with our products. Increased pricing pressure in the healthcare industry in general as well as industry consolidation could also impact our ability to generate returns and invest for the allocationfuture. Additionally, our products are subject to competition from lower priced versions of liabilities between usour products, and Nestlé, particularly with respectour industry continues to product liability and environmental, health and safety matters.  Generally, we assumed responsibility for all claims arisingbe challenged by the vulnerability of distribution channels to counterfeiting. Product recalls or voluntary market withdrawals in connection with our business, including, without limitation, product liability claims and claims relating to environmental, health and safety matters, and we agreed to indemnify Nestlé for all costs and expenses incurred in connection with any such claims.

We also assumed liability for all employment matters of the employees engaged in our business at the time of the IPO.  In this connection, we entered into special arrangements with local Nestlé companies on the allocation of pension fund obligations between Nestlé and us. In certain countries, our employees participated in Nestlé's existing pension funds and we did not establish independent pension funds for our employees.  Prior to the change of control of ownership by Novartis, the Company and Nestlé entered into an agreement outlining the terms to segregate Alcon employees from Nestlé pension plans.  The agreement provides that, except for certain circumstances, all current Alcon pension participants will be migrated from Nestlé pension plans to other, not yet determined Alcon pension plans by January 1, 2011.

Under the Shareholders Agreement, Alcon's obligation to indemnify Nestlé for certain liabilities will continue for 18 months following the Second Stage Closing Date of August 25, 2010.

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In addition, we were part of the Nestlé Swiss Value-Added Tax Group until October 2010, when a new Swiss Alcon Value-Added Tax Group was formed.  Alcon is jointly and severally liable for any Swiss value-added tax liabilities of all other Swiss Alcon Group participants effective October 2010.

(g)         Contracts

The Separation Agreement contained provisions governing the continuation and termination of contracts between the Company and Nestlé (and its affiliates).

Depending on the nature of the contract, under the Shareholders Agreement, each contract either wasdefects or will be terminated in accordance with Legal Requirements on or following the Second Stage Closing Date, or continue through the remainder of its term and thereafter not be renewed.

(h)Shared Sites

Three sites relating to the administrationunanticipated use of our business continued to be shared with Nestlé in 2010.  These offices were located in Brazil, Norway and South Africa.

Pursuant to the terms of the Shareholders Agreement, these Shared Site Agreements will continue in effect for the remainder of their terms and may or may not be renewed.

(i)Shared Services

The Separation Agreement allowed the Company and Nestlé to share certain internal services so long as the cost of the arrangements were based on arm's length prices and on terms no less favorable than would be available from a third party. Nestlé continued to provide us with certain services during 2010, including but not limited to information technology and certain insurance arrangements.  To the extent that we were covered under Nestlé's insurance arrangements prior to the initial public offering, we continued to be covered under those arrangements through the Second Stage Closing.  Nestlé charged us our portion of the cost of these arrangements based on arm's length prices.

In certain markets, the Company provided an affiliate of Nestlé with certain services during 2010, including but not limited to, administrative, distribution, fleet management, warehousing and other services.  These services were provided to Nestlé's affiliate on terms no less favorable than would be available to a third party.  The fees received by the Company for these services were not material.

A limited number of shared services may continue during 2011.

(j)Registration Rights

Pursuant to the Separation Agreement, on March 20, 2002, we granted registration rights under the Securities Act to Nestlé with respect to sales of our common shares by Nestlé.

Under the terms of the Purchase and Option Agreement, Nestlé agreed to cause Alcon to enter into a registration rights agreement with Novartis with an effective date of the earlier of (i) the Second Stage Closing Date (as defined in the Purchase and Option Agreement) and (ii) the date on which the Purchase and Option Agreement is terminated, providing Novartis with registration rights with respect to the shares initially purchased by Novartis and shares subject to the Second Stage Closing that are no less favorable to Novartis than the registration rights granted to Nestlé under the Separation Agreement.

On December 10, 2009, Alcon entered into two substantially identical registration rights agreements with Novartis and Nestlé.  Both of these agreements are substantially identical to the original registration rights provided to Nestlé, with minor modifications to reflect subsequent changes to applicable U.S. securities laws.  Also on December 10, 2009, Novartis, Nestlé and Alcon entered into a shareholder coordination letter to avoid a duplication of Alcon's registration and related obligations and to regulate the exercise of registration rights under the two registration rights agreements, whichproducts could otherwise possibly occur simultaneously.  Under the terms of the Purchase and Option Agreement, neither Novartis nor Nestlé were permitted to buy or sell any additional Alcon shares until completion of
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the Second Stage Closing and the shareholder coordination letter was to become effective only if the Purchase and Option Agreement was terminated prior to the Second Stage Closing such that Nestlé would continue to hold Alcon shares.  Given that the Second Stage Closing occurred and Novartis acquired the balance of Nestlé's Alcon shares, the registration rights agreements with Novartis became effective and the registration rights agreement with Nestlé ceased toalso have any effect.

(k)Covenants Not to Compete and Not to Solicit

Nestlé had undertaken, for so long as it held at least a majority of our common shares, not to compete with our business except in certain limited areas as set out in the Separation Agreement.  The Separation Agreement also governed the allocation of business opportunities which could be taken by both Nestlé and us.  Under the Shareholders Agreement, subject to certain exceptions, Nestlé has covenanted to Novartis that it would not compete with our business for two years following the Second Stage Closing Date or hire or solicit certain key employees for one year following Second Stage Closing Date.

6.     Services Agreement

We entered into a services agreement with Cary R. Rayment, whereby Alcon retained Mr. Rayment as the non-executive chairman of its board of directors, as of April 1, 2009.  The term of the service agreement renews automatically on an annual basis thereafter unless or until terminated by either party upon thirty days written notice.  On October 24, 2010, Mr. Rayment ceded his position as chairman of the board and was appointed vice chairman.  At the December 2010 meeting, the board approved extending Mr. Rayment's agreement with the same remuneration on a monthly basis for his service as vice chairman of the board until the next annual general meeting of the shareholders.  Additional information pertaining to this agreement has been provided under Item 10.C, "Material Contracts," of this annual report.

7.Co-Marketing Agreement for Japan between Novartis Pharma AG and Alcon Pharmaceuticals Ltd.

On January 9, 2009, Alcon Pharmaceuticals Ltd. entered into an agreement with Novartis Pharma AG (an affiliate of Novartis) providing for the co-promotion under their license of the Lucentis® product in Japan.  This agreement has a three-year term ending on December 31, 2011.  During the years ended December 31, 2010 and 2009, the Company recognized approximately $10 million and $3 million, respectively, in co-promotion fees from this agreement, which were more than sufficient to recover the Company's costs under the agreement.

8.Line of Credit

During 2010, the Company entered into an unsecured line of credit agreement denominated in Venezuelan bolivars with a subsidiary of Novartis.  These short term borrowings were $4 million at December 31, 2010 and become due October 15, 2011.  The weighted average interest rate at December 31, 2010 was 10.0%.  The unused portion under the line of credit agreements was $8 million at December 31, 2010.

C.  INTEREST OF EXPERTS AND COUNSEL

Not Applicable.
ITEM 8. FINANCIAL INFORMATION

A.     CONSOLIDATED STATEMENTS AND OTHER FINANCIAL INFORMATION

1.      AUDITED CONSOLIDATED FINANCIAL STATEMENTS
See Item 18.

2.      THREE YEARS COMPARATIVE FINANCIAL STATEMENTS
See Item 18.

3.     AUDIT REPORT
See Report of Independent Auditors at page F-3.

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4.     LATEST AUDITED FINANCIAL STATEMENTS MAY BE NO OLDER THAN 15 MONTHS
Alcon has complied with this requirement.

5.     INTERIM FINANCIAL STATEMENTS IF DOCUMENT IS MORE THAN NINE MONTHS SINCE LAST AUDITED FINANCIAL YEAR
Not Applicable.

6.    EXPORT SALES IF SIGNIFICANT
See Item 18.

7.    LEGAL PROCEEDINGS

Minority Shareholder Class Action Lawsuits

On January 4, 2010, Novartis announced that it submitted to the Alcon board of directors a proposal for a merger of Alcon with and into Novartis to be effected under Swiss merger law.  Under the terms of the merger proposal, holders of the Alcon shares that are publicly traded would receive 2.8 Novartis shares for each Alcon share.

The Independent Director Committee was formed in 2008 in connection with Novartis's initial purchase of slightly less than 25% of the Alcon shares from Nestlé to evaluate transactions such as the merger proposed by Novartis.  The Independent Director Committee engaged independent financial and legal advisors in connection with its evaluation of the proposed merger.  On January 20, 2010, the Independent Director Committee issued its formal response rejecting the Novartis merger proposal.  The committee rejected the merger proposal based on its assessment that the price offered and other terms were not acceptable and that Novartis's merger proposal was not in the best interests of Alcon and its minority shareholders.  Further information on Novartis's merger proposal can be found in Item 7.B, "Related Party Transactions."

Certain Alcon minority shareholders filed several class action lawsuits related to Novartis's merger proposal concerning the acquisition of the remaining publicly held minority interest.  The claims varied among cases, but include allegations of:  (i) breach of contract against Alcon; (ii) tortious interference with contract against Novartis and Nestlé; (iii) breach of fiduciary duties against the Alcon board of directors, Nestlé and Novartis; (iv) aiding and abetting breaches of fiduciary duties against the Alcon board of directors, Nestlé and Novartis; (v) breach of Section 13(d) of the Exchange Act against Novartis and Nestlé for an alleged failure to disclose that they were acting as a "group;" and (vi) breach of Section 14(d) of the Exchange Act against Novartis and Nestlé for an alleged failure to file with the U.S. Securities and Exchange Commission the materials required in connection with a "tender offer."

Eight cases filed in the U.S. District Courts for the Southern District of New York and the Northern District of Texas were consolidated into one class action case in the Southern District of New York.  A ninth case, which did not name Alcon, Inc. and its board of directors as parties, had been filed in the Eastern District of New York but was voluntarily dismissed by the plaintiffs on March 18, 2010.
On April 14, 2010, plaintiffs in the consolidated action dismissed their claims against Nestlé and the five Alcon directors designated by Nestlé in exchange for Nestlé's and its directors' agreement that, without impairing the directors' ability to exercise their fiduciary obligations to Alcon, among other things, during the pendency of the action, they will take no action to (1) amend the Alcon Organizational Regulations, (2) remove or replace the Alcon independent directors or (3) facilitate Novartis's proposal to take Alcon private other than pursuant to a recommendation of the Independent Director Committee.  On May 24, 2010, the court granted a motion by Novartis and dismissed the action in its entirety on the ground of the Forum Non Conveniens doctrine.  The court denied motions filed by plaintiffs seeking reconsideration of this dismissal order and requesting leave to file an amended complaint.  On July 14, 2010, the plaintiffs appealed the district court's dismissal to the U.S. Court of Appeals for the Second Circuit.  Plaintiffs moved to dismiss the appeal on January 5, 2011, and the Second Circuit granted their motion the next day.

Two cases filed in District Court, Tarrant County, Texas and two cases filed in the County Court at Law, Dallas County, Texas were consolidated for pre-trial purposes by the Texas Multidistrict Litigation Panel in the Texas
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District Court, Dallas County.  Novartis filed a motion seeking dismissal of these actions on the ground of the Forum Non Conveniens doctrine.  In November 2010, these four cases also were dismissed by the court.  The plaintiffs appealed the court's dismissal, and the appeal is pending.

Other Litigation

From time to time we are involved in legal proceedings arising in the ordinary course of business.  We may be subject to litigation or other proceedings, which could cause us to incur significant expenses or prevent us from selling certain products. With the exception of the following matters, we believe that there is no litigation pending that will likely have, individually or in the aggregate, a material adverse effect onupon our financial position, results of operations or cash flows:

The Company, either alone or jointly with its commercial partners, has filed fourteen North American patent infringement actions against six different generic drug companies.  With the exception of international generic challenges, all of these generic drug companiesbusiness. We are seeking U.S. Foodalso implementing new information technology systems and Drug Administration ("FDA") approval to market generic versions of the Company's products, under what are known as Abbreviated New Drug Applications ("ANDAs").

The first infringement action was filed after the Company received notice that Teva Pharmaceuticals USA, Inc. had filed an ANDA seeking approval to sell a generic version of the Company's Vigamox® antibiotic ophthalmic solution.  Moxifloxacin, the primary ingredient in Vigamox®, is licensed to Alcon by Bayer Schering Pharma AG.  As part of its ANDA, Teva challenged three patents covering the Company's innovator product Vigamox®. Two of the patents are owned by the Company's licensor, Bayer Schering Pharma AG, and the third,integrating those new systems into our legacy systems, which expires in 2020 (including a six month pediatric extension), is owned by the Company.  The two Bayer Schering Pharma patents were also the subject of another Teva ANDA seeking approval to sell a generic version of Bayer Schering Pharma's systemic moxifloxacin product, Avelox®.  Suit was filed by Alcon and Bayer Schering Pharma as co-plaintiffs against Teva relative to the ANDA challenging Vigamox® on April 5, 2006 in the U.S. District Court in Delaware.  Bayer Schering Pharma subsequently filed suit in the same court relative to the Avelox® ANDA, and the two suits were merged.  Trial was scheduled to begin February 26, 2008, but the dispute between Bayer Schering Pharma and Teva relative to the two Bayer Schering Pharma patents was resolved by settlement on the eve of trial.  Under the terms of the settlement, Teva acknowledged the validity and enforceability of both Bayer Schering Pharma patents, and further acknowledged that its proposed generic ophthalmic product would infringe both patents.  Teva has therefore relinquished any claim that it is entitled to market the generic ophthalmic product prior to September 4, 2014.  The Company remains the exclusive ophthalmic licensee under the Bayer Schering Pharma patents.  The trial relative to the Company's patent began on February 28, 2008 and concluded on March 6, 2008.  Since then, the Company has received issuance of a related patent with claims that will cover the Vigamox® product and Teva's proposed generic product.  U.S. Patent No. 7,761,010 issued on March 2, 2010, and has been added to the FDA Orange Book relative to the Company's Vigamox® product.  On October 19, 2009, the court ruled in the Company's favor on all counts, finding the Company's patent to be valid and infringed by the proposed generic product.  Teva has appealed the trial court ruling, but the appeal was suspended because the trial court had not formally entered an amended form of judgment.  It is expected that the appeal will be reinstated after the lower court amends its form of judgment.  However, even if Teva were to succeed in having the district court decision reversed on appeal, it would still have to address the Company's recently issued second patent before competing with the Company's Vigamox® product in September 2014 when the underlying Bayer patent expires.  If Teva were to win on appeal and overcome the Company's second patent, the resulting generic competition would be expected to impact significantly the Company's sales and profits.  On a related note, the Company's European counterpart patent to the patent-in-suit was determined to be invalid in a European Patent Office Opposition Proceeding.  That invalidity decision was upheld by an Enlarged Board of Appeal on October 22, 2009.  Divisional patent applications on the Company's Vigamox® product remain pending in the European Patent Office.  In December 2010, one of those pending applications was allowed with claims that cover the Vigamox® product, but the patent has not yet formally issued.

The second patent infringement action was filed after the Company received notice that Apotex, a Canadian-based generic drug company, had filed an ANDA challenging one of the patents covering the Company's Patanol® anti-allergy eye product.  The Company's raw material supplier, Kyowa Hakko Kirin Co., Ltd., holds another U.S. patent, which, with the benefit of a six-month pediatric extension, expires on June 18, 2011.  Thus, this generic challenge poses no threat to the Patanol® product market prior to June 2011.  The patent that Apotex has challenged, which is
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co-owned by the Company and Kyowa, will expire in 2015.  The Company and Kyowa, as co-plaintiffs, filed suit against Apotex Inc. and Apotex Corp. on November 15, 2006 in the U.S. District Court in Indianapolis, Indiana.  As a result of the lawsuit filing, the FDA was required to delay any approval of the Apotex ANDA for 30 months until April 2009, unless the litigation were earlier resolved or the court were to modify the 30-month stay on FDA approval.  Because of the protection until June 2011 provided by the unchallenged Kyowa patent, the expiration of the 30-month period was inconsequential.  Trial had been scheduled for July 27, 2009, but was postponed until April 26, 2010.  Trial testimony was completed May 7, 2010, but closing arguments were postponed until August 3, 2010.  A ruling has not been issued.  Should Apotex succeed in overcoming the challenged patent and secure FDA approval, it would not be entitled to begin selling a generic olopatadine product that would compete with the Company's Patanol® product in the United States until June 18, 2011.  Such competition would be expected to impact significantly the Company's sales and profits.

The third patent infringement action was filed after the Company received notice on October 1, 2007 that Barr Laboratories, Inc. had filed an ANDA challenging the patents underlying the Company's Patanol® product.  Unlike the Apotex ANDA described above, which is challenging only the patent jointly owned by Kyowa and the Company, the Barr ANDA was also challenging Kyowa's composition patent on olopatadine, the active agent in Patanol®.  The Company and Kyowa filed suit in the Federal District Court in Indianapolis (where the Apotex case is pending) on October 23, 2007.  As a result of the lawsuit filing, the FDA was required to delay any approval of the Barr ANDA for 30 months unless the litigation were earlier resolved or the court modified the 30-month stay on FDA approval.  The 30-month period after which the FDA could approve Barr's generic product would have expired at the end of March 2010, nine months before the Kyowa composition patent expires.  A consolidated trial (with Apotex described above) was scheduled for late April 2010.  However, in September 2009, Barr withdrew its ANDA and subsequently was dismissed from the suit.

The fourth patent infringement action was filed after the Company received notice in late November 2008 that Barr Laboratories, Inc. had filed an ANDA challenging the patents underlying Alcon's Pataday once daily olopatadine product.  The Barr ANDA is challenging the patent jointly owned by Kyowa and the Company (described above), as well as two later issued patents owned by the Company that cover the Pataday formulation.  Of the two Company patents, the latest expiry date is November 2023 (effectively extended until May 2024 by a pediatric extension).  Barr is not challenging the Kyowa patent on olopatadine that expires in December 2010 (effectively extended until June 2011 by a pediatric extension).  The Company and Kyowa filed suit in the Federal District Court in Indianapolis on January 8, 2009.  As a result of the lawsuit filing, the FDA must delay any approval of the Barr ANDA for 30 months unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  The 30-month period after which the FDA could approve Barr's generic product will expire in May 2011.  This case has been consolidated with the Apotex case (Pataday) described below.  Trial has not yet been scheduled in this case, but it will not occur before the June 2011 expiration of the Kyowa patent.  In the absence of preliminary injunctive relief from the court, Barr could launch its generic version of Pataday "at risk" upon expiration of the Kyowa patent on June 18, 2011.  If Barr succeeds in overcoming all of the challenged patents and secures FDA approval, it would be entitled to begin or continue selling a generic olopatadine product that would compete with the Company's Pataday product in the United States.  Such competition would be expected to impact significantly the Company's sales and profits.

The fifth and sixth ANDA patent suits were filed February 2, 2009 in the U.S. District Court in Indianapolis against Apotex and Sandoz, respectively.

The Company received notice January 12, 2009, that Apotex has followed Barr in filing an ANDA challenging the patents underlying the Company's Pataday once daily olopatadine product.  Like Barr's ANDA, the Apotex ANDA is challenging the patent jointly owned by Kyowa and the Company (described above), as well as two later issued patents owned by the Company that cover the Pataday formulation.  Apotex is not challenging the Kyowa patent on olopatadine that expires in December 2010 (June 2011 with the pediatric extension).  Because the suit was filed within the statutory 45-day period, the FDA must delay any approval of the Apotex ANDA for 30 months (until June 2011), unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  In addition, because Apotex is the second filer, it is also subject to the first filer's 180-day exclusivity period, which could further delay its FDA approval.  This case has been consolidated with the Barr case (Pataday) described above.  Trial has not yet been scheduled in this case.  If Apotex succeeds in overcoming both of the challenged patents and secures FDA approval, then after the expiration of Barr's potential 180-day "first filer" exclusivity period,
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it would be entitled to begin selling a generic olopatadine product that would compete with the Company's Pataday product in the United States.  Such competition would be expected to impact significantly the Company's sales and profits.

The Company received notice on January 15, 2009 that Sandoz Inc. (an affiliate of Novartis) has filed an ANDA challenging one of the patents underlying the Company's Patanol® product.  Similar to the Apotex ANDA on Patanol®, the Sandoz ANDA is challenging only the patent jointly owned by Kyowa and the Company, but not the Kyowa-owned patent on olopatadine, which expires December 2010 (June 2011 with the pediatric extension).  Because the suit was filed within the statutory 45-day period, the FDA must delay any approval of the Sandoz ANDA for 30 months (until June 2011) unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  However, Sandoz would not be entitled to receive FDA approval until the expiration or forfeiture of a 180-day exclusivity period that would be granted to Apotex (the first ANDA filer) if it were successful in its patent challenge.  Trial had been scheduled for April 26, 2010, and consolidation with the above-described Apotex suit (Patanol®) had been ordered by the court.  Apotex, however, advised the court of public statements of intent by Novartis to acquire all outstanding shares of Alcon stock, and filed a motion to sever Sandoz from the trial.  On February 22, 2010, the court granted the motion, ordering the suit against Sandoz to proceed separately and confirming the April 26, 2010 trial date with Apotex.  A new trial date for the Sandoz case has not yet been set, and further proceedings in the case were stayed until November 2010.  Sandoz requested a six-month extension of that stay, which was granted.  Subject to the possibility of the 180-day exclusivity period that could accrue to Apotex, if Sandoz succeeds in overcoming the challenged patent and secures FDA approval, it would be entitled to begin selling a generic olopatadine product that would compete with the Company's Patanol® product in the United States.  Such competition would be expected to impact significantly the Company's sales and profits.
The seventh ANDA patent suit was filed after the Company received notice by letter dated March 17, 2009, that Barr Laboratories, Inc. had filed a Paragraph IV certification with its ANDA for a generic version of the Company's TRAVATAN® product containing 0.004% travoprost.  Barr is challenging the following patents listed in the Orange Book for TRAVATAN®: U.S. Patent Nos. 5,510,383; 5,631,287; 5,849,792; 5,889,052; and 6,011,062.  With the exception of the '383 patent, which expires in 2013, all of the patents will expire in December 2014.  The Company filed suit against Barr in the U.S. District Court in Delaware on April 30, 2009 and thereby secured the statutory 30-month stay on FDA approval of the generic product.  The FDA must delay any approval of the Barr ANDA until September 2011, unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  This case has been consolidated with the Par and Apotex cases on TRAVATAN® described below.  Trial originally had been scheduled to commence March 7, 2011.  It was rescheduled to commence May 2, 2011, but recently was delayed again with no set trial date from the court.  In June 2010, the Company announced plans to discontinue TRAVATAN® in the United States.  That same month, Apotex withdrew its ANDA and, as noted below, subsequently has been dismissed from the lawsuit.  In November 2010, Barr advised that it was withdrawing its ANDA on TRAVATAN ® and is seeking dismissal from the lawsuit with respect to the TRAVATAN ® product.  The withdrawal leaves Par (described below) as the effective first filer on the TRAVATAN ® product.

The eighth patent suit was filed after Sandoz Canada Inc. (an affiliate of Novartis) notified Alcon Canada by letter dated April 9, 2009, that Sandoz had filed an Abbreviated New Drug Submission ("ANDS") seeking approval from the Canadian Minister of Health to market a generic version of the Company's Patanol® product.  The Sandoz ANDS is challenging only one of the two patents listed in the Canadian Patent Register for the Patanol® product.  The challenged patent (Canadian Patent No. 2,195,094) is jointly owned by Kyowa and the Company and expires in May 2016.  The Company and Kyowa filed suit on May 25, 2009 in the Federal Court in Toronto, thereby securing a 24-month delay (until May 25, 2011) in the regulatory approval from the Minister of Health, which can only be shortened if the litigation is earlier resolved or the court modifies the 24-month stay on such approval.  Trial had been scheduled to commence March 7, 2011, but the court has released that date and will, if necessary, reschedule trial at a later date.  Should Sandoz succeed in overcoming the challenged patent and secure Minister of Health approval, it would be entitled to begin selling a generic olopatadine product that would compete with the Company's Patanol® product in Canada well before the patent expiration in 2016, but not before expiration of the unchallenged patent in November 2012.  Such competition would be expected to impact the Company's sales and profits.

The ninth ANDA patent suit was filed after the Company received notice by letter dated June 1, 2009, that Par Pharmaceutical, Inc. had filed a Paragraph IV certification with its two ANDAs for generic versions of the Company's TRAVATAN® and TRAVATAN Z® products.  Par is challenging the following patents listed in the Orange
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Book for TRAVATAN® and TRAVATAN Z®:  U.S. Patent Nos. 5,510,383; 5,631,287; 5,849,792; 5,889,052; 6,011,062; 6,503,497; and 6,849,253.  All of these patents will expire by the end of 2014.  On July 1, 2009, the Company filed suit in the U.S. District Court in Delaware, thereby securing a statutory stay under which the FDA must delay any approval of the Par ANDAs until December 2011, unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  All of the ANDA cases concerning TRAVATAN® and TRAVATAN Z® (Barr, Par and Apotex) were consolidated.  Trial originally had been scheduled for March 7, 2011.  It was rescheduled to commence May 2, 2011, but recently was delayed again with no set trial date from the court.  In June 2010, the Company announced plans to discontinue TRAVATAN ® in the United States.  That same month, Apotex withdrew its ANDA and, as noted below, subsequently has been dismissed from the lawsuit.  In November 2010, Barr advised that it was withdrawing its ANDA on TRAVATAN ® and is seeking dismissal from the lawsuit (as noted above).  The withdrawal leaves Par as the effective first filer on the TRAVATAN ® product.  If Par succeeds in overcoming all of the challenged patents and secures FDA approval, it would be entitled to begin selling generic travoprost products that would compete with the Company's TRAVATAN ® and TRAVATAN Z® products in the United States in December 2011.  Such competition would be expected to impact significantly the Company's sales and profits.

The tenth ANDA patent suit was filed after the Company received notice by letter dated June 24, 2009, that Barr Laboratories, Inc. had filed a Paragraph IV certification with its ANDA for a generic version of the Company's TRAVATAN Z® product.  Barr is challenging the following patents listed in the Orange Book for TRAVATAN Z®:  U.S. Patent Nos. 5,510,383; 5,889,052; 6,503,497; and 6,849,253.  All of the patents will expire by the end of 2014.  On July 13, 2009, Alcon filed suit in the U.S. District Court in Delaware, thereby securing a statutory stay under which the FDA must delay any approval of the Barr ANDA until December 2011, unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  Trial originally had been scheduled for March 7, 2011.  It was rescheduled to commence May 2, 2011, but was recently delayed again with no set trial date from the court.  This case was consolidated with the above-described Barr suit (TRAVATAN®) and Par suit (TRAVATAN® and TRAVATAN Z®) and consolidated further to include the Apotex suit (TRAVATAN®) described below (Note: in June 2010, Apotex withdrew its ANDA and subsequently has been dismissed from the suit).  Subject to the possibility of the 180-day exclusivity period that could accrue to Par (as first filer) relative to the TRAVATAN Z® product, if Barr succeeds in overcoming all of the challenged patents and secures FDA approval, it would be entitled to begin selling a generic travoprost product that would compete with the Company's TRAVATAN Z® product in the United States.  Such competition would be expected to impact significantly the Company's sales and profits.

The eleventh ANDA patent suit was filed after the Company received notice by letter dated September 11, 2009, that Apotex Corp. and Apotex Inc. had filed an ANDA for a generic version of Alcon's TRAVATAN® product.  Apotex was challenging all five of the Orange Book listed patents for TRAVATAN®: 5,510,383; 5,631,287; 5,849,792; 5,889,052; and 6,011,062.  The Company filed suit in the U.S. District Court in Delaware, thereby securing a statutory stay under which the FDA would be required to delay any approval of the Barr ANDA until March 2012, unless the litigation were earlier resolved or the court modified the 30-month stay on FDA approval.  This case was consolidated with the Barr and Par cases (TRAVATAN® and TRAVATAN Z®) described above.  Trial originally was scheduled for March 7, 2011.  It was rescheduled to commence May 2, 2011, but recently was delayed again with no set trial date from the court.  However, in June 2010 Apotex withdrew its ANDA and subsequently has been dismissed from the suit.

The twelfth ANDA patent suit was filed after the Company received notice on December 15, 2009 that Sandoz Inc. (an affiliate of Novartis) had filed an ANDA with a Paragraph IV certification directed to the Company and Kyowa patents on Pataday.  The Sandoz ANDA is challenging the patent jointly owned by Kyowa and The Company (described above), as well as two later issued patents owned by the Company that cover the Pataday formulation.  Of the two Company patents, the latest expiry date is November 2023 (effectively extended until May 2024 by a pediatric extension).  Sandoz is not challenging the Kyowa patent on olopatadine that expires in December 2010 (effectively extended until June 2011 by a pediatric extension).  On January 27, 2010, the Company and Kyowa filed suit in the Federal District Court in Indianapolis. Because the suit was filed within the statutory 45-day period, the FDA must delay any approval of the Sandoz ANDA for 30 months (until June 2012) unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  However, because Sandoz is the third filer (behind both Barr and Apotex) and subject to a potential 180-day exclusivity period of the first filer, the 30-month stay is of no practical consequence.  At the request of Sandoz, the court has stayed proceedings until November 2010.  Sandoz has requested a six-month extension of that stay.  Subject to the possibility of the 180-day exclusivity period
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that potentially could accrue to Barr (as first filer) relative to the Pataday product, if Sandoz were to succeed in overcoming all the challenged patents and to secure FDA approval, it would be entitled to begin selling a generic product that would compete with the Company's Pataday product in the United States.  Such competition would be expected to impact significantly the Company's sales and profits.

The thirteenth ANDA patent suit was filed after the Company received notice that Wockhardt Limited (headquartered in India) has filed an ANDA with a Paragraph IV certification for a generic version of the Company's Patanol® product.  Wockhardt is challenging U.S. Patent No. 5,641,805, which is jointly owned by the Company and its raw material supplier, Kyowa Hakko Kirin Co., Ltd.  The challenged patent will expire in 2015.  Wockhardt is not challenging, however, another Kyowa-owned U.S. patent covering Patanol®, which expires on December 18, 2010 (effectively extended until June 2011 by a pediatric extension).  The Company and Kyowa filed suit against Wockhardt in the Federal District Court in Indianapolis on February 12, 2010, to avail themselves of the statutory 30-month stay on FDA approval of the proposed generic product.  That 30-month period will expire August 2, 2012, unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  However, as a third ANDA filer (behind both Apotex and Sandoz), Wockhardt would not be entitled to receive FDA approval until the expiration or forfeiture of a 180-day exclusivity period that would be granted to Apotex (the first filer) if it were successful in its patent challenge.  Subject to the 30-month stay and the possibility of the 180-day exclusivity period that potentially could accrue to Apotex (as first filer) relative to the Patanol® product, if Wockhardt were to succeed in overcoming the challenged patent and to secure FDA approval, it would be entitled to begin selling a generic product that would compete with the Company's Patanol® product in the United States.  Such competition would be expected to impact significantly the Company's sales and profits.

The fourteenth patent suit was initiated after receipt of a letter dated February 24, 2010, notifying Alcon Canada that Apotex, Inc. had filed an ANDS seeking approval from the Canadian Minister of Health to market a generic version of the Company's Patanol® product.  The Apotex ANDS is challenging only one of the two patents listed in the Canadian Patent Register for the Patanol® product.  The challenged patent (Canadian Patent No. 2,195,094) is jointly owned by Kyowa and the Company and expires in May 2016.  The Company and Kyowa filed suit April 13, 2010 in the Federal Court in Toronto, Ontario, to secure a 24-month delay (until April 2012) in the regulatory approval from the Minister of Health, which can only be shortened if the litigation is earlier resolved or the court modifies the 24-month stay on such approval.  Should Apotex succeed in overcoming the challenged patent and secure Minister of Health approval, it would be entitled to begin selling a generic olopatadine product that would compete with the Company's Patanol® product in Canada well before the patent expiration in 2016, but not before expiration of the unchallenged patent in November 2012.  Such competition would be expected to impact the Company's sales and profits.

The Company is also enforcing patents against generic challengers in China (Patanol®), Chile (Vigamox®) and Korea (Patanol®).

On April 16, 2008, Synergetics USA, Inc., a microsurgical device company, filed a civil antitrust lawsuit in the U.S. District Court for the Southern District of New York against the Company and its subsidiary, Alcon Laboratories, Inc. Synergetics asserted damages that it claimed could exceed $100 million.  In 2008 and 2009, subsidiaries of the Company filed two suits against Synergetics for patent infringement in the U.S. District Court for the Northern District of Texas in Fort Worth.  Synergetics answered the complaints.  A series of counterclaims and motions followed.  On April 23, 2010, the parties entered a Confidential Settlement and License Agreement together with a Supply Agreement.  Under the agreements, Alcon paid $32 million in exchange for worldwide rights to sell Synergetics patented vitreoretinal products.  The products will be manufactured by Synergetics and supplied to Alcon.  The agreements also settled all pending litigation between Alcon and Synergetics, including both the antitrust and the patent litigation, and provide a process for future dispute resolution.

On December 18, 2008, James M. Nielsen, M.D. filed a patent infringement suit against Alcon, Inc. and Alcon Laboratories, Inc. in the U.S. District Court for the Northern District of Texas in Dallas.  Dr. Nielsen is asserting that his U.S. Patent No. 5,158,572 entitled "Multifocal Intraocular Lens" is being infringed by the Company's AcrySof® ReSTOR® intraocular lens.  The patent, which expired at the end of October 2009, was previously licensed to Advanced Medical Optics, Inc.  The Company filed its Answer January 12, 2009.  The Answer included a counterclaim for a declaratory judgment that the patent-in-suit is invalid and not infringed.  The case had been set for trial in August 2010 but has been postponed.  No new trial date has been set.  Summary judgment motions were filed
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by both parties January 7, 2011.  Alcon is seeking summary judgment on noninfringement, invalidity and laches, while Dr. Nielsen is seeking partial summary judgment on invalidity and laches/estoppels.  On January 10, 2011, the court ordered that both parties' motions be stricken and refiled in a "cross-motion" format, the briefing for which was extended by the court until the end of March 2011.  An adverse ruling by the court, while possible, would not be expected to impact significantly the Company's sales and profits.

On January 22, 2009, Elan Pharma International Ltd. sued two of the Company's subsidiaries, Alcon Laboratories, Inc. and Alcon Research, Ltd., in the U.S. District Court for the Eastern District of Texas in Sherman, alleging infringement of two Elan patents on nanoparticle technology (U.S. Patent Nos. 5,298,262 and 5,429,842).  The complaint claims that the Company's Azopt® product and, potentially, other products infringe the two patents.  The Company answered and counterclaimed on May 12, 2009.  Elan then moved to dismiss certain of the Company's affirmative defenses and counterclaims.  The Company has filed an amended answer and counterclaims providing greater detail with respect to the Company's inequitable conduct counterclaims.  The case has been set for trial on October 17, 2011.  The Company believes that it has strong defenses and intends to defend itself vigorously.  An adverse ruling by the court, however, could impact significantly the Company's sales and profits.
Alcon and its subsidiaries are parties to a variety of other legal proceedings arising out of the ordinary course of business, including proceedings relating to product liability and patent infringement.  The Company believes that it has valid defenses and is vigorously defending the litigation pending against it.

Alcon and its subsidiaries are obligated to comply with the laws of each of the many countries in which we operate, covering a broad range of activities.  Despite our efforts, any failure to comply with law could lead to substantial liabilities that may not be covered by insurance, and could affect our business and reputation.

The Company is subject to various legal proceedings, including legal proceedings relating to Novartis's January 2010 merger proposal.  The Company may also be subject to additional legal proceedings in the future.  Such proceedings could relate to, among other things, product liability, commercial disputes, employment and wrongful discharge, antitrust, securities, sales and marketing practices, health and safety, environmental, tax, privacy, intellectual property matters and the proposed merger with Novartis.  Such proceedings are inherently unpredictable, and large verdicts sometimes occur.  As a consequence, the Company may in the future incur judgments or enter into settlements of claims that could have a material adverse effect upon our business if we are unsuccessful in the implementation. We have incurred debt that we must continue to service, and we may need additional financing in debt or equity.
We also may be adversely affected by changes in inventory levels or fluctuations in buying patterns by our large distributor and retail customers. If we overestimate demand and produce too much of a particular product, we face a risk of inventory obsolescence. In addition, for certain materials, components and services, we rely on itssole or limited sources of supply. Our customer relations could be negatively impacted by the loss of our significant suppliers or the inability of any such supplier to meet certain specifications or delivery schedules. Further, we have developed strong relationships with numerous healthcare providers and rely on them to recommend our products to their patients and to other members of their organizations. Consumers in the eye health industry have a tendency not to switch products regularly and are repeat consumers, meaning that a physician's initial recommendation of our products, and a consumer's initial choice to use our products, have an impact on the success of our products. Therefore, it is important to our business and results of operations to retain and grow these relationships.
Given our global presence, our operations and business results are also influenced and affected by the global economic and financial environment, including unpredictable political conditions that currently exist in various parts of the world. Additionally, a portion of our operations are conducted in emerging markets and are subject to risks and potential costs such as economic, political and social uncertainty, as well as relatively low average income levels and limited government reimbursement for the cost of healthcare products and services. Our operations and business results are also affected by
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the varying degrees of governmental regulation in the countries in which we operate, making the process of developing new products and obtaining necessary regulatory marketing authorization lengthy, expensive and uncertain. The manufacture of our products is also highly regulated. Any changes or new requirements related to the regulatory approval process or postmarket requirements applicable to our products in any jurisdiction could be costly and onerous to comply with.
For more details on these trends and how they could impact our results, see "Item 3. Key Information—3.D. Risk Factors".
Components of results of operations
Net sales to third parties
Revenue on the sale of Alcon products and services, which is recorded as "Net sales to third parties" in the Consolidated Income Statement, is recognized when a contractual promise to a customer (i.e., a performance obligation) has been fulfilled by transferring control over the promised goods and services to the customer, substantially all of which is at the point in time of shipment to or receipt of the products by the customer or when the services are performed. If contracts contain customer acceptance provisions, revenue would be recognized upon the satisfaction of acceptance criteria. The amount of revenue to be recognized is based on the consideration Alcon expects to receive in exchange for its goods and services, which may be fixed or variable. Variable consideration may include rebates, discounts including cash discounts, chargebacks and sales returns. Variable consideration is only recognized when it is highly probable that a significant reversal of cumulative sales will not occur.
Surgical equipment may be sold together with other products and services under a single contract. The total consideration is allocated to the separate performance obligations based on the relative standalone selling price for each performance obligation. Revenue is recognized upon satisfaction of each performance obligation under the contract.
Other revenues
"Other revenues" mainly include revenue from contract manufacturing services provided to our Former Parent which are recognized over time as the service obligations are completed. Associated costs incurred are recognized in "Cost of other revenues".
Inventories
Inventory is valued at the lower of acquisition or production cost determined on a first-in, first-out basis and net realizable value. This value is used for the "Cost of net sales" and "Cost of other revenues" in the Consolidated Income Statement. Unsalable inventory is fully written off in the Consolidated Income Statement under "Cost of net sales" and "Cost of other revenues".
Research & development
Internal research and development costs are fully charged to "Research & development" in the Consolidated Income Statement in the period in which they are incurred. Alcon considers that regulatory and other uncertainties inherent in the development of new products preclude the capitalization of internal development expenses as an intangible asset until marketing approval from a regulatory authority is obtained in relevant major markets, such as the United States, the European Union, Switzerland, China or Japan.
Critical accounting policies and estimates
Selected accounting policies are set out in Note 3 to the Consolidated Financial Statements included elsewhere in this Annual Report, which are prepared in accordance with IFRS as issued by the IASB.
Given the uncertainties inherent in our business activities, we must make certain estimates and assumptions that require difficult, subjective and complex judgments. Because of uncertainties inherent in such judgments, actual outcomes and results may differ from our assumptions and estimates, which could materially affect our Consolidated Financial Statements. We have assessed various accounting estimates and other matters, including those that require consideration of forecasted financial information, in context of the unknown future impacts of COVID-19 using information reasonably available to us at this time. The inherent uncertainties of COVID-19 including the duration, scope, and severity of the pandemic may result in actual outcomes that differ materially from our current assumptions and estimates.
Application of the following accounting policies requires certain assumptions and estimates that have the potential for the most significant impact on the Consolidated Financial Statements.
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Impairment of goodwill and intangible assets
We review long-lived intangible assets for impairment whenever events or changes in circumstance indicate that the carrying amount may not be recoverable. Goodwill, the Alcon brand name and intangible assets not yet ready for use are not amortized but are reviewed for impairment at least annually. Our annual impairment testing date is Alcon's year-end, December 31.
A cash generating unit to which goodwill has been allocated (reportable segments) is considered impaired when its carrying amount, including the goodwill, exceeds its recoverable amount, which is defined as the higher of its fair value less costs of disposal and its value in use. If the recoverable amount of the reportable segment is less than its carrying amount, an impairment loss shall be recognized.
An intangible asset other than goodwill is considered impaired when its balance sheet carrying amount exceeds its estimated recoverable amount, which is defined as the higher of its fair value less costs of disposal and its value in use. Usually, Alcon applies the fair value less costs of disposal method for its impairment assessment. In most cases, no direct or indirect observable market prices for identical or similar assets are available to measure the fair value less costs of disposal. Therefore, an estimate of fair value less costs of disposal is based on net present value techniques utilizing post-tax cash flows and discount rates. In the pricelimited cases where the value in use method would be applied, net present value techniques would be applied using pre-tax cash flows and discount rates.
Fair value less costs of Alcon's common shares maydisposal reflects estimates of assumptions that market participants would be affectedexpected to use when pricing the asset or cash generating units, and for this purpose management considers the range of economic conditions that are expected to exist over the remaining useful life of the asset. The estimates used in calculating net present values involve significant judgment by speculation concerningmanagement and include assumptions with measurement uncertainty, such as the potential outcomefollowing:
Amount and timing of legal proceedings.projected cash flows;

Long-term sales forecasts for up to 25 years including sales growth rates;
The Company is subjectTiming and probability of regulatory and commercial success;
Royalty rate for the Alcon brand name;
Terminal growth rate; and
Discount rate.
Generally, for intangible assets with a definite useful life Alcon uses cash flow projections for the whole useful life of these assets. For goodwill and the Alcon brand name, Alcon generally utilizes cash flow projections for a five-year period based on management forecasts, with a terminal value based on cash flow projections considering the long-term expected growth rates and impact of demographic trends of the population to governmental oversightwhich Alcon products are prescribed, for later periods. Probability-weighted scenarios are typically used.
Discount rates used consider Alcon estimated weighted average cost of capital adjusted for specific country and associated civil and criminal enforcement relating to drug and medical device advertising, promotion and marketing, and such enforcement is evolving and intensifying.  Other parties, including private plaintiffs, also are commonly bringing suit against pharmaceutical and medical device companies, alleging off-label marketing and other violations.  Given the significantcurrency risks associated with cash flow projections to approximate the weighted average cost of capital of a comparable market participant.
Due to the above factors and those further described in the "Opportunity and risk summary" section above, actual cash flows and values could vary significantly from forecasted future cash flows and related values derived using net present value techniques.
For additional information on intangible assets and impairment charges recognized, see Note 10 to the Consolidated Financial Statements included elsewhere in this Annual Report.
Goodwill and other intangible assets represent a significant part of our Consolidated Balance Sheet, primarily due to acquisitions. Although no significant additional impairments are currently anticipated, impairment evaluation could lead to material impairment charges in the future.
Business combinations
The acquisition method of accounting is used to account for all business combinations, regardless of whether equity instruments or other assets are acquired. Identifiable assets acquired and liabilities assumed in a business combination are measured initially at their fair values at the acquisition date. The excess of the consideration transferred over the fair value of the net identifiable assets acquired is recorded as goodwill, or directly in the income statement if it is a bargain purchase. Alcon primarily uses net present value techniques, utilizing post-tax cash flows and discount rates in calculating the fair value of identifiable assets acquired when allocating the purchase consideration paid for the acquisition. The
55


estimates used in calculating fair values involve significant judgment by management and include assumptions with measurement uncertainty, such enforcementas the following:
Amount and suits,timing of projected cash flows;
Long-term sales forecasts;
Timing and probability of regulatory and commercial success; and
Discount rate.
Alcon may elect on a transaction-by-transaction basis to apply the Company has adopted enhanced compliance controlsoptional concentration test to assess whether a trans-action qualifies as a business. Under the test, when substantially all of the fair value of the gross assets acquired is concentrated in a single identifiable asset or a group of similar identifiable assets, Alcon will account for the transaction as an asset purchase and not a business combination.
If the concentration test is not met, or Alcon elects not to apply this optional test, Alcon will perform an assessment focusing on the existence of inputs and processes that have the ability to create outputs to determine whether the transaction is an asset purchase or a business combination.
Contingent consideration
In a business combination, it is necessary to recognize contingent future payments to previous owners, representing contractually defined potential amounts as a liability. Usually for Alcon these are linked to development or commercial milestones related to certain assets and are recognized as a financial liability at their fair value, which is then re-measured at each subsequent reporting date.
For the determination of the fair value of contingent consideration, various unobservable inputs are used. A change in these inputs might result in a significantly higher or lower fair value measurement. The inputs used are, among others, the timing and probability of regulatory and commercial success, sales forecast and assumptions regarding the discount rate, timing and different scenarios of triggering events. The significance and usage of these inputs to each contingent consideration may vary due to differences in the timing and triggering events for payments or in the nature of the asset related to the contingent consideration. These estimations typically depend on factors such as technical milestones or market performance and are adjusted for the probability of their likelihood of payment, and if material, are appropriately discounted to reflect the impact of time.
Changes in the fair value of contingent consideration liabilities in subsequent periods are recognized in the Consolidated Income Statement in "Cost of net sales" for currently marketed products and in "Research & development" for in-process research & development.
The effect of unwinding the discount over time is recognized in "Interest expense" in the Consolidated Income Statement.
Taxes
The estimated amounts for current and deferred tax assets or liabilities, including any amounts related to any uncertain tax positions, are based on currently known facts and circumstances. Tax returns are based on an interpretation of tax laws and regulations and reflect estimates based on these judgments and interpretations. The tax returns are subject to examination by the competent taxing authorities which may result in an assessment being made requiring payments of additional tax, interest or penalties. Inherent uncertainties exist in the estimates of the tax positions.
Research & development
Internal research & development costs are fully charged to "Research & development" in the Consolidated Income Statement in the period in which they are incurred. Alcon considers that regulatory and other uncertainties inherent in the development of new products preclude the capitalization of internal development expenses as an intangible asset until marketing approval from the regulatory authority is obtained in a relevant major market, such as the United States, the European Union, Switzerland, China or Japan.
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Factors affecting comparability of period to period results of operations
The comparability of the period to period results of our advertising,operations can be significantly affected by the COVID-19 pandemic, our Spin-off from Novartis, the issuance and refinancing of financial debts and acquisitions. Our net sales, operating results and cash flows in 2021 and 2020 were adversely affected by COVID-19. Additionally, in 2021 we acquired the US commercialization rights of Simbrinza. In 2020, one transaction of significance was the issuance of senior notes due in 2030. The transactions of significance during 2019 included the acquisition of PowerVision, Inc., Spin-off from Novartis through a dividend in kind distribution to Novartis shareholders, and refinancing of the bridge and term loans which had been issued in April 2019. Refer to Note 4 to the Consolidated Financial Statements for details related to each of these significant transactions.

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Results of operations
In evaluating our performance, we consider not only the IFRS results, but also certain non-IFRS measures, including various "core" results and constant currency ("cc") results. These measures assist us in evaluating our ongoing performance from period to period and we believe this additional information is useful to investors in understanding the performance of our business. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures" section for additional information and reconciliation tables. These measures are not intended to be substitutes for the equivalent measures of financial performance prepared in accordance with IFRS and may differ from similarly titled non-IFRS measures of other companies.
Key figures
2021 compared to 20202020 compared to 2019
Change %Change %
($ millions unless indicated otherwise)20212020$
cc(1)
2019$
cc(1)
 
Net sales to third parties8,222 6,763 22 20 7,362 (8)(8)
Gross profit4,652 2,940 58 56 3,662 (20)(19)
Operating income/(loss)580 (482)nmnm(187)(158)(138)
Operating margin (%)7.1 (7.1)(2.5)
Net income/(loss)376 (531)nmnm(656)19 24 
Basic earnings/(loss) per share ($)0.77 (1.09)nmnm(1.34)19 24 
Diluted earnings/(loss) per share ($)0.76 (1.09)nmnm(1.34)19 24 
Core results(1)
Core operating income1,443 789 83 78 1,265 (38)(35)
Core operating margin (%)17.6 11.7 17.2 
Core net income1,063 512 108 102 925 (45)(42)
Core basic earnings per share ($)2.17 1.05 107 101 1.89 (44)(42)
Core diluted earnings per share ($)2.15 1.04 107 101 1.89 (45)(42)
nm = not meaningful
(1)Core results and constant currencies (cc) as presented in this table are non-IFRS measures. Alcon uses certain non-IFRS metrics when measuring performance, including when measuring current period results against prior periods. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures" section for additional information and reconciliation tables.

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All comments below focus on constant currencies (cc) movements for the year ended December 31, 2021 compared to 2020 unless otherwise noted. Commentary for the year ended December 31, 2020 compared to 2019 may be found in Item 5 of the Company's Annual Report on Form 20-F filed with the Securities and Exchange Commission ("SEC") on February 23, 2021 ("2020 Form 20-F").
Net sales by segment
2021 compared to 20202020 compared to 2019
Change %Change %
($ millions unless indicated otherwise)20212020$
cc(1)
2019$
cc(1)
Surgical     
Implantables1,522 1,126 35 34 1,210 (7)(6)
Consumables2,388 1,952 22 21 2,304 (15)(15)
Equipment/other793 632 25 24 660 (4)(3)
Total Surgical4,703 3,710 27 25 4,174 (11)(11)
Vision Care
Contact lenses2,139 1,838 16 15 1,969 (7)(7)
Ocular health1,380 1,215 14 12 1,219 — 
Total Vision Care3,519 3,053 15 14 3,188 (4)(4)
Net sales to third parties8,222 6,763 22 20 7,362 (8)(8)
(1)Constant currencies is a non-IFRS measure. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures" section for additional information.
Surgical
Surgical net sales were $4.7 billion (+27%, +25% cc), with increases in all three categories as sales in the prior year period were heavily impacted by COVID-19. Market improvements in the current year reflect strong recovery in the United States with varied paces of recovery in international markets. Implantables net sales increased (+35%, +34% cc), reflecting market improvements and ongoing adoption of advanced technology intraocular lenses, including the launch of Vivity and continued demand for PanOptix. Consumables net sales increased (+22%, +21% cc), primarily due to market improvements over the prior year period. Equipment/other net sales increased (+25%, +24% cc), primarily driven by demand for cataract and refractive equipment and other refractive products.
Vision Care
Vision Care net sales were $3.5 billion (+15%, +14% cc), with increases in both categories as sales in the prior year were heavily impacted by COVID-19. Contact lenses net sales increased (+16%, +15% cc), reflecting strong recovery in the United States with varied paces of recovery in international markets and growth in silicone hydrogel daily contact lenses including Precision1, Precision1 for Astigmatism and Dailies Total1. Ocular health net sales increased (+14%, +12% cc), led by Systane, growth of Pataday, primarily due to the recent launch of Pataday Extra Strength, and sales of Simbrinza following our recent acquisition of the US commercialization rights.
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Operating income/(loss)
2021 compared to 20202020 compared to 2019
Change %Change %
($ millions unless indicated otherwise)20212020$
cc(1)
2019$
cc(1)
Gross profit4,652 2,940 58 56 3,662 (20)(19)
Selling, general & administration(3,076)(2,694)(14)(13)(2,847)
Research & development(842)(673)(25)(25)(656)(3)(3)
Other income43 235 (82)(82)55 nmnm
Other expense(197)(290)32 33 (401)28 28 
Operating income/(loss)580 (482)nmnm(187)(158)(138)
Operating margin (%)7.1 (7.1)(2.5)
Core results(1)
Core gross profit5,216 4,092 27 26 4,663 (12)(12)
Core operating income1,443 789 83 78 1,265 (38)(35)
Core operating margin (%)17.6 11.7 17.2 
nm = not meaningful
(1)    Core results and constant currencies are non-IFRS measures. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures" section for additional information and reconciliation tables.
Operating income was $580 million, compared to a $482 million loss in the prior year period which was heavily impacted by COVID-19. Higher sales, lower amortization for intangible assets as certain intangible assets have become fully amortizedand lower separation costs were partially offset by higher marketing and promotional activities, amongselling expenses to support higher sales as markets recover and to support new product launches, increased investment in research and development, higher associate short-term incentive benefits in line with company performance, higher intangible asset impairments and an increase in legal items. The prior year period was impacted by unabsorbed fixed overhead costs and labor inefficiencies of $120 million and increased provisions for expected credit losses due to COVID-19, increased inventory provisions and losses for manufacturing asset retirements. The prior year period benefited from a $154 million net gain on post-employment benefit plan amendments and a gain relating to an extinguishment of certain potential liabilities under the employee matters agreement executed at Spin-off. There was a positive 0.4 percentage point impact on operating margin from currency.
Adjustments to arrive at core operating income in the current year were $863 million, mainly due to $529 million of amortization, $225 million in impairments of intangible assets, $68 million of transformation program costs, an increase of $50 million in legal items and $36 million of separation costs, partially offset by a $42 million benefit from fair value adjustments of contingent liabilities. Adjustments to arrive at core operating income in the prior year period were $1.3 billion, mainly due to $1.0 billion of amortization, $217 million of separation costs, $167 million in impairments of intangible assets and $49 million of transformation program costs, partially offset by a $154 million net gain on post-employment benefit plan amendments and a $63 million benefit from fair value adjustments to contingent liabilities.
Core operating income was $1.4 billion (+83%, +78% cc), compared to $789 million in the prior year period which was heavily impacted by COVID-19. Higher sales were partially offset by higher marketing and selling expenses to support higher sales as markets recover and to support new product launches, increased investment in research and development and higher associate short-term incentive benefits. The prior year period was impacted by unabsorbed fixed overhead costs and labor inefficiencies of $120 million and provisions for expected credit losses due to COVID-19 and higher inventory provisions. There was a positive0.3 percentagepoint impact on core operating margin from currency.
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Segment contribution
For additional information regarding segment contribution, please refer to Note 5 to the Consolidated Financial Statements.
2021 compared to 20202020 compared to 2019
($ millions unless indicated otherwise)Change %Change %
20212020$
cc(1)
2019$
cc(1)
Surgical segment contribution1,184 672 76 72 957 (30)(28)
As % of net sales25.2 18.1 22.9 
Vision Care segment contribution604 419 44 41 580 (28)(25)
As % of net sales17.2 13.7 18.2 
Not allocated to segments(1,208)(1,573)23 23 (1,724)
Operating income/(loss)580 (482)nmnm(187)(158)(138)
Core adjustments(1)
863 1,271 1,452 
Core operating income(1)
1,443 789 83 78 1,265 (38)(35)
nm = not meaningful
(1)Core results and constant currencies are non-IFRS measures. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures" section for additional information and reconciliation tables.
Surgical
Surgical segment contribution was $1.2 billion (+76%, +72% cc), compared to $672 million in the prior year period which was impacted by COVID-19. Segment contribution margin increased with improved operating leverage from higher sales, partially offset by higher associate short-term incentive benefits. The prior year period segment contribution margin was impacted by unabsorbed fixed overhead costs and labor inefficiencies and increased provisions for expected credit losses due to COVID-19. There was a positive0.3 percentage point impact on segment contribution margin from currency.
Vision Care
Vision Care segment contribution was $604 million (+44%, +41% cc), compared to $419 millionin the prior year period which was impacted by COVID-19. Segment contribution margin increased with improved operating leverage from higher sales, partially offset by higher marketing and selling expenses, including support for new product launches and key products, and higher associate short-term incentive benefits. Gross margin in the prior year period was impacted by unabsorbed fixed overhead costs and labor inefficiencies due to COVID-19 and higher inventory provisions. There was a positive0.2 percentage point impact on segment contribution margin from currency.
Not allocated to segments
Operating loss not allocated to segments totaled $1.2 billion (+23%,+23% cc), compared to $1.6 billion in the prior year period. The decrease in amounts not allocated was primarily driven by lower amortization and separation costs in the current year period, partially offset by higher intangible asset impairments and an increase in legal items. The prior year period also included a benefit from a net gain on post-employment benefit plan amendments.
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Non-operating income & expense
2021 compared to 20202020 compared to 2019
Change %Change %
($ millions unless indicated otherwise)20212020$
cc(1)
2019$
cc(1)
Operating income/(loss)580 (482)nmnm(187)(158)(138)
Interest expense(120)(124)(113)(10)(11)
Other financial income & expense(42)(29)(45)(41)(32)
Income/(loss) before taxes418 (635)nmnm(332)(91)(81)
Taxes(42)104 nmnm(324)nmnm
Net income/(loss)376 (531)nmnm(656)19 24 
Basic earnings/(loss) per share ($)0.77 (1.09)nmnm(1.34)19 24 
Diluted earnings/(loss) per share ($)0.76 (1.09)nmnm(1.34)19 24 
Core results(1)
Core taxes(218)(124)(76)(72)(195)36 34 
Core net income1,063 512 108 102 925 (45)(42)
Core basic earnings per share ($)2.17 1.05 107 101 1.89 (44)(42)
Core diluted earnings per share ($)2.15 1.04 107 101 1.89 (45)(42)
nm = not meaningful
(1)Core results and constant currencies are non-IFRS measures. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures" section for additional information and reconciliation tables.
Interest expense
Interest expense was $120 million, compared with $124 million in the prior year period. The current year period had more favorable interest rates and lower interest expense from discounting of long-term contingent consideration liabilities, partially offset by interest for the senior notes issued in May 2020.
Other financial income & expense
Other financial income & expense, consisting primarily of hedging costs and foreign currency exchange gains and losses, was anet expense of $42 million, compared with $29 million in the prior year period.
Taxes
Tax expense was $42 million, compared to a tax benefit of $104 million in the prior year period, primarily due to profitability in the current period compared to the prior period loss. The current period tax expense benefited from the pre-tax loss in the United States, which includes an impairment of intangible assets and legal items, partially offset by pre-tax income in other areas.  However, there remains substantial riskjurisdictions. The current period was also impacted by a benefit associated with an agreement for the deductibility of a statutory expense in Switzerland related to fiscal year 2021. It is uncertain whether Alcon will obtain a similar benefit for the deductibility of this area given evolving enforcement theoriesstatutory expense in Switzerland in future years.
Adjustments to arrive at core tax expense in the current year period were $176 million, compared to $228 million in the prior year with the impact in both periods primarily driven by tax associated with operating income core adjustments.
Core tax expense was $218 million, compared to $124 million in the prior year period. The average core tax rate was 17.0% compared to 19.5% in the prior year period, primarily due to a favorable mix of pre-tax income/(loss) across geographical tax jurisdictions and increasing claims broughta benefit associated with an agreement for the deductibility of a statutory expense in Switzerland.
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Net income/(loss) and earnings/(loss) per share
Net income was $376 million, compared to a net loss of $531 million in the prior year period. The change was mainly attributable to the current year period operating income compared to the prior year period operating loss, partially offset by governmentalthe tax expense in the current period compared to the prior period tax benefit.The associated basic and private parties.diluted earnings per share were $0.77 and $0.76, respectively, compared to basic and diluted loss per share of $1.09 in the prior year period.

Core net income was $1.1 billion, compared to $512 million in the prior year period, primarily due to higher core operating income, partially offset by core tax expense. The associated core basic earnings per share were $2.17 compared to $1.05 in the prior year period, and core diluted earnings per share were $2.15 compared to $1.04 in the prior year period.
While
Effects of currency fluctuations
We prepare our Consolidated Financial Statements in US dollars. As a result, fluctuations in the exchange rates between the US dollar and other currencies can have a significant effect on our results of the aforementioned contingencies cannot be predicted with certainty, management believes that the ultimate liability, if any, will not have a material adverse effectoperations as well as on the Company's consolidated financial position orreported value of our assets, liabilities and cash flows. This in turn may significantly affect reported earnings (both positively and negatively) and the comparability of period-to-period results of operations.  Litigation contingencies
For purposes of our Consolidated Balance Sheet, we translate assets and liabilities denominated in other currencies into US dollars at the prevailing market exchange rates as of the relevant balance sheet date. For purposes of our Consolidated Income Statement and statement of cash flows, revenue, expense and cash flow items in local currencies are subjecttranslated into US dollars at average exchange rates prevailing during the relevant period. As a result, even if the amounts or values of these items remain unchanged in the respective local currency, changes in exchange rates have an impact on the amounts or values of these items in our Consolidated Financial Statements.
Alcon manages its global currency exposure by engaging in hedging transactions where management deems appropriate (forward contracts and swaps). Specifically, Alcon enters into various contracts that reflect the changes in the value of foreign currency exchange rates to changepreserve the value of assets.
There is also a risk that certain countries could devalue their currency. If this occurs, then it could impact the effective prices we would be able to charge for our products and also have an adverse impact on both our Consolidated Income Statement and Consolidated Balance Sheet. Alcon is exposed to a potential adverse devaluation risk on its intercompany funding and total investment in certain subsidiaries operating in countries with exchange controls.
The hyperinflationary economies in which we operate are Argentina and Venezuela which were both hyperinflationary for all years presented. Refer to Note 3 to the Consolidated Financial Statements included elsewhere in this Annual Report for additional information.

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Foreign exchange rates for foreign currency translation
The following tables set forth the foreign exchange rates of the US dollar against key currencies used for foreign currency translation when preparing the Consolidated Financial Statements:
 Average for yearAs of December 31
($ per unit unless indicated otherwise)20212020Change %20212020Change %
AUD0.7520.6900.7260.771(6)
BRL0.1860.196(5)0.1800.193(7)
CAD0.7980.7460.7850.784— 
CHF1.0941.0661.0931.135(4)
CNY0.1550.1450.1570.153
EUR1.1831.1411.1301.229(8)
GBP1.3761.2841.3511.365(1)
JPY (100)0.9120.937(3)0.8680.970(11)
RUB (100)1.3581.390(2)1.3361.337— 
 Average for yearAs of December 31
($ per unit unless indicated otherwise)20202019Change %20202019Change %
AUD0.6900.695(1)0.7710.70110 
BRL0.1960.254(23)0.1930.249(22)
CAD0.7460.754(1)0.7840.767
CHF1.0661.0061.1351.03210 
CNY0.1450.145— 0.1530.144
EUR1.1411.1201.2291.12110 
GBP1.2841.2771.3651.313
JPY (100)0.9370.9170.9700.920
RUB (100)1.3901.546(10)1.3371.613(17)


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The following table shows information concerning the rate of exchange of US dollar per Swiss franc based on settlementsexchange rate information found on Bloomberg Market System. The exchange rate in effect on February 10, 2022 as found on Bloomberg Market System was CHF 1.00 = USD 1.08.
($ per CHF)
Low(1)
High(1)
January 20211.121.13
February 20211.101.11
March 20211.061.06
April 20211.091.10
May 20211.111.12
June 20211.081.09
July 20211.101.11
August 20211.091.10
September 20211.07 1.07 
October 20211.09 1.10 
November 20211.08 1.09 
December 20211.09 1.10 
January 20221.07 1.08 
February 2022 (through February 10, 2022)1.08 1.08 
(1) Represents the lowest and court decisions.highest, respectively, of the exchange rates on the last day of each month during the year.

Currency impact on key figures
The following table provides a summary of the currency impact on key company figures due to their conversion into US dollars, Alcon's reporting currency, of the financial data from entities reporting in non-US dollars.
2021 compared to 20202020 compared to 2019
Change %Percentage point currency impactChange %Percentage point currency impact
$
cc(1)
$
cc(1)
Net sales to third parties22 20 (8)(8)— 
Gross profit58 56 (20)(19)(1)
Operating income/(loss)nmnmnm(158)(138)(20)
Net income/(loss)nmnmnm19 24 (5)
Basic earnings/(loss) per share ($)nmnmnm19 24 (5)
Diluted earnings/(loss) per share ($)nmnmnm19 24 (5)
Core results(1)
Core operating income83 78 (38)(35)(3)
Core net income108 102 (45)(42)(3)
Core basic earnings per share ($)107 101 (44)(42)(2)
Core diluted earnings per share ($)107 101 (45)(42)(3)
(1)     Core results and constant currencies (cc) as presented in this table are non-IFRS measures. Alcon uses certain non-IFRS metrics when measuring performance, including when measuring current period results against prior periods. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures" section for additional information.
A 1% movement in the USD versus our basket of currencies would have resulted in a $43 million change in annual net sales and a $18 million change in both annual operating income and core operating income.
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SUPPLEMENTARY INFORMATION - DEFINITIONS AND RECONCILIATIONS OF NON-IFRS MEASURES
Non-IFRS measures as defined by the Company
Alcon uses certain non-IFRS metrics when measuring performance, including when measuring current period results against prior periods, including core results, percentage changes measured in constant currencies, EBITDA, free cash flow, and net (debt)/liquidity.
Because of their non-standardized definitions, the non-IFRS measures (unlike IFRS measures) may not be comparable to the calculation of similar measures of other companies. These supplemental non-IFRS measures are presented solely to permit investors to more fully understand how Alcon management assesses underlying performance. These supplemental non-IFRS measures are not, and should not be viewed as, a substitute for IFRS measures.
Core results
Alcon core results, including core operating income and core net income, exclude all amortization and impairment charges of intangible assets, excluding software, net gains and losses on fund investments and equity securities valued at fair value through profit and loss ("FVPL"), fair value adjustments of financial assets in the form of options to acquire a company carried at FVPL, obligations related to product recalls, and certain acquisition related items. The following items that exceed a threshold of $10 million and are deemed exceptional are also excluded from core results: integration and divestment related income and expenses, divestment gains and losses, restructuring charges/releases and related items, legal related items, gains/losses on early extinguishment of debt or debt modifications, past service costs for post-employment benefit plans, impairments of property, plant and equipment and software, as well as income and expense items that management deems exceptional and that are or are expected to accumulate within the year to be over a $10 million threshold.
Taxes on the adjustments between IFRS and core results take into account, for each individual item included in the adjustment, the tax rate that will finally be applicable to the item based on the jurisdiction where the adjustment will finally have a tax impact. Generally, this results in amortization and impairment of intangible assets and acquisition-related restructuring and integration items having a full tax impact. There is usually a tax impact on other items, although this is not always the case for items arising from legal settlements in certain jurisdictions.
Alcon believes that investor understanding of its performance is enhanced by disclosing core measures of performance because, since they exclude items that can vary significantly from period to period, the core measures enable a helpful comparison of business performance across periods. For this same reason, Alcon uses these core measures in addition to IFRS and other measures as important factors in assessing its performance.
A limitation of the core measures is that they provide a view of Alcon operations without including all events during a period, such as the effects of an acquisition, divestment, or amortization/impairments of purchased intangible assets and restructurings.
Constant currencies
Changes in the relative values of non-US currencies to the US dollar can affect Alcon's financial results and financial position. To provide additional information that may be useful to investors, including changes in sales volume, we present information about changes in our net sales and various values relating to operating and net income that are adjusted for such foreign currency effects.
Constant currency calculations have the goal of eliminating two exchange rate effects so that an estimate can be made of underlying changes in the Consolidated Income Statement excluding:
the impact of translating the income statements of consolidated entities from their non-US dollar functional currencies to the US dollar; and
the impact of exchange rate movements on the major transactions of consolidated entities performed in currencies other than their functional currency.
Alcon calculates constant currency measures by translating the current year's foreign currency values for sales and other income statement items into US dollars, using the average exchange rates from the historical comparative period and comparing them to the values from the historical comparative period in US dollars.
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For additional information on the effects of foreign currencies, refer to "Item 5.A. Operating Results-Effects of currency fluctuations" section.
EBITDA
Alcon defines earnings before interest, tax, depreciation and amortization ("EBITDA") as net income/(loss) excluding income taxes, depreciation of property, plant and equipment (including any related impairment charges), depreciation of right-of-use assets, amortization of intangible assets (including any related impairment charges), interest expense and other financial income and expense. Alcon management primarily uses EBITDA together with net (debt)/liquidity to monitor leverage associated with financial debts. For a reconciliation of EBITDA to the most directly comparable measure presented in accordance with IFRS, see "Item 5.B. Liquidity and Capital Resources—EBITDA (non-IFRS measure)" section.
Free cash flow
Alcon defines free cash flow as net cash flows from operating activities less cash flow associated with the purchase or sale of property, plant and equipment. Free cash flow is presented as additional information because Alcon management believes it is a useful supplemental indicator of Alcon's ability to operate without reliance on additional borrowing or use of existing cash. Free cash flow is not intended to be a substitute measure for net cash flows from operating activities as determined under IFRS. For a reconciliation of free cash flow to the most directly comparable measure presented in accordance with IFRS, see "Item 5.B. Liquidity and Capital Resources—Free cash flow (non-IFRS measure)" section.
Net (debt)/liquidity
Alcon defines net (debt)/liquidity as current and non-current financial debt less cash and cash equivalents, current investments and derivative financial instruments. Net (debt)/liquidity is presented as additional information because management believes it is a useful supplemental indicator of Alcon's ability to pay dividends, to meet financial commitments and to invest in new strategic opportunities, including strengthening its balance sheet. For a reconciliation of net (debt)/liquidity to the most directly comparable measure presented in accordance with IFRS, see "Item 5.B. Liquidity and Capital Resources—Net (debt)/liquidity (non-IFRS measure)" section.
Growth rate and margin calculations
For ease of understanding, Alcon uses a sign convention for its growth rates such that a reduction in operating expenses or losses compared to the prior year is shown as a positive growth.
Gross margins, operating income/(loss) margins and core operating income margins are calculated based upon net sales to third parties unless otherwise noted.
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Reconciliation of IFRS results to core results
2021    
($ millions except earnings per share)IFRS results
Amortization of certain intangible assets(1)
Impairments(2)
Separation costs(3)
Transformation costs(4)
Post-employ-
ment benefits
(5)
Legal items(6)
Other items(7)
Core results
Gross profit4,652 520 45     (1)5,216 
Operating income580 529 225 36 68 (16)50 (29)1,443 
Income before taxes418 529 225 36 68 (16)50 (29)1,281 
Taxes(8)
(42)(95)(51)(6)(13)(12)(1)(218)
Net income376 434 174 30 55 (14)38 (30)1,063 
Basic earnings per share ($)0.77 2.17 
Diluted earnings per share ($)0.76 2.15 
Basic - weighted average shares outstanding (millions)(9)
490.0 490.0 
Diluted - weighted average shares outstanding (millions)(9)
493.4 493.4 
Adjustments to arrive at core operating income
Selling, general & administration(3,076)— — 19 — — — — (3,057)
Research & development(842)180 — — — — (29)(682)
Other income43 — — — — (16)— (2)25 
Other expense(197)— — 17 68 — 50 (59)
Refer to the associated explanatory footnotes at the end of the 'Reconciliation of IFRS results to core results' tables.
2020
($ millions except (loss)/earnings per share)IFRS results
Amortization of certain intangible assets(1)
Impairments(2)
Separation costs(3)
Transformation Costs(4)
Post-employ-ment benefits(5)
Other items(7)
Core results
Gross profit2,940 1,001 106 13   32 4,092 
Operating (loss)/income(482)1,021 167 217 49 (154)(29)789 
(Loss)/income before taxes(635)1,021 167 217 49 (154)(29)636 
Taxes(8)
104 (172)(34)(37)(10)38 (13)(124)
Net (loss)/income(531)849 133 180 39 (116)(42)512 
Basic (loss)/earnings per share ($)(1.09)1.05 
Diluted (loss)/earnings per share ($)(1.09)1.04 
Basic - weighted average shares outstanding (millions)(9)
489.0 489.0 
Diluted - weighted average shares outstanding (millions)(9)
489.0 491.8 
Adjustments to arrive at core operating income
Selling, general & administration(2,694)— — 22 — — — (2,672)
Research & development(673)20 61 — — — (25)(617)
Other income235 — — — — (166)(36)33 
Other expense(290)— — 182 49 12 — (47)
Refer to the associated explanatory footnotes at the end of the 'Reconciliation of IFRS results to core results' tables.
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Reconciliation of IFRS results to core results (continued)
2019
($ millions except (loss)/earnings per share)IFRS results
Amortization of certain intangible assets(1)
Separation costs(3)
Transformation costs(4)
Legal items(6)
Other items(7)
Core results
Gross profit3,662 1,007 10   (16)4,663 
Operating (loss)/income(187)1,040 237 52 32 91 1,265 
(Loss)/income before taxes(332)1,040 237 52 32 91 1,120 
Taxes(8)
(324)(140)(54)(7)(8)338 (195)
Net (loss)/income(656)900 183 45 24 429 925 
Basic (loss)/earnings per share ($)(1.34)1.89 
Diluted (loss)/earnings per share ($)(1.34)1.89 
Basic - weighted average shares outstanding (millions)(9)
488.2488.2
Diluted - weighted average shares outstanding (millions)(9)
488.2490.1
Adjustments to arrive at core operating income
Selling, general & administration(2,847)— 30 — — 15 (2,802)
Research & development(656)33 — — 35 (584)
Other income55 — — — — (9)46 
Other expense(401)— 193 52 32 66 (58)
Explanatory footnotes to IFRS to Core reconciliation tables
(1)Includes recurring amortization for all intangible assets other than software.
(2)Includes impairment charges related to intangible assets.
(3)Separation costs, primarily related to IT and third party consulting fees, following completion of the Spin-off.
(4)Transformation costs, primarily related to restructuring and third party consulting fees, for the multi-year transformation program.
(5)Includes impacts from pension and other post-employment benefit plan amendments.
(6)For 2021, includes an increase in provisions for legal matters. For 2019, includes legal settlement costs and certain external legal fees.
(7)For 2021, Gross profit includes fair value adjustments to contingent consideration liabilities. Research & development includes fair value adjustments to contingent consideration liabilities of $41 million, partially offset by $12 million for the amortization of option rights. Other income and Other expense include fair value adjustments of financial assets.
For 2020, Gross profit includes $35 million primarily for losses on disposal of property, plant & equipment, partially offset by $3 million in fair value adjustments to contingent consideration liabilities. Research & development includes $60 million in fair value adjustments to contingent consideration liabilities, partially offset by $35 million in expenses primarily related to the amortization of option rights. Other income includes a gain relating to an extinguishment of certain potential liabilities under the employee matters agreement executed at Spin-off and fair value adjustments of financial assets.
For 2019, Gross profit includes $37 million in fair value adjustments to contingent consideration liabilities, partially offset by $21 million in spin readiness costs, manufacturing sites consolidation activities, and integration of recent acquisitions. Selling, general & administration primarily includes spin readiness costs and the integration of recent acquisitions. Research & development includes $73 million for the amortization of option rights, post-marketing study following a product's voluntary market withdrawal, and the integration of recent acquisitions, partially offset by $38 million in fair value adjustments to contingent consideration liabilities. Other income primarily includes a realized gain on a financial asset. Other expense primarily includes spin readiness costs, fair value adjustments of a financial asset and other items.
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(8)For 2021, total tax adjustments of $176 million include tax associated with operating income core adjustments of $863 million with an average tax rate of 20.4%.
For 2020, total tax adjustments of $228 million include tax associated with operating income core adjustments and discrete tax items. Tax associated with operating income core adjustments of $1.3 billion totaled $221 million with an average tax rate of 17.4%. Core tax adjustments for discrete items totaled $7 million.
For 2019, total tax adjustments of $129 million include tax associated with operating income core adjustments and discrete tax items. Tax associated with operating income core adjustments of $1.5 billion totaled $215 million with an average tax rate of 14.8%. Core tax adjustments for discrete items totaled $344 million, primarily including $304 million in non-cash tax expense for re-measurement of deferred tax balances as a result of Swiss tax reform, tax expense related to rate changes in the US following legal entity reorganizations executed related to the Spin-off, non-cash tax expense related to the re-measurement of deferred tax assets and liabilities following a tax rate change in India, and net changes in uncertain tax positions.
(9)Core basic earnings per share is calculated using the weighted-average shares of common stock outstanding during the period. Core diluted earnings per share also contemplate dilutive shares associated with unvested equity-based awards as described in Note 8 to the Consolidated Financial Statements.

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5.B. LIQUIDITY AND CAPITAL RESOURCES
Our sources of funds have consisted principally of cash flows from operations, issuance of senior notes, bank debt and credit facilities with lenders. Our uses of those funds (other than for operations) have consisted principally of dividend payments, investments in capital expenditures, cash paid for acquisitions and associated expenses and other obligations.
We believe that we have adequate liquidity to meet our needs. At December 31, 2021, we had cash and cash equivalents of $1.6 billion, in line with December 31, 2020. At December 31, 2021, we had current financial debt of $114 million, compared to $169 million at December 31, 2020, consisting of bank and other financial debt. At December 31, 2021, we had non-current financial debt of $4.0 billion, compared to $3.9 billion at December 31, 2020, consisting of bank debt and senior notes primarily as a result of the Spin-off.
To date, all of our sales are generated by our subsidiaries and not directly by us. Thus, we are dependent on dividends, other payments or loans from our subsidiaries to meet our liquidity needs. Some of our subsidiaries may be subject to legal requirements of their respective jurisdictions of organization that may restrict their paying dividends or other payments, or making loans, to us.
Potential future litigationuses of our liquidity include capital expenditures, acquisitions, debt repayments, dividend payments, and infringement claims,other general corporate purposes. As of December 31, 2021, we had commitments for purchases of property, plant & equipment of $186 million. In addition, we completed the acquisition of Ivantis, Inc. on January 7, 2022. Cash paid for the acquisition, net of cash acquired, was $475 million. The agreement also includes amounts to be potentially paid upon achievement of a development milestone and commercial milestones calculated as a percentage of sales in excess of defined targets that expire in calendar year 2024.
We use the US Dollar as our reporting currency and are therefore exposed to foreign currency exchange movements, primarily in Euros, Japanese Yen, Chinese Renminbi, Swiss Francs, and emerging market currencies. We manage our global currency exposure by engaging in hedging transactions where management deems appropriate (forward contracts and swaps) to preserve the value of assets. As of December 31, 2021 unsettled derivative positions included $3 million in unrealized gains and $7 million in unrealized losses.
All comments in this section relate to the year ended December 31, 2021 compared to 2020. Commentary for the year ended December 31, 2020 compared to 2019 may be found in Item 5 of the 2020 Form 20-F.
Free cash flow (non-IFRS measure)
The following is a summary of free cash flow for 2021, 2020 and 2019, together with a reconciliation to net cash flows from operating activities, the most directly comparable IFRS measure.
($ millions)202120202019
Net cash flows from operating activities1,345 823 920 
Purchase of property, plant & equipment(700)(479)(553)
Proceeds from sale of property, plant & equipment— — 
Free cash flow645 350 367 
Free cash flow amounted to an inflow of $645 million in 2021, compared to an inflow of $350 million in the prior year period, driven by increased cash flow from operating activities, partially offset by increased purchases of property, plant and equipment.
For additional information refer to Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures".
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Cash flow and net (debt)/liquidity
($ millions)20212020
Net cash flows from operating activities1,345 823 
Net cash flows used in investing activities(1,198)(572)
Net cash flows (used in)/from financing activities(123)466 
Effect of exchange rate changes on cash and cash equivalents(6)18 
Net change in cash and cash equivalents18 735 
Change in derivative financial instrument assets— 
Change in equity securities of public companies— 
Change in current and non-current financial debts38 (639)
Change in net (debt)59 98 
Net (debt) at January 1(2,558)(2,656)
Net (debt) at December 31(2,499)(2,558)
Net cash flows from operating activities amounted to $1.3 billion in 2021, compared to $823 million in the prior year period. The current year cash flows benefited from higher sales, lower separation spending and lower transformation payments, partially offset by increased discretionary spending and increased taxes paid due to timing of payments and increased profitability. Both periods were impacted by changes in net working capital and semi-annual interest payments.
Changes in net working capital in the current year were mainly driven by increases in inventories and trade receivables, partially offset by the net change in other operating liabilities and increases in trade payables. The increase in inventories was primarily associated with new product launches as well as to meet expected upcoming demand and to support supply chain continuity. The increase in trade receivables was primarily driven by new receivables from higher sales outpacing collections. The net change in other operating liabilities was primarily related to accruals for associate short-term incentive benefits and revenue deductions, partially offset by payments for Value Added Tax ("VAT") and other payables. The increase in trade payables was primarily driven by increased discretionary spending. Changes in net working capital in the prior year period were mainly due to increases in inventories, partially offset by changes in other operating assets. The increase in inventories was primarily driven by inventory builds for new product launches and decreased demand due to the COVID-19 pandemic, while the reduction in other operating assets was due to decreases in the current portion of long-term receivables and finance lease agreements from customers and other receivables. There were also decreases in trade payables related to operating activities due to management of discretionary spending and decreases in trade receivables as collections outpaced new sales. The net change in other operating liabilities was driven by decreased accruals for associate short-term incentive benefits and for obligations under the employee matters agreement executed at Spin-off, partially offset by increases in accruals for taxes other than income taxes.Refer to Note 21 to the Consolidated Financial Statements for additional details regarding changes within net working capital.
Net cash flows used in investing activities amounted to $1.2 billion in 2021, compared to $572 million in the prior year period, primarily due to the acquisition of exclusive US commercialization rights to Simbrinza and increased capital expenditures, including new contact lens manufacturing lines. Refer to Notes 4 of the Consolidated Financial Statements for additional information on the Simbrinza US commercialization rights acquisition.
Net cash flows used in financing activities amounted to $123 million in 2021, compared to net cash flows from financing activities of $466 million in the prior year period. Cash outflows in the current year primarily include lease payments, dividends paid, payment of certain local debt facilities and withholding taxes paid upon net settlements of equity-based compensation, partially offset by net proceeds from refinancing of local debt facilities in Japan. Cash inflows in the prior year period include the issuance of senior notes in May 2020, partially offset by repayments of current financial debts, realized foreign exchange losses, lease payments and withholding taxes paid upon net settlements of equity-based compensation. Refer to Notes 4, 17 and 21 of the Consolidated Financial Statements for additional information.
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Balance sheet
Assets
Total non-current assets were $22.6 billion as of December 31, 2021, in line with December 31, 2020. Property, plant, and equipment increased $286 million primarily due to capital expenditures, partially offset by depreciation and foreign currency translation effects. There was a decrease of $332 million in Intangible assets other than goodwill primarily due to recurring amortization and asset impairments, partially offset by the acquisition of exclusive US commercialization rights to Simbrinza.
Total current assets were $5.4 billion as of December 31, 2021, an increase of $399 million when compared to $5.0 billion as of December 31, 2020. Inventories increased $255 million primarily associated with new product launches as well as to meet expected upcoming demand and to support supply chain continuity. Trade receivables increased $135 million primarily driven by higher sales.
Closely monitored countries include Greece, Italy, Portugal, Spain, Brazil, Russia, Turkey, Saudi Arabia, and Argentina. The majority of the outstanding trade receivables from Greece, Italy, Spain, Saudi Arabia and Argentina are due directly from local governments or from government-funded entities. We evaluate trade receivables in these countries for potential collection risk. Should there be a substantial deterioration in our economic exposure with respect to those countries, we may increase our level of provisions by updating our expected loss provision or may change the terms of trade on which we operate.
The gross trade receivables from these countries at December 31, 2021 amounted to $252 million ($211 million at December 31, 2020), of which $10 million are past due for more than one year ($14 million at December 31, 2020) and for which provisions of $11 million have been recorded ($15 million at December 31, 2020). At December 31, 2021, amounts past due for more than one year are not significant in any of these countries.
The following table summarizes the aging of trade receivables as of December 31, 2021 and 2020:
($ millions)20212020
Not overdue1,273 1,137 
Past due for not more than one month96 109 
Past due for more than one month but less than three months74 67 
Past due for more than three months but less than six months43 36 
Past due for more than six months but less than one year23 31 
Past due for more than one year42 49 
Provisions for doubtful trade receivables(55)(68)
Total trade receivables, net1,496 1,361 
There is also a risk that certain countries could causedevalue their currency. Currency exposures are described in more detail in the "Item 5.A. Operating Results — Effects of currency fluctuations" section.
Liabilities
Total non-current liabilities were $6.3 billion as of December 31, 2021, a decrease of $249 million when compared to $6.5 billion as of December 31, 2020. Provisions and other non-current liabilities decreased $120 million primarily related to reductions in pensions and post-employment benefit obligations and contingent consideration liabilities. Deferred tax liabilities decreased $170 million primarily related to recurring amortization of intangible assets and asset impairments.
Total current liabilities were $2.5 billion as of December 31, 2021, an increase of $214 million when compared to $2.3 billion as of December 31, 2020. Provisions and other current liabilities increased $207 million primarily related to accruals for associate short-term incentive benefits, legal items and revenue deductions, partially offset by VAT payments, settlement of contingent consideration obligations and other payables. Current income tax liabilities increased $38 million primarily driven by increased profitability, partially offset by tax payments. Trade payables increased $27 million primarily due to increased discretionary spending, partially offset by foreign currency translation effects. Current financial debts decreased $55 million primarily due to the payment of certain local debt facilities and the refinancing of local debt facilities in Japan.

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Equity
Equity was $19.3 billion as of December 31, 2021, an increase of $434 million when compared to $18.8 billion as of December 31, 2020.
Net (debt)/liquidity (non-IFRS measure)
The following is a summary of net (debt) as of December 31, 2021 and December 31, 2020, together with a reconciliation to total financial debt, the most directly comparable IFRS measure.
($ millions)20212020
Current financial debt(114)(169)
Non-current financial debt(3,966)(3,949)
Total financial debt(4,080)(4,118)
Less liquidity:
Cash and cash equivalents1,575 1,557 
Equity securities of public companies— 
Derivative financial instruments
Total liquidity1,581 1,560 
Net (debt)(2,499)(2,558)
Net debt of $2.5 billion as of December 31, 2021 decreased $59 million compared to $2.6 billion as of December 31, 2020. Alcon's liquidity amounted to $1.6 billion as of December 31, 2021, in line with December 31, 2020. Total financial debt amounted to $4.1 billion as of December 31, 2021, in line with December 31, 2020. The average maturity of financial debts outstanding as of December 31, 2021 is 8.0 years.
The $1 billion revolving credit facility remained undrawn as of December 31, 2021 and February 15, 2022. For additional information regarding net (debt)/liquidity, which is a non-IFRS measure, see the explanation of non-IFRS measures in "Item 5.A. Operating Results—Supplementary Information—Definitions and Reconciliations of Non-IFRS Measures".
Additional COVID-19 considerations
Associate safety
To protect our associates, we have implemented a response framework with required COVID-19 prevention, containment and mitigation measures. We are continuing to manage return to the workplace protocols in line with local conditions and CDC guidelines, and our sales and customer service teams are equipped with the tools to keep them healthy and safe, including pre-visit checklists and appropriate personal protective equipment (“PPE”). In addition, we encourage our associates to be vaccinated.
Net sales trends
Following a low point in the second quarter of 2020 due to the pandemic, net sales have improved with total net sales in 2021 showing growth compared to both 2020 and 2019, with a strong recovery in the United States and varying paces of recovery in international markets. We are encouraged by current trends in surgical procedures with the improved adoption of safety measures and the availability of vaccines. However, uncertainty remains as we expect the pace of recovery will continue to vary on a market by market basis, depending on existing capacity, differences between private and public channels, hospital and non-hospital settings, the nature of patient needs and sense of safety and availability of vaccines. Based on these factors, we believe we will likely see some lingering impact from COVID-19 through mid-2022.
Supply chain continuity
To protect our customers and the patients who depend on our products, we continue to manufacture and supply our products and are actively working to mitigate any potential supply chain disruptions. Prior to the current crisis, we
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developed a diverse manufacturing footprint, which has enabled us to maintain sufficient inventory on hand. We have enhanced our business continuity plans to ensure our supply chain is maintained. We have increased the levels of certain raw materials on hand for supply chain continuity. We generally target at least 12 weeks of customer-ready products in our supply chain and, for most of our products, we are at or close to this level. We are experiencing and expect to continue to experience inflationary pressures in electronic components, freight, labor, resins and plastics, which we continue to manage but anticipate may impact operating margin in 2022 despite price increases and productivity initiatives. We have also encountered supply chain challenges in certain components including microchips, resins and plastics, PPE, metals and filters. Our procurement teams are staying in close contact with our critical suppliers to maintain access to raw materials and other components. When necessary, we are also utilizing alternative methods of product distribution and supplier sourcing, as well as alternative shipping options where possible. We expect these supply chain challenges to continue through 2022. In addition, we have partnered with industry trade groups and the medical community as they developed new protocols to serve patients safely during the pandemic.
Financial measures
We ended 2021 with $1.6 billion in cash and cash equivalents. Further, collections and trade receivables have stabilized. However, we may see delays or reductions in collections in the coming months as we continue to work with our customers during this pandemic.
Because we believe the COVID-19 conditions are transitory, we are not making structural changes to our operational costs that could impede our ability to fully ramp up with the recovery across allgeographic markets. We will continue to monitor trends and manage our discretionary spending in line with sales recovery.
Key assumptions
Management has assessed the past and potential impact of the adverse effects of COVID-19 on Alcon’s results of operations, cash flows and liquidity. The preparation of financial statements requires management to make certain estimates and assumptions, either at the balance sheet date or during the period that affects the reported amounts of assets and liabilities as well as revenues and expenses. In particular, the Consolidated Financial Statements for the period ended December 31, 2021 required the use of significant estimates and assumptions pertaining to the impact of COVID-19 on Alcon's operations, results and liquidity. Key assumptions include:
Customers in some geographies will continue to face COVID-19 challenges, including a resurgence of the virus and its variants;
Global markets will grow over 2021 in line with historical averages;
We will retain our associates and meet supplier obligations while managing discretionary costs; and
Transformation and strategic investment priorities will continue.
Actual outcomes and results could differ materially from our estimates and assumptions. For example, extended or new COVID-19 related shut-down periods or slower recovery periods could result in supply chain disruptions, labor shortages, an inability to manufacture products, reduced sales, incremental provisions for expected customer credit losses and inventory, incremental costs, reduced cash on hand and increased debt or impairments of assets. We use the US Dollar as our reporting currency and are therefore also exposed to foreign currency exchange movements, primarily in Euros, Japanese Yen, Chinese Renminbi, Swiss Francs and emerging market currencies.
Financial debts
Our financial debts do not have any major maturities before 2024 and do not contain any financial covenants. Our $1 billion revolving credit facility remained undrawn as of February 15, 2022 and there are no current limitations on our ability to borrow under the facility.
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EBITDA (non-IFRS measure)
($ millions)202120202019
Net income/(loss)376 (531)(656)
Taxes42 (104)324 
Depreciation of property, plant & equipment323 293 267 
Depreciation on right-of-use assets81 79 66 
Amortization of intangible assets590 1,078 1,084 
Impairments of property, plant & equipment, and intangible assets225 173 
Interest expense120 124 113 
Other financial income & expense42 29 32 
EBITDA1,799 1,141 1,238 
Liquidity and financial debt by currency
The following table summarizes liquidity and financial debts by currency as of December 31, 2021 and 2020.
Liquidity (%)(1)
Financial debts (%)(2)
2021202020212020
USD91 90 87 86 
EUR10 11 
CHF— — — 
JPY— — 
Other— 
Total100 100 100 100 
(1)Liquidity includes cash and cash equivalents and time deposits.
(2)Financial debts includes non-current and current financial debts.
5.C. RESEARCH AND DEVELOPMENT, PATENTS AND LICENSES, ETC.
Alcon research & development spending totaled $842 million, $673 million and $656 million for the years 2021, 2020 and 2019, respectively. As described in the "Risk Factors" section and elsewhere in this Annual Report, we are subject to varying degrees of governmental regulation in the countries in which we operate, which makes the process of developing new products and obtaining necessary regulatory marketing authorization lengthy, expensive and uncertain. See "Item 3. Key Information—3.D. Risk Factors". For further information on Alcon research and development policies and additional product information, as well as a description of the regulatory approval process, see "Item 4. Information on the Company—4.B. Business Overview".
5.D. TREND INFORMATION
Please see "Item 5.A. Operating Results—Opportunity and risk summary" and "Item 4. Information on the Company—4.B. Business Overview" for trend information.
5.E. OFF-BALANCE SHEET ARRANGEMENTS
We have no unconsolidated special purpose financing or partnership entities or other off balance sheet arrangements that have or are reasonably likely to have a current or future effect on our financial condition, changes in financial condition, revenues or expenses, results of operations, liquidity, capital expenditures or capital resources, that is material to investors. See also Note 26 to the Consolidated Financial Statements included elsewhere in this Annual Report.
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ITEM 6.    DIRECTORS, SENIOR MANAGEMENT AND EMPLOYEES
6.A. DIRECTORS AND SENIOR MANAGEMENT
The information set forth under “Item 6.C. Board Practices—Corporate Governance—Board of Directors—Composition” and “Item 6.C. Board Practices—Corporate Governance—Executive Committee—Composition of the Executive Committee” is incorporated by reference.
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6.B. COMPENSATION
Introduction
Dear Shareholder
On behalf of the Alcon Board of Directors ("Board") and Compensation Committee ("CC"), I am pleased to present the 2021 Compensation Report. This report outlines Alcon’s overall 2021 compensation framework and philosophy for the members of the Board as well as for the members of the Executive Committee of Alcon ("ECA") and provides a general outlook for our 2022 compensation structure.
This Compensation Report covers the financial year 2021 from January to December.
2021 in Review
We employ a strong pay-for-performance compensation system that motivates our senior executives to create long-term value for the Company and its shareholders.
Business Overview
2021 was a very successful year for Alcon. Despite continuing challenges from the COVID-19 pandemic, the Company delivered outstanding financial performance as a result of our innovative product offerings and strong commercial execution.
Our efforts to retain and protect our associates in 2020 paid off; the Company was well positioned as the markets recovered in 2021. We benefited from our share positions as the US market recovered and although we continue to see varying paces of recovery in our international markets, our associates have carefully navigated these trends to ensure growth alongside careful cost management. Highlights from the year are outlined below:
Net Sales reached $8.2 billion in 2021, representing a growth of +12% compared to a pre-COVID and unaffected 2019, despite the continued market disruption created by the COVID-19 pandemic
Robust product innovation for Alcon, with the launch of 11 new products, including Vivity, Vivity Toric, PRECISION1 for Astigmatism, TOTAL30 Sphere and Pataday Once Daily Extra Strength
Product innovation and strong commercial execution which enabled both Franchises to grow ahead of the market compared to 2019; sales of Contact Lenses grew +9% while the market grew in low single digits; the Surgical business grew an impressive +13% while the overall global procedures were ~10% below 2019 levels
Net cash flows from operating activities grew significantly, from $920 million in 2019 to $1,345 million in 2021; likewise, Free Cash Flow1 increased from $367 million in 2019 to $645 million in 2021 as income growth substantially improved
In 2021, Alcon's share price increased by 32% and outperformed industry peers and relevant indices resulting in an $11 billion increase in shareholder value with our market capitalization reaching $44 billion by year-end; in addition, Alcon paid its first dividend to shareholders in May 2021
We approached an uncertain year with enthusiasm for the products that help people See Brilliantly and the financial discipline to execute 2021 in line with our long-term goals.
2021 Annual General Meeting Vote and Engagement with Shareholders
At our 2021 Annual General Meeting (“AGM”), our 2020 Compensation Report received support from 44% of the votes cast. The Board and the CC took the outcome of this vote seriously and, as a result, members of our Board and management team conducted broad shareholder outreach during the second half of 2021 engaging with and gathering feedback from
1 Free Cash Flow is a non-IFRS measure. Refer to "Item 5.A. Operating Results—Supplementary Information—Definitions and
Reconciliations of Non-IFRS Measures" section for additional information.
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our shareholders regarding our executive compensation programs in order to better understand and appropriately respond to their concerns.
Our engagement team included Mr. Ball, our Board Chair, our Chief Human Resources Officer, General Counsel and Head of Investor Relations. We heard directly from investors on a range of important topics tied to the executive compensation programs as well as broader ESG matters. We discussed and took their feedback on a number of items related to 2021 AGM results, our use of discretion in determining the payout of our Short-Term Incentive ("STI") plan for 2020, CEO compensation during 2020, the level of transparency in the payouts under our STI and Long-Term Incentive ("LTI") plans contained in our 2020 Compensation Report, our peer group and Board compensation. While we were encouraged to hear that shareholders broadly supported our overall executive compensation program, we noted certain specific concerns and we have addressed them through an increased level of transparency in this report. Specifically, we have provided increased disclosure of the following topics:
the targets for each of the metrics of the 2021 STI plan;
increased disclosure of the Individual Performance Factor (IPF) impacting 2021 STI payout including linking of specific ESG objectives to ECA compensation;
the structure of the Share of Peers and Innovation metrics in our LTI plan;
the rationale for our blended peer group; and
the underlying philosophy regarding the quantum of compensation for our CEO and ECA.
Additionally, we have enhanced these disclosures to provide an increased understanding of Alcon's compensation and retention philosophies, which are grounded in our pay-for-performance principles that align directly with shareholder interests. For your convenience, we have included a table in the Compensation at a Glance section of this Compensation Report that details the input received from our shareholders and how our CC has addressed each of these matters.
2022 Annual General Meeting
In line with the Articles of Incorporation, we will ask our shareholders to cast a binding vote on the maximum aggregate amount of compensation for members of the Board for their term of office from the 2022 AGM to the 2023 AGM. We will also ask our shareholders to cast a binding vote on the maximum aggregate amount of compensation for members of the ECA for the 2023 financial year. In addition, we will ask our shareholders to endorse this 2021 Compensation Report in an advisory vote.
We are not requesting an increase to the Say-on-Pay budget for the ECA in 2023 or the Board compensation from 2022-2023 AGM as compared to prior year.
On behalf of the Board and the members of the CC, we thank you for your trust and investment in Alcon as well as your feedback and support.
Sincerely,
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Karen May
Chair of the Compensation Committee
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Compensation at a Glance
Shareholder Outreach and Consideration of 2021 AGM Vote
As a result of the voting outcome at our 2021 AGM, we undertook a robust shareholder outreach effort to understand the perspectives of our shareholders. While we were encouraged to hear that shareholders strongly supported our management team and our overall executive compensation program, we noted certain specific concerns. The following table highlights the primary concerns expressed by shareholders and actions we have taken to address them:
Exhibit 1
DiscretionConcerns regarding the use of discretion in the 2020 STI Payout.
BackgroundIn 2020, the CC used positive discretion to payout 75% STI to executives during an extraordinary year marred by the impacts of the global pandemic. In making the decision to utilize discretion, the committee took into consideration a number of factors, including company actions taken to mitigate the business impacts of the pandemic, market share gains, stock price performance, continued delivery of innovation pipeline, associate experience as well as shareholder feedback. We previewed our planned use of discretion during our shareholder outreach in late 2020 and incorporated the feedback we received into our final decision and the associated disclosures. No discretion was applied to any mid-cycle LTI awards. Targets set prior to the impacts of the pandemic were not altered.
OutcomeNo discretion was applied for the 2021 STI plan. In 2020, the CC made a discretionary adjustment in the extraordinary circumstances of the global pandemic. We maintained full employment of, and did not furlough associates as well as maintained pay levels, including paying approximately 85% STI to all associates, and did not accept any government funding. The current compensation program remains well-suited to effectively align pay and performance.
DisclosureDesire for additional disclosure of the STI and LTI Plan targets as well as Alcon’s actual performance against the goals—while acknowledging the potential competitive sensitivity of this data.
BackgroundThe CC attempts to balance the need to prevent competitive harm from disclosing targets with our shareholders’ need for reassurance regarding the strength of the link between our pay and our performance and have sought to achieve this balance in making changes for 2021.
Outcome
In the current 2021 Compensation Report, we have provided a full description of performance achieved on each metric during the previous fiscal year to allow shareholders to assess the rigor of our performance assessment.
We have disclosed the specific STI targets for 2021 STI payments. We have increased disclosure of Individual Performance KPIs (including ESG related objectives) that directly impact the STI payout.
We have also enhanced disclosures for the target setting methodology and achievement level determination of Share of Peers and Innovation metrics that each comprise 25% of the long-term incentive plan metrics for our LTI plan.
CEO CompensationConcerns with the magnitude of the 2020 CEO target pay increase.
Background
In 2019, the Board reviewed the CEO's compensation and it was significantly below the median of our peer group. In 2020, the Board set the CEO’s total compensation opportunity below the median CEO compensation of our peer group. This increase in pay opportunity was achieved through an increase solely in performance share units with a 3-year cliff vest. We note that we implemented this action prior to the pandemic.
In alignment with our pay-for-performance compensation philosophy, we will continue to monitor our CEO's target compensation versus the peer group.
Outcome
In 2021, the CEO received a 3% base salary increase in line with the average base salary increase received by all other Alcon associates, and no other increases. We note that we made this adjustment before the 2021 AGM.
In 2022, the CEO will not receive any increase to his compensation, including base salary and STI and LTI targets.
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2021 ECA Compensation-Summary
The executive compensation program consisted of a balanced set of fixed and variable elements rewarding short-term and long-term performance through the delivery of cash payments and equity awards. Performance goals were aligned to the strategic plan in a mix of absolute and relative measures including financial and non-financial metrics. The current compensation program remains well suited to effectively align pay and performance.
In 2021, Ms. Lin was appointed as a new ECA member after Mr. Onuscheck departed. No extraordinary payments were made to Mr. Onuscheck upon his departure nor any special payments or equity awards were made to Ms. Lin upon the start of her new role. Mr. Bell and Mr. Narayanan assumed new roles in the Company (continuing on the ECA) effective September 1, 2021. Each individuals’ compensation was adjusted to be commensurate with their new roles.
The CC exercised no discretion with regard to our STI and LTI plans during 2021.
Exhibit 2
Annual Base SalaryShort-Term Incentive
(annual incentive)
Long-Term IncentiveBenefits
PurposeIn line with global pay practices, reflects responsibilities, experience and skillsRewards annual performance against key objectivesRewards long-term value creation in line with Alcon’s strategy and business prioritiesRetirement savings and insurance in line with local market practices and benefits associated with global mobility and international relocation
PaymentCashCashEquity (Performance Stock Units)Cash or in-kind, contributions to retirement savings and insurance policies
Performance
period
One yearThree-year cliff vesting
Performance
measures
Three financial performance measures, individual performance ratingFour equally weighted performance measures including financial, external and innovation metrics
Payout range0%-200% of the individual target award0%-200% of the number of Performance Stock Units granted
BasisFixedVariableVariableFixed in proportion of pay
Total Compensation for 2021
From January 1, 2021 to December 31, 2021, we awarded the ECA members the amounts set out below. For more detailed information, see section "ECA Compensation 2021" in this 2021 Compensation Report.
Exhibit 3
CompensationFixed compensationVariable compensationAdditional
comp.
Totals in USD
Totals in CHF3
From January 1, 2021 to December 31, 2021Annual
base
salary
Pension and
insurance benefits
2021
STI award
2021-2023
LTI awards 1
Other
benefits
Total
compen-sation
Total
compen-sation
David J. Endicott, CEO1,289,196141,5632,747,9375,613,8481,116,71910,909,2639,974,666
Other ECA members4,291,981745,4315,709,9698,427,0404,160,53123,334,95221,335,847
Totals in USD2
5,581,177886,9948,457,90614,040,8885,277,25034,244,215
Totals in CHF3
5,103,038811,0057,733,31712,838,0054,825,14831,310,513
1Performance Stock Units.
2Includes the CEO and six other ECA members.
3The amounts were converted at the rate of 1.0 CHF : 1.093697 USD.
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2021 Board of Directors Compensation-Summary
We paid our Directors a fixed fee for services covering the term of their office from the 2021 Annual General Meeting ("2021 AGM") to the 2022 Annual General Meeting ("2022 AGM"). No changes have been made to Board compensation since Alcon's spin-off from Novartis in April 2019.
The fixed compensation consists of a base fee for Board membership and additional fees for service on Board committees. Board members and the Board Chair receive fifty percent of their compensation in cash and fifty percent in unrestricted Alcon shares. On a voluntary basis, a Board member may opt to receive all or part of the cash portion in additional shares. Alcon does not provide any performance-based components of pay to the members of the Board.
Exhibit 4
Board functionCHF
USD1
Annual base fee:
Board Chair950 0001,039,012
Board member base fee (Board retainer fee)200 000218,739
Additional fees:
Vice Chair40 00043,748
Chair of the Audit and Risk Committee70 00076,559
Chair of the Compensation Committee50 00054,685
Chair of the Governance and Nomination Committee50 00054,685
Chair of the Innovation Committee50 00054,685
Member of the Audit and Risk Committee35 00038,279
Member of the Compensation Committee25 00027,342
Member of the Governance and Nomination Committee25 00027,342
Member of the Innovation Committee25 00027,342
1The Board fees are paid in Swiss Francs (CHF), converted at the rate of 1.0 CHF : 1.093697 USD.
Alcon Board Fee Payments in 2021
In 2021, Alcon paid the members of the Board the following total amounts.
Exhibit 5
Payment in
cash
Tax and
other cash
Payment in
shares
Number of
shares
Other
payments
Total fees
Total fees paid in 20211 in USD
325,374635,8112,481,22832,49052,0573,494,470
Total fees paid in 2021 in CHF2
297,499581,3412,268,66132,49047,5973,195,099
1Represents compensation for nine out of ten members of the Board as David J. Endicott does not receive additional compensation for his service as a member of the Board.
2The payments in cash were made in Swiss Francs (CHF). For consistency all compensation payments are reported in USD in this report. The amounts were converted at the rate of 1.0 CHF : 1.093697 USD. All amounts are before deduction of the social security contributions and income tax due by the Board member.
For more details regarding the compensation paid to the individual members of the Board, see section "Board of Directors Compensation 2021" in this Compensation Report.
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Corporate Governance
The Board makes decisions regarding Board compensation upon proposals from the CC. These proposals are based on analysis and review of board compensation practices, policies and benchmarking information. Similarly, the Board makes decisions regarding CEO compensation upon proposals from the CC. The CC makes decisions with regard to compensation of the other ECA members based upon the analysis of relevant executive compensation practices, policies and benchmarking information.
The Board is responsible for approving the Compensation Report and for the proposal of the aggregate budget of Board compensation and ECA compensation to the shareholders at the AGM. The Corporate Governance Report contained in our 2021 Annual Report in "Item 6.C. Board Practices" provides further details regarding the responsibilities of the CC.
2022 Compensation Outlook
ECA Compensation
The CC is committed to a pay-for-performance compensation framework to align Company and executive performance with shareholder interests. Our executive compensation framework will continue to be benchmarked against a carefully selected peer group, consisting of European and North American companies designed, in aggregate, to be representative of Alcon's size, industry and geographies. The inclusion of European and North American companies reflects our global footprint, business mix and sources of management talent.
Based on the Company’s business strategy, compensation philosophy and the analysis of peer group compensation practices, below are the key features of ECA compensation for 2022:
No compensation increase for the CEO including base salary and short and long term incentive targets;
Same overall structure of ECA compensation as compared to 2021 (base pay, STI, LTI and benefits);
Continuation of robust share ownership requirements; and
No material changes to benefits provisions.
Board Compensation
The Board compensation framework will remain unchanged for the upcoming term of office from the 2022 AGM to the 2023 AGM, including:
Board Chair and Board member fees unchanged compared to 2021; and
Same mix of fees payable in cash and shares as in 2021, including the option to elect a higher percentage in shares in lieu of cash.
In 2021, the Board conducted a benchmarking study of Alcon's Board pay against other SMI companies and determined that our Board pay is below the median level of SMI companies. Nonetheless, the Board made the decision to not propose any compensation change at the 2022 AGM for the 2022-2023 AGM term. Our Board's pay has not changed in Alcon's history as a public Company. The CC and the Board will reconsider possible changes to Board compensation in 2023 for future terms.
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Adherence to Strong Governance Practices
The CC evaluates many governance factors when designing and establishing compensation for members of the ECA. It uses these mechanisms to help guide its decisions to ensure that the Company is rewarding long-term success, discouraging excessive risk-taking and aligning executive and shareholder interests.
Exhibit 6
What we doWhat we don’t do
Provide a majority of executive pay in variable, rather than fixed, compensation in order to ensure pay-for- performance
No severance agreements
Tie 100% of Short-Term and Long-Term Incentive to appropriately ambitious performance metrics
No single-trigger change in control payments
Follow best practices in executive compensation design
No change in control related excise tax gross ups
Prohibit hedging, pledging and short sales of Company stock by executive officers and Directors
No termination notice period in excess of twelve months
Have robust share ownership requirements to reinforce alignment between executives and shareholders
No stock option awards
Include forfeiture and claw-back provisions for all variable compensation payments
No active defined benefit pension plans
Ensure that STI and LTI plans have target and maximum payout limits
No guaranteed compensation
Award all equity grants at market value
Conduct ongoing investor outreach
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ECA Compensation 2021
Compensation Governance
Authority for ECA Compensation Decisions
All decisions regarding CEO compensation and performance are made by the Board as a whole, excluding the CEO who is recused from such matters. The Board has delegated the authority to make compensation decisions for ECA members, excluding the CEO, to the CC.
The CEO makes recommendations to the CC on executive compensation policy and incentive plan design as well as proposals regarding the compensation and performance targets for ECA members. The CEO also makes proposals regarding the assessment of performance achievements for ECA members. The CEO does not make proposals regarding his own compensation or performance.
Exhibit 9
Authority levels in ECA compensationCEOCCBoardAGM
ECA compensation policy and principlesRA
CEO compensation and benefitsRA
Other ECA member compensation and benefitsRA
CEO performance targets and assessment of achievementsRA
Other ECA members' performance targets and assessment of achievementsRA
Share ownership requirements for the CEO and other members of the ECARA
Maximum aggregate ECA compensationRP
A1
Incentive plan design and rulesRPA
Compensation report of the CompanyRP
A2
R   Recommend     P   Propose     A   Approve
1binding vote
2advisory vote
Compensation Program
In the financial year 2021, Alcon’s ECA compensation framework includes the strategic objectives of:
Paying for performance and the execution of the Alcon strategy;
Pursuing value for shareholders over the long-term;
Creating alignment in the interests of executives and shareholders; and
Motivating and retaining executives for the long-term.
The general principles for ECA compensation are defined in Articles 31 and 32 of our Articles of Incorporation (http://investor.alcon.com/governance//default.aspx). ECA compensation comprises fixed and variable elements. Fixed elements include an annual base salary and benefits. Variable compensation consists of STI and LTI plans, which are subject to performance measures and caps.
Pay-for-Performance
Variable compensation represents a majority of total compensation and affirms our pay-for-performance philosophy (see more information in Exhibits 12 and 22). Actual payout is contingent on the achievement of Company and individual performance goals. Performance metrics and goals are aligned with the Company’s business strategy and compensation philosophy as well as long-term value creation for shareholders and are approved annually by the CC and the Board.
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Peer Group
External peer compensation is an important reference point for consideration of market competitive compensation for the members of the ECA, including our CEO.
The CC believes that a consistent and relevant set of peer companies that are similar to Alcon in size and scope in aggregate, enables shareholders to assess the appropriate levels and practices of compensation and allows for pay-for-performance comparisons. Alcon’s revenue and market capitalization are approximately at the median of the peer group companies.
Although Alcon is headquartered in Switzerland, a significant portion of our sales, management team and associate population are in the US. The US is the largest pool for both medical device and ophthalmology talent, and it is therefore critical that Alcon is able to attract and retain key talent from the US. As a result, our CC has selected a blended Peer Group of North American and European companies (58% US and 42% outside US) to balance the European compensation structure with a need to attract and retain US talent. While we do not pay as much as our US competitors, we desire to stay close to the median of the blended Peer Group. The 2021 Peer Group is outlined in Exhibit 7.
Exhibit 7
Global Peer Group
Agilent Technologies Inc.Fresenius Medical Care
Align Technology Inc.Givaudan
BauschHealthCompanies Inc.Lonza Group
Baxter International Inc.Merck KGaA
Becton Dickinson & CompanySmith & Nephew
Biogen Inc.Stryker Corporation
Boston ScientificThe Cooper Companies Inc.
Dentsply Sirona Inc.UCB
Edwards Lifesciences CorporationZimmer Biomet Holding Inc.
EssilorLuxottica
Revenue*Market Capitalization*
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*Revenue and Market Capitalization as of December 31, 2021
The annual total compensation of ECA members is targeted to the market median of benchmarks for comparable roles within this peer group. The CC considers compensation practices, structures and levels based on benchmarking information and advice provided by the committee’s independent external advisors (see more information under the section "Compensation Governance").
The CC and the Board review the compensation of the CEO and the other ECA members periodically and consider relevant benchmark information. The CC will also review periodically the peer group and make adjustments to its composition as appropriate.
Forfeiture and Claw-back Rules
Any variable compensation paid or payable to ECA members is subject to forfeiture and claw-back rules under our STI and LTI plans, which allow the Company to incurretain unpaid or unvested compensation (forfeiture) or recover compensation already paid in cash or shares (claw-back). Such rules apply in cases where the action or behavior of an executive violates internal codes, guidelines or policies or conflicts with management standards, including Company and accounting rules and regulations or violates laws. These forfeiture or claw-back rules apply to payments under both the STI and LTI plans. The action to retain or recover variable compensation is subject to applicable laws of the jurisdiction involved.
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Share Ownership Requirements for ECA Members
The Board has established share ownership requirements for members of the ECA in order to align executives’ interests with those of shareholders. The ownership requirement is expressed as a multiple of the executive’s annual base salary and is in line with the practices of our peer group. The following Exhibit illustrates those requirements:
Exhibit 8
Leadership levelShare ownership requirement
David J. Endicott, CEO5 times annual base salary
Other members of the ECA3 times annual base salary
All members of the ECA must meet these requirements within five years of service from the later of the date of the Spin-off from Novartis or commencement of ECA level role. If any of the ECA members fail to meet the requirement, or if they are not on track with the requirements, the CC may take several actions such as prohibiting the sale of Alcon shares until such time the requirement is met. At the end of 2021, each member of the ECA has met or is on track to meet the applicable ownership requirement.
Compensation Elements
Alcon’s compensation program has three broad components: annual base salary, variable compensation elements and employment benefits. Variable compensation elements are geared towards encouraging executives to deliver outstanding results and create sustainable shareholder value. They are also designed to prevent executives from taking excessive risks. The compensation program balances:
fixed and variable compensation elements;
short-term and long-term incentive compensation; and
Company and individual performance.
Exhibit 10
Annual Base Salary
Annual Base Salary
Annual base salary is set and reviewed considering:
Market value of the role
Benchmark information of peer companies
Market median within the peer companies
Executive’s role, performance, experience and potential
Increases in line with inflation and market
Business performance and the external environment
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Exhibit 11
Variable Compensation
Short-Term Incentive
The STI is designed and delivers awards based on:
Target value
Annual base salary (ABS) x STI target (% of ABS) = STI target value in USD/CHF
Performance measurement
Measurement of financial performance (Business Performance Factor “BPF”) and individual performance (Individual Performance Factor “IPF”), see the description of the STI below for more information
Payout
Performance period: 1 year
Range 0%-200% of the target value
Payout formula: STI target value x IPF x BPF = STI payout
Paid in the first quarter of the following year
Delivered in cash
Long-Term Incentive
The LTI is designed and delivers awards based on:
Target value
Annual Base Salary (ABS) x LTI target (% of ABS) = Target value in USD/CHF
Target award
Target value divided by the Alcon share price at grant date = number of Performance Stock Units (PSUs) at target
Granted at the onset of the performance period
Performance measurement
Measurement of metrics (see the description of the LTI below for more information)
Payout
Performance period: 3 years
Range 0%-200% of the target number of PSUs
Payout formula: Target number of PSUs x LTI payout factor = number of PSUs vested
Cliff vesting of PSUs (i.e., all PSUs vest at the end of the performance period, subject to performance conditions)
Conversion of vested PSUs to Alcon shares
Payout delivered in unrestricted Alcon shares
Paid in the first quarter of the year following the performance period
PSUs carry dividend equivalents payable in cash at the end of the performance period based on the number of PSU vested
Variable compensation represents a large majority of total direct compensation for ECA members. At target opportunity, the variable compensation represents 85% of the CEO’s total direct compensation. The average variable compensation of the other ECA members represents 71% of total direct compensation.

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Exhibit 12
Mix of Fixed and Variable Compensation at Target
CEOOther ECA members (excl. CEO)
alc-20211231_g15.jpg
alc-20211231_g16.jpg
CEO ratios and average ratios of other ECA members are based on 2021 values of ABS, target STI and target 2021-2023 LTI. Graphics exclude retirement savings and insurance benefits as well as any other benefits.    
CEO Compensation
Our CEO’s compensation is aligned with Alcon’s pay - for - performance philosophy and is reflected in the pay mix for Mr. Endicott’s target direct compensation. Approximately 85% of his pay is at risk with 79% of his at risk pay tied to the achievement of long-term strategic goals.
Prior to the 2021 AGM, Mr. Endicott received a base salary increase of 3% in line with the average base salary increase received by all other Alcon associates with no increase to either his STI or LTI targets.
In 2022, Mr. Endicott will not receive any increase to his compensation, including base salary and short and long term incentive targets.
In alignment with our pay - for - performance compensation philosophy, we will continue to monitor our CEO's target compensation versus the peer group
Short-Term Incentive
The short-term incentive compensation element is designed to reward the ECA members for their contribution towards achieving annual Company results and for their individual annual performance. The metrics used for the Business Performance Factor are the same for all ECA members. The Individual Performance Factor varies by individual. Based on this design, each member of the ECA participates in the overall Company’s success while also being rewarded for their individual contributions. The annual STI award value at target is based on a percentage of the ECA member’s annual base salary.
Exhibit 13
STI payout opportunity as a % of annual base salaryat targetat maximum
David J. Endicott, CEO120 %240 %
Other members of the ECA (average)83 %166 %
The financial metrics for the short-term performance in 2021 are set out in the Exhibit below. The payout of STI is calculated by multiplying the target award by the BPF and IPF.

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Exhibit 14
Metric
Financial Metrics 1
Non-financial Metric
Third Party Net SalesCore Operating IncomeFree Cash FlowIndividual Performance
DefinitionMeasures the Company's Third Party Net Sales performanceMeasures the Company’s profitabilityMeasures the Company’s capacity to realize cashMeasures the achievement of individual objectives and individual values and behaviors
RationaleFosters the Company’s top line performanceRecognizes the primary indicator of profitabilityIndicates the cash realized from operating activitiesConsiders individual contribution to the Company’s results
Weighting40%40%20%100%
Performance
factors
BPF (total weightings of financial metrics 100%)IPF
Payout formula
ABSXSTI
Target
XBPFXIPF=STI
Payout
BPF maximum 150% x IPF maximum 150% = maximum 225% (capped at 200%)
Payout range0 - 200%
1Financial achievements are measured in constant exchange rates to reflect operational performance.
In 2021, the Board and CC incorporated the achievement of ESG objectives in determining the IPF for ECA members and overall STI payout. Each ECA member has five individual performance goals with each having specific measurable objectives and initiatives. The five focus areas are as outlined below:
Key strategic business and customer objectives;
Advancing product innovation and delivery;
Alcon's transformation program;
ESG objectives, including environmental sustainability, diversity and inclusion, and company culture and values programs ; and
Achieving a range of key financial and operational performance measures.
At the end of the year, the Board and CC assess each ECA member's achievement of performance objectives to determine their individual performance and Individual Performance Factor (IPF) which directly impacts the final STI payout amount.
Performance levels, thresholds, targets and maximum values for the financial performance metrics are determined at the beginning of each one-year performance period. In line with good governance practice, the Board and the CC set targets that are appropriately ambitious and in support of the Company’s business strategy and the Board’s strategic plan without encouraging the ECA member to take undue risks.
At the end of the performance period, the Board and the CC determine the financial performance achievements against the targets originally set and determine the BPF. In addition, they consider the IPF of each ECA member. The IPF is determined by the achievement of individual objectives and the demonstration of values and behaviors. The individual performance rating is the basis for determining the IPF (between 0% and 150%). The CEO and other ECA members are not present when their IPF is discussed and determined.
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Long-Term Incentive
The long-term incentive program is designed to make a significant expenses or preventportion of compensation of ECA members contingent on long-term Company performance and to ensure alignment with shareholders’ interests. LTI awards consist of PSUs, which convert to shares at vesting, contingent on the achievement of the performance measures. The annual LTI grant value at target is based on a percentage of the ECA member’s annual base salary.
Exhibit 15
LTI payout opportunity as a % of annual base salaryBelow thresholdat target
at maximum1
David J. Endicott, CEO0%430%860%
Other members of the ECA (average)0%165%330%
1The maximum number of units that may be awarded is limited to 200% of the target number of units granted.
The metrics for the measurement of long-term performance are set out in the Exhibit below. The payout is calculated by adding the weighted achievements of the individual targets in a range from 0-200% and multiplying the number of PSUs granted by the resulting performance factor. We intend to disclose the outcome of each LTI metric and the final LTI payout at the end of their respective performance period, in the applicable compensation report.
Exhibit 16
Metric
Third Party Net Sales CAGR1,2
Core EPS CAGR2
Share of Peers3
Innovation Scorecard4
DefinitionMeasures the Company's Third Party Net Sales performanceMeasure of the profitability by the earnings per shareMeasures the Company’s market performance versus competitorsMeasure of key product pipeline and achievement of milestones
RationaleFosters the Company’s Sales performanceAligns ECA with shareholders by measuring earnings per shareIndicates relative competitive position against peers in terms of market shareDelivery of future products and key future growth drivers
Weighting25%25%25%25%
Payout formula
Metric
1
25%
+Metric
2
25%
+Metric
3
25%
+Metric
4
25%
ABSXLTI
Target
XAddition of weighted metrics
= Performance Factor
=Payout/Number of PSUs
Weighted achievements of metrics = additive payout factor maximum 200% (cap)
Payout range0-200%
1CAGR means Compound Annual Growth Rate.
2Financial achievements are measured in constant exchange rates to reflect operational performance.
3Metric “Share of peers” measures Alcon’s market share of key products in the Surgical and Vision Care segments against a peer group of competitors using third party syndicated data.
4The innovation scorecard for 2020-2022 includes 10 milestones: one sales-related; one related to the cost of a development program; and eight related to the timeline of achievements. Each milestone is tied to a key internal development project. The LTI payout for the innovation metric will depend upon the overall achievement of the 10 milestones, within the relevant performance period. The milestones established are approved by the Board’s Innovation Committee.
Net Sales CAGR - Measures Alcon’s Net Sales Third Party growth over a 3-year period. The goal setting process for the metric is defined by triangulating between Alcon’s internal strategic plan, expected market growth and investors' expectations.
Core EPS CAGR – Measures Alcon’s profitability growth over a 3-year period. Similar to Net Sales CAGR, goal setting process for this metric is also based on a triangulated approach of assessing Alcon’s internal strategic plan, expected market growth and investors' expectations.
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Share of Peers - Measures Alcon’s market share of key product categories in the Surgical and Vision Care segments against a peer group of competitors. Market share performance is a relative performance measure based on independent, third-party market data, and is calculated as the change in share across the three-year period. Market share changes are weighted across multiple key product categories to develop a blended Alcon share change for the three-year cycle.
Innovation – This metric is comprised of 10 milestones per annual cycle, typically five in both Surgical and Vision Care. Milestones are linked to internal development programs, measuring against one of four performance areas:
Timeline - measure the on-time completion of key product development activities
Program cost - measure budget adherence
Total product cost- measure the ability to meet unit cost targets
Sales - measure new product revenue, typically in the first calendar year after launch
Each Innovation Scorecard cycle spans a rolling three-year period with performance milestones in each year. At the completion of each cycle, the Board's Innovation Committee evaluates milestone achievement against performance tiers set at the beginning of the cycle.
Similar to the performance target-setting and measurement of the STI award, the thresholds, targets and maximum values for the LTI performance metrics are determined at the onset of the three-year performance period. In line with good governance practice, the Board and the CC set targets and ensure they are appropriately ambitious and in support of the strategic plan but do not encourage undue risk taking.
At the end of the three-year performance period of each LTI award, the Board and the CC determine the performance achievements of each metric against the targets originally set.
At the end of the performance period of each LTI award, the Company from selling its products.  The Company operates in an industry susceptibleintends to significant product liability claims.  Product liability claims may be asserted against the Companydisclose in the future arising out of events not known to the Company at the present time.

While the resultsapplicable compensation report details of the aforementioned contingencies cannot be predictedfinal LTI payout.
Benefits
All ECA members except one are enrolled in local benefit plans providing for retirement income savings and insurance for disability and loss of life. These plans are in line with certainty, management believes that the ultimate liability, if any, will not have a material adverse effect on the Company's consolidated financial position or results of operations.  Litigation contingencieslocal market practices and legislation and are subject to changethe Company's plan rules and policies. The ECA members and the Company pay statutory contributions. The sole ECA member with an employment contract governed by US law is enrolled in a Company-provided health plan.
Exhibit 17
Retirement savings
and insurance contributions
Retirement and insurance benefits plan contributions provided in line with local market practice (most governed by legal provisions) - Company-paid:
Contributions to retirement savings plan
Insurance premiums for disability and survivor benefits
Health insurance (only in the US)
Contributions to mandatory social security systems
Other benefits
Expense and representation allowance in line with Swiss market practice (covering small expenses)
Mandatory allowances for children and education (only in Switzerland)
Car allowance
International benefits (e.g. relocation cost, cost of living adjustments, settling in allowance, international health insurance, housing, schooling/education fees) in line with Alcon’s global mobility policies
Alcon is a global company headquartered in Switzerland with multinational operations and international business strategies. As a result, from time to time, executives are relocated to Switzerland or will be relocated from their home country. Relocated executives receive relocation support and are provided with international benefits in line with Alcon’s global mobility and relocation policies (e.g. relocation support, tax and social security equalization, benefit equalization and other international benefits as appropriate).
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Compensation Payments to the ECA Members
ECA Compensation Payments FY 2021
The following Exhibit 18 sets forth the total compensation received by the CEO (highest paid member of the ECA) and the aggregate total compensation received by all of the other ECA members for the period from January 1, 2021 to December 31, 2021. 2021 ECA payments are larger than 2020 ECA payments due to the following reasons:
Superior 2021 performance (148%) resulting in above target STI payout compared to below target (75%) STI payout in 2020 due to the impact of the pandemic;
Change in ECA members, including the appointment of a new ECA member and movement of two others to new roles and associated relocation expenses; and
Year over year exchange rate impact.
The competition for specialized talent in the fields necessary for Alcon’s success is significant and growing – particularly in the United States. Recent changes in the landscape for ophthalmic talent led the Company to assess potential vulnerabilities to competitive threats for talent. As a result of that assessment, Alcon made equity awards to certain key associates in its US organization, including an award to an ECA member, Sergio Duplan, based in the US. On February 17, 2021, the CC granted Mr. Duplan an award of Alcon Performance Share Units at a target opportunity equal to 1X his annual LTI award (USD 1,006,825). The award is 100% in Performance Share Units that cliff-vest after three years. The award is subject to the same performance conditions as our annual PSU award (sales growth; earnings growth; market share growth and achievement of key innovation metrics) and will forfeit if the executive is not employed by the company at the time of vesting. Alcon clawback/malus rules apply to the award.
The compensation Alcon paid to the ECA members in 2021 remained within the approved Say-On-Pay budget.
Exhibit 18
CompensationFixed compensationVariable compensationAdditional
compen-sation
Totals in USDTotals in CHF
From January 1, 2021 to December 31, 2021
Annual
base
salary
1
Pension
and
insurance
2
2021
short-term
incentive
3
2021-2023
long-term
incentive
4,5
Other
benefits
6
Total
compen-sation
7
Total
compen-sation
7
David J. Endicott, CEO1,289,196141,5632,747,9375,613,8481,116,71910,909,2639,974,666
Aggregate amount of 6 other ECA members4,291,981745,4315,709,9698,427,0404,160,53123,334,95221,335,847
Totals in USD6
5,581,177886,9948,457,90614,040,8885,277,25034,244,215
Totals in CHF5,103,038811,0057,733,31712,838,0054,825,14831,310,513
1The total of Annual Base Salaries paid for the period from January 1, 2021 to December 31, 2021, including increases effective throughout the year, if applicable.
2The retirement, pension and insurance benefits are the actual contributions paid to benefit plans for the period from January 1 to December 31, 2021. It also includes the amount of USD 52,507 for mandatory contributions paid by Alcon to governmental social security systems for all ECA members, which provide the ECA members with the right to the maximum future insured government pension benefit. The aforementioned amount is a portion of a total amount of contributions of USD 643,390 paid by Alcon to the social security systems.
3The STI award disclosed is the amount earned for the performance year 2021. It will be paid in March 2022 in cash.
4The amounts of the 2021-2023 LTI awards represent the total value of the target number of PSUs granted to the six active ECA members on February 17, 2021. The value of the PSUs is based on settlementsthe closing price of the underlying Alcon share on the date of grant of USD 72.05. Our President of Global Business and court decisions.
Innovation departed Alcon on August 31, 2021 and all of his unvested LTI equity awards were forfeited upon his departure. No extraordinary payments were made upon his departure.
5Includes the value of the target PSUs of a special, one-time LTI retention award granted to Mr. Duplan on February 17, 2021, subject to the same performance conditions and vesting schedule as the 2021-2023 PSU awards.
6The amounts of other benefits include the Company-paid benefits, values of benefits in kind, payments made and payments or values promised to ECA members for the relevant period in 2021, including benefits for international assignment (e.g. housing, schooling, tax and social security equalization, benefit equalization and other international relocation benefits).
7Payments to ECA members were made in CHF and/or USD. The amounts were converted at the rate of 1.0 CHF : 1.093697 USD.

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117Alcon reports the 2021-2023 Long-Term Incentive Awards at the value at the time of grant in accordance with Swiss market practice. The basis for disclosure is the target value of the PSU at grant, reflecting the assumption that the awards will vest at 100% achievement, excluding any share price movement that may occur over the performance period. The future payout will be determined only after the conclusion of the performance period in three years (i.e. at the end of 2023) and the awards will vest in February 2024. The payout range is between 0% and 200% of the target number of PSUs.
ECA Compensation Payments FY 2020
The following Exhibit 19 sets forth the total compensation received by the CEO (highest paid member of the ECA) and the aggregate total compensation received by all of the other ECA members for the period from January 1, 2020 to December 31, 2020.
The compensation Alcon paid to the ECA members in 2020 remained within the approved Say-On-Pay budget.
Exhibit 19
CompensationFixed compensationVariable compensationAdditional
compen-sation
Totals in USDTotals in CHF
From January 1, 2020 to December 31, 2020
Annual
base
salary
1
Pension
and
insurance
2
2020
short-term
incentive
3
2020-2022
long-term
incentive
4
Other
benefits
5
Total
compen-sation
6
Total
compen-sation
6
David J. Endicott, CEO1,225,049160,7711,102,5444,975,110635,7088,099,1827,603,010
Aggregate amount of 6 other ECA members4,088,839791,7502,546,6526,651,9813,209,25417,288,47616,229,349
Totals in USD1,4
5,313,888952,5213,649,19611,627,0913,844,96225,387,658
Totals in CHF1,4
4,988,348894,1683,425,63910,914,7923,609,41223,832,358
1The total of Annual Base Salaries paid for the period from January 1, 2020 to December 31, 2020, including increases effective March 1 if applicable.
2The retirement pension and insurance benefits are the actual contributions paid to benefit plans for the period from January 1 to December 31, 2020. It also includes the amount of USD 37,303 for mandatory contributions paid by Alcon to governmental social security systems for all ECA members, which provide the ECA members with the right to the maximum future insured government pension benefit. The aforementioned amount is a portion of a total amount of contributions of USD 1,138,868 paid by Alcon to the social security systems.
3The STI award disclosed is the amount earned for the performance year 2020. It was paid in March 2021 in cash.
4The amounts of the 2020-2022 LTI awards represent the total value of the target number of PSUs granted to the seven active ECA members on February 18, 2020. The value of the PSUs is based on the closing price of the underlying Alcon share on the date of grant of USD 63.00.
5The amounts of other benefits include the Company-paid benefits, values of benefits in kind, payments made and payments or values promised to ECA members for the relevant period in 2020, include benefits for international assignment (e.g. housing, schooling, tax and social security equalization, benefit equalization and other international relocation benefits).
6Payments to ECA members were made in CHF and/or USD. The amounts were converted at the rate of 1.0 CHF : 1.06526 USD.
Outcome of Performance Awards 2021
2021 Short-Term Incentive
Alcon’s operational and financial performance exceeded target level for all metrics. Sales in both Surgical and Vision Care franchises outperformed the target, driven by innovation, commercial execution and better than expected demand in certain markets.
In the Surgical franchise, Alcon’s leadership in AT-IOLs was further cemented in the year with the success of the Vivity launch and continued popularity of PanOptix. In addition, our Equipment & Consumable offerings were able to help eye care professionals meet the rebounding consumer demand with optimized patient and surgeon experience.
In the Vision Care franchise our newest daily lens, PRECISION1, drove global share gains, and DAILIES TOTAL1 remained a favorite premium daily lens of lens wearers. Systane remains a leading brand in the dry eye market, and Pataday continues to see growth following its OTC introduction in 2020.
Core operating income benefited from higher sales which outpaced increases in selling, general, and administrative expenses, resulting in improved operating leverage.
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Free Cash Flow was above the target primarily due to the strong operating performance coupled with investments in manufacturing line expansion which led to improved inventory management.
Exhibit 20 shows the weighting, target, and payout level for the 2021 STI.
Exhibit 20
Performance metricWeighting
2021 Target1
($ millions)
Payout Level2
Weighted Payout3
Third Party Net Sales40%7,938138%55%
Core Operating Income4
40%1,364138%55%
Free Cash Flow4
20%620187%37%
STI payout100%148%
1     Target is expressed at the exchange rates prevalent at the time of Board approval.
2Financial achievement is measured in constant exchange rates to reflect operational performance. Impact of acquisitions, divestitures and certain non-recurring items may also be excluded from Actual achievement; in 2021, no discretion was applied in determining STI payout level.
3Rounded to the nearest whole %.
4Core Operating Income and Free Cash Flow are non-IFRS measures.
In 2021, the Board and CC incorporated the achievement of ESG objectives in determining the IPF for ECA members and their overall STI payout. Each ECA member has five individual performance goals with each having specific measurable objectives and initiatives. The five focus areas are as outlined below:
Key strategic business and customer objectives;
Advancing product innovation and delivery;
Alcon's transformation program;
ESG objectives, including environmental sustainability, diversity and inclusion, and company culture and values programs ; and
Achieving a range of key financial and operational performance measures.
At the end of the year, the Board and CC assess each ECA member's achievement of performance objectives to determine their individual performance and IPF which directly impacts the final STI payout amount.
For 2021, the CEO’s individual performance goals assessment is outlined below:
Gained market share and delivered growth compared to 2019 significantly above market in both Surgical and Vision Care franchises; the Surgical business grew +13% and sales of Contact Lenses grew +9%;
Announced intention to acquire Ivantis (transaction closed January 7, 2022), a leader in the minimally invasive glaucoma surgery space and also the US commercialization rights to Simbrinza (from Novartis), deepening the Company's position in the glaucoma market;
Advanced innovation through strategic investment in internal and external research and development with the launch of 11 new products, including Vivity, Vivity Toric, PRECISION1 for Astigmatism, TOTAL30 Sphere and Pataday Once Daily Extra Strength;
Completed separation activities from Novartis on schedule and under expected expense targets while advancing Alcon’s transformation program to optimize cost structure and achieve greater organizational agility;
Expanded access to eye care through physician training and education programs, advanced our environmental impact reduction strategies and delivered diversity and inclusion strategy and objectives to advance Alcon's ESG objectives; and
Alcon's share price increased by 32% and outperformed industry peers and relevant indices resulting in an $11 billion increase in shareholder value with our market capitalization reaching $44 billion by year-end; in addition Alcon paid its first dividend to shareholders in May 2021.
Based on the Board and CC’s assessment of the CEO’s performance against his individual goals in 2021, Mr. Endicott's IPF was assessed at 120% resulting in an overall STI payout of 178% (148% BPF X 120% IPF) of target. An average IPF of 124% was determined for the other ECA members resulting in an average STI payout of 184% of target.
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2019-2021 Long-Term Incentive
The 2019-2021 LTI awards for the CEO and other ECA members will vest in early 2022. As a result of Alcon being a division of Novartis prior to April 9, 2019, payouts under the program have been split into two periods (pre and post spin-off). For the first three month period while Alcon was a division of Novartis, ECA payouts were determined based upon overall Novartis performance, which is not disclosed in Alcon's 2021 Compensation Report.
For the thirty-three-month period from post spin-off to the end of the performance period in December 2021, PSUs were subject to Alcon stand-alone performance.
The Alcon LTI program for the ECA consists of 100% PSUs. Currently, performance for the PSU consists of the following four metrics: Sales CAGR, Core EPS CAGR, Share of Peers and Innovation weighted equally. At spin, Alcon underwent a rigorous goal setting process to establish the construction of ambitious goals while balancing against incentivizing excessive risk taking. The CC considers a number of factors, both external and internal such as Alcon's forward-looking strategic plan, shareholders’ and analysts’ expectations regarding our future performance, general market outlook and the performance of our direct competitors to set targets that are appropriately challenging and aligned with shareholder expectations.
Sales CAGR Metric
Our superior sales performance over the three-year performance period was driven by significant market share gains from PanOptix and Vivity in the global AT-IOL market. We also grew market share in contact lenses driven by the launches of PRECISION1 and PRECISION1 for Astigmatism. This was partially offset by slower market growth due to COVID-19.
Core EPS CAGR Metric
Core EPS was up over the three-year performance period but did not reach the payout threshold primarily due to Covid-19 impact.
Share-of-Peer Metric
Share-of-Peer metric measures Alcon’s market share of key product categories in the Surgical and Vision Care segments against a peer group of competitors. Market share performance is a relative performance measure based on independent, third-party market data, and is calculated as the change in share across the three-year period. For the 2019-2021 cycle, we significantly outperformed our targets and we continued to gain share in key product categories. In the global AT-IOL market, Alcon grew significantly ahead of peers driven by PanOptix and Vivity. In contact lenses, the launches of PRECISION1 and PRECISION1 for Astigmatism also helped us to take share in the fast-growing daily disposable SiHy segments. Alcon contact lenses have grown significantly ahead of the market since the first launch of PRECISION1 in late 2019.
Innovation Metric
We have continued to execute on our research and development strategy during the pandemic and meet innovation milestones of Sales, Timeline and Total Product Cost set out for the 2019-2021 cycle, bolstered, in part, by the success of Alcon's PanOptix and the launch of PRECISION1 and TOTAL30. For the 2019-2021 cycle, Alcon achieved a performance tier rating of “Exceeds Expectations” assigned by the Alcon Innovation Committee and a payout factor of 160%.
Exhibit 21
Performance metricWeightingPayout LevelWeighted Payout % (0-200%)
Third Party Net Sales CAGR1, 2
25 %130 %32.5 %
Core EPS CAGR1, 2, 3
25 %%0.0 %
Share of Peers25 %200 %50.0 %
Innovation25 %160 %40.0 %
PSU payout4
123.0 %
1    Financial achievement is measured in constant exchange rates to reflect operational performance.
2     Financial achievement is measured in constant exchange rates to reflect operational performance. Impact of acquisitions, divestitures and certain non-recurring items may also be excluded from Actual achievement.
3      Core EPS is a non-IFRS measure.
4     Rounded to the nearest whole %.
Based on our results, the performance factor for the 2019-2021 PSU award was 123%.

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Fixed and Variable Compensation
The mix of fixed and variable compensation over the period from January 1, 2021 to December 31, 2021 is as follows:
Exhibit 22
Mix of Fixed and Variable Compensation at Actual 2021 STI Payout and 2021-2023 LTI at Grant
8.     DIVIDEND POLICY
CEOOther ECA members (excl. CEO)
alc-20211231_g17.jpg
alc-20211231_g18.jpg

Average ratios are based on ABS, payout of 2021 STI (in March 2022) and grants of 2021-2023 LTI awards at grant value. Mix excludes retirement, pension and insurance benefits as well as any other benefits.
Under
Equity Instruments Granted to the merger agreement with Novartis dated December 14, 2010, Alcon has agreed notECA Members
Equity Instruments Granted in FY 2021
The LTI awards (in PSUs) for the performance period 2021-2023 were granted on February 18, 2021 to pay dividends pending completionthe CEO and the six other members of the merger.ECA. The number of PSU are set out in Exhibit 23 below. The values of the awards are based on the closing price of the underlying Alcon share on the date of grant and disclosed in section "ECA Compensation Payments FY 2021", Exhibit 18.

Exhibit 23
B.     SIGNIFICANT CHANGES
Number of units granted to
2021
PSUs based on the
2021-2023 LTI
target Award1,2,3
David J. Endicott, CEO77,916
Other ECA members116,961
Total194,877
None.1The values of the awards in PSU are disclosed under "ECA compensation payments FY 2021" (Exhibit 18).

2Our President of Global Business and Innovation departed Alcon on August 31, 2021 and the target PSUs were forfeited upon his departure.
3Number of units includes the target PSUs of a special, one-time LTI retention award granted to Mr. Duplan on February 17, 2021, subject to the same performance conditions and vesting schedule as the 2021-2023 PSU awards.

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Equity Instruments Granted in FY 2020
The LTI awards (in PSUs) for the performance period 2020-2022 were granted on February 18, 2020 to the CEO and the six other members of the ECA. The number of PSU are set out in Exhibit 24 below. The values of the awards are based on the closing price of the underlying Alcon share on the date of grant and disclosed in section "ECA Compensation Payments FY 2020", Exhibit 19.
Exhibit 24
Number of units granted to
2020 RSUs based on the
2019 STI Award1
2020 PSUs based on the 2020-2022 LTI target Award2
David J. Endicott, CEO14,03278,970
Other ECA members19,320105,587
Total33,352184,557
1Although these shares were granted based on 2019 STI awards, the number of RSUs that were to be granted to the ECA members were not available at the time the 2019 Compensation Report was published. They are included in Exhibit 24 for reference.
2The values of the awards in PSU are disclosed under "ECA compensation payments FY 2020" (Exhibit 19).
Share Ownership of the ECA Members
The number of Alcon shares or share-based units held by ECA members and “persons closely linked” (as defined below) to them as of each of December 31, 2021 and December 31, 2020 is set out in the Exhibit below. As of each of these dates, no ECA members, either individually or together with “persons closely linked”, owned 1% or more of the outstanding shares of Alcon.
Exhibit 25
Number of unitsDecember 31Vested sharesUnvested RSUsUnvested target PSUsTotal
David J. Endicott202198,44820,468209,365328,281
202088,95321,162150,013260,128
Laurent Attias20217,4352,31035,51045,255
202016,8202,60229,92249,344
Ian Bell20217,1647,19048,14862,502
202019,5277,50839,26666,301
Leon Sergio Duplan Fraustro20214,9806,49259,82471,296
202016,5308,17438,61063,314
Sue-Jean Lin202120,47411,15233,85765,483
2020NANANANA
Rajkumar Narayanan202113,7612,63936,78253,182
202010,6222,79531,04644,463
Tim C. Stonesifer202113,5684,989125,124143,681
202020,0004,98993,611118,600
Total2021165,83055,240548,610769,680
2020200,69356,286432,293689,272
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Additional Disclosures
Employment Agreements
The Company and the members of the ECA entered into employment agreements for an indefinite period of time. Six of seven ECA members’ employment agreements are governed by Swiss law. The seventh ECA member’s employment agreement is governed by US law.
All employment contracts with ECA members provide for advanced notice of termination of employment, none of which exceed a 12-month period in accordance with our Articles of Incorporation. None of the employment agreements with the ECA members provide for any severance payment.
Such employment agreements also prohibit the ECA member from competing against Alcon for a period up to 12 months after termination in accordance with our Articles of Incorporation.
Payments to Current or Former Members of the ECA
During 2021, no payments (or waivers of claims) other than those set out in Exhibit 18 (including the related notes) under section "ECA Compensation Payments FY 2021" were made to current or former members of the ECA or to “persons closely linked” to them. Our President Global Business and Innovation departed Alcon on August 31, 2021 and no extraordinary payments were made to him upon his departure and all of his unvested LTI equity awards were forfeited upon his departure.
Loans to Members of the ECA
Alcon’s Articles of Incorporation and corporate policies do not permit loans to current or former members of the ECA or to “persons closely linked” to them. As a result, no loans were granted in 2021, and none were outstanding as of December 31, 2021.
Persons Closely Linked
Persons closely linked to members of the ECA are (i) their spouse, (ii) their children below age 18, (iii) any legal entities that they own or otherwise control (iv) any legal or natural person who is acting as their fiduciary or agent and (v) family trusts.
Compensation Expense 2021
The total expense for the year 2021 for compensation awarded to ECA members, using International Financial Reporting Standards (IFRS) measurement rules, is presented in Note 25 to the Company’s audited Consolidated Financial Statements. The numbers for compensation expense in Note 25 may differ from the numbers reported in this 2021 Compensation Report due to the accounting and disclosure standards applied.
Alcon Share-Based Units Awarded to Alcon Associates in 2021
In the financial year 2021, the total of approximately 1.9 million restricted shares, RSUs and target PSUs (all unvested) were granted, and approximately 1.3 million Alcon shares vested and were delivered to Alcon associates under the various equity-based incentive or participation plans. Current unvested equity instruments (restricted shares, RSUs and target PSUs) represent approximately 1% of issued shares. Alcon delivers treasury shares to associates to fulfill these obligations.
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Board of Directors Compensation 2021
Compensation Framework
The Board compensation was set at a level that allowed for the attraction and appointment of high-caliber talent for Board roles with the relevant background and skills, including global experience in the medical devices and ophthalmology industry. The Board is comprised of both Swiss and international members.
Non-executive Board members are awarded a base fee. Further, they are entitled to additional fees for their roles of Chair and/or member on the Board committees. The Vice Chair also receives an additional fee. The Board Chair does not receive additional fees for work in committees. David J. Endicott, the CEO of Alcon, does not receive any fees for his Board membership. Mr. Endicott is compensated as a member of the ECA and his compensation is disclosed in section "ECA Compensation 2021."
The following table sets out the compensation for the non-executive members of the Board from the 2021 AGM to the 2022 AGM:
Exhibit 26
ITEM 9. THE OFFER AND LISTING
Board functionCHF
USD1
Annual base fee:
Board Chair950 0001,039,012
Board member base fee (Board retainer fee)200 000218,739
Additional fees:
Vice Chair40 00043,748
Chair of the Audit and Risk Committee70 00076,559
Chair of the Compensation Committee50 00054,685
Chair of the Governance and Nomination Committee50 00054,685
Chair of the Innovation Committee50 00054,685
Member of the Audit and Risk Committee35 00038,279
Member of the Compensation Committee25 00027,342
Member of the Governance and Nomination Committee25 00027,342
Member of the Innovation Committee25 00027,342
1Converted into USD at a rate of CHF 1.0 = USD 1.093697.
In 2021, the following framework applied to the compensation of non-executive Board members:
Fifty percent of the total fees is paid in shares on a mandatory basis in two installments: September 2021 and March 2022;
Fifty percent of the total fees is paid in cash in four installments: June, September and December 2021 and March 2022;
Each Board member may elect to receive up to one hundred percent of their fees in shares;
The fees are paid in Swiss Francs;
The shares delivered are unrestricted (free shares) listed on the SIX Swiss Exchange;
The members of the Board are subject to share ownership requirements (see below);
Board members bear the full cost of their own social security contributions; and
Board members do not receive variable compensation, in line with their focus on corporate strategy, supervision and governance. Their payment in shares is in unrestricted shares. They do not receive share options or other share-based instruments.

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The general principles of compensation of the members of the Board are defined in our Articles of Incorporation. According to our Articles of Incorporation, Alcon may enter into agreements with members of the Board relating to their compensation for a fixed term of up to one year.
Share Ownership Requirements for Members of the Board
Board members are committed to align their interests with those of shareholders. The Board has set forth share ownership requirements which apply to the non-executive members of the Board.
Each member of the Board, including the Board Chair, is required to own Alcon shares that represent the value of his or her annual base fee. This requirement must be met within four years in office.
Exhibit 27
A.     OFFER AND LISTING DETAILS
Board levelShare ownership requirement
Board Chair1 times annual base fee, within 4 years
Other Board members1 times annual base fee, within 4 years

Each member of the Board has met or is on track to meet the ownership requirement. Board members are prohibited from hedging or pledging their ownership positions in Alcon shares that are part of the share ownership requirement.
Compensation Governance
Authority for Board Compensation Decisions
Decisions regarding Board compensation are taken by the Board upon proposals from the CC. The CC's proposals are based on analysis and review of compensation practices, policies and benchmarking information provided by external compensation advisors.
The Board is responsible for approving the Compensation Report and for proposing the aggregate budget of Board compensation subject to a shareholders’ vote at the applicable AGM.
Exhibit 28
1.     EXPECTED PRICE
Authority levels in Board compensationCCBoardAGM
Board compensation policy and principlesPA
Board Chair compensationPA
Other Board member compensationPA
Share ownership requirements for Board membersPA
Maximum aggregate compensation of the Board membersRP
A1
Compensation Report of the companyRP
A2
R   Recommend     P   Propose     A   Approve
                   Not Applicable.1binding vote

2advisory vote
The Corporate Governance Report in Item 6.C. Board Practices of this Annual Report provides further details to the authorities of the CC.

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Independence of Members of the Compensation Committee
Each of the members of the CC meets the independence criteria set forth in our Board Regulations. Effective from the 2021 AGM, the CC has been comprised of the following three members: Karen J. May (Chair), Thomas H. Glanzmann, and Ines Pöschel. At each AGM, the shareholders elect the CC Chair and its members individually for a term of office of one year. Our Articles of Incorporation permit re-election. The 2021 Corporate Governance Report in Item 6.B. of the Alcon 2021 Annual Report provides details regarding the members of the Board and the independence criteria for Board members. The Board Chair, the CEO and the Secretary of the Board attend the CC meetings by invitation. None is present when decisions relating to their respective interests are taken.
The Compensation Committee’s External Advisors
During 2021, the CC retained Willis Towers Watson ("WTW") as its external compensation advisor. For the same period, the CC also retained HCM International (Switzerland) ("HCM") for advice with regard to Swiss compensation matters. The CC appointed each of them in 2019 following a thorough process of evaluating proposals from various consulting firms. During 2020, WTW provided additional services to Alcon related to, among other things, compensation programs, pension and benefit plans. During the same period, HCM did not provide additional services to Alcon.
At the end of 2021, the CC conducted a review of the support received from the selected external advisors and is satisfied with the result of the work completed in 2021. At least annually, the CC will evaluate the quality of the consulting services received and the need to use specific advisors.
Compensation of the Members of the Board of Directors
Board Compensation FY 2021
The following Exhibit 29 sets out the total compensation received by non-executive members of the Board during 2021.
The disclosed compensation represents (i) the fees paid to the members of the Board in March 2021, which was the last installment of the fees for their term of office up to the 2021 AGM, and (ii) the fees paid up to December 31, 2021 for their term of office from the 2021 AGM to the 2022 AGM.
The installment of the fees paid in March 2021 completed the delivery of all fees due for the term of office from 2020 AGM to the 2021 AGM. The total of fees paid for that term remained within the approved budget.
The fees paid between the 2021 AGM and December 31, 2021 to the members of the Board of Directors are only a part of the total fees they will receive for the service on the Board during the term of office from the 2021 AGM to the 2022 AGM (three of four installments). In accordance with our normal payout schedule, a further payment of fees in cash and shares will be made in March 2022. Total 2021 Board fees are higher than in 2020 primarily due to fees received by members of the Governance and Nomination Committee for the full year of 2021 as compared to a partial year in 2020. The board fee structure did not change from 2020 to 2021.
The CEO of Alcon, David J. Endicott, is not included in this Exhibit 29 as he is not compensated for his Board membership. Mr. Endicott is compensated as a member of the ECA and his compensation is disclosed in section "ECA Compensation 2021."
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Exhibit 29
Board members, functions1
Payment in
cash
Tax and
other cash2
Payment in
shares3
Number of
shares4
Other
payments5
Total
fees 2021
F. Michael Ball
Board Chair, member GNC
0259,825779,18810,169— 1,039,013
Lynn D. Bleil
Member ARC and IC
106,63553,335159,9372,152— 319,907
Arthur B. Cummings
Member IC
123,04137,13585,9061,12037,096283,178
Thomas H. Glanzmann
Chair IC, member GNC, CC
019,874308,2364,0234,987333,097
D. Keith Grossman
Vice Chair, Chair GNC, member IC
089,579268,6073,518— 358,186
Scott H. Maw
Chair ARC
073,936221,3622,889— 295,298
Karen J. May
Chair CC, member ARC
078,005233,6993,050— 311,704
Ines Pöschel
Member GNC, CC
95,6988,445182,9512,4194,987292,081
Dieter P. Spälti
Member ARC
015,677241,3423,1504,987262,006
Total fees paid in 2021 in USD 6
325,374635,8112,481,22832,49052,0573,494,470
Total fees paid in 2021 in CHF 7
297,499581,3412,268,66132,49047,5973,195,099
1Board Committees: “ARC” Audit and Risk Committee; "CC" Compensation Committee; “GNC” Governance and Nomination Committee; “IC” Innovation Committee. F. Michael Ball does not receive an additional fee as a member of the GNC.
2These amounts represent the values of tax and, if applicable, social security due upon the allocation of shares, which were delivered in cash to the accounts. They were then deducted and paid to the applicable authorities. Further, the amounts include the residual amount of cash resulting from rounding down the number of shares to the next whole share.
3The amounts in USD represent the converted value in CHF based on the Alcon shares granted on March 11, 2021 at the closing price of CHF 64.10 per share on the date of grant and on September 3, 2021, at the closing price of CHF 77.24. The shares granted are listed on the SIX Swiss Exchange.
4The total number of shares reported were delivered to each Board member in (i) the second installment of the fee in shares in March 2021 (2020 AGM - 2021 AGM), and (ii) the first installment of the fee in shares (term 2021 AGM - 2022 AGM). The second and final installment in shares for the services from the 2021 AGM to the 2022 AGM will be delivered in March 2022.
5Includes (i) an amount of USD 19,948 for mandatory employer contributions paid by Alcon to governmental social security systems, which provides the relevant members of the Board with a right to the maximum future insured government pension benefit (this amount is a part of total mandatory employer contributions of USD 97,086 to the governmental social security systems) and (ii) USD 32,109 paid to Dr. Cummings (or his related entities) for consulting services, including assistance with clinical trials that Dr. Cummings, as an ophthalmologist, provided to Alcon (these services were unrelated to Dr. Cummings' board service).
6All amounts include the payments made and the shares delivered in March 2021 as installment of the fee for the term of office 2020 AGM - 2021 AGM.
7The payments in cash were made in Swiss Francs (CHF). For consistency they are reported in USD as all compensation in this 2021 Compensation Report. The amounts in CHF were converted to USD at the exchange rate of 1.0 CHF : 1.093697 USD. All amounts are before deductions of social security contributions and income tax paid by the Board members.

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Board Compensation FY 2020
The following Exhibit 30 sets out the total compensation received by non-executive members of the Board during 2020.
The disclosed compensation represents (i) the fees paid to the members of the Board in March 2020, which was the last installment of the fees for their term of office up to the 2020 AGM, and (ii) the fees paid up to December 31, 2020 for their term of office from the 2020 AGM to the 2021 AGM.
The installment of the fees paid in March 2020 completed the delivery of all fees due for the term of office from spin-off on April 9, 2019 to the 2020 AGM. The total of fees paid for that term remained within the approved budget.
The fees paid between the 2020 AGM and December 31, 2020 to the members of the Board of Directors are only a part of the total fees they received for the service on the Board during the term of office from the 2020 AGM to the 2021 AGM (three of four installments). In accordance with our normal payout schedule, a further payment of fees in cash and shares was made in March 2021.
The CEO of Alcon, David J. Endicott, is not included in this Exhibit as he is not compensated for his Board membership.
Exhibit 30
Board members, functions1
Payment in
cash
Tax and other cash2
Payment in
shares3
Number of
shares4
Other
payments5
Total
fees 2020
F. Michael Ball
Board Chair, member GNC
126,500189,784569,21310,476— 885,497
Lynn D. Bleil
Member ARC and IC
17,31060,637181,7103,346— 259,657
Arthur B. Cummings
Member IC
119,84237,22082,6231,52259,603299,288
Thomas H. Glanzmann
Chair IC, member GNC, CC
16,405289,8575,3394,794311,056
D. Keith Grossman
Vice Chair, Chair GNC, member CC, IC
38,61664,639193,6873,564— 296,942
Scott H. Maw
Chair ARC
71,945215,6763,973— 287,621
Karen J. May
Chair CC, member ARC
75,927227,6734,194— 303,600
Ines Pöschel
Member GNC, CC
63,9166,378172,0533,1684,794247,141
Dieter P. Spälti
Member ARC
15,227235,1084,3314,794255,129
Total fees paid in 2020 in USD6
366,184538,1622,167,60039,91373,9853,145,931
Total fees paid in 2020 in CHF7
343,751505,1932,034,80839,91369,4532,953,205
1.Board Committees: “ARC” Audit and Risk Committee; "CC" Compensation Committee; “GNC” Governance and Nomination Committee; “IC” Innovation Committee. F. Michael Ball does not receive an additional fee as a member of the GNC.
2.These amounts represent the values of tax and, if applicable, social security due upon the allocation of shares, which were delivered in cash to the accounts. They were then deducted and paid to the applicable authorities. Further, the amounts include the residual amount of cash resulting from rounding down the number of shares to the next whole share.
3.The amounts in USD represent the converted value in CHF based on the Alcon shares granted on March 11, 2020 at the closing price of CHF 50.82 per share on the date of grant and on September 11, 2020, at the closing price of CHF 51.10 on September 10, 2020. The shares granted are listed on the SIX Swiss Exchange.
4.The total number of shares reported were delivered to each Board member in (i) the second installment of the fee in shares in March 2020 (term April 9, 2019 - 2020 AGM), and (ii) the first installment of the fee in shares (term 2020 AGM - 2021 AGM) . The second and final installment in shares for the services from the 2020 AGM to the 2021 AGM were delivered in March 2021.
5.Includes (i) an amount of USD 19,176 for mandatory employer contributions paid by Alcon to governmental social security systems, which provides the relevant members of the Board with a right to the maximum future insured government pension benefit (this amount is a part of total mandatory employer contributions of USD 87,533 to the governmental social security systems) and (ii) USD 54,809 paid to Dr. Cummings (or his related entities) for consulting services, including assistance with clinical trials that Dr. Cummings, as an ophthalmologist, provided to Alcon (these services were unrelated to Dr. Cummings' board service).
6.All amounts include the payments made and the shares delivered in March 2020 as installment of the fee for the term of office April 9, 2019 - 2020 AGM.
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7.The payments in cash were made in Swiss Francs (CHF). For consistency they are reported in USD as all compensation in this 2020 Compensation Report. The amounts in CHF were converted to USD at the exchange rate of 1.0 CHF : 1.06526 USD. All amounts are before deductions of social security contributions and income tax paid by the Board members.
Share Ownership of the Members of the Board of Directors
The number of Alcon shares held by members of the Board and “persons closely linked” to them as of December 31, 2021 are set out in the Exhibit below. As of this same date, no Board member, either individually or together with “persons closely linked”, owned 1% or more of the outstanding shares of Alcon. The CEO of Alcon and Board member, David J. Endicott, is not included in this Exhibit as his share ownership is disclosed in Exhibit 25.
The number of shares held as of December 31, 2020 is shown for comparison.
Exhibit 31
Board member
2021
Total shares
2020
Total shares
F. Michael Ball33,847 23,678
D. Keith Grossman7,998 4,480
Lynn D. Bleil6,729 4,577
Arthur B. Cummings3,429 2,309
Thomas H. Glanzmann11,835 7,812
Scott H. Maw8,567 5,678
Karen J. May19,044 15,994
Ines Pöschel6,746 4,847
Dieter P. Spälti16,341 13,191
Total114,536 82,566
Additional Disclosures
Loans to Board Members
Alcon’s Articles of Incorporation and corporate policies do not permit loans to current or former members of the Board or to persons closely linked to them. No loans were granted in 2021, and none were outstanding as of December 31, 2021.
Other Payments to Board Members
No payments (or waivers of claims) other than those set out in Exhibit 29 (including the related notes) under section "Board compensation FY 2021" were made to current Board members or to persons closely linked to them.
Persons Closely Linked
Persons closely linked to members of the Board are (i) their spouse, (ii) their children below age 18, (iii) any legal entities that they own or otherwise control (iv) any legal or natural person who is acting as their fiduciary or agent and (v) family trusts.
Payments to Former Board Members
None.
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Outlook for 2022
Compensation Philosophy and Principles
The Company will continue to adopt a compensation philosophy which:
Ensures a broadly competitive level of remuneration appropriate to each executives’ scale of responsibility and individual performance;
Attracts, retains and motivates a world-class executive team to drive performance;
Supports long-term value creation for shareholders;
Considers the geographic and industry-specific nature of our talent pool and the medical device industry;
Aligns the compensation program for the senior executives with the broader management and employee population;
Fully embraces Swiss governance expectations and follows principles of simplicity and transparency; and
Links pay to achievement of ESG objectives through the STI plan.
Exhibit 32
2.    METHOD TO DETERMINE EXPECTED PRICE
                   Not Applicable.

Pay - for - performance
Programs are designed to compensate short-term performance and long-term success
Rewards are achieved if financial and non-financial performance metrics are met
3.    Alignment with shareholdersPRE-EMPTIVE EXERCISE RIGHTS
A significant part of compensation is delivered in Alcon equity
Executives are expected to hold a meaningful level of Alcon shares
                   Not Applicable.

Market competitiveness
Overall compensation is competitive with other companies in the medical device and other industries in which Alcon competes for talent
Total opportunity is targeted at market median
4.    Motivation and retentionSTOCK PRICE HISTORY
Compensation is designed to attract, retain and motivate executives to achieve Company objectives
Compensation is reviewed periodically to ensure competitiveness and alignment to key strategic objectives
ECA Compensation
The CC is committed to a pay-for-performance framework to align Company and executive performance with shareholder interests. Following a thorough review of Alcon's compensation structures during 2021, we have made refinements to our overall compensation structures to better reflect Alcon's status as an independent, stand-alone company.
Headquartered in Switzerland, Alcon operates on a truly global basis. Our main business competitors are found in both Europe and North America, which is where we compete for talent. Consequently, our executive compensation framework has been benchmarked against a carefully selected peer group, consisting of European and North American companies with a blend of similar size, industry and geographic characteristics to Alcon. The inclusion of European and North American companies reflects our global footprint, business mix and source for management talent. Although Alcon is headquartered in Switzerland, a significant portion of our sales, management team and our associate population are in the US. The US is the largest pool for both medical device and ophthalmology talent and it is therefore critical that Alcon is able to attract and retain key talent especially from the US. As a result, our CC has selected a blended Peer Group of North American and European companies (58% US and 42% outside US) to balance the European compensation structure with a need to attract and retain US talent. While we do not pay as much as our US competitors, we desire to stay close to the median of the blended Peer Group. Based on the Company’s business strategy, compensation philosophy and the analysis of peer group compensation practices, below are the key features of ECA compensation for 2022:
No compensation increase for the CEO including base salary and short and long term incentive targets;
Same overall structure of ECA compensation as compared to 2021 (base pay, STI, LTI and benefits);
Broadly no significant change to the ECA members' compensation levels;
Continuation of robust share ownership requirements; and
No material changes to benefits provisions.
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Board Compensation
The Board compensation framework will remain unchanged for the upcoming term of office from the 2022 AGM to the 2023 AGM, including:
The overall framework of Board compensation from the 2021 AGM to the 2022 AGM will be carried forward to the term from the 2022 AGM to 2023 AGM;
The Board Chair fee and Board member fees will remain unchanged; and
The payment of fifty percent in shares (mandatory) and a voluntary election of a higher percentage in shares will continue.
In 2021, the Board conducted a benchmarking study of Alcon's Board pay against other SMI companies and determined that our Board pay is below the median level of SMI companies. Nonetheless, the Board made the decision to not propose any compensation change at the 2022 AGM for the 2022 - 2023 AGM term. Our Board's pay has not changed in Alcon's history as a public Company. The CC and the Board will reconsider possible changes to Board compensation in 2023 for future terms.
Shareholder Vote at the 2022 AGM
In accordance with Article 29 of the Articles of Incorporation (http://investor.alcon.com/governance//default.aspx), the Board will ask shareholders at the 2022 AGM meeting to cast a binding vote on:
The aggregate amount of compensation payable to non-executive members of the Board for their term of office from the 2022 AGM to the 2023 AGM; and
The aggregate amount of compensation payable to ECA members in the financial year 2023.
In addition, the Board will ask shareholders to cast an advisory vote on the 2021 Compensation Report.
The procedures of voting on the compensation of ECA members and the Board are defined in our Articles of Incorporation. Our Articles allow for an additional amount of compensation to be used when promoting or adding new members to the ECA.
The Exhibit below depicts the proposal for the 2022 AGM and the respective period of the compensation affected by the vote.
Exhibit 33
Compensation Proposals for Shareholder Approval at 2022 AGM
alc-20211231_g19.jpg
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6.C. BOARD PRACTICE
Corporate Governance
Group Structure and Shareholders
Operational Group Structure
The Company, with its registered office at Rue Louis-d’Affry 6, 1701 Fribourg, Switzerland, is a corporation organized under Swiss law and is the ultimate parent company of Alcon. As of December 31, 2021, the market capitalization of the Company was $42.696 billion (CHF 39.570 billion).
Alcon is the global leader in eye care with $8.2 billion in net sales during the year ended December 31, 2021. We research, develop, manufacture, distribute and sell a full suite of eye care products within two key businesses: Surgical and Vision Care. Our Surgical business is focused on ophthalmic products for cataract surgery, vitreoretinal surgery, refractive laser surgery and glaucoma surgery. Our Vision Care business is comprised of various contact lenses and a comprehensive portfolio of ocular health products, including products for dry eye, glaucoma, contact lens care and ocular allergies, as well as ocular vitamins and redness relievers. Further information is available under "Item 4. Information on the Company" and Note 5 to the Consolidated Financial Statements.
Listed and Non-listed Companies Belonging to the Alcon Group
The registered shares of the Company are listed on the SIX Swiss Exchange (Valor 43249246 / ISIN code CH0432492467) and the New York Stock Exchange (CUSIP code H01301128). The Company owns directly or indirectly all consolidated entities of Alcon, none of which has its shares otherwise listed.
The following table lists the highmost significant subsidiaries of the Company, including those entities with total assets or net sales to third parties in excess of 5% of the Company’s consolidated total assets or net sales to third parties, as applicable, at December 31, 2021. The referenced share capital may not reflect the taxable share capital and low closing market prices for Alcon's common shares fordoes not include any paid in surplus. Further information regarding the periods indicated as reported:


 High Low 
Year ended December 31,    
2006                                                    $138.12 $93.24 
2007                                                     153.91  109.80 
2008                                                     175.47  67.98 
2009                                                     166.00  76.34 
2010                                                     170.18  135.00 
       
Year ended December 31,      
2009:  First quarter                                                     95.14  76.34 
Second quarter                                             117.74  86.28 
Third quarter                                             143.53  112.50 
Fourth quarter                                             166.00  136.23 
       
2010:  First quarter                                                     163.27  152.51 
Second quarter                                             161.38  135.00 
Third quarter                                             168.21  148.54 
Fourth quarter                                             170.18  157.25 
       
Month of:      
September 2010                                                     168.21  162.98 
October 2010                                                     170.18  166.60 
November 2010                                                     168.00  157.25 
December 2010                                                     164.10  160.38 
January 2011                                                     163.70  162.28 
February 2011                                                     165.43  163.82 
       

118
Company’s subsidiaries is disclosed in Note 28 of the Consolidated Financial Statements. The combination of the Company’s subsidiaries disclosed in the table below and in Note 28 of the Consolidated Financial Statements does not cover all subsidiaries of the Company.
5.    TYPE AND CLASS OF SECURITIES
Country of Organization/ Entity NameEquity InterestPrincipal Place of BusinessShare Capital
China
Alcon (China) Ophthalmic Product Co., Ltd.100%BeijingUSD 60,000,000
Japan
Alcon Japan Ltd.100%TokyoJPY 500,000,000
Switzerland
Alcon Pharmaceuticals Ltd.100%FribourgCHF 200,000
United States
Alcon Finance Corporation100%Fort Worth, TXUSD 1
Alcon Laboratories, Inc.100%Fort Worth, TXUSD 1
Alcon Research, LLC100%Fort Worth, TXUSD 1,000
Alcon Vision, LLC100%Fort Worth, TXUSD 1,000
                      Not Applicable.
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Significant Shareholders
According to the Alcon share register, the following nominee shareholders held more than 3% of the share capital of Alcon Inc. as of December 31, 2021:
HolderNumber of SharesPercentage
Chase Nominee Ltd., London (UK)38,272,135.007.65%
Cede & Co (DTC nominee), New York, NY (USA)101,901,633.0020.39%
Nortrust Nominees Limited, London (UK)21,770,1814.36%
In addition, according solely to disclosure of shareholdings notifications filed with (i) Alcon and the SIX Swiss Exchange ("SIX Threshold Notifications") pursuant to the obligations set forth in the Swiss Federal Act on Financial Market Infrastructure and Market Conduct in Securities and Derivatives Trading ("FMIA") and the rules and regulations promulgated thereunder or (ii) the SEC, there are two shareholders that held shares representing at least 3% of the Company’s total share capital as of December 31, 2021, but was not registered with the Alcon share register. These shareholders are identified in the table below.
The information required to be included in the SIX Threshold Notifications regarding this shareholder varies from the information required to be included in beneficial ownership statements filed with the SEC (“SEC Notification”).
Interested persons can access the relevant SIX Threshold Notifications online at the SIX Swiss Exchange: https://www.ser-ag.com/en/resources/notifications-market-participants/significant-shareholders.html#/
The below table shows the information available to the Company, based on both notification regimes, with respect to shareholders reported to have significant positions in Alcon’s share capital as of December 31, 2021:
HolderNumber of shares and voting rights as per SIX Threshold Notification
Percentage as per SIX Threshold Notification1
Number of shares beneficially owned as per SEC Notification2
Percentage as per SEC Notification2
BlackRock, Inc.
c/o BlackRock Investment Management (UK) Limited
12 Throgmorton Ave, London, EC2N 2DL, UK
24,679,2313
5.06 %N/AN/A
WCM Investment Management, LLC
281 Brooks St
Laguna Beach, CA 92651 USA
N/AN/A
26,016,5754
5.21%4
6.    LIMITATIONS OF SECURITIES
                      Not Applicable.
7.    RIGHTS CONVEYED BY SECURITIES ISSUED
                      Not Applicable.

B.    PLAN OF DISTRIBUTION
                      Not Applicable.

C.    MARKETS FOR STOCK
                      Alcon's common shares are listed for trading1     Percentages indicated in this column have been established based on the NYSE and are traded undershare capital of the symbol "ACL".

D.   SELLING SHAREHOLDERS
                      Not Applicable.

E.    DILUTION FROM OFFERING

Not Applicable.

F.    EXPENSES OF OFFERING
                      Not Applicable.
ITEM 10.ADDITIONAL INFORMATION


A.    SHARE CAPITAL
                      Not Applicable.

B.    MEMORANDUM AND ARTICLES OF ASSOCIATION

General

Alcon, Inc. isCompany registered inwith the commercial register of the Canton of Zug, SwitzerlandFribourg on the date on which the respective disclosure obligation pursuant to the FMIA was triggered. Furthermore, according to the FMIA, this shareholder is required to notify Alcon and the SIX Swiss Exchange only at the time it reaches, exceeds or falls below any of the thresholds set forth in the FMIA; therefore, its shareholding as of December 31, 2021 may differ from the figures indicated as per the contents of the relevant SIX Threshold Notification.
2    In general, under number CH-170.3.017.372-9.SEC rules, "beneficial ownership", for the purposes of this column, refers to shares that an entity had the power to vote or the power to dispose of and shares that such entity or individual had the right to acquire within 60 days after December 31, 2021. Information in this column is current as of February, 11, 2022.

3    Based solely on a SIX Threshold Notification dated November 9, 2019. This figure does not include its derivative position.
4    Based solely on a Schedule 13G filed with the SEC on February 10, 2022.
Cross-Shareholdings
Neither the Company nor any of its consolidated entities has any shareholdings exceeding 5% of the holdings of capital or voting rights in any entity that also has shareholdings exceeding 5% of the holdings of the capital or voting rights in the Company or any of its consolidated entities.

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Capital Structure
Share Capital
As of December 31, 2010, our issued2021, the share capital of Alcon Inc. was CHF 19,988,000, fully paid-in and divided into 499,700,000 registered shares, each with a nominal value of CHF 0.04.
Authorized and Conditional Share Capital
On January 29, 2019, the Company’s annual general meeting approved the creation of an authorized share capital. According to this shareholder resolution, the Board was authorized, at any time until January 29, 2021, to increase the Company’s share capital by a maximum of CHF 977,400 through the issue of up to 24,435,000 fully paid up new shares of CHF 0.04 nominal value each for the purpose of any share-based incentive or other participation plans, schemes or arrangements for directors, associates or advisors of the Company or its consolidated subsidiaries (“Employees Participation Plans”).
The Board resolved on November 19, 2019 to increase the share capital by CHF 120,000 through the issuance of 3,000,000 new registered shares under the authorized share capital in order to comply with Alcon’s obligations under the relevant Employees Participation Plans.
On November 10, 2020, the Board resolved to further increase the share capital by CHF 320,000 through the issuance of 8,000,000 new registered shares under the remaining authority available under the authorized share capital, i.e. 21,435,000 shares, in order comply with Alcon’s obligations under the relevant Employees Participation Plans.
The remaining authority to issue new registered shares under the authorized share capital expired on January 29, 2021. As of December 31, 2021, the Company did not have authorized share capital available.
The Company did not have any conditional share capital available on December 31, 2021.
Changes in Capital
The Company was formed on September 21, 2018 with a share capital of CHF 100,000 divided into 2,500,000 registered shares with a nominal value of CHF 0.04 each. In view of the contemplated Spin-off from the Novartis group, the Company’s share capital was increased on January 29, 2019 to CHF 61,008,996.60 on 305,044,983 common19,548,000 divided into 488,700,000 registered shares at CHF 0.20with a par value per common share.

Set out below is information concerning our sharesof CHF 0.04 each. Following the two successive increases through the authorized share capital, as described above under “Authorized and a brief summary of someConditional Share Capital”, the share capital of the significant provisionsCompany was, as of December 31, 2021, CHF 19,988,000 divided into 499,700,000 registered shares.
Shares, Participation Certificates and Profit-sharing Certificates
The Company has a single class of shares, being registered shares in the form of uncertificated securities (in the sense of the Swiss Code of Obligations). A portion of these uncertificated shares is issued as intermediated securities (titres intermédiés) within the meaning of the Swiss Federal CodeIntermediated Securities Act via the settlement system operated by SIX SIS, with the remaining shares directly held through Computershare Trust Company, N.A. in the US (including shares held through Computershare Trust Company, N.A. via DTC). All Alcon shares have equal voting rights and carry equal entitlements to dividends. No participation certificates (bons de participations) or profit-sharing certificates (bons de jouissance) have been issued.
Based solely upon shares registered in the Alcon share registry, as of Obligations (Schweizerisches Obligationenrecht),December 31, 2021, approximately 17.3% of ourthe Company's total share capital was held in Switzerland by 77,110 registered shareholders.
Limitations on Transferability and Nominees Registrations
The Articles of Association (Statuten), andIncorporation of the written regulationsCompany do not provide for any limitation on transferability of our board of directors, known as Organizational Regulations (Organisationsreglement), the Articles of Association and the Organizational Regulations having been filed previously with the SEC.  This description does not purport to be complete and is qualified by reference to our Articles of Association, our Organizational Regulations and the Swiss Federal Code of Obligations.

Common Shares

All common shares are registered common shares which are fully paid, validly issued and non-assessable.  There is no limitation under our Articles of Association on the right of non-Swiss residents or nationals to own or vote our common shares.


119

Share Register

Our share register is kept by BNY Mellon Shareowner Services in New York, New York, which acts as transfer agent and registrar. The share register reflects only record owners of our shares; beneficial owners of common shares holding their shares through The Depository Trust Company, which we refer to as "DTC," are not recorded in our share register.  Shares held through DTC are registered in our share register in the name of DTC's nominee.  We are entitled to accept only those persons as shareholders, usufructuaries or nominees who have been recorded in our share register,registration.
Convertible Bonds and to perform dividend payment and other obligations only to our shareholders of record, including DTC.  A shareholder of record must notify BNY Mellon Shareowner Services of any change in address. Until notice of a change in address has been given, all of our written communication to our shareholders of record shall be deemed to have validly been made if sent to the address recorded in the share register.
Share Certificates

We issue certificates evidencing our common shares to our shareholders of record, unless shares are held in uncertificated position through the DTC's book-entry Direct Registration System.

Transfers of Common Shares

Beneficial owners of our common shares, as well as registered owners with uncertificated positions, may transfer their shares through the DTC's book-entry Direct Registration System.  Common shares held of record represented by share certificates may be transferred only by delivery of the share certificates representing those common shares duly endorsed or accompanied by an executed stock power.  A transferee who wishes to become a shareholder of record must deliver the duly executed certificate in a form proper for transfer to our transfer agent and registrar, BNY Mellon Shareowner Services, in order to be registered in our share register (Aktienregister).

Voting Rights

Each common share carries one vote at a shareholders' meeting.  Voting rights may be exercised by our registered shareholders or by a duly appointed proxy of a shareholder, which proxy need not be a shareholder.  This provision will allow for the exercise of voting rights by beneficial owners of our common shares.  Our Articles of Association do not limit the number of shares that may be represented by a single shareholder.  See "-Transfers of Common Shares" above and "Certain Provisions of Our Articles of Association, Organizational Regulations and Swiss Law-Shareholders' Meetings" below.

Treasury shares, i.e., shares held by us or our majority-owned subsidiaries, will not be entitled to vote at our shareholders' meetings.

Preemptive Rights

Shareholders have preemptive rights to subscribe for newly issued common shares and other equity instruments, stock options and convertible bonds in proportion to the nominal amount of our common shares they own.  The vote of a supermajority of two-thirds of the common shares represented at a shareholders' meeting may, however, limit or suspend preemptive rights in certain limited circumstances.

Informational Rights

At a shareholders' meeting, each shareholder is entitled to request certain information from our board of directors concerning our affairs and to request information from our auditors concerning their audit and its results.  Such information must be provided to the extent that it is necessary to exercise shareholder rights (for example, voting rights) and does not jeopardize business secrets or other legitimate interests of Alcon.  Additionally, our books and correspondence may be inspected by our shareholders if such an inspection is expressly authorized by our shareholders or our board of directors, subject to the protection of business secrets.  If information is withheld or a request to inspect refused, a court in our place of incorporation (Zug, Switzerland) may be petitioned to order access to information or to permit the inspection.
120

The right to inspect our share register is limited to the right to inspect that shareholder's own entry on our share register.
Preferred Shares

Options
As of December 31, 2010, no2021, Alcon preferred shares were authorized, issueddid not have any convertible bonds, warrants, options or outstanding.

Future Share Issuances

Under Swiss law, all decisions with respectother securities granting rights to capital increases, whether of common or nonvoting preferred shares and whether for cash, non-cash or no consideration, are subject to the approval or authorization by shareholders.
Creation of Conditional Share Capital for the Amended 2002 Alcon Incentive Plan

As of December 31, 2010, our share capital may be increased by a maximum aggregate amount of CHF 3,041,843.40 through the issuance of a maximum of 15,209,217 fully paid common shares, subject to adjustments to reflect share splits, upon the exercise of options to purchase common shares.  New common shares will be issued upon the exercise of options which our management, employees and directors may be granted pursuant to the Amended 2002 Alcon Incentive Plan.  The grant of these options and the issuance of the underlying common shares upon option exercises will not entitle our shareholders to preemptive rights.  The exercise price of the stock options shall be no less than the market price of common shares upon the date of grant of the options.  See "Management-Amended 2002 Alcon Incentive Plan."

At December 31, 2010, 12,625,084 common shares, including 1,028,693 common shares during 2010, had been issued cumulatively from conditional share capital pursuant to the exercise of stock options and restricted share units granted under the Amended 2002 Alcon Incentive Plan.  Another 2,165,699 shares of conditional capital were issued in 2002 as contingent restricted shares; for which the last condition for vesting expired January 1, 2006.

The restricted common shares and the common shares issued pursuant to the exercise of stock options and restricted share units reduced the conditional share capital from the 30 million common shares originally authorized in 2002.

Certain Provisions of Our Articles of Association, Organizational Regulations and Swiss Law

Business Purpose and Duration

Article 2 of our Articles of Association provides that our business purpose is to purchase, administer and transfer patents, trademarks and technical and industrial know-how; to provide technical and administrative consultancy services; and to hold participations in other industrial or commercial companies.  In addition, we may conduct all transactions to which our business purpose may relate.

Our Articles of Association do not limit our duration.

Notices

Article 31 of our Articles of Association requires us to publish notices, including notice of shareholders' meetings, to our shareholders in the Swiss Official Gazette of Commerce (Schweizerisches Handelsamtsblatt).  Our board of directors may, but is not generally required by Swiss law to, designate additional means of providing notice to shareholders.  We also may communicate with our shareholders through the addresses registered in our share register.
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Shareholders' Meetings

Annual General Meetings

Under Swiss corporate law, we must hold an annual general meeting of shareholders within six months after the end of our financial year, which is the calendar year.  Our board of directors has the authority to convene annual general meetings. Holders of common shares with a nominal value equal to at least CHF 1 million have the right to request that a specific proposal be discussed and voted upon at a shareholders' meeting.  Under Swiss corporate law, notice of a shareholders' meeting must be given at least 20 days prior to the date of that meeting.

The 2011 annual general meeting of shareholders is scheduled for April 7, 2011 in Zug, Switzerland.

Extraordinary General Meetings

Our board of directors is required to convene an extraordinary general meeting of shareholders, for among other reasons, if a shareholders' meeting adopts a resolution to that effect or if holders of common shares representing an
aggregate of at least 10% of our nominal share capital request in writing that it do so.  An extraordinary general meeting is convened by publication of a notice as set forth above under "– Notices."
Powers and Duties

Pursuant to Swiss corporate law, our shareholders have the exclusive right to decide on the following matters:

·  adoption and amendment of our Articles of Association;

·  election of members of our board of directors, statutory auditors and the special auditors;

·  approval of our annual report, our statutory financial statements and our consolidated financial statements;

·  payments of dividends and any other distributions to shareholders;

·  discharge of the members of our board of directors from liability for previous business conduct to the extent such conduct is known to the shareholders; and

·  any other resolutions which are submitted to a shareholders' meeting pursuant to law, our Articles of Association or by voluntary submission by our board of directors.

Proxies

Shareholders can choose to be represented at a shareholders' meeting by a proxy who is not required to be a shareholder. Shares held in collective custody through DTC will be able to participate in shareholders' meetings regardless of record ownership.  See "- Record Date" below.

Quorum

No quorum for shareholders' meetings is specified in our Articles of Association.

Action by Shareholders

At a shareholders' meeting, all voting takes place by a show of hands, unless voting by ballot is resolved by a majority vote of shareholders present or ordered by the chairman of the meeting or unless voting is done by electronic form as ordered by the chairman of the meeting.  Resolutions of shareholders generally require the approval of a majority of the common shares represented at a shareholders' meeting, with abstentions having the effect of votes against the resolution.  Shareholders' resolutions requiring the affirmative vote of a majority of the common shares represented at a shareholders' meeting include:

·  amendments to our Articles of Association, unless the amendment is subject to the requirement that it be approved by holders of two-thirds of our common shares represented at a shareholders' meeting;


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·  elections of directors and auditors;

·  approval of our annual report, statutory financial statements and consolidated financial statements;

·  payment of dividends;

·  decisions to discharge the directors and management from liability for matters disclosed to the shareholders' meeting; and

·  
ordering of an independent investigation into specific matters proposed to the shareholders' meeting (Sonderprüfung).

Pursuant to Swiss corporate law, the affirmative vote of two-thirds of the common shares represented at a shareholders' meeting is required to approve:
·  changes in our business purpose;

·  the creation of shares having different par values, each of which is entitled to one vote (i.e., dual-class common shares);

·  the creation of restrictions on the transferability of common shares;

·  the creation of authorized share capital or conditional share capital;

·  
an increase in our share capital by way of capitalization of reserves (Kapitalerhöhung aus Reserven), against contribution in kind (Sacheinlage), for the acquisition of assets (Sachübernahme), as well as involving the grant of preferences;

·  a restriction or elimination of preemptive rights of shareholders in connection with a share capital increase;

·  a relocation of our place of incorporation;

·  the dissolution of the Company; and

·  a merger, a demerger or a conversion according to the Swiss Merger Act.

In addition, our Articles of Association require the approval of a supermajority of at least two-thirds of the common shares represented at a shareholders' meeting to:

·  create or abolish any restrictions on the exercise of voting rights;

·  abolish any applicable restrictions on the transferability of shares;

·  convert registered shares into bearer shares and vice versa; and

·  modify any provisions in our Articles of Association requiring actions to be approved by a supermajority of the common shares represented at a shareholders' meeting.

Under Swiss corporate law, shareholders are not permitted to act by written consent in lieu of a shareholders' meeting.

Record Date

We intend to announce the dates of forthcoming shareholders' meetings not less than 30 days prior to the date of the shareholders' meeting in question and to set a date for eligibility to vote at the shareholders' meeting, which we refer to as the date of the closing of the books, not more than 20 days prior to the date of the shareholders' meeting in question.

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We intend to mail shareholders' meeting materials to record owners and to beneficial owners of shares holding their shares through DTC through customary banking and brokerage channels within eight business days after the date of the closing of the books.

Shareholders of record and beneficial owners of shares holding their shares through DTC will have the opportunity to appoint proxies, in the case of shareholders of record, or give voting instructions, in the case of beneficial owners of shares holding their shares through DTC, or to request attendance at shareholders' meetings.  Any request must be made through the same banking and brokerage channels as we originally used to send the shareholders' materials.
Net Profits and Dividends

Swiss corporate law requires us to retain at least 5% of our annual net profits as general reserves for so long as these reserves amount to less than 20% of our nominal share capital.  All other net profits may be paid as dividends if approved by our shareholders.

Under Swiss corporate law, we may only pay dividends if we have sufficient distributable profits from prior business years, or if the reserves on our holding company-only balance sheet prepared in accordance with Swiss statutory accounting rules are sufficient to allow the distribution of a dividend. In either event, dividends may be distributed only following approval by our shareholders based on our statutory holding company-only accounts.  Our board of directors may propose that a dividend be distributed, but our shareholders retain the final authority to determine whether a dividend is paid.  Our statutory auditors also must confirm that the dividend proposal of the board of directors conforms to statutory law and our Articles of Association. Subject to the foregoing, we intend to pay dividends on our common shares.  See "Dividend Policy."

We are required under Swiss corporate law to declare dividends on our shares in Swiss francs. Holders of our common shares will receive payments in U.S. dollars, unless they provide notice to our transfer agent, BNY Mellon Shareowner Services, that they wish to receive dividend payments in Swiss francs.  BNY Mellon Shareowner Services will be responsible for paying the U.S. dollars or Swiss francs to registered holders of common shares, less amounts subject to withholding for taxes.

Dividends usually become due and payable promptly after our shareholders approve their payment.  Dividends which remain unclaimed for five years after the due date become barred by the statute of limitations under Swiss law and are allocated to our general reserves.

Dividends on our common shares are subject to Swiss withholding taxes as described under the heading "Taxation."

Borrowing Powers

Neither Swiss law nor our Articles of Association restrict in any way our power to borrow and raise funds.  The decision to borrow funds is made by or under the direction of our board of directors, and no approval by our shareholders is required.

Conflicts of Interest

Swiss law does not have a general provision regarding conflicts of interest. However, the Swiss Federal Code of Obligations requires directors and officers to safeguard the interests of the company and, in this connection, imposes duties of care and loyalty.  This rule is generally understood as disqualifying directors and officers from participating in decisions directly affecting them.  A breach of these provisions results in the breaching director or officer incurring personal liability to us.  Our Organizational Regulations and Corporate Governance Guidelines provide special provisions addressing conflicts of interest of directors and requiring that interested directors abstain from voting on matters involving such a conflict of interest.  In addition, under Swiss law, payments made to a shareholder or a director or any persons associated therewith, other than on arm's length terms, must be repaid to us if the recipient of the payment was acting in bad faith.


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Repurchases of Shares

Swiss law limits the amount of our shares that we may hold or repurchase.  We, together with our subsidiaries, may only repurchase shares if (i) we have sufficient freely distributable reserves to pay the purchase price and (ii) the aggregate par value of the repurchased shares does not exceed 10% of the nominal share capital of our Company.  Furthermore, we must create a reserve on our statutory balance sheet in the amount of the purchase price of the repurchased shares.  Rights to vote are suspended on shares we or our subsidiaries repurchase, but these shares are entitled to the economic benefits applicable to our shares generally.
Dissolution; Merger

We may be dissolved at any time with the approval of two-thirds of the common shares represented at a shareholders' meeting.  Swiss law also requires the approval of two-thirds of the common shares represented at a shareholders' meeting in case of (i) a merger, (ii) a demerger or (iii) a conversion.  Furthermore, our Independent Director Committee believes our Organizational Regulations provide that our board of directors may only approve a decision with respect to a merger, takeover, other business combination or related party transaction of Alcon with its majority shareholder if a majority of the Independent Director Committee so recommends; however, we cannot predict the outcome of any proceeding that might be initiated to interpret or challenge this position.  Dissolution by court order is possible if we become bankrupt, or for cause at the request of shareholders holding at least 10% of our share capital.  Under Swiss law, any surplus arising out of a liquidation, after the settlement of all claims of all creditors, is distributed to shareholders in proportion to the paid-up par value of shares held, subject to a Swiss withholding tax of 35% on the amount exceeding the paid-up par value.  See "Taxation-Swiss Tax Considerations-Swiss Withholding Tax on Dividends and Similar Distributions."

Board of Directors

Composition
Number, Removal, Vacancies and Term

OurThe Board consists of eight to 13 members according to the Articles of Association provide that we will have at least seven directors at all times.  AllIncorporation. As of our directors are elected byDecember 31, 2021, the votesize of the holders of a majorityBoard was 10 members and the Board was comprised of the common shares represented at a shareholders' meeting, and directors may be removed at any time with or without cause by the holders of a majority of the common shares represented at a shareholders' meeting.  All vacancies on our board of directors must be filled by a vote of our shareholders.  Each member of our board of directors must have nominal ownership of at least one common share, other than members of our board of directors who are representatives of a legal entity that owns common shares.following members:

Our Articles of Association provide that the term of office for each director is three years, with the interval between two annual general meetings being deemed a year for this purpose.  The initial term of office for each director will be fixed in such a way as to assure that about one-third of all the members must be newly elected or re-elected every year.  Swiss law permits staggered terms for directors.  Non-executive directors currently may only be appointed for up to four terms of office.  Our Organizational Regulations provide that directors will retire from office no later than the annual general meeting after their 72nd birthday.

Powers and Duties

Pursuant to Swiss statutory law, our Articles of Association and Organizational Regulations, our board of directors is the corporate body responsible for our business strategy, financial planning and control, and supervision of executive management. Our Organizational Regulations contemplate that our board of directors is responsible for our business operations.  Among other things, our board of directors as a whole has ultimate responsibility for: (i) the ultimate direction of Alcon and the issuance of the necessary guidelines; (ii) the determination of our organizational structure, including the enactment and amendment of the Organizational Regulations; (iii) the determination of our accounting principles, financial controls and financial planning; (iv) the appointment and removal of the secretary of the board of directors, members of board committees and our executive management, as well as the termination of their signatory power; (v) the ultimate supervision of our executive management; (vi) the preparation of our business report and financial statements, the preparation of shareholders' meetings and the implementation of resolutions adopted by our shareholders; (vii) the examination of the professional qualifications of our auditors; (viii) the
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notification of the court if our liabilities exceed our assets (art. 725 CO); (ix) the approval of certain significant transactions, details of which are set out in our Organizational Regulations; (x) the exercise of shareholder rights in our subsidiaries, as well as the ultimate control of the business activities of our subsidiaries; (xi) the establishment of our dividend policy; (xii) the review and approval of the recommendations of the board committees; and (xiii) the response to any approach regarding a takeover offer.

Our Organizational Regulations set forth that they may be amended with the approval of two-thirds of the members of our board of directors attending a meeting, except as otherwise provided in our Organizational Regulations with respect to the Independent Director Committee.
Certain Anti-Takeover Provisions

Business Combinations

Pursuant to our Organizational Regulations, certain mergers, takeovers or other business combinations involving us must be approved by a majority of the Independent Director Committee, which is charged with protecting the interests of minority shareholders, as well as by the full board of directors.

The Independent Director Committee is charged with protecting the interests of minority shareholders.  It has to evaluate and decide upon (i) a proposed merger, takeover, business combination or related party transaction of Alcon with its majority shareholder or any group company of the majority shareholder, (ii) a proposed bid for the minority shareholdings of Alcon by any entity owning a majority of our outstanding voting rights or (iii) a proposed repurchase by us of all of our shares not owned by an entity owning a majority of the outstanding voting rights of Alcon.  The Independent Director Committee believes our board of directors may only approve a decision with respect to any of these matters if a majority of the Independent Director Committee so recommends; however, we cannot predict the outcome of any proceeding that might be initiated to interpret or challenge this position.

Since our common shares are not listed on any Swiss stock exchange, the restrictions on implementing a poison pill set forth in the Swiss Act on Stock Exchanges and Securities Trading, which we refer to as the "Swiss Stock Exchange Act," are not applicable to us. Anti-takeover measures implemented by our board of directors would be restricted by the principle of equal treatment of shareholders and the general rule that new shares may only be issued based on a shareholders' resolution; this rule generally bars a board of directors from issuing shares or options to all shareholders other than a hostile bidder.  Shareholders may, however, implement certain anti-takeover measures through a shareholders' resolution.

Mandatory Bid Rules

Since our common shares are not listed on any Swiss exchange, the mandatory bid rules specified in the Swiss Stock Exchange Act will not apply to us.

Notification and Disclosure of Substantial Share Interests

The disclosure obligations generally applicable to shareholders of Swiss corporations under the Swiss Stock Exchange Act do not apply to us, since our common shares are not listed on a Swiss exchange.  Since our common shares are listed on the NYSE, the provisions of the United States Securities Exchange Act of 1934, as amended, requiring disclosure of certain beneficial interests will apply to our common shares.

Transfer and Paying Agents

Our transfer agent and paying agent for dividends and all other similar payments on our common shares is BNY Mellon Shareowner Services.

Auditors and Special Auditors

In May 2010, the shareholders re-elected KPMG AG as Auditors for a one-year term of office. KPMG AG meets the requirements of the Swiss Federal Code of Obligations for auditing Swiss public companies.  To the extent necessary for a review of the U.S. GAAP financial statements of Alcon, Inc., KPMG AG will draw on the expertise


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and the resources of KPMG LLP, Fort Worth, Texas (USA).  KPMG LLP also was retained for the filings to be made by Alcon, Inc. with the U.S. regulatory authorities.  The shareholders re-elected OBT AG, Zurich, as special auditors for a one-year term of office.  OBT AG meets the requirements of the Swiss Federal Code of Obligations for auditing Swiss public companies.  The auditors and the special auditors are elected for a term ending at our next annual general shareholders' meeting.
Shares Eligible for Future Sale

Our common shares held by Novartis are deemed "restricted securities" as defined in Rule 144, and may not be sold other than through registration under the Securities Act or under an exemption from registration, such as the one provided by Rule 144.



C.    MATERIAL CONTRACTS
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F. Michael Ball, Chairman
A seasoned healthcare executive with nearly four decades of experience with global healthcare companies, including nearly a decade as the CEO of medical device and pharmaceutical companies, F. Michael Ball brings extensive executive leadership experience as well as in-depth industry and Alcon-specific knowledge to the Board. He previously held the position of Chief Executive Officer of the Alcon Division and served as a member of the Novartis Executive Committee from February 1, 2016 until June 30, 2018. He previously served as Chief Executive Officer of Hospira, Inc. from 2011 to 2015. Prior to that, Mr. Ball held a number of senior leadership positions at Allergan, Inc., including President from 2006 to 2011. Before joining Allergan, Inc. in 1995, he held roles of increasing responsibility in marketing and sales at Syntex Corporation and Eli Lilly & Co. Mr. Ball served on the board of directors of several organizations, including Kythera Biopharmaceuticals Inc., Hospira, Inc., IntraLase Corp., AdvaMed and sTec, Inc. He began his career in the healthcare industry in 1981. Mr. Ball has been a member of the board of directors of the Ophthalmology Foundation since 2021.
He holds a Bachelor of Science and a Master of Business Administration from Queen’s University in Canada.
Key Competencies: Global Business Operations, Healthcare Industry and Marketing

Age: 66
Citizenship:
Canada and United States
Year of initial
appointment:
2019
Expiration of current
term of office:
2022

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Lynn D. Bleil
An experienced healthcare industry consultant with nearly three decades of experience as a Senior Partner at McKinsey & Company combined with her valuable experience as a director of publicly-held healthcare and life sciences companies, Lynn D. Bleil brings to the Board extensive US and Swiss experience, strategy and leadership. Ms. Bleil has been a member of the boards of directors of Stericycle, Inc. since 2015 (where she chairs the Nominating & Governance Committee), Sonova Holding AG since 2016 and Amicus Therapeutics, Inc. since 2018. She is a former member of the board of directors of DST Systems Inc. and Auspex Pharmaceuticals, Inc. (until their sale to SS&C Technologies Holdings, Inc. and Teva Pharmaceutical Industries, Ltd., respectively). From 1985 through 2013, Ms. Bleil was a Senior Partner at McKinsey & Company.
Ms. Bleil holds a Bachelor of Science in Chemical Engineering from Princeton University and a Master of Business Administration from the Stanford Graduate School of Business, both in the United States.
Key Competencies: Financial, Healthcare Industry and Regulatory/Public Policy


Age: 58
Citizenship:
United States
Year of initial
appointment:
2019
Expiration of current
term of office:
2022
Except as noted below, we are not party to any material contracts other than those entered into in the ordinary course of business.
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1.  The Company's $2.0 billion Commercial Paper Program (the "CP Program"), under which Nestlé guaranteed the commercial paper issued and assisted
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Arthur Cummings, M.D.
As a native of South Africa with a large ophthalmology practice in its management, was terminated priorIreland whose opinion is frequently sought by innovators in ophthalmology, Arthur Cummings, M.D. brings to the changeBoard an international perspective of majority ownership.  We paid Nestléa physician entrepreneur and practical first-hand knowledge of the innovation that ophthalmologists seek. Dr. Cummings has been Consultant Ophthalmologist at Beacon Hospital, since 2007, and Owner and Medical Director at Wellington Eye Clinic, since 1998, both in Dublin, Ireland. Also, he has been Owner of Arthur Cummings Eye Clinic Ltd. since 2014.
Dr. Cummings holds a Bachelor of Science in Medicine and Surgery (MB. ChB.) and a Master of Medicine in Ophthalmology (M. Med) from the University of Pretoria, South Africa. Dr. Cummings is a Fellow of the College of Surgeons in South Africa (FCS SA) in Ophthalmology and a Fellow of the Royal College of Surgeons of Edinburgh (FRCSEd) in Ophthalmology.
Key Competencies: Healthcare Industry, Marketing and Technology
Age: 59
Citizenship:
Ireland and South Africa
Year of initial
appointment:
2019
Expiration of current
term of office:
2022
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David J. Endicott
A lifelong healthcare executive with leadership experience at global pharmaceutical and medical device companies, David J. Endicott is the Chief Executive Officer of Alcon and brings to the Board an annual fee basedin-depth knowledge of Alcon as well as the healthcare industry. He joined the Alcon Division, when still operating under the Novartis group, in July 2016 as President, Commercial and Innovation, and Chief Operating Officer. Prior to joining the Alcon Division in 2016, Mr. Endicott was President of Hospira Infusion Systems, a Pfizer company. Before joining Hospira, Mr. Endicott served as an officer and executive committee member of Allergan, Inc. where he spent more than 25 years of his career in leadership roles across Europe, Asia and Latin America, as well as the U.S. Mr. Endicott served on the average outstanding commercial paper balances. We believe that fees paid by usboard of directors of Zeltiq, Inc. and Orexigen Therapeutics, Inc. He currently serves on the board of AdvaMed.
He holds an undergraduate degree in Chemistry from Whitman College and a Master’s degree in Business Administration from the University of Southern California, both in the United States.
Key Competencies: Global Business Operations, Healthcare Industry and Marketing

Age: 56
Citizenship:
United States
Year of initial
appointment:
2019
Expiration of current
term of office:
2022







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Thomas Glanzmann
Thomas Glanzmann, a venture capital investor with Medtech Ventures Partners where he evaluates and invests in medical device companies, brings those strategic insights and financial and risk management experience to Nestlé for their guarantee of any indebtedness or for the managementBoard, as well as his decades long experience in the healthcare industry. Thomas Glanzmann is the Founder and has been a Partner at Medtech Ventures Partners since 2017. He has been a member of the CP Program were comparable toboard of directors of Grifols S.A. since 2006, including serving as Vice Chairman since 2017 and the fees that would be paid in an arm's length transaction.  Total fees paid to Nestlé for the years ended December 31, 2010, 2009 and 2008 were less than $1 million in each year.

In October 2005, the parties executed a Guarantee Fee and Commercial Paper Program Services Agreement (the "Services Agreement"), effective as of October 28, 2002, which is incorporated by reference as an exhibit to this annual report.  Through this Services Agreement, the parties more formally documented the pre-existing CP Program.  The Services Agreement stated that Nestlé would:  (i) provide a guarantee in favor of the holders of notes issued by Alcon Capital Corporation, Alcon, Inc.'s indirect wholly owned subsidiary, as part of the CP Program and (ii) manage the CP Program.  This agreement alsoPresident of its Sustainability Committee. He was terminated prior to the change of majority ownership.

2.  All prior lending commitments under unsecured demand notes payable to various Nestlé affiliates were terminated prior to the change of majority ownership.

3.  On January 1, 2004, the Company entered into an agreement whereby Nestec S.A., an affiliate of Nestlé, provided certain treasury and investment services for the Company for a fee that was comparable to fees that would be paid in an arm's length transaction.  The agreement was terminated prior to the change of majority ownership.  Total fees paid to Nestec S.A. for the years ended December 31, 2010, 2009 and 2008 were $1 million or less annually.

4.  On January 12, 2009, Alcon Laboratories, Inc. entered into an employment contract under which it is to employ Kevin J. Buehler as President and Chief Executive Officer of Alcon Laboratories,Gambro AB from 2006 to 2011 and Chief Executive Officer and Managing Director of HemoCue AB from 2005 to 2006. Mr. Glanzmann was Senior Advisor to the Executive Chairman and Acting Managing Director of the World Economic Forum from 2004 to 2005. From 1988 to 2004, Mr. Glanzmann worked in various positions at Baxter International Inc., including President of Baxter Bioscience, Chief Executive Officer of Immuno International Co., Ltd. and Alcon,President of Europe Biotech Group. In 2004, he was a Senior Vice President and Corporate Officer of Baxter Healthcare Corporation and Baxter World Trade Corporation.
He holds a Bachelor of Science in Political Science from Dartmouth College in the United States, a Master of Business Administration from the IMD Business School in Switzerland and a Board of Directors Certification from the UCLA Anderson School of Management in the United States.
Key Competencies: Global Business Management, Healthcare Industry and Technology

Age: 63
Citizenship:
Switzerland
Year of initial
appointment:
2019
Expiration of current
term of office:
2022
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D. Keith Grossman
D. Keith Grossman, with more than 35 years of experience with medical devices and supplies, including as Chief Executive Officer of publicly held healthcare companies, brings to the Board his executive and board leadership experience as well as operational and strategic planning expertise in the healthcare industry. He has been the Chairman, Chief Executive Officer and President of Nevro, Inc. since March 2019. He has also been Chairman of the board of directors of Outset Medical, Inc. since 2014. He was President and subjectChief Executive Officer of Thoratec Corporation from 1996 to shareholder approval,2006 and from 2014 to 2015 and was a member of the board of directors from 1996 to 2015. Mr. Grossman was Chief Executive Officer and a member of the board of directors at Conceptus, Inc. from 2011 to 2013. He was Managing Director and Senior Advisor at TPG Capital, L.P. from 2007 to 2011. Mr. Grossman also served as a member of the Alcon, Inc. board of directors.  The agreement contains terms providing that Mr. Buehler will receive an annual base salary plus a performance bonus, assuming specified performance objectives are achieved.  The agreement also provides that Mr. Buehler will be entitled to a lump sum payment if Alcon elects to terminate the agreement without cause or declines to renew the agreement. In addition, under the agreement, Mr. Buehler is entitled to receive an initial long term incentive grant.

5.  On January 15, 2009, Alcon, Inc. entered into a services agreement with Cary R. Rayment in which Alcon agreed to appoint Mr. Rayment as the non-executive chairman of its board of directors commencingof ViewRay, Inc. from 2018 to 2021, Zeltiq, Inc., as Lead Director, from 2013 to 2017, Intuitive Surgical, Inc. from 2004 to 2010 and Kyphon Inc. in 2007 and served on April 1, 2009, followinga number of private boards of directors.
Mr. Grossman holds a Bachelor of Science in Animal Sciences from The Ohio State University and Master of Business Administration in Finance from Pepperdine Graziadio Business School at Pepperdine University, both in the United States.
Key Competencies: Healthcare Industry, International Supply Chain and Technology
Age: 61
Citizenship:
United States
Year of initial
appointment:
2019
Expiration of current
term of office:
2022
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Scott Maw
An experienced financial executive with over two decades of experience at global companies, including Chief Financial Officer of Starbucks Corporation, Scott Maw contributes to the Board his retirement asextensive understanding of complex financial analysis and reporting and internal controls over financial reporting of a global company. He has been a member of the Company'sboard of directors of Avista Corporation since 2016, where he is the Chair of the Compensation Committee; Chipotle Mexican Grill Inc. since 2019, where he is the Lead Independent Director and Chair of the Audit Committee; and Root, Inc. since 2020. Mr. Maw is also member of the board of trustees of Gonzaga University. Previously, he was Executive Vice President and Chief Executive Officer.  The Financial Officer at Starbucks Corporation from 2014 until the end of 2018, Senior Vice President in Corporate Finance from 2012 to 2013 and Senior Vice President and Global Controller from 2011 to 2012. From 2010 to 2011, he was Senior Vice President and Chief Financial Officer of SeaBright Holdings, Inc. From 2008 to 2010, he was Senior Vice President and Chief Financial Officer of the Consumer Bank at JP Morgan Chase and Company. Prior to this, Mr. Maw held leadership positions in finance at Washington Mutual, Inc. from 2003 to 2008 and GE Capital from 1994 to 2003.
Mr. Maw holds a Bachelor of Business Administration in Accounting from Gonzaga University in the United States.
Key Competencies: Financial, Global Business Operations and Consumer Industry
Age: 54
Citizenship:
United States
Year of initial
appointment:
2019
Expiration of current
term of the agreement commenced on April 1, 2009 and renews automatically on an annual basis thereafter unless or until terminated by either party upon thirty days written notice.  Mr. Rayment was paid the customary Alcon, Inc. director compensation plus an additional amount relating to his duties as non-executive chairman of the board.office:
2022

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On October 24, 2010, Mr. Rayment ceded his position as chairman
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Karen May
Karen May, who possesses a unique combination of having been both a financial executive and a human resource executive of global companies, brings to the Board extensive operational, financial and human capital strategy experience. Ms. May has been a member of the board andof directors of Ace Hardware Corporation, where she is Chair of the Audit Committee, since 2017. Previously, Ms. May was appointed vice chairman.  At the December 2010 meeting,on the board approved extending Mr. Rayment's agreementof directors of MB Financial, Inc., where she served as Chair of the Compensation Committee until 2019. From 2012 to 2018, she was Executive Vice President and Chief Human Resources Officer at Mondelez International, Inc. (name changed from Kraft Foods, Inc. after the spin-off of select Kraft North American businesses in 2012). From 2005 to 2012, Ms. May was the Executive Vice President and Chief Human Resources Officer of Kraft Foods, Inc. Between 1990 and 2005, she held various positions in Human Resources and Finance at Baxter International Inc., including Corporate Vice President and Chief Human Resources Officer, Vice President, International Finance, and Vice President, Division Controller. Prior to Baxter International Inc., Ms. May was a Certified Public Accountant in the audit practice of Price Waterhouse.
Ms. May holds a Bachelor of Science in Accounting from the University of Illinois in the United States.
Key Competencies: Human Capital Management, Financial and Consumer Industry
Age: 63
Citizenship:
United States
Year of initial
appointment:
2019
Expiration of current
term of office:
2022







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Ines Pöschel
Ines Pöschel brings to the Board not only her deep experience as a Swiss lawyer, particularly in corporate governance, capital markets and mergers and acquisitions, but her extensive leadership roles in public policy with the same remunerationher appointments on government and public commissions. Ms. Pöschel has been a monthly basis for his service as vice chairmanPartner at Kellerhals Carrard Zurich KIG since 2007. She has been a member of the board untilof directors of Implenia AG since 2016 and Graubündner Kantonalbank since 2018 and serves on the next annual general meetingboard of directors of several non-listed Swiss companies. Ms. Pöschel is also a member of the shareholders.Swiss Federal expert commission for commercial register. From 2002 to 2007, Ms. Pöschel was a Senior Associate at Bär & Karrer AG. She was a Senior Manager at Andersen Legal LLC from 1999 to 2002.
Ms. Pöschel has a Master in Law from the University of Zurich in Switzerland, and passed the Swiss Bar Exam in 1996.
Key Competencies: Government Relations, Legal/Governance and Regulatory/Public Policy
Age: 53
Citizenship:
Switzerland
Year of initial
appointment:
2019
Expiration of current
term of office:
2022
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Dieter Spälti, Ph.D.
As an executive of Spectrum Value Management Ltd., the family office of an iconic industrial Swiss family, Dr. Spälti oversaw all of its investments for nearly two decades, which allows Dr. Spälti to bring to the Board significant financial and operational experience in addition to his previous consulting experience with numerous industrial, financial and technology firms in Europe, the US and Southeast Asia. Dr. Spälti has been Vice Chair since May 2021 and a member of the board of directors at Spectrum Value Management Ltd., Switzerland since 2006 and Managing Partner from 2002 to 2006. He served as Chief Executive Officer of Spectrum Value Management Ltd., from 2006 through May 2021. He has been a member of the board of directors at Holcim Ltd. since 2003 and became its Vice Chair in May 2021. Dr. Spälti served, or continues to serve, on the board of directors of various non-listed Swiss and international companies, including several that are controlled by the same beneficial owner. Dr. Spälti was a Partner at McKinsey & Company from 1993 to 2001.
He holds a Ph.D. in Law from the University of Zurich, Switzerland.
Key Competencies: Financial, Legal/Governance and Technology
Age: 61
Citizenship:
Switzerland
Year of initial
appointment:
2019
Expiration of current
term of office:
2022
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Independence and Executive Function
The independence of Board members is a key element of Alcon’s corporate governance framework. Therefore, Alcon has developed a strong set of independence criteria for its board members based on international best practice standards, including the Swiss Code of Best Practices for Corporate Governance and the NYSE standards, which can be found in the Alcon Board Regulations, available under the investor relations portion of the Alcon website (https://investor.alcon.com/governance/governance/default.aspx).
The Board assesses the independence of its Board members on a regular basis, at least annually. As of December 31, 2021, all Board members qualified as independent according to Alcon independence criteria, except for F. Michael Ball, and David J. Endicott.
Other than Mr. Endicott, who currently serves as Alcon’s Chief Executive Officer, no Board member was a member of the management of the Company or any other Alcon consolidated subsidiary in the last three financial years up to December 31, 2021.
Mr. Ball, who previously served as Chief Executive Officer of the Alcon Division of Novartis and as a member of the Novartis Executive Committee from February 1, 2016 until June 30, 2018, served in an unofficial senior leadership role to Alcon during the period from June 30, 2018 until Alcon’s Spin-off from Novartis. Based on the foregoing, the Board made the determination that Mr. Ball was not independent as of December 31, 2021.
No Board member has a significant business relationship with the Company or with any other Alcon consolidated subsidiary.
Mr. Endicott is an executive member of the Board by reason of his function as Chief Executive Officer of Alcon. All other members of the Board are non-executive directors since none of them carries out operational management tasks within Alcon.
As of December 31, 2021, none of the Board members held any official government functions or political posts.
Limitations of Number of Mandates
No member of the Board may hold more than ten additional mandates in other companies, of which no more than four shall be in other listed companies. Chairs of the board of directors of other listed companies count as two mandates. Mandates in different legal entities which are under joint control are deemed one mandate. Further details can be found in Article 34 of the Articles of Incorporation, available under https://investor.alcon.com/governance/governance/default.aspx.
Elections and Terms of Office
The Board members, the Chair of the Board and the members of the Compensation Committee shall be elected individually by the General Meeting of Shareholders for a term of office lasting until completion of the next Annual General Meeting of Shareholders.
There is no mandatory term limit for Board members.
The rules in the Articles of Incorporation reflect the statutory legal provisions regarding the appointment of the Chairman, the members of the Board, the members of the Compensation Committee and the independent proxy.
Internal Organizational Structure
General Principles and Areas of Responsibilities
The Board constitutes itself in compliance with legal requirements and taking into consideration the resolutions of the General Meeting of Shareholders. It shall elect one or two Vice-Chairs. It shall appoint a secretary, who need not be a member of the Board.
The Board is the ultimate governance body of the Company, under the leadership of the Chair. F. Michael Ball has been the Chair of the Board since the Spin-off from Novartis. In this role, Mr. Ball leads the Board to represent the interests of all stakeholders. Notably, he (i) provides leadership to the Board, (ii) supports the CEO, (iii) ensures an efficient way of working with the Board's Committees, the CEO and the Executive Committee, (iv) leads the annual performance assessment and (v) ensures an effective communication with the shareholders, other stakeholders and the public.
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The Vice Chair is D. Keith Grossman, also acting in this role as Senior or Lead Independent Director. In this role, Mr. Grossman (i) leads the Board as long as the Chairman is incapacitated, (ii) chairs the sessions of the independent Board members, when necessary, and (iii) leads the independent board members in case of a crisis or matter requiring their separate consideration or decision.
The duties of Mr. Ball and Mr. Grossman in their respective functions are described in more detail in Articles 20 and 21, respectively, of the Alcon Board Regulations (https://investor.alcon.com/governance/governance/default.aspx).
The Board is responsible for the duties assigned to it by the Articles of Incorporation and the Alcon Board Regulations, which include the overall direction and supervision of management. It holds the ultimate decision-making authority for Alcon, with the exception of any decisions reserved to the shareholders. In performing its tasks, the Board follows the highest standards of ethics, integrity and governance. It undertakes annually a self-assessment process to evaluate its performance, the performance of its committees and the individual performance of its members.
Within the limits of the law and the Articles of Incorporation, the Alcon Board has delegated certain of its duties to the Executive Committee and the Board’s Committees.
Delegation to the Executive Committee
The Board has delegated to the Executive Committee the management of the business in accordance with the terms set forth in the Alcon Board Regulations. Such delegation has been formalized in Article 12 of the Alcon Board Regulations and further regulated in a set of internal regulations. Under the lead of the Chief Executive Officer, the Executive Committee is responsible for the management of the business and functions as a coordination committee, independent of any legal entity of the Alcon Group. A non-exhaustive list of the duties assigned to the Executive Committee can be found in Article 23 of the Alcon Board Regulations (https://investor.alcon.com/governance/governance/default.aspx).
Delegation to the Board’s Committees
The Board’s Committees enable the Board to work in an efficient and effective manner, ensuring a thorough review and discussion of matters, while giving the Board more time for deliberation and decision-making. For this purpose, the Board has delegated certain of its duties to each of its four permanent committees: the Audit and Risk Committee, the Compensation Committee, the Governance and Nomination Committee and the Innovation Committee.Details of the duties, responsibilities and decision-making powers of each committee can be found in the respective committee’s charter, contained in the Alcon Board Regulations, available under https://investor.alcon.com/governance/governance/default.aspx.
In 2021, the composition of the respective Board’s Committees was as follows:
NameAudit and Risk CommitteeCompensation CommitteeGovernance and Nomination CommitteeInnovation Committee
F. Michael BallMember
Lynn D. BleilMemberMember
Arthur CummingsMember
David J. Endicott
Thomas GlanzmannMemberMemberChair
D. Keith Grossman
Member1
ChairMember
Scott MawChair
Karen MayMemberChair
Ines PöschelMemberMember
Dieter SpältiMember
1 Keith Grossman served as a member of the Compensation Committee until the Alcon Annual General Meeting held on April 28, 2021. He withdrew his candidacy for re-election prior to the Annual General Meeting and thus did not serve as a member of the Compensation Committee after the 2021 Annual General Meeting.
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Audit and Risk Committee
The Audit and Risk Committee consisted of four members in 2021, all of whom were determined by the Board to be independent and in possession of the financial literacy and accounting or related financial management expertise, as defined in the NYSE standards. The Audit and Risk Committee meets and consults regularly with the management, the Alcon Internal Audit function, the independent external auditors and external consultants. The Audit and Risk Committee regularly reports to the full Board on its decisions and deliberations.
The primary responsibilities of this committee include:
supervising external auditors and selecting and nominating external auditors for election at the Annual General Meeting of shareholders;
overseeing internal auditors;
overseeing accounting policies, financial controls and compliance with accounting and internal control standards;
approving quarterly financial statements and financial results releases;
overseeing internal control and compliance processes and procedures;
overseeing compliance with laws and external and internal regulations;
ensuring that Alcon has implemented and maintained an appropriate and effective risk management system and process;
ensuring that all necessary steps are taken to foster a culture of risk-adjusted decision-making without constraining reasonable risk-taking and innovation;
approving guidelines and reviewing policies and processes; and
reviewing with management, internal auditors and external auditors the identification, prioritization and management of risks; the accountabilities and roles of the functions involved in risk management; the risk portfolio; and the related actions implemented by management.
Compensation Committee
The Compensation Committee consisted of three members in 2021, all of whom were determined by the Board to be independent1. The Compensation Committee meets and consults regularly with management and external consultants. The Compensation Committee regularly reports to the full Board on its decisions and deliberations.
The primary responsibilities of this committee include:
developing a compensation philosophy in line with the principles set forth in the Articles of Incorporation and submit to the Board;
providing oversight for Alcon's human capital strategy, including talent management, CEO and ECA succession planning, diversity and inclusion initiatives and pay equity measures;
designing, reviewing and recommending to the Board compensation policies and programs;
reviewing and approving a peer group of companies for executive compensation comparisons;
advising the Board on the compensation of Directors and the Chief Executive Officer of Alcon;
determining the compensation of ECA members;
supporting the Board in preparing the proposals to the General Meeting of Shareholders regarding the compensation of the members of the Board and ECA;
preparing the annual compensation report and submitting it to the Board for approval;
establishing executive and director stock ownership guidelines and stock trading policies and monitoring compliance with such policies; and
overseeing communication and engagement on executive compensation matters with shareholders and their advisors.
1The Compensation Committee operated with four members until the Alcon Annual General Meeting held on April 28, 2021, from which it then consisted of three members only.
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Governance and Nomination Committee
The Governance and Nomination Committee consisted of four members in 2021. The Governance and Nomination Committee meets and consults regularly with management and external consultants. The Governance and Nomination Committee regularly reports to the full Board on its decisions and deliberations.
The primary responsibilities of this committee include:
designing, reviewing and recommending corporate governance principles to the Board;
overseeing Alcon's strategy and reputation regarding ESG matters and annually approve Alcon's Corporate Responsibility Report;
establishing criteria and identifying candidates for election as Directors;
assessing existing Directors and recommending to the Board whether they should stand for re-election;
developing and reviewing an onboarding program for new Directors and an ongoing education plan for existing Directors;
reviewing periodically the Articles of Incorporation with a view to reinforcing shareholder rights;
reviewing periodically the composition and size of the Board and its committees;
direct periodic assessments of the Board, directors and committees;
reviewing annually the independence status of each Director; and
reviewing directorships and agreements of Directors for conflicts of interest and dealing with conflicts of interest.
Alcon is committed to fostering a sustainable business that supports the well-being of our associates, customers, communities, and planet. The environmental, social, and governance (ESG) objectives of the Group are integrated into its decision-making to deliver long-term value for all of its stakeholders. ESG is of key importance within the Alcon governance framework and is subject to the oversight of the Board, acting principally through its Governance and Nomination Committee. Under the supervision of the Governance and Nomination Committee, the Alcon ESG Executive Steering Committee, supported by dedicated working groups, is tasked with the identification and management of environmental and social impacts. The implementation of the related strategy and day-to-day activities are conducted by subject matter experts across the enterprise, under the leadership of the Alcon Head of ESG.
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Innovation Committee
The Innovation Committee consisted of four members in 2021. The Innovation Committee meets and consults regularly with management. The Innovation Committee regularly reports to the full Board on its decisions and deliberations.
The primary responsibilities of this committee include:
providing counsel to the Board and management in the area of technology, application of technology and new business models;
reviewing and making recommendations to the Board on internal pipeline and external investments (e.g. potential acquisitions, equity investments, alliances and collaborations) relative to Alcon’s business portfolio, forecasted capital and operating capacity during the strategic and operating reviews;
reviewing, evaluating and advising the Board on the strategic direction and competitiveness of the innovation pipeline through the evaluation of key innovation metrics;
reviewing and recommending for approval any innovation goals/targets that may be incorporated into Alcon’s incentive compensation plans;
assisting the Board with oversight, risk management and evaluation of management’s criteria for selecting major new R&D and BD&L projects, assessing progress against major milestones, budget execution and post-launch revenue impact;
reviewing, discussing and informing the Board of significant emerging science, technology, programs, issues or trends relevant to Alcon; and
reviewing such other matters in relation to Alcon research and development, technology and innovation programs as the committee may, in its own discretion, deem desirable in connection with its responsibilities.
Frequency, Duration and Attendance of the Meetings of the Board of Directors and its Committees
The Board and its Committees are convened as often as the conduct of the business may require.
In 2021, the Board and its Committees met as follows:
Board of DirectorsAudit and Risk
Committee
Compensation CommitteeGovernance and Nomination CommitteeInnovation
Committee
Number of meetings1
89756
Approximate average duration2
4 hrs 50 min1 hrs 45 min2 h 20 min1 h 55 min1 hrs 45 min
Overall attendance100%100%100%100%100%
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During 2021, each Board member attended all of the meetings of the Board and each Committee on which he or she serves, as represented below:
Meeting attendanceBoard of DirectorsAudit and Risk
Committee
Compensation
Committee
Governance and Nomination CommitteeInnovation
Committee
Number of Meetings
8
Number of Meetings
9
Number of Meetings
7
Number of Meetings
5
Number of Meetings
6
F. Michael Ball85
Lynn D. Bleil896
Arthur Cummings86
David J. Endicott8
Thomas Glanzmann8756
D. Keith Grossman8
33
56
Scott Maw89
Karen May897
Ines Pöschel875
Dieter Spälti89
1    Thenumber of meetings includes physical meetings as well as meetings held through videoconference or conference call. In 2021, due to the ongoing COVID-19 pandemic, all but one meeting were held virtually.
2    The approximate average duration does not include dinners, lunches and breaks.
3    Keith Grossman served as a member of the Compensation Committee until the Annual General Meeting held on April 28, 2021 only.

Board Evaluation and Education
The Governance and Nomination Committee and the Chair of the Board coordinate an annual self-evaluation of the Board and its Committees, which includes individual interviews with the Board Chair and the completion of a confidential survey by Board members. The Chair summarizes for the Board the results of the evaluation, and any findings are appropriately addressed. In addition, each Committee conducts its own self-evaluation annually.
The Board recognizes the value of independent development and learning by its members. Therefore, it established a Director Education Program for its members, the purpose of which is to provide for internal and external speakers on trending topics, experiential learning of Alcon and its industry through site tours and product demonstrations and, at each Board member’s option, externally provided coursework. The intent of the Director Education Program is to ensure Board members are well-versed in matters related to Alcon, its business and the rapidly changing corporate governance environment.
Information and Control System of the Board vis-à-vis the Management
The Board ensures that it receives through several channels sufficient information from the Executive Committee to perform its supervisory duties and to make the decisions that are reserved to it by law, i.e. its non-delegable decisions.
Information to the Board of Directors
The Alcon Board Regulations confer to the members of the Board the right to have full and unrestricted access to management and employees of the Company and its subsidiaries in the execution of their duties. Also, the Chief Executive Officer regularly informs the Board on business developments, including significant transactions and risk issues. The Board and its Committees meet as often as required with the Chief Executive Officer and members of the Executive Committee or other members of the senior management. Further, the Board may invite, in accordance with the Alcon Board Regulations, external advisors to attend board or committee meetings in order to obtain a third party independent perspective on certain topics. Information is further communicated to the Board through regular reports (please refer to the section below “Alcon Management Information System”).
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Alcon Management Information System
The Board receives monthly reports on the financial performance of the Company, including the performance of the Surgical and Vision Care franchises. On a quarterly basis, prior to the release of each quarter’s results, the Board receives the Consolidated Financial Statement information and an outlook of the full-year results in accordance with IFRS and “core” results together with related commentary.
On an annual basis, the Board receives and approves the financial targets for the following year. Mid-year, the Board met for a strategic review of the business and approved the strategic plan for the next five years.
Additionally, throughout the year, the Board directly or through its Committees also received reports on, among other things:
the enterprise risk management program and risk assessment reports;
the compliance program;
the internal audit function;
manufacturing and technical operations;
research & development and product pipeline;
organic and inorganic innovation;
commercial strategies and product launches;
digital commerce opportunities;
legal matters;
competitive developments; and
industry trends.
In matters of significance, the Board receives direct, immediate information.
Internal Audit
The purpose of the internal audit function is to review Alcon’s financial, operational, IT and compliance activities to review compliance with laws, regulations and internal policies. It also supports Alcon’s efforts to maintain accurate and timely financial reporting while seeking to add value by suggesting improvements to Alcon’s operations and to assist Alcon in achieving its strategic and financial objectives. Internal audit is led by the Chief Audit Executive (“CAE”) who functionally reports to the Audit and Risk Committee. The CAE is responsible for the development, review and modification of Alcon’s internal audit policies and procedures. The CAE shall ensure effectiveness and efficiency of the internal control framework with existing policies and regulations and proposes remediation actions where deficiencies were identified. The CAE periodically submits to the Audit and Risk Committee reports on the activities of the internal audit function. In 2021, internal audit was involved in a total of 36 audit engagements. The results and remediation status of these audit engagements are reported to the Audit and Risk Committee on a periodic basis. At the final meeting for the year 2021, the ARC reviewed and approved the Internal Audit plan for 2022.
Internal Control System
Alcon's internal control system is designed to provide reasonable assurance to the Board and management regarding the reliability of financial reporting and accounting policies and the preparation and the presentation of the Company’s financial statements. In 2021, the Alcon's internal controls framework has been fully tested for effectiveness. The Audit and Risk Committee has ultimate responsibility to oversee the adequacy and effectiveness of internal control over financial reporting.
Risk Management
The Audit and Risk Committee has the responsibility to ensure the implementation of an appropriate and effective risk management system and process and to foster a culture of risk-adjusted decision-making without constraining reasonable risk taking and innovation. It approves guidelines and reviews policies and processes. In addition, the Audit and Risk Committee reviews with management, internal auditors and external auditors, the identification, prioritization and management of the risks, the accountabilities and roles of the functions involved with risk management, the risk portfolio and the related actions implemented by management. The Audit and Risk Committee informs the Executive Committee
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and the Board on a periodic basis on the risk management system and on the most significant risks and how these are managed. The CAE supports the Audit and Risk Committee and perform appropriate reviews of Alcon's risk management strategy.
Alcon’s key risk management tool is the Enterprise Risk Management ("ERM") program, the purpose of which is to help execute on Alcon’s strategy within the boundaries of regulations and improve the probability for achieving Alcon’s strategic and financial objectives. Alcon’s vision is to design a sustainable and appropriately scaled ERM program to proactively manage existing and emerging threats and opportunities to the business. The ERM program aims in particular to provide the business with the following: (i) operation discipline and rigor to enable business continuity, creation and preservation of value, (ii) forums for frequent risk discussions and escalation of relevant items with leadership, and (iii) guidance, techniques and support to identify, assess (e.g. likelihood and impact), manage, monitor and report on major risks, including proper mitigation if necessary. The ERM program is under the supervision of a dedicated committee that is comprised of senior members of the management and the members of the Audit and Risk Committee.
Compliance Function
As part of its global control system, Alcon has also established a comprehensive global integrity and compliance program, under the supervision of the Audit and Risk Committee. The program is led by the Global Head, Integrity and Compliance under the functional leadership of Alcon’s General Counsel and is intended to help prevent, detect and mitigate compliance risk across the organization. The program is built on a culture and expectation of compliance at all levels. The fundamental elements of the program include dedicated resources to address compliance globally, formal compliance governance, a global intake process to receive questions and concerns (including through the Alcon's Ethics Helpline), written standards, communications, training, multiple levels of risk-based auditing and monitoring, review of alleged misconduct and corrective/disciplinary actions for violations. The Audit and Risk Committee of the Board receives periodic updates on the performance of the Integrity and Compliance program and compliance related matters. The program also includes compliance committees, which have been established at the corporate, regional and country-levels and include participation by the Executive Committee and other senior leadership to provide strategic direction and oversight relating to the management of compliance risks for Alcon. Policies are reviewed and updated on a regular basis to address changes in laws and regulations and to strengthen compliance.

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Executive Committee
Composition of the Executive Committee
As of December 31, 2021, the Executive Committee of Alcon was composed of the following members:
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David J. Endicott, Chief Executive Officer
Please refer to the biography set forth under "Board of Directors."
Age: 56
Citizenship:
United States
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Tim C. Stonesifer, Chief Financial Officer
Tim Stonesifer has been the Chief Financial Officer since April 2019. Prior to joining Alcon, he had served as Executive Vice President and Chief Financial Officer at Hewlett Packard Enterprise from November 2015 through September 2018. Prior to that role, Mr. Stonesifer acted as Senior Vice President and Chief Financial Officer, Enterprise Group at HP Co. since 2014. Before joining HP Co., he served as Chief Financial Officer of General Motors’ International Operations from 2011 to 2014. Previously, he served as Chief Financial Officer of Alegco Scotsman, a storage company, from 2010 to May 2011; Chief Financial Officer of Sabic Innovative Plastics (formerly GE Plastics) from 2007 to 2010; and various other positions at General Electric since joining the company in 1989.
Mr. Stonesifer holds a Bachelor of Arts in Economics from the University of Michigan in the United States.
Age: 54
Citizenship:
United States
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6.  On February 27, 2008, Alcon entered into a letter agreement with Sabri Markabi, M.D.
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Laurent Attias, Head Corporate Development, Strategy, Business Development and Licensing (BD&L) and Mergers and Acquisitions (M&A)
Laurent Attias is Head of Corporate Development, Strategy, BD&L and M&A where he leads the development of long-term strategic plans for the positionSurgical and Vision Care franchises of Alcon and is responsible for the Alcon’s BD&L, M&A, partnerships and alliance activities, a role which he has held since 2012. Since 1994 when Mr. Attias joined Alcon, he has had various roles with increasing responsibility beginning with positions in Alcon’s Sales and Marketing functions and then holding the positions of Vice President, Refractive Sales and Marketing from 2002 to 2007; Vice President/General Manager of Alcon Canada from 2007 to 2009; Vice President, Central & Eastern Europe, Italy and Greece from 2009 to 2010; and President, Europe, Middle East and Africa (“EMEA”) from 2010 to 2012.
Mr. Attias holds both a Bachelor of Business Administration in Marketing and a Master of Business Administration from Texas Christian University in the United States.

Age: 54
Citizenship:
France and United States
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Ian Bell, President, Global Business & Innovation1
Ian Bell has been the President, Global Business & Innovation since September 2021 where he is responsible for driving the innovation pipeline for Alcon. From January 2019 until he was appointed to his current role, he was President-International, overseeing the Europe, Russia, Middle East and Africa, Asia Pacific, Japan and Latin America and Caribbean markets. He joined Alcon in March 2016 as President of EMEA. From 2014 until joining Alcon, Mr. Bell served as Corporate Vice President and President of the EMEA region for Hospira. Mr. Bell was Corporate Vice President and President of Allergan, Inc.’s Asia Pacific region, based in Singapore, from 2008 to 2014. Mr. Bell joined Allergan in 2005 as Vice President and Managing Director of its neurosciences division for the EMEA region. He began his career at GlaxoSmithKline, where he held roles of increasing responsibility and scope in sales, marketing and strategy for more than 10 years.
Mr. Bell was awarded the degree of Bachelor of Arts with honors in Economics from the University of York in the United Kingdom.
Age: 52
Citizenship:
United Kingdom
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Leon Sergio Duplan Fraustro, President North America
Sergio Duplan has served as President-North America, overseeing the United States and Canada markets since 2015. Mr. Duplan joined Alcon in 2012 and served as Alcon’s President of Latin America and Canada for Alcon for three years. Mr. Duplan began his career with Novartis in 2004, as Vice President of Sales in General Medicines, in Mexico then served as Head of Marketing and Sales for Latin America, General Medicines, Pharma from 2006 to 2008 and then Country Pharma Organization Head and Country President of Novartis Mexico from 2008 to 2012. Prior to joining Novartis, Mr. Duplan held several positions of increasing responsibility in Sales, Finance and Country Management at Procter & Gamble and Eli Lilly & Co. He is also currently a board member of The Alcon Foundation.
Mr. Duplan holds a Bachelor degree in Industrial Engineering from Universidad Iberoamericana in Mexico and a Master of Business Administration from The Wharton School at the University of Pennsylvania in the United States.
Age: 54
Citizenship:
Mexico and United States
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Rajkumar Narayanan, President, International2
Mr. Narayanan has been the President, International since September 2021 where he oversees the Europe, Russia, Middle East and Africa, Asia Pacific, China, Japan, Latin America and Caribbean markets. From April 2019 until he was appointed to his current role, he was Senior Vice President, Operational Strategy and Chief Transformation Officer and was responsible for leading the development and implementation of Alcon’s transformation program. He joined Alcon in June 2017 as President Asia Pacific Region from Allergan, Inc., where he worked for 22 years in roles of increasing responsibility, including Senior Vice President Asia Pacific Region from 2014 to 2017; Vice President and Managing Director of the Medical Aesthetic Franchise for Europe Africa and Middle East from 2011 to 2014; and Vice-President, Greater China & Japan from 2008 to 2011. Prior to those roles, Mr. Narayanan was a part of Allergan’s Finance function in a number of Country, Region and Corporate Finance roles. Mr. Narayanan started his career in finance with Hindustan Unilever India in 1987.
Mr. Narayanan holds a Bachelor of Science degree in Accounting and Finance from Mumbai University. He is also a Chartered Accountant and a Cost and Works Accountant in India.
Age: 57
Citizenship:
United States

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Sue-Jean Lin, SVP, Chief Information & Transformation Officer3
Sue-Jean Lin is Senior Vice President, Chief Information and Transformation Officer where she leads the technology initiatives within Alcon and is responsible for leading the development and implementation of Alcon’s transformation program. Ms. Lin joined Alcon in August 2018 as Senior Vice President, Chief Information Officer. Prior to joining Alcon, Ms. Lin was Senior Vice President and Chief Information Officer for Hill-Rom Holdings, Inc., a global medical technology company. Prior to joining Hill-Rom in 2016, she was the Senior Vice President and Chief Information Officer, and before that, the Vice President of Finance & Regional Controller (Europe, Middle East, and Africa and Asia Pacific) for Allergan, Inc. In 2015, she also served as Interim Executive for Presbyterian Healthcare Services in the capacity of Senior Vice President Research and Development.  Pursuant toChief Information Officer.

Ms. Lin holds both a Bachelor’s degree in Accounting and a Master’s degree in Business Administration from the termsUniversity of Nevada, Reno. She also completed the agreement, Alcon will pay Dr. MarkabiExecutive Leadership Program from the University of Southern California, Marshall School of Business, and holds a monthly base salaryCybersecurity Oversight certificate from Software Engineering Institute of Carnegie Mellon University.
Age: 63
Citizenship:
United Kingdom and he will be eligible for an annual performance bonus based upon the achievement of mutually agreed upon performance objectives.  If Alcon, Inc. undergoes a change of control and Dr. Markabi's employment with Alcon or the successor entity is terminated without cause or there is a material reduction in his responsibilities or a change in geographic location for his performance six months preceding or one year following such a change of control, Alcon or the successor entity will pay Dr. Markabi a lump sum payment.  The agreement provides that Dr. Markabi is eligible to participate in and receive various benefits under the programs generally available to members of Alcon's senior management.United States

1 Until September 1, 2021, Ian Bell served as President, International and was already a member of the Executive Committee of Alcon. As of this date, he was appointed President, Global Business & Innovation, replacing in this function Michael Onuscheck who simultaneously stepped down from his roles with the Company.
7.  On December 21, 2009, Alcon entered into a letter agreement with Merrick R. McCracken for the position of Senior Vice President, Global Human Resources.  Pursuant to the terms of the agreement, Alcon will pay Mr. McCracken an annual base salary and he will be eligible for an annual performance bonus based upon the achievement of mutually agreed upon performance objectives.  If Alcon, Inc. undergoes a change of control and Mr. McCracken's employment with Alcon or the successor entity is terminated without cause or there is a material reduction in his responsibilities or a change in geographic location for his performance six months preceding or one year following such a change of control, Alcon or the successor entity will pay Mr. McCracken a lump sum payment.  The agreement provides that Mr. McCracken is eligible to participate in and receive various benefits under the programs generally available to members of Alcon's senior management.
2 Rajkumar Narayanan was appointed President, International as of September 1, 2021, replacing in this function Ian Bell. He was previously a member of the Executive Committee of Alcon, serving as Senior Vice President, Operational Strategy and Chief Transformation Officer.

3 Sue-Jean Lin was appointed as a new member of the Executive Committee of Alcon as of September 1, 2021.
8.  On July 6, 2010, Alcon entered into an agreement to acquire privately held LenSx Lasers, Inc., a surgical device company located in Aliso Viejo, CA.  LenSx has developed and is nearing commercialization of a femtosecond laser system for use in cataract surgery.  Alcon paid LenSx stockholders $367 million in cash at closing and agreed to contingent payments of up to $383 million based on achievement and over-achievement of annual revenue targets over the next 5 years.  Following regulatory approval, the transaction closed on August 18, 2010.


Role of the Executive Committee
9.  On July 7, 2010, Alcon, as grantor, entered into the Alcon Litigation Trust Agreement with Thomas G. Plaskett, Joan W. Miller and Lodewijk J.R. De Vink, as trustees.  The irrevocable Trust was established under New York law pursuant to a resolution of the Alcon board of directors.  The Trust, which was funded with $50 million, is intended to provide the financial means to commence, defend or maintain litigation relating to any transaction between Alcon and a majority shareholder, including the transaction contemplated by the merger proposal announced by Novartis on January 4, 2010.  The Trust was dissolved and its property was returned to Alcon in December 2010 in connection with entry into the merger agreement below.
The members of the Executive Committee are appointed by the Board. In accordance with the Articles of Incorporation and the Alcon Board Regulations, the Board delegated the responsibility for the management of the business to the Executive Committee, under the lead of the Chief Executive Officer.

The Executive Committee shall in particular (i) develop strategies and policies and implement those upon approval by the Board, (ii) coordinate and monitor the group’s functions to achieve the business targets, (iii) ensure the efficient operation of the group, (iv) manage the proper provision and use of capacity and financial and other resources within the group and (v) ensure the development and succession of the senior management.
10.  On December 14, 2010, Novartis and Alcon entered into a merger agreement whereby the parties agree that, subject to certain conditions, Novartis and Alcon shall merge pursuant to Swiss law and in accordance with the merger agreement.  Novartis shall be the acquiring company which shall continue to operate, and Alcon shall be the transferring company which shall be dissolved upon completion.  By operation of law, Alcon's assets, liabilities and contracts shall be transferred to Novartis in their entirety.
Alcon has not entered into any management agreements with any third parties pursuant to which Alcon would delegate any business management responsibilities to any such third parties.

As of December 31, 2021, none of the members of the Executive Committee held any official functions or political posts.

Limitations of Number of Mandates
D.    EXCHANGE CONTROLS
No member of the Executive Committee may hold more than six additional mandates in other companies, of which no more than two additional mandates shall be in other listed companies. Each of these mandates shall be subject to approval by the Board. Members of the Executive Committee are not allowed to hold chairs of the board of directors of other listed companies. Further details can be found in Article 34 of the Articles of Incorporation, available under https://investor.alcon.com/governance/governance/default.aspx.

Compensation, Shareholdings and Loans
OtherPlease refer to "Item 6.B - Compensation".
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Shareholders’ Participations Rights
Voting-right Restrictions and Representation
Alcon has not imposed any restriction regarding share ownership or voting rights. Nominees shareholdings are not subject to any limitations. The right to vote at Alcon general meetings may only be exercised by a shareholder, usufructuary or nominee who is duly registered in Alcon share register on the record date for the applicable general meeting. Shareholders can be represented at general meetings by the independent proxy or by a third person authorized by written proxy who does not need to be a shareholder. As required by law, shareholders will also be given the opportunity to issue their voting instructions to the independent proxy electronically through an online voting platform.
Each Alcon share has the right to one vote. Shares held by the Company or any of its consolidated subsidiaries are not entitled to vote. Votes are taken either by a show of hands or by electronic voting, unless the General Meeting of Shareholders resolves to have a ballot or where a ballot is ordered by the chairman of the meeting.
Statutory Quorums
Unless otherwise required by law, the General Meeting passes resolutions and elections with the absolute majority of the votes duly represented.
According to Article 704 of the Swiss Code of Obligation, the following shareholders’ resolutions require the approval of at least two thirds of the votes represented at a General Meeting of Shareholders: (1) an alteration of Alcon’s corporate purpose; (2) the creation of shares with increased voting powers; (3) an implementation of restrictions on the transfer of registered shares and the removal of such restrictions; (4) an authorized or conditional increase of the share capital; (5) an increase of the share capital by conversion of equity, by contribution in kind, or for the purpose of an acquisition of property or the grant of special rights; (6) a restriction or an exclusion of shareholders’ pre-emptive rights; (7) a change of Alcon’s registered office; (8) Alcon’s dissolution; or (9) any amendment to the Articles of Incorporation which would create or eliminate a supermajority requirement.
Swiss law further provides for a qualified majority for certain special resolutions, such as in case of merger or demerger.
Convocation of General Meetings
The Annual General Meeting shall be held within six months after the close of the financial year of the Company. Extraordinary General Meetings may be convened upon request of the Alcon Board, the auditors or one or more shareholders representing in aggregate not less than 10% of the Company’s share capital. At least 20 days before the General Meeting, the invitation including the agenda is published in the Swiss Gazette of Commerce and mailed to the registered shareholders.
Agenda
One or more Alcon shareholders whose combined shareholdings represent an aggregate nominal value of at least CHF 1 million may demand that an item be included in the agenda of a General Meeting of Shareholders. Such a demand must be made in writing at the latest 45 days before the meeting and shall specify the items and the proposals of such shareholder.
Registration in the Share Register
The share register of the Company is a non-public register, subject to confidentiality and privacy and data protections imposed on Alcon to protect registered shareholders. Alcon shares can be voted only if their relevant holder is registered in the Alcon share register by the record date determined by the Board. The Articles of Incorporation do not provide for any specific rule regarding the closure of the share register.
Quiet Periods
The Company has strict internal policies regarding insider trading, in line with applicable regulations and international best practice standards.
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Quiet Periods start fourteen days prior to the beginning of the last trading day of each calendar quarter and end following the first full trading day after the date of the release of the quarterly and/or annual results, unless otherwise designated by the Alcon Disclosure Committee. The Company has identified a certain number of Continuing Insiders, i.e. key individuals who may continuously be in possession of material non-public information, that are prohibited from trading in any Alcon securities during Quiet Periods and may trade in any such securities outside of Quiet Periods only with the prior written approval of the Company's corporate legal department.
In addition, Alcon associates may be designated Temporary Insiders in connection with government sanctionsconfidential projects. In this capacity, they are prohibited to trade, during a certain period of time defined as a No Trading Period, in any securities of either Alcon or another company in which any such Alcon associate may have acquired material non-public information.
Changes of Control and Defense Measures
Duty to Make an Offer
Under the Swiss Financial Market Infrastructure Act, shareholders and groups of shareholders acting in concert who acquire more than 33.3% of Alcon shares would be under an obligation to make an offer to acquire all remaining Alcon shares. Alcon has neither opted out from the mandatory takeover offer obligation nor opted to increase the threshold for mandatory takeover offers in the Articles of Incorporation.
Clauses on Change of Control
In accordance with the rules of the Ordinance against Excessive Compensation in Listed Companies, Alcon does not provide severance payments upon a change of control or “golden parachute” provisions in its agreements with its Directors, Executive Committee members or other members of senior management. Alcon’s Long Term Incentive Plan and Deferred Bonus Stock Plan, each applicable to all employee participants including Executive Committee members, provide for double trigger accelerated vesting of outstanding stock awards in the event a participant leaves the company for “good reason” or Alcon terminates the employee without “cause,” as such terms are defined in the plans, within two years following a change of control. If such a double trigger event occurs, the participant’s outstanding unvested awards would vest in full. In the case of Performance Share Units, awards less than 50% vested would vest at target and awards more than 50% vested would vest in accordance with Alcon’s actual performance, as determined by the Compensation Committee.
Auditors
Duration of the Mandate and Terms of Office of the Auditors
PricewaterhouseCoopers SA, Switzerland (“PwC Switzerland”), has been the statutory auditor of the Company since 2019 and conducts the audit activities required by Swiss law and the related SIX regulations. It was re-elected on April 28, 2021 for a term of one year until the 2022 Annual General Meeting. Mike Foley has been the auditor in charge of the statutory audit since 2019. Alcon has a policy to rotate the lead audit partner of the statutory auditor at least once every five years.
Separately, on February 16, 2021, the Company appointed PricewaterhouseCoopers LLP, United States (“PwC US”) (PCAOB ID No. 238), for a term of one year, as its independent registered accounting firm to conduct the audit activities required by US law and the related NYSE regulations. PwC US performs the audit from offices located in Fort Worth, Texas. The appointment of PwC US does not require approval of the Company’s shareholders.

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Auditing Fees and Additional Fees
The following table sets forth the amount of audit fees, audit-related fees, tax fees and all other fees billed or expected to be billed in aggregate by PwC Switzerland, PwC US and any other member firm of PricewaterhouseCoopers International Limited that rendered audit and related services to any member of Alcon, for the fiscal years ended December 31, 2021 and December 31, 2020:
($ millions)20212020
Audit fees9.4 10.3
Audit related fees0.2 0.2
Tax fees0.1 0.1
Total9.7 10.6
Audit fees include fees billed for professional services rendered for audits of our annual consolidated and standalone financial statements, reviews of consolidated quarterly financial information and statutory audits of the Company (including in particular the Compensation Report) and our subsidiaries.
Audit-related fees include fees billed for assurance and related services such as due diligence, accounting consultations and audits in connection with mergers and acquisitions, employee benefit plan audits, internal control reviews and consultations concerning financial accounting and reporting standards.
Tax fees include fees billed for professional services for tax compliance, tax advice and tax planning.
Control Measures over the Activities of the Auditors
The Board has delegated to the Audit and Risk Committee ("ARC") the oversight of the activities of the external auditors. The ARC evaluates on an annual basis the qualifications and performance of our auditors and will determine whether PwC Switzerland should be proposed to the general meeting to stand for re-election. The criteria applicable of the performance assessment of our auditors include professional competence, sufficiency of resources to complete the audit mandate, independence and objectivity, capability to provide effective and pragmatic recommendations and coordination with the ARC and other functions of the Alcon group, including internal audit.
Upon recommendation of the ARC, the Board proposed that the shareholders accept the audited Consolidated Financial Statements of the Alcon group and the financial statements of the Company.
The ARC is further responsible for the compensation of our auditors and pre-approve all auditing services, internal control-related services and non-audit services permitted under applicable statutory law, regulations and listing requirements.
In 2021, our auditors participated in five meetings of the ARC in order to discuss auditing matters and present the 2021 audit strategy and audit results. In addition, our auditors regularly meet in private session with the ARC and individually with the Chair of the ARC. Our auditors provide at least once a year to the ARC a report regarding (i) the external auditor’s internal quality-control procedures, (ii) any material issues raised by quality-control reviews or any inquiry or investigation by governmental or professional authorities, (iii) any step taken to deal with such issues and (iv) all relationships between the external auditor and the Alcon group.
Information Policy
Alcon is committed to pursuing an open and transparent communication with shareholders, suppliers, customers and other stakeholders. It publishes information in a professional manner in accordance with best practices and legal requirements.
Investor Relations
Effective communication with shareholders is an important part of Alcon's governance framework. Therefore, the Company is committed to actively engaging with shareholders and keeping them informed about Alcon's business, governance, strategy and performance, in accordance with applicable laws and regulations. Supported by the Investor Relations team, the Chair leads and supervises the annual shareholders outreach initiative, while the CEO and the CFO are responsible for the management of the day-to-day activities necessary to maintain transparent and open shareholders relationships. The Company believes good engagement and dialogue with the financial community is critical in securing
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support and confidence in management's leadership and Board's governance of Alcon. The Investor Relations team regularly organizes opportunities to learn about the Company through in-person and virtual meetings and product showcases throughout the year, subject to its quiet period policy.
Communications
Financial information is published in the form of annual and quarterly financial results, in accordance with internationally recognized accounting standards. Related material, including annual reports, Form 20-Fs, quarterly results releases, investors presentations and conference call webcasts are available on the Alcon website. From time to time, Alcon issues press releases regarding business developments. Investors may subscribe to receive via email distributions providing news and notification about Alcon. The dissemination of material information about business developments is made in accordance with the rules of the SIX and the NYSE.
Information contained in reports and releases may only be deemed accurate in any material respect at the time of the publication. Past releases are not updated to reflect subsequent events.
Alcon's website provides regular information and updates about the Company at www.alcon.com. Detailed information regarding certain topics may be found as follows:
TopicWebsite
Investor relationshttps://investor.alcon.com
Media releaseshttps://investor.alcon.com/news-and-events/press-releases/default.aspx
Leadershiphttps://investor.alcon.com/governance/leadership-team/default.aspx
Governancehttps://investor.alcon.com/governance/governance/default.aspx
Financialshttps://investor.alcon.com/financials/quarterly-results/default.aspx
Any information included on our internet websites or the information that might be accessed through such websites is not included in this Annual Report and is not incorporated into this Annual Report by reference.
Corporate Responsibility Report
Alcon publishes an annual Corporate Responsibility Report, which describes Alcon’s corporate responsibility strategy and highlights Alcon's approach to ESG matters, available at https://investor.alcon.com/governance/esg/default.aspx.
Differences in Corporate Governance Standards
According to the NYSE listing standards on corporate governance, listed foreign private issuers are required to disclose any significant ways in which their corporate governance practices differ from those governance practices that must be followed by NYSE-listed US domestic companies. We briefly summarize those differences in the following paragraphs.
Responsibility of the Audit Committee with regard to Independent Auditors
Our Audit and Risk Committee is responsible for the compensation, retention and oversight of our independent statutory auditors. It assesses the performance and qualification of our statutory auditors and submits its proposal for appointment, reappointment or removal of our statutory auditors to the full Board. As required by the Swiss Code of Obligations, our Board then submits its proposal to the shareholders for their vote at the Annual General Meeting (AGM). In contrast, under NYSE listing standards, the audit committee for US domestic companies is responsible for the appointment of the independent auditors.
Supervision of the Internal Audit Function
The CFO and the Audit and Risk Committee share the supervisory responsibility with respect to the internal audit function. In contrast, under NYSE standards, only the audit committee supervises the internal audit function.
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Responsibility of the Compensation Committee for Performance Evaluations of Senior Management
In line with Swiss law, our Compensation Committee, together with the Board, proposes for shareholder approval at the AGM the maximum aggregate amount of compensation for the Board and the maximum aggregate amount of fixed and variable compensation for the Executive Committee of Alcon. Our shareholders elect each of the members of the Compensation Committee at the Annual General Meeting. In contrast, under NYSE standards, it is the responsibility of the compensation committee to evaluate senior management performance and to determine and approve, as a committee or together with the other independent directors, the compensation for senior officers and the board. US domestic companies listed on NYSE are only required to provide shareholders a periodic advisory non-binding vote on a company’s executive compensation practices.
Shareholders’ Votes on Equity Compensation Plans
Swiss law authorizes the Board to approve equity-based compensation plans. Shareholder approval is only mandatory if equity-based compensation plans require an increase in capital. No shareholder approval is required if shares for issuance under such plans are purchased by the issuer in the open market. In contrast, the NYSE standards require shareholder approval for the establishment of and material revisions to all equity compensation plans.


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6.D. EMPLOYEES
The table below sets forth the breakdown of the total year-end number of our full-time equivalent employees by main category of activity for the past three years.
 For the year ended December 31,
 202120202019
Production & Supply12,362 12,237 11,026 
Marketing & Sales7,893 7,450 7,301 
General & Administration2,180 2,087 2,120 
Research & Development (including support)1,954 1,881 1,695 
Total full-time equivalent employees24,389 23,655 22,142 
Unions or works councils represent a significant number of our associates. We have not experienced any material work stoppages in recent years, and we consider our employee relations to be good.
6.E. SHARE OWNERSHIP
The information set forth under “Item 6.B. Compensation” is incorporated by reference. Also, refer to Note 24 to the Consolidated Financial Statements for a discussion of our equity-based compensation programs.
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ITEM 7.    MAJOR SHAREHOLDERS AND RELATED PARTY TRANSACTIONS
7.A. MAJOR SHAREHOLDERS
The information set forth under “Item 6. Directors, Senior Management and Employees—6.C. Board Practices—Corporate Governance” is incorporated by reference.
7.B. RELATED PARTY TRANSACTIONS
None.
7.C. INTERESTS OF EXPERTS AND COUNSEL
Not Applicable.

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ITEM 8.    FINANCIAL INFORMATION
8.A. CONSOLIDATED STATEMENTS AND OTHER FINANCIAL INFORMATION
Please refer to the financial statements beginning on page F-1 of this Annual Report.
Legal Proceedings
From time to time, we may become involved in litigation or may receive inquiries from regulatory authorities, including antitrust and competition authorities in various jurisdictions relating to matters arising from the ordinary course of business. In addition, we are from time to time and may in the future be subject to audit or investigation by tax authorities in the ordinary course of business in the various jurisdictions in which we operate. Our management believes that, except as described below, there are currently no claims or actions pending against us, the ultimate disposition of which could have a material adverse effect on our results of operations, financial condition or cash flows.
Contact lenses class actions
Since the first quarter of 2015, more than 50 class action complaints have been filed in several courts across the US naming as defendants contact lens manufacturers, including Alcon, and alleging violations of federal antitrust law, as well as the antitrust, consumer protection and unfair competition laws of various states, in connection with the implementation of unilateral price policies by the defendants in the sale of contact lenses. The cases have been consolidated in the Middle District of Florida by the Judicial Panel on Multidistrict Litigation and the claims are being vigorously contested. Trial is set for March 28, 2022.
JJSVI patent dispute
On June 23, 2020, Johnson & Johnson Surgical Vision, Inc. ("JJSVI"), acting through its subsidiaries, filed a patent infringement action in the US District Court in Delaware alleging that the manufacture, use, sale, offer for sale and/or importation of Alcon’s LenSx Laser System willfully infringes, directly and/or indirectly, one or more claims of 12 US patents. JJSVI subsequently amended its complaint to include copyright infringement claims relating to source code used in the LenSx Laser System as well as additional claims of patent infringement. Also beginning on June 23, 2020, JJSVI filed claims in Mannheim, Germany, alleging that Alcon directly infringes certain European patents through its manufacture and sale of LenSx. In these cases, JJSVI seeks monetary and injunctive relief. Alcon intends to defend all of these cases vigorously and has asserted various patent infringement and invalidity claims against JJSVI in Europe and the United States. The Delaware court has stayed the parties' US patent claims pending final written decisions by the Patent Trial and Appeal Board of the US Patent and Trademark Office in various ongoing inter partes review proceedings pertaining to the patents in the suit. Trial on the copyright claims in the Delaware action is set for February 2023.
Hoya patent dispute
On December 11, 2020, Hoya Corporation and one of its affiliates filed suit against Alcon in the US District Court for the Northern District of Texas alleging that Alcon's UltraSert Pre-Loaded Delivery System infringes six of Hoya's US patents. The court denied in part Alcon's motion to dismiss Hoya's complaint on September 20, 2021. Trial is set for April 2023. Alcon intends to defend the case vigorously.
Dividend Policy
Alcon expects that it will continue to recommend to shareholders the payment of a regular annual cash dividend based on the prior year’s core net income; however, the declaration, timing and amount, including potential increases, of any dividends will be imposed on Belarus,subject to the Democratic Republicapproval of Congo, Guinea,our shareholders at a General Meeting. The determination of the Islamic RepublicBoard as to whether to recommend a dividend and the approval of Iran, Republicany such proposed dividend by our shareholders will depend upon many factors, including our financial condition, earnings, corporate strategy, capital requirements of Iraq, Ivory Coast, Lebanon, Liberia, Myanmar (Burma),our operating subsidiaries, covenants, legal requirements and other factors deemed relevant by the Democratic People's Republic of Korea (North Korea), Sierra Leone, Sudan, Somalia, Zimbabwe, Eritrea, personsBoard and shareholders. For additional information, see "Item 3. Key Information—3.D. Risk Factors—Risks related to the assassinationOwnership of Rafik Hariri,our Shares—We may not pay or declare dividends".
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For information about deduction of the withholding tax or other duties from dividend payments, see "Item 10. Additional Information—10.E. Taxation—Swiss Taxation—Swiss Residents—Withholding Tax on Dividends" and "Item 10. Additional Information—10.E. Taxation—US Federal Income Taxation—Distributions on the Shares".
Past Dividends
On February 23, 2021, the Alcon Board of Directors proposed a dividend of CHF0.10 per share which was subsequently approved by the shareholders at the Annual General Meeting on April 28, 2021 and paid in May 2021 for an amount of $54 million.
8.B. SIGNIFICANT CHANGES
A discussion of significant changes in our business can be found under "Item 4. Information on the Company —4.A. History and Development of the Company", "Item 4. Information on the Company — 4.B. Business Overview" and "Item 5. Operating and Financial Review and Prospects — 5.A. Operating Results".
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ITEM 9.    THE OFFER AND LISTING
9.A. OFFER AND LISTING DETAILS
Alcon Inc. shares are listed on the SIX and the NYSE as global registered shares under the trading ticker “ALC”. As such, they can be traded and transferred across applicable borders, without the need for conversion, with identical shares traded on different stock exchanges in different currencies. During 2021, the average daily trading volume of Alcon Inc. shares was approximately 0.9 million shares on the SIX and approximately 0.8 million shares on the NYSE.
As of the date of this Annual Report, our shares are included in a number of indices, including the “Swiss Market Index”, or SMI, the principal Swiss index published by the SIX. This index contains 20 of the largest and most liquid stocks based on market capitalization and the most active stocks listed on the SIX. The SMI indicates trends in the Swiss stock market as a whole and is one of the most widely followed stock price indices in Switzerland.
9.B. PLAN OF DISTRIBUTION
Not applicable.
9.C. MARKETS
See “Item 9.A. Offer and listing Details.”
9.D. SELLING SHAREHOLDERS
Not applicable.
9.E. DILUTION
Not applicable.
9.F. EXPENSES OF THE ISSUE
Not applicable.
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ITEM 10.    ADDITIONAL INFORMATION
10.A. SHARE CAPITAL
Not Applicable.
10.B. MEMORANDUM AND ARTICLES OF ASSOCIATION
We incorporate by reference into this Annual Report the description of our Articles of Incorporation and our Regulations of the Board contained in our Registration Statement on Form 20-F, as amended, initially filed with the SEC on November 13, 2018 (File No. 001-31269).
10.C. MATERIAL CONTRACTS
Bridge Loan, Term Loan and Revolving Credit Facilities
In connection with the Spin‑off, we entered into a $1.5 billion unsecured 364‑day bridge loan facility with two extension options, each for a period of 180 days (the “Bridge Facility”), a $0.5 billion unsecured three‑year term loan facility (“Facility A”), a $0.8 billion unsecured five‑year term loan facility (“Facility B”), a $0.4 billion (or the equivalent in EUR) unsecured five‑year term loan facility (“Facility C”) and a $1.0 billion unsecured five‑year committed multicurrency revolving credit facility (the “Revolving Facility” and, together with the Bridge Facility, Facility A, Facility B and Facility C, the “Facilities” and the related agreement, the “Group Facilities Agreement”). In February 2021, the Revolving Facility term was extended to March 2026.
We and certain personsof our subsidiaries are borrowers under the Facilities. We guarantee the borrowings of such subsidiaries under the Facilities. In addition, the Revolving Facility includes a mechanism through which certain of our subsidiaries, as approved by the lenders, can accede as a borrower.
Prior to the Spin‑off, we borrowed an aggregate of approximately $3.2 billion under the Facilities and paid to Novartis approximately $3.0 billion of the net proceeds of the Bridge Facility, Facility A, Facility B and Facility C, including in satisfaction of certain intercompany indebtedness owed by Alcon and its subsidiaries to Novartis and its affiliates. We retained the remaining net proceeds of such Facilities for general corporate and working capital purposes. In September 2019, we used the proceeds of our Initial Notes Offering (as defined below) to pay off in full the Bridge Facility and Facility A. The Bridge Facility and Facility A are no longer available to us for borrowings.
We are permitted to voluntarily prepay loans under the Facilities, in whole or in part, without penalty or premium subject to certain minimum prepayment amounts and the payment of accrued interest on the amount prepaid and customary breakage costs.
The terms of the Facilities include certain events of default and covenants customary for investment grade credit facilities, including restrictive covenants that limit, among other things, the grant or incurrence of security interests over any of our assets, the incurrence of certain indebtedness and entry into certain fundamental change transactions. The Facilities do not contain any financial covenants.
The Facilities originally bore interest at a rate equal to the interest rate benchmark (EURIBOR in the case of loans denominated in EUR, USD LIBOR in the case of loans denominated in USD and CHF LIBOR in the case of loans denominated in CHF), plus an applicable margin. On December 14, 2021, we amended the terms of the Facilities in response to interest rate benchmark reform, which includes the replacement of certain interbank offered rates with alternative benchmark rates. The amended terms incorporate a mechanism to switch from the former RepublicFacilities’ original interest rates to compounded risk free rates, including any relevant credit adjustment spread.
As of Yugoslavia,December 31, 2021, $1.2 billion of borrowings was outstanding under the Facilities. Such indebtedness requires us to dedicate a portion of our future cash flows to payments on our debt, reducing our ability to use our cash flows to pay dividends, fund capital expenditures, BD&L or other strategic transactions, working capital and other general operational requirements.
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2019 Bond Offering
On September 23, 2019, Alcon Finance Corporation (the “Issuer”), an indirect, wholly owned subsidiary of Alcon, completed an offering of $500,000,000 aggregate principal amount of its 2026 Notes, $1,000,000,000 aggregate principal amount of its 2029 Notes and $500,000,000 aggregate principal amount its 2049 Notes (collectively, the "Initial Notes"). The Initial Notes were issued under an Indenture, dated September 23, 2019 (the “Indenture”), by and among the Issuer, Alcon Inc. and Citibank, N.A., as trustee (the “Trustee”). The Initial Notes are senior unsecured obligations of the Issuer and are fully and unconditionally guaranteed on persons or organizations with linksa senior basis by Alcon.
Interest is payable on the Initial Notes on March 23 and September 23 of each year, beginning on March 23, 2020. The 2026 Notes will mature on September 23, 2026, the 2029 Notes will mature on September 23, 2029 and the 2049 Notes will mature on September 23, 2049.
The Issuer may redeem the 2026 Notes prior to Osama bin Laden,July 23, 2026 (the date that is two months prior to their maturity date), the "al-Qaeda" group2029 Notes prior to June 23, 2029 (the date that is three months prior to their maturity date) or the Taliban,2049 Notes prior to March 23, 2049 (the date that is six months prior to their maturity date) at a redemption price equal to 100% of the principal amount of the applicable series of Initial Notes plus a “make-whole premium” and accrued and unpaid interest, if any, other similar sanctionsup to, but excluding, the redemption date. The Issuer may also redeem the 2026 Notes on or after the date that is two months prior to their maturity date, the Swiss government2029 Notes on or after the date that is three months prior to their maturity date or the 2049 Notes on or after the date that is six months prior to their maturity date at a redemption price equal to 100% of their principal amount plus accrued and unpaid interest, if any, to, but excluding, the redemption date.
In addition, the Issuer may impose against various countries, regimesredeem any series of the Initial Notes at its option, in whole, but not in part, for cash, at any time prior to their respective maturities at a price equal to 100% of the outstanding principal amount of such Initial Notes, plus accrued and unpaid interest, to, but excluding, the redemption date, if certain tax events occur that would obligate the Issuer to pay additional amounts as described in the Indenture.
Subject to certain limitations, in the event of a change of control triggering event, the Issuer will be required to make an offer to purchase each series of the Initial Notes at a price equal to 101% of the principal amount of the Initial Notes, plus accrued and unpaid interest, if any, to, but excluding, the date of repurchase.
The Indenture also contains certain limitations on the Issuer’s ability to incur liens, as well as customary events of default.
2020 Bond Offering
On May 27, 2020, the Issuer completed an offering of an additional $750,000,000 aggregate principal amount of its 2030 Notes. The 2030 Notes were issued under the same Indenture as the Initial Notes. The 2030 Notes are senior unsecured obligations of the Issuer and are fully and unconditionally guaranteed on a senior basis by Alcon.
Interest is payable on the 2030 Notes on May 27 and November 27 of each year, beginning on November 27, 2020. The 2030 Notes will mature on May 27, 2030.
The Issuer may redeem the 2030 Notes prior to February 27, 2030 (the date that is three months prior to their maturity date) at a redemption price equal to 100% of the principal amount of the 2030 Notes plus a “make-whole premium” and accrued and unpaid interest, if any, up to, but excluding, the redemption date. The Issuer may also redeem the 2030 Notes on or parties, thereafter the date that is three months prior to their maturity date at a redemption price equal to 100% of their principal amount plus accrued and unpaid interest, if any, to, but excluding, the redemption date.
In addition, the Issuer may redeem the 2030 Notes at its option, in whole, but not in part, for cash, at any time prior to their respective maturities at a price equal to 100% of the outstanding principal amount of such 2030 Notes, plus accrued and unpaid interest, to, but excluding, the redemption date, if certain tax events occur that would obligate the Issuer to pay additional amounts as described in the Indenture.
Subject to certain limitations, in the event of a change of control triggering event, the Issuer will be required to make an offer to purchase the 2030 Notes at a price equal to 101% of the principal amount of the 2030 Notes, plus accrued and unpaid interest, if any, to, but excluding, the date of repurchase.
The Indenture also contains certain limitations on the Issuer’s ability to incur liens, as well as customary events of default.
Acquisition Agreement
On November 5, 2021, Alcon exercised its option to purchase Ivantis, Inc. pursuant to an Option Agreement and Plan of Merger by and among Alcon Research, LLC, Ithaca Merger Sub, Inc., and Ivantis, Inc., dated as of November 9, 2018 (as subsequently amended, the "Merger Agreement"). Pursuant to the Merger Agreement, Alcon agreed to pay total upfront
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consideration of $475 million and potential contingent payments upon the achievement of certain regulatory and commercial milestones. As a result of the merger, which closed on January 7, 2022, Ivantis, Inc. became a wholly-owned subsidiary of Alcon. The transaction expanded Alcon's Surgical portfolio to include the Hydrus microstent, a minimally-invasive glaucoma surgery (MIGS) device for the treatement of mild-to-moderate glaucoma.
10.D. EXCHANGE CONTROLS
There are currently no Swiss governmental laws, decrees or regulations that restrict, in a manner material to Alcon, the export or import of capital, including but not limited to, Swissany foreign exchange controls, onor that generally affect the paymentremittance of dividends interest or liquidation proceeds, if any,other payments to non-resident holdersnon-residents or non-citizens of registeredSwitzerland who hold Alcon shares.


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12810.E. TAXATION

E.    TAXATION

The followingtaxation discussion set forth below is intended only as a general summary and does not purport to be a complete analysis or listing of the material Swiss tax and U.S. Federal incomeall potential tax considerations relevant to the ownership acquisition andor disposition of our common shares. By its nature, this summary includes only a general discussionThe statements of such tax consequencesUS and as such is not intended to be relied upon as tax advice.  DUE TO THE INHERENTLY INDIVIDUAL AND FACT SPECIFIC NATURE OF TAX CONSEQUENCES, ALL HOLDERS SHOULD CONSULT THEIR OWN TAX ADVISORS WITH RESPECT TO THE PARTICULAR TAX CONSEQUENCES TO THEM OF OWNING AND DISPOSING OF COMMON SHARES, INCLUDING THE EFFECTS OF SWISS FEDERAL, U.S. FEDERAL, STATE, LOCAL, FOREIGN AND OTHER TAXES.

For purposes of this discussion, a "U.S. Holder" is a holder that is any one of the following:

·  an individual who is a citizen or resident of the United States;

·  a corporation, or other entity taxable as a corporation, created or organized in or under the laws of the United States or of any political subdivision of the United States;

·  an estate the income of which is subject to U.S. Federal income taxation regardless of its source;

·  a trust if a court within the United States is able to exercise primary supervision over the administration of the trust and one or more U.S. persons have the authority to control all substantial decisions of the trust; or

·  a person otherwise subject to U.S. Federal income tax on its worldwide income.

If a partnership holds common shares, the tax treatment of a partner will generally depend upon the partner's circumstances and upon the activities of the partnership.  Partners of partnerships holding these common shares should consult their tax advisors as to the tax consequences of owning or disposing of common shares.

For purposes of this discussion, a "Swiss Holder" is any one of the following:

·  an individual who is a resident of Switzerland;

·  corporations and other legal entities that are incorporated in Switzerland;

·  corporations and other legal entities that are effectively managed and controlled in Switzerland;

·  a person otherwise subject to Swiss tax on its worldwide income; or

·  corporations or other legal entities that hold our common shares as part of a permanent establishment located in Switzerland.

A "Non-U.S. Holder" is a holder that is not a U.S. Holder. This discussion does not address the U.S. Federal, local, state, foreign or other tax consequences for Non-U.S. Holders (other than Swiss tax consequences for Swiss Holders) as a result of the ownership or disposal of common shares.  NON-U.S. HOLDERS SHOULD CONSULT THEIR TAX ADVISORS WITH RESPECT TO THE U.S. FEDERAL, LOCAL, STATE, FOREIGN AND OTHER TAX CONSEQUENCES TO THEM AS A RESULT OF THE OWNERSHIP OR DISPOSAL OF COMMON SHARES.

This summary is not a complete description of all of the tax consequences of the ownership or disposition of common shares. It islaws set forth below are based on the laws and regulations in force as of the date of this Annual Report, including the current tax laws of Switzerland andConvention Between the United States includingand the United StatesSwiss Confederation for the Avoidance of Double Taxation with Respect to Taxes on Income, entered into force on December 19, 1997 (the "Treaty"), and the US Internal Revenue Code of 1986, as amended its legislative history, temporary, existing and proposed(the "Code"), Treasury Regulations, U.S. Internal Revenue Service rulings, judicial decisions and judicial opinions,administrative pronouncements, all as in effect on the date of this reporthereof, and all of which are subject to change possibly(possibly with retroactive effect) and to differing interpretations.
Swiss Taxation
The following is a general summary of certain tax consequences relating to owning and disposing of Alcon shares based on the Swiss tax laws and regulations and regulatory practices in force on the date of this Annual Report. Tax consequences are subject to changes in applicable law (or subject to changes in interpretation), including changes that could have a retroactive effect.  Your individual circumstances may affect
This is not a complete summary of the potential Swiss tax effects relevant to the Alcon shares nor does the summary take into account or discuss the tax consequences arising from your ownership and disposallaws of common shares, and your particular facts or circumstances are not considered in the discussion below.


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The summary is not intended to apply to holders of common shares in particular circumstances, such as:

·  dealers in securities;

·  traders in securities who elect to apply a mark-to-market method of tax accounting;

·  financial institutions;

·  regulated investment companies;

·  tax-exempt organizations;

·  insurance companies;

·  persons holding common shares as part of a hedging, straddle, conversion or other integrated transaction;

·  holders who hold their common shares other than as capital assets;

·  persons whose functional currency is not the U.S. dollar;

·  certain U.S. expatriates;

·  Swiss Holders of common shares with a value of at least CHF 1 million;

·  persons subject to the U.S. alternative minimum tax; and

·  holders of common shares that will own directly or indirectly, or will be deemed to own, 10% or more of either the total voting power or the total value of our stock.

Furthermore,any jurisdiction other than Switzerland. For example, this summary does not describeaddress estate, gift, inheritance, capital or wealth taxes. It also does not take into account investors' individual circumstances. This summary does not purport to be a legal opinion or to address all the tax considerationsaspects that may be relevant to persons who acquired common shares pursuant to compensatory arrangements.any particular investor.

YOU ARE URGED TO CONSULT YOUR OWN TAX ADVISOR WITH RESPECT TO ACQUIRING, OWNING AND DISPOSING OF ALCON SHARES.
Swiss Tax ConsiderationsResidents

Swiss Withholding Tax on Dividends
Dividends that we pay and Similar Distributions

Dividends paid and otherany similar cash or in-kind distributions that are notwe may make to a repaymentholder of our shares (including distributions of liquidation proceeds in excess of the nominal value, stock dividends and, under certain circumstances, proceeds from repurchases of shares by us in excess of the shares or of qualifying additional paid-in capital made by us to a holder of common shares (including dividends on liquidation proceeds and stock dividends)nominal value) are generally subject to a Swiss federal withholding tax (the "Withholding Tax") at a current rate of 35%. The withholding tax will be withheldUnder certain circumstances distributions out of capital contribution reserves made by us onshareholders after December 31, 1996 are exempt from the Withholding Tax. We are required to withhold this Withholding Tax from the gross distributionsdistribution and will be paidto pay the Withholding Tax to the Swiss Federal Tax Administration.
Swiss Holders

A The Withholding Tax is refundable in full to Swiss Holderresidents who is an individual resident in Switzerland for tax purposes is generally entitled to a tax credit of the withholding tax incurred if that holder is the beneficial owner of such distributions at the time the distribution is due and duly reports the receipt thereof in the relevant tax return.

Legal entities incorporated in Switzerland or legal entities holding the common shares in the Company as part of a Swiss business operation or Swiss permanent establishment are generally entitled to a total refund of the withholding tax incurred if they are the beneficial ownerowners of suchthe taxable distribution at the time the distributionit is dueresolved and duly report the gross distribution received on their personal tax return or in their profit and loss statement.
U.S. Holders

A U.S. Holder who is an individual or a legal entity not resident in Switzerlandfinancial statements for tax purposes, as the case may be entitledbe.
The Swiss corporate tax reform, which entered into force on January 1, 2020, requires that Swiss listed companies must make distributions as dividends subject to a partial refund of the withholding tax incurred on a taxable distribution from us if the conditions of the bilateral tax
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treaty between the United States and Switzerland are satisfied.  A U.S. Holder who is a resident of the United States for purposes of the bilateral tax treaty between the United States and Switzerland is eligible for a reduced rate of withholding tax on dividends equal to 15% of the dividend, provided that such holder (i) qualifies for benefits under this treaty, (ii) holds, directly or indirectly, less than 10% of our voting stock and (iii) does not conduct business through a permanent establishment or fixed base in Switzerland to which common shares are attributable.  Such an eligible U.S. Holder may apply for a refund of the amount of the withholding tax in excess of the 15% treaty rate.  The claim for refund must be filed on SwissWithholding Tax Form 82 (82C for corporations; 82I for individuals; 82E for other entities), which may be obtained from any Swiss consulate general in the United States or from the Swiss Federal Tax Administration at the address below, together with an instruction form.  Four copies of the form must be duly completed, signed before a notary public of the United States and sent to the Swiss Federal Tax Administration, Eigerstrasse 65, CH 3003, Berne, Switzerland.  The form must be accompanied by suitable evidenceextent distributions are made out of deduction of Swiss tax withheld at source, suchcapital contribution reserves, which, as certificates of deduction, signed bank vouchers or credit slips.  The form may be filed on or after July 1 or January 1 following the date the dividend was payable, but no later than December 31 of the third year following the calendar year in which the dividend became payable.  To facilitate the refund process, we have made arrangements with Globe Tax Services, Inc. to offer all U.S. Holders the opportunity to participate in a group refund claim.

Other Holders

Any other holder who is an individual or a legal entity not resident in Switzerland for tax purposes may be entitled to a total or partial refund of the withholding tax incurred on a taxable distribution from us if the country in which such holder resides for tax purposes has entered into a bilateral treaty for the avoidance of double taxation with Switzerland and the further conditions of such treaty are met.  Other holders of common shares not resident in Switzerland should be aware that the procedures for claiming treaty benefits (and the time required for obtaining a refund) may differ from country to country.  Other holders of common shares not resident in Switzerland should consult their own legal, financial or tax advisors regarding the receipt, ownership, purchase, sale or other disposition of shares and the procedures for claiming a refund of the withholding tax.

As of January 1, 2011, Switzerland had entered into bilateral treaties for the avoidance of double taxation with respect to income taxes with the following countries.

AlbaniaFranceLuxembourgSerbia
AlgeriaGermanyMacedoniaSingapore
ArgentinaGhanaMalaysiaSlovak Republic
ArmeniaGreeceMexicoSlovenia
AustraliaHungaryMoldovaSouth Africa
AustriaIcelandMongoliaSouth Korea
AzerbaijanIndiaMontenegroSpain
BangladeshIndonesiaMoroccoSri Lanka
BelarusIranNetherlandsSweden
BelgiumIsraelNew ZealandThailand
BulgariaItalyNorwayTrinidad and Tobago
CanadaIvory CoastPakistanTunisia
ChileJamaicaPeople's Republic of ChinaUkraine
CroatiaJapanPhilippinesUnited Kingdom
Czech RepublicKazakhstanPolandUnited States
DenmarkKuwaitPortugalUzbekistan
EcuadorKyrgyzstanQatarVenezuela
EgyptLatviaRepublic of IrelandVietnam
EstoniaLiechtensteinRomania
FinlandLithuaniaRussia


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In addition, new treaties have been signed with Colombia, Georgia, Hong Kong, Malta, Tajikistan, Turkey and Uruguay.  These treaties are not yet in force, however.  By exchange of notes, extension of the 1954 Treaty with the United Kingdom applies to Antigua and Barbuda, Barbados, Belize, British Virgin Islands, Dominica, Gambia, Grenada, Malawi, Montserrat, St. Kitts and Nevis, Anguilla, St. Lucia, St. Vincent and Zambia.  By exchange of notes, the 1973 Treaty with Denmark applies to the Faroe Islands.

Income and Profit Tax on Dividends and Similar Distributions

Swiss Holders

A Swiss Holder of common shares who is an individual resident in Switzerland for tax purposes or a non-Swiss resident holding common shares as part of a Swiss business operation or a Swiss permanent establishment is required to report the receipt of taxable distributions received on the common shares in his or her relevant Swiss tax returns.  A Swiss Holder that is a legal entity resident for tax purposes in Switzerland or a non-Swiss resident holding common shares as part of a Swiss establishment is required to include taxable distributions received on the common shares in its income subject to Swiss corporate income taxes.  A Swiss corporation or co-operative or a non-Swiss corporation or co-operative holding common shares as part of a Swiss permanent establishment may, under certain circumstances, benefit from a tax relief with respect to dividends (Beteiligungsabzug).

U.S. Holders and Other Holders

U.S. and other holders of common shares that are not resident in Switzerland for tax purposes and do not hold common shares as part of a Swiss business operation or a Swiss permanent establishmentdescribed above, are not subject to Swiss income taxes in respect of dividends and similar distributions received from us.

Capital Gains Realized on Common Shares

Withholding Tax.
Swiss HoldersIssuance Stamp Duty

Switzerland levies a one-time Issuance Stamp Duty (Emissionsabgabe) on the issuance of corporate equity capital by Swiss companies. A 1% Swiss Holder who is an individual resident in Switzerland for tax purposes holding common shares as part of his or her private property generally is exempt from Swiss federal, cantonal and communal taxes with respectIssuance Stamp Duty applies to capital gains realized upon the sale or other disposal of the shares, unless such individual is qualified as a security trading professional for income tax purposes.  Gains realized upon a repurchase of the common shares by uscontributions received for the purposeissuance of acorporate shares, non-voting shares, participation rights, as well as informal capital reduction are characterized as taxable distributions.  The same is truecontributions in cash or in kind for gains realized upon a repurchase of the common shares if we were not to dispose of the repurchased shares within six years after the repurchase or such shares were repurchased in view of a capital reduction.  Taxable income would be the difference between the repurchase price and the nominal value of the common shares and qualifying additional paid-in capital.

A Swiss Holder that holds the shares as business assets or a non-Swiss resident holding shares as part of a Swiss business operation or Swiss permanent establishment is required to include capital gains realized upon the disposal of common shares in its income subject to Swiss income tax.  A Swiss Holder that is a legal entity resident in Switzerland for tax purposes or a non-Swiss resident legal entity holding common shares as part of a Swiss permanent establishment is required to include capital gains realized upon the disposal of common shares in its income subject to Swiss corporate income tax.

In both cases, capital gains would be the surplus (if any) of sales proceeds over tax book value.

U.S. Holders and Other Holders

U.S. and other holders of common shares that are not resident in Switzerland for tax purposes and do not hold common shares as part of a Swiss business operation or a Swiss permanent establishment are not subject to Swiss income taxes on gains realized upon the disposal of common shares.


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Net Worth and Capital Taxes

no consideration.
Swiss Holders

A Swiss Holder of common shares who is an individual resident in Switzerland for tax purposes or is a non-Swiss resident holding common shares as part of a Swiss business operation or Swiss permanent establishment is required to include his or her shares in his or her wealth that is subject to cantonal and communal net worth tax.  A Swiss Holder that is a legal entity resident in Switzerland for tax purposes or a non-Swiss resident legal entity holding common shares as part of a Swiss permanent establishment is required to include its common shares in its assets.  The legal entity equity is then subject to cantonal and communal capital tax.

U.S. Holders and Other Holders

U.S. and other holders of common shares that are not resident in Switzerland for tax purposes and do not hold common shares as part of a Swiss business operation or a Swiss permanent establishment are not subject to Swiss cantonal and communal net worth and capital taxes.
Transfer Stamp TaxesDuty upon Transfer of Securities

The transfersale of commonour shares, whether by any holderSwiss residents or Non-resident Holders, may be subject to a Swissfederal securities transfer taxTransfer Stamp Duty (Umsatzabgabe) of up to 0.15%, calculated on the transaction valuegross sale proceeds, if itthe sale occurs through or with a Swiss bank or other Swiss securities dealer (Effektenhändler), as defined in the Swiss Federal Stamp TaxDuty Act. The stamp duty isTransfer Stamp Duty has to be paid by the securities dealer and may be charged to the parties in a taxable transaction who are not securities dealers or exempt entities.  Transactions in commondealers. In addition to this Transfer Stamp Duty, the sale of shares effected by or through a member of the SIX may be subject to a minor stock exchange levy.
Income Tax on Dividends
A Swiss Holder who holds Alcon shares as private assets ("Swiss Resident Private Shareholder") is required to report the receipt of dividends and similar distributions (including stock dividends and liquidation surplus) in its individual income tax
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returns and is subject to Swiss federal, cantonal and communal income tax on any net taxable income for the relevant tax period.
A Swiss Holder who is Swiss resident for tax purposes, a non-Swiss financial institutionsindividual who is subject to Swiss income tax for reasons other than residency and a legal entity tax resident in Switzerland, in each case that holds Alcon shares as business assets, and a non-Swiss tax resident legal entity that holds Alcon shares as part of a Swiss permanent establishment or fixed place of business (each, a "Swiss Resident Commercial Shareholder") is required to recognize dividends and similar distributions (including stock dividends and liquidation surplus) on Alcon shares in its income statement for the relevant taxation period and is subject to Swiss federal, cantonal and communal individual or corporate income tax, as the case may be, on any net taxable earnings for such taxation period. The same tax treatment also applies to a Swiss Holder who, for income tax purposes, is classified as a "professional securities dealer" for reasons of, inter alia, frequent dealing, or leveraged investments, in shares and other securities. Swiss Resident Commercial Shareholders who are corporate taxpayers may be eligible for a participation deduction (Beteiligungsabzug) in respect of dividends if the Alcon shares held by them as part of a Swiss business have an aggregate market value of at least CHF 1 million.
Taxes upon Disposition of Alcon Shares
Capital gains realized on the sale or other disposal of Alcon shares held by a Swiss Resident Private Shareholder are generally not subject to any federal, cantonal or communal income taxation. However, gain realized upon a repurchase of shares by us may be characterized as taxable dividend income if certain conditions are met. Capital gains realized on shares held by a Swiss Resident Commercial Shareholder are, in general, included in the taxable income of such person.
Residents of Other Countries
Recipients of dividends and similar distributions on our shares who are neither residents of Switzerland for tax purposes nor holding shares as part of a business conducted through a permanent establishment situated in Switzerland ("Non-resident Holders") are not subject to Swiss income taxes in respect of such distributions. Moreover, gain realized by such recipients upon the disposal of our shares is not subject to Swiss income tax.
Non-resident Holders of our shares are, however, subject to the Withholding Tax on dividends and similar distributions mentioned above and under certain circumstances to the Transfer Stamp Duty described above. Such Non-resident Holders may be entitled to a partial refund of the Withholding Tax if the country in which they reside has entered into a bilateral treaty for the avoidance of double taxation with Switzerland. Non-resident Holders should be aware that the procedures for claiming treaty refunds (and the time frame required for obtaining a refund) may differ from country to country. Non-resident Holders should consult their own tax advisors regarding the receipt, ownership, purchase, sale or other dispositions of our shares and the procedures for claiming a refund of the Withholding Tax.
A Non-resident Holder of our shares will not be liable for any Swiss taxes other than the Withholding Tax described above and, if the transfer occurs through or with a Swiss bank or other Swiss securities transferdealer, the Transfer Stamp Duty described above. If, however, the shares of Non-resident Holders can be attributed to a permanent establishment or a fixed place of business maintained by such person within Switzerland during the relevant tax butyear, the shares may be subject to Swiss income taxes in respect of income and gains realized on the shares and such person may qualify for a full refund of the Withholding Tax based on Swiss tax law.
Residents of the United States
Non-resident Holders who are residents of the United States for purposes of the Treaty are eligible for a reduced rate of tax on dividends equal to 15% of the dividend, provided that such holders qualify for benefits under the Treaty and do not conduct business through a permanent establishment or fixed base in Switzerland to which our shares are attributable. Such holders should consult their own tax advisors regarding their eligibility to claim the reduced rate and the procedures for claiming a refund of the amount of the Withholding Tax in excess of the 15% Treaty rate.
International Automatic Exchange of Information in Tax Matters
On November 19, 2014, Switzerland signed the Multilateral Competent Authority Agreement, which is based on article 6 of the OECD/Council of Europe administrative assistance convention and is intended to ensure the uniform implementation of automatic exchange of information (the "AEOI"). The Federal Act on the International Automatic Exchange of Information in Tax Matters (the "AEOI Act") entered into force on January 1, 2017. The AEOI Act is the legal basis for the implementation of the AEOI standard in Switzerland.
The AEOI is being introduced in Switzerland through bilateral agreements or multilateral agreements. The agreements have been, and will be, concluded on the basis of guaranteed reciprocity, compliance with the principle of specialty (i.e. the
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information exchanged may only be used to assess and levy taxes (and for criminal tax proceedings)) and adequate data protection. The United States is not a treaty state.
Based on such multilateral agreements and bilateral agreements and the implementing laws of Switzerland, Switzerland has begun to collect data in respect of financial assets (including shares) held in, and income derived thereon and credited to, accounts or deposits with a paying agent in Switzerland for the benefit of individuals resident in a EU member state or in a treaty state from, depending on the effective date of the respective agreement, 2017 or 2018, as the case may be, and has begun to exchange such data in 2018 or 2019, as the case may be.
US Federal Income Taxation
The following discussion is a summary of the US federal income tax considerations generally applicable to the ownership and disposition of our shares. This summary is based on the Code, its legislative history, US Treasury Regulations, administrative guidance, published court decisions and the Treaty, all in effect as of the date hereof, and any of which may be repealed, revoked, or modified (possibly with retroactive effect) so as to result in US federal income tax consequences different from those discussed below. This summary is applicable to US Holders (as defined below) who are residents of the United States for purposes of the Treaty and who qualify for the full benefits of the Treaty. It applies only to US Holders that hold our shares as capital assets (generally, property held for investment purposes). This summary should not be construed to constitute legal or tax advice to any particular US Holder.
This summary does not apply to or address US Holders subject to special rules, including, without limitation, brokers, dealers in securities or currencies, traders in securities that elect to use a mark-to-market method of accounting for securities holdings, tax-exempt entities (including private foundations), insurance companies, banks, thrifts and other local stamp taxes,financial institutions, persons liable for alternative minimum tax, persons that hold an interest in an entity that holds our shares, persons that will own, or will have owned, directly, indirectly or constructively 10% or more (by vote or value) of our stock, exchange leviespersons that hold our shares as part of a straddle, hedge, conversion, constructive sale or other duties.integrated transaction for US federal income tax purposes or persons whose functional currency is not the US dollar.

This summary does not purport to be a complete analysis of all of the potential US federal income tax considerations that may be relevant to US Holders in light of their particular circumstances. Further, it does not address any aspect of foreign, state, local or estate or gift taxation or the 3.8% Medicare tax imposed on certain net investment income. Each US Holder is urged to consult its tax advisor regarding the application of US federal taxation to its particular circumstances and the, state, local, non-US and other tax considerations of the ownership and disposition of our shares.
U.S. Federal Income Tax ConsiderationsGeneral
For purposes of this discussion, a “US Holder” is a beneficial owner of our shares that is, for U.S. HoldersUS federal income tax purposes:

an individual who is a citizen or resident of the United States;
Taxationa corporation (or other entity or arrangement treated as a corporation for US federal income tax purposes) created in or organized under the laws of Dividendsthe United States, any state thereof or the District of Columbia;

an estate the income of which is includable in gross income for US federal income tax purposes regardless of its source; or
Thea trust (A) the administration of which is subject to the primary supervision of a US court and which has one or more US persons who have the authority to control all substantial decisions of the trust or (B) that has otherwise validly elected to be treated as a US person under the Code.
If a partnership (or other entity or arrangement treated as a partnership for US federal income tax purposes) is a beneficial owner of our shares, the tax treatment of a partner in the partnership that will generally depend upon the status of the partner and the activities of the partnership. Partnerships holding our shares and partners in such partnerships are urged to consult their tax advisors as to the particular US federal income tax consequences of an investment in our shares.
Distributions on the Shares
Subject to the passive foreign investment company (“PFIC”) rules discussed below, the gross amount of any distribution received by a distribution made by us, includingUS Holder with respect to our shares (including any amounts ofwithheld to pay Swiss tax withheld,withholding taxes) generally will be taxable to a U.S.included in the gross income of the US Holder as a dividend income to the extent paid out of ourattributable to the Company’s current or accumulated earnings and profits, as determined under US federal income tax principles. The Company may not calculate its earnings and profits under US federal income tax rules. Accordingly, US Holders should expect that a
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distribution generally will be treated as a dividend for U.S. FederalUS federal income tax purposes. TheUnless the Company is treated as a "qualifiedPFIC for the taxable year in which it pays a distribution or in the preceding taxable year (see “Passive foreign investment company rules” below), the Company believes that it may qualify as a “qualified foreign corporation,"” in which case distributions treated as dividends and thus dividend income received by an individual taxpayer (assuming certain holding period requirements are met)non-corporate US Holders may be eligible for a preferential tax rate. Distributions on our shares generally is taxable to such U.S. Holder at the rate imposed on net capital gains, which currently cannot exceed 15%.  Dividends received on common shares will not be eligible for the dividends received deduction generally allowedavailable to corporations.

Distributions in excess of our current and accumulated earnings and profits will constitute a nontaxable return of capital to a U.S. Holder to the extent of the U.S. Holder's tax basis in its common shares.  To the extentUS Holders that such distributions are in excess of the U.S. Holder's basis in its common shares, the distribution will constitute gain from the deemed sale or exchange of the U.S. Holder's shares.  See "Tax on Sale or Exchange of Common Shares" below.

corporations.
The amount of a distributionany dividend paid in Swiss francs (including any amounts withheld to pay Swiss withholding taxes) will be included in the U.S.gross income of a US Holder in an amount equal to the US dollar value of the Swiss franc payment, determined atfrancs calculated by reference to the spot Swiss franc/U.S. dollarexchange rate in effect on the date the dividend is includible in a U.S. Holder's income,actually or constructively received by the US Holder, regardless of whether the payment in fact isSwiss francs are converted into U.S. dollars.

US dollars on such date. A US Holder will have a tax basis in the Swiss francs equal to their US dollar value on the date of receipt. If the Swiss francs received are converted into US dollars on the date of receipt, the US Holder generally should not be required to recognize foreign currency gain or loss in respect of the distribution. If the Swiss francs received are not converted into US dollars on the date of receipt, a US Holder may recognize foreign currency gain or loss on a subsequent conversion or other disposition of the Swiss francs. Such gain or loss generally will be treated as US source ordinary income or loss.
A U.S.US Holder will generallymay be entitled to claim a foreign taxdeduct or credit with respect to distributions received from us only for foreign taxes (such as Swiss withholding taxes)tax imposed on dividends paid to such U.S.a US Holder, and not for taxes imposed on ussubject to applicable limitations in the Code. The rules governing the foreign tax credit are complex. US Holders are urged to consult their own tax advisors regarding the availability of the foreign tax credit under their particular circumstances.
Sale, Exchange or on any entity in which we have made an investment.  Distributions with respectOther Taxable Disposition of Our Shares
Subject to the commonPFIC rules discussed below, a US Holder generally will recognize a capital gain or loss on the sale, exchange or other taxable disposition of our shares that are taxable as dividendsin an amount equal to the difference between the amount realized for the shares and the US Holder’s adjusted tax basis in the shares. Any capital gain or loss will be long-term capital gain or loss if the ordinary shares have been held for more than one year. Individuals and other non-corporate US Holders who have long-term capital gains will generally be eligible for reduced tax rates. The deductibility of capital losses is subject to limitations. Any capital gain or loss recognized by a US Holder generally will be treated as foreignUS source passive income (or,gain or loss for certain U.S. Holders of "financial services income," as defined in the Code, general category income) for U.S.US foreign tax credit purposes.  For the purpose
Passive Foreign Investment Company Rules
A foreign corporation will be considered a PFIC for any taxable year in which (i) 75% or more of determining the foreign tax credit limitation, the amount of such dividend distributionsits gross income is reduced under a special rule that generally ensures that the amount“passive income” or (ii) 50% or more of the foreign taxes imposed onaverage quarterly value of its assets produce (or are held for the dividendproduction of) “passive income.” For this purpose, “passive income” generally includes interest, dividends, rents, royalties and certain gains. We currently do not believe that can be currently credited against the U.S. Holder's U.S. Federal income tax liability will not exceed the U.S. Federal income tax on the distribution. Alternatively,we were a U.S. Holder may generally deduct foreign taxes (such as Swiss withholding taxes) imposed on dividends paid to such U.S. Holder. The decision to claim a credit or take a
133
deduction for foreign taxes imposed on a U.S. Holder applies to all such taxes incurred by the U.S. Holder duringPFIC in the taxable year.

Tax on Sale or Exchange of Common Shares

For U.S. Federal income tax purposes, a U.S. Holder generally will recognize gain or loss on a sale, exchange or other disposition of common shares, unless a specific nonrecognition provision applies.  That gain or lossyear ending December 31, 2021, nor do we anticipate that we will be measured bya PFIC in subsequent taxable years. However, the difference betweendetermination of PFIC status is based on an annual determination that cannot be made until the U.S. dollar valueclose of the amount of cash, andtaxable year, involves extensive factual investigation, including ascertaining the fair market value of any other property, receivedall of our assets on a quarterly basis and the U.S. Holder's tax basischaracter of each item of income that we earn, and is subject to uncertainty in the common shares.  A U.S. Holder's tax basis in the common sharesseveral respects. Accordingly, we cannot assure you that we will generally equal the amount paid by the U.S. Holder for the common shares.  Gain or loss arising from a sale or exchange of common shares will be capital gain or loss and will be long term if the holding period of the U.S. Holder for the shares exceeds one year.  In general, gain from a sale or exchange of shares by a U.S. Holder willnot be treated as United States source incomea PFIC for U.S. foreign tax credit limitation purposes.the taxable year ending December 31, 2021, or any subsequent taxable year, or that the IRS will not take a contrary position.

Required Disclosure with Respect to Foreign Financial Assets
Controlled Foreign Corporation

We do not expectCertain US Holders are required to be deemed a "controlled foreign corporation" because we expect more than 50% of the voting power and value ofreport information relating to their holding an interest in our shares, subject to be held by non-U.S. persons.  If more than 50% of the voting power or value of our shares were owned (directly or indirectly or by attribution) by U.S. Holders who hold 10% or more of the voting power of our outstanding shares, then we would become a controlled foreign corporation and the U.S. Holders who hold 10% or more of our voting power would be required to include in their taxable income as a constructive dividendcertain exceptions (including an amount equal to their share of certain of our undistributed income.

Passive Foreign Investment Company

We do not expect to be a passive foreign investment company because less than 75% of our gross income will consist of certain "passive" income and less than 50% of the average value of our assets will consist of assets that produce, or are heldexception for the production of, such passive income.  For this purpose, "passive" income generally includes dividends from unrelated companies, interest, royalties, rents, annuities and the excess of gains over losses from the disposition of assets that produce passive income.  If we were to become a passive foreign investment company, which determination will be made on an annual basis, the passive foreign investment company rules could produce significant adverse consequences for a U.S. Holder (regardless of the ownership percentage of our shares held in accounts maintained by such holder)certain financial institutions), includingby attaching a completed IRS Form 8938, Statement of Specified Foreign Financial Assets, with their tax return for each year in which they hold an interest in the loss of the preferentialshares. US Holders are urged to consult their tax rate on dividends.

Backup Withholding and Information Reporting

Under certain circumstances, a U.S. Holder who is an individual may be subject toadvisors regarding information reporting requirements relating to their ownership of our shares.
10.F. DIVIDENDS AND PAYING AGENTS
Not applicable.
10.G. STATEMENTS BY EXPERTS
Not applicable.

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10.H. DOCUMENTS ON DISPLAY
We maintain a website at the following address: www.alcon.com. The information on our website is not incorporated by reference in this Annual Report. We make available on or through our website certain reports and backup withholding, currentlyamendments to those reports that we file with or furnish to the SEC in accordance with the Exchange Act. We make this information available on our website free of charge as soon as reasonably practicable after we electronically file the information with, or furnish it to, the SEC.
You may read and copy any reports or other information that we file through the Electronic Data Gathering, Analysis and Retrieval (EDGAR) system through the SEC’s website on the Internet at a 28% rate, www.sec.gov.
We also make certain other documents available to the public (such as our Board committee charters, press releases and investor presentations) on dividends received on common shares.  This withholding generally applies only if that individual holder:

·  fails to furnish his or her taxpayer identification number to the U.S. financial institution that is in charge of the administration of that holder's common shares or any other person responsible for the payment of dividends on the common shares;

·  furnishes an incorrect taxpayer identification number;

·  is notified by the U.S. Internal Revenue Service that he or she has failed to properly report payments of interest or dividends and the U.S. Internal Revenue Service has notified us that the individual holder is subject to backup withholding; or

·  fails, under specified circumstances, to comply with applicable certification requirements.

our website (www.alcon.com).
Any amount withheld from a payment to a U.S. Holder under the backup withholding rules will be allowable as a credit against such U.S. Holder's U.S. Federal income tax liability, provided that the required information is furnished to the U.S. Internal Revenue Service.

134
U.S. Holders should consult their own tax advisor as to the applicationstatement in this Annual Report about any of the U.S. Federal information reporting and backup withholding requirements to them and their qualification, if any, for an exemption under these rules.

This discussion, which does not address any aspects of U.S. taxationour contracts or other than Federal income taxation relevant to U.S. Holders of common shares, is of a general nature only anddocuments is not intended to be, and should not be construed to be, legalnecessarily complete. If the contract or tax advice to any prospective investor and no representation with respect to the tax consequences to any particular investordocument is made.  DUE TO THE INDIVIDUAL NATURE OF TAX CONSEQUENCES, U.S. HOLDERS ARE URGED TO CONSULT THEIR OWN TAX ADVISORS WITH RESPECT TO THE PARTICULAR TAX CONSEQUENCES TO THEM OF OWNING AND DISPOSING OF COMMON SHARES, INCLUDING THE EFFECTS OF U.S. FEDERAL, STATE, LOCAL, FOREIGN AND OTHER TAX CONSEQUENCES.

F.    DIVIDENDS AND PAYING AGENTS

Not Applicable.

G.    STATEMENT OF EXPERTS

Not Applicable.

H.    DOCUMENTS ON DISPLAY

The descriptions of each contract, agreement or other document filed as an exhibit to this report on Form 20-F are summaries only and do not purportAnnual Report, the contract or document is deemed to be complete.  Each suchmodify the description is qualifiedcontained in its entirety by reference to such exhibitthis Annual Report. You must review the exhibits themselves for a more complete description of the matter involved.contract or document.

Unless stated otherwise in this Annual Report, none of these documents form part of this Annual Report. 
We
10.I. SUBSIDIARY INFORMATION
Not applicable.
ITEM 11.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
The major financing risks faced by Alcon are subjectmanaged by the Alcon treasury function. For information about the effects of currency and interest rate fluctuations and how we manage currency and interest risk, see "Item 5. Operating and Financial Review and Prospects—5.A. Operating Results" and "—5.B. Liquidity and Capital Resources". Please also see the information set forth under Note 18 to the informational requirementsConsolidated Financial Statements and related notes included elsewhere in this Annual Report.
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ITEM 12.    DESCRIPTION OF SECURITIES OTHER THAN EQUITY SECURITIES
12.A. DEBT SECURITIES
Not applicable.
12.B. WARRANTS AND RIGHTS
Not applicable.
12.C. OTHER SECURITIES
Not applicable.
12.D. AMERICAN DEPOSITARY SHARES
Not applicable.

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PART II
ITEM 13.    DEFAULTS, DIVIDEND ARREARAGES AND DELINQUENCIES
None.

148


ITEM 14.    MATERIAL MODIFICATIONS TO THE RIGHTS OF SECURITY HOLDERS AND USE OF PROCEEDS
None.
149


ITEM 15.    CONTROLS AND PROCEDURES
Disclosure Controls and Procedures
As of December 31, 2021, the end of the Exchange Actperiod covered by this Annual Report, our management, including our Chief Executive Officer and Chief Financial Officer, evaluated the effectiveness of our disclosure controls and procedures (as defined in accordance therewith will file reports and other information with the SEC.  Such reports and other information can be inspected and copied at the public reference facilities maintained by the SEC at its principal offices at Room 1024, 450 Fifth Street, N.W., Washington, D.C. 20549.  Copies of such information may be obtained from the Public Reference Section of the SEC at 100 F Street, N.E., Washington, D.C. 20549 at prescribed rates.  The Commission also maintains a website (http://www.sec.gov) that contains reports, proxy and information statements and other information regarding registrants that file electronically with the SEC.

As a foreign private issuer, we are not subject to the proxy rulesRule 13a-15(e) under Section 14 of the Exchange ActAct). Based upon that evaluation, our Chief Executive Officer and our officers, directors and principal shareholders are not subject to the insider short-swing profit disclosure and recovery provisions under Section 16 of the Exchange Act.

As a foreign private issuer, we are not required to publish financial statements as frequently or as promptly as U.S. companies; however, we intend to publish and, upon request, to furnish holders of our common shares with reports annually containing consolidated financial statements audited by independent accountants.  We also intend to file quarterly unaudited financial statements under cover of Form 6-K.

I.    SUBSIDIARY INFORMATION

Not Applicable.

ITEM 11. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

Interest Rate Risks

Because we have previously, and expect to continue, to finance our operations, in part, through loans, we are exposed to interest rate risks that could impact our results of operations and financial position. At December 31, 2010, the majority of our loans were short term, floating rate loans that will become more expensive when interest rates rise and less expensive when they fall.  We have partly mitigated this risk by investing our cash, cash
135
equivalents and short term investments in floating rate investments.  We evaluate the use of interest rate swaps and periodically use such agreements to manage interest rate risk on selected debt instruments.

In January 2001, we entered into a 10-year interest rate swap with a notional amount of 5 billion Japanese yen, effectively converting our 5 billion Japanese yen fixed interest rate (1.6%) obligation to a floating rate LIBOR (0.2% at December 31, 2010) instrument.  At December 31, 2010, the fair value of the interest rate swap was less than $1 million, based on market data, including the relevant interest rate.  The equivalent notional principal amount at December 31, 2010 was $61 million.

At December 31, 2010, our interest rate sensitivity was largely dependent on the following balance sheet components:

Interest Rate Sensitivity 
       
   Annual Pretax Earnings Effect 
 Fair Value/ 100 Basis 100 Basis 
 Notional Amount Points Decrease Points Increase 
 Segment in Rates in Rates 
Variable Rate Instruments  (in millions)   
Assets:      
Cash and Cash Equivalents - Variable Rate$2,525 $(25)$25 
          
Liabilities:         
Short Term Debt - Variable Rate 337  3   (3 )
Interest Rate Swaps – Variable Rate 61  1   (1 )
          
Net
   $(21)$21 
          

Additionally, the Company holds fixed income portfolios with various strategies, all of which are actively managed within specific risk parameters.  The market value of the Company's fixed income portfolios classified as available-for-sale investments was approximately $1,281 million at December 31, 2010, of which $560 million were U.S. government and agency securities, $9 million were mortgage-backed securities, $690 million were corporate debt securities, and $22 million were certain other investments.

Credit Risks

In the normal course of our business, we incur credit risk because we extend trade credit to our customers.  We believe that these credit risks are well diversified, and our internal staff actively manages these risks.  Our principal concentrations of trade credit are generally with large and financially sound corporations, such as large retailers and grocery chains, drug wholesalers and governmental agencies.  It is not unusual for our five largest customers in the United States to represent in the aggregate approximately 16% of the outstanding balance of gross accounts receivable; however, no single customer accounted for more than 10% of the Company's consolidated sales in the year ended December 31, 2010.

In connection with our sales of surgical equipment, we frequently finance the purchase of our equipment and enter into leases and other financial transactions with our customers.  In general, these loans and other transactions range in duration from one to five years and in principal amount range from $15,000 to $500,000.  We conduct credit analyses of the customers to whom we extend credit and secure the loans and leases with the purchased surgical equipment.  Over the last 24 years, we have offered financing programs for surgical equipment and losses have not been material to our operations.  In countries that may be subject to high inflation, the credit risks to which we are exposed can be larger and less predictable.

We conduct some of our business through export operations and are exposed to country credit risk.  This risk is mitigated by the use, where applicable, of letters of credit confirmed by large commercial banks in Switzerland and the United States.
136

In certain countries in the European Union, many of our government customers have significantly delayed payment of amounts owed to us for their purchase of our products.  This has increased our exposure to credit risk in these countries.  We regularly review these risks and take appropriate actions related to them.

Currency Risk

Because a significant portion of our revenues and earnings are denominated in foreign currencies, we are exposed to market risk from changes in currency exchange rates that could impact our results of operations and financial position.  We manage our exposure to these currency risks through our regular operating and financing activities and, when appropriate, through the use of derivative financial instruments.

We use foreign currency forward contracts and options to manage the volatility of non-functional currency monetary assets and liabilities resulting from changes in exchange rates.  Foreign currency forward contracts are used primarily to hedge intercompany receivables and payables.  The use of these derivative financial instruments allows us to reduce our overall exposure to exchange rate fluctuations, since the gains and losses on the derivative contracts substantially offset losses and gains on the underlying assets and liabilities being hedged.

The fair value of foreign currency forward contracts is subject to changes in currency exchange rates.  Because we target hedging less than 100% of currency risk, we believe that any gains or losses to foreign currency forward contracts resulting from exchange rate fluctuations primarily would offset gains or losses on the underlying foreign currency assets or liabilities.  Regarding foreign currency forward contracts, an instantaneous 10% appreciation in the value of foreign currencies against the U.S. dollar at December 31, 2010 would have decreased our earnings before income taxes by approximately $68 million.  We believe that such losses would be offset primarily by gains on the underlying foreign currency assets or liabilities.

At December 31, 2010, our financial instruments included $680 million equivalent notional amount of foreign currency forward contracts intended to offset potential earnings effects from intercompany receivables and loans (denominated in various currencies) held by a Swiss subsidiary.

Other Market Risk

Management reevaluated the Company's overall investment portfolio strategy and mix of investments in light of market conditions late in 2008.  In December 2008, the board of directors authorized the Company to liquidate holdings in hedge funds and real estate investment trusts in an effort to reduce investment portfolio volatility.  In January 2009, the Company sold its investment in real estate investment trusts. The Company filed redemption requests with the managers of the hedge funds and received the majority of the proceeds of these redemptions during 2009.  Proceeds from these liquidations in 2009 were reinvested primarily in cash, cash equivalents and investment-grade fixed income investments.  The Company expects to receive additional proceeds from the remaining hedge funds redemptions during 2011.

The Company's hedge fund investments are professionally managed by firms with long term performance records.  Asset allocation and manager performance are monitored regularly.  At December 31, 2010, the fair value of the Company's hedge funds was $6 million.  The hedge funds were classified as trading securities.

The values of these investments are subject to market price volatility.  The potential impact to the fair value of this portion of the investment portfolio assuming a hypothetical change in value of each security of a decline and an increase of 10% would be a reduction of $1 million or an increase of $1 million, respectively.  While actual market prices for individual securities of this type can be volatile, this sensitivity assumes that all securities in the portfolio exhibit the same volatility concurrently.  Security market prices change in a more complex fashion than presented.

ITEM 12. DESCRIPTION OF SECURITIES OTHER THAN EQUITY SECURITIES
                      Not Applicable.

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           PART II

ITEM 13.DEFAULTS, DIVIDEND ARREARAGES AND DELINQUENCIES
                        None.

ITEM 14.MATERIAL MODIFICATIONS TO THE RIGHTS OF SECURITY HOLDERS AND USE OF PROCEEDS
                        Not Applicable.

ITEM 15.CONTROLS AND PROCEDURES

(a)  
Disclosure Controls and Procedures.  As of the end of the period covered by this annual report (the "Evaluation Date"), the Company conducted an evaluation (under the supervision and with the participation of the Company's management, including its chief executive officer and its chief financial officer) pursuant to Rule 13a-15 of the Exchange Act of the effectiveness of the design and operation of the Company's disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)).

Based on this evaluation, the Company's chief executive officer and its chief financial officerChief Financial Officer concluded that as of December 31, 2021, the Evaluation Date,end of the Company'speriod covered by this Annual Report, we maintained effective disclosure controls and procedures were effective to provide reasonable assurance that material information required to be disclosed by the Company in reports it files or submits under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the rules and forms of the SEC.  Basedprocedures.
Management’s Annual Report on this evaluation, the Company's chief executive officer and its chief financial officer concluded that as of the Evaluation Date, the Company's disclosure controls and procedures also were effective to provide reasonable assurance that material information required to be disclosed by the Company in reports it files or submits under the Exchange Act were accumulated and communicated to the Company's chief executive officer and its chief financial officer, as appropriate to allow timely decisions regarding required disclosure.Internal Control Over Financial Reporting

(b)  
Management's Report on Internal Control over Financial Reporting.  Management's Report on Internal Control over Financial Reporting is included under Item 18 on page F-2.

(c)  
Attestation Report of the Registered Public Accounting Firm.  The report of KPMG LLP, an independent registered public accounting firm, is included under Item 18 on page F-4.

(d)  
Changes in Internal Control over Financial Reporting.  There were no changes in the Company's internal control over financial reporting identified in connection with the evaluation performed above that occurred during the period covered by this annual report that have materially affected, or are reasonably likely to materially affect, the Company's internal control over financial reporting.

ITEM 16. [RESERVED]
ITEM 16A.AUDIT COMMITTEE FINANCIAL EXPERT

Alcon's board of directors has determined that Thomas G. Plaskett is an "audit committee financial expert" as defined in the instructions for Item 16A of Form 20-F.  Mr. Plaskett is "independent," as determined in accordance with the rules of the NYSE.

ITEM 16B.CODE OF ETHICS

Alcon has adopted a Code of Business Conduct and Ethics that applies to all employees, including its Chief Executive Officer, Chief Financial Officer and its principal accounting officer.  The Company has posted this Code of Ethics to its website, www.alcon.com, where it is publicly available.  In addition, Alcon will provide a printed copy of its Code of Business Conduct and Ethics to its shareholders without charge upon request.  All such requests should
138
be sent in writing to Global Compliance, Alcon Laboratories, Inc., 6201 South Freeway, TA2-2, Fort Worth, Texas 76134.

ITEM 16C.PRINCIPAL ACCOUNTANT FEES AND SERVICES
The aggregate worldwide fees billed by KPMG LLP and its affiliates for professional services to the Company were $7.8 million in 2010 and $6.1 million in 2009, as noted below.

  2010 2009 
  (in thousands) 
      
Audit fees (1)                                    ��                                                $7,306 $5,790 
Audit-related fees (2)                                                                                      57  57 
Tax fees (3)                                                                                      353  240 
All other fees (4)                                                                                      78  47 
Total fees                                                                                $7,794 $6,134 

(1)  Audit fees represent fees for professional services provided for the integrated audit of the Company's annual financial statements, review of the Company's quarterly financial statements, and statutory audits for the Company's worldwide subsidiaries/affiliates.  In 2010, audit fees include additional fees related to the change of majority ownership and reporting to Novartis, for which the Company expects reimbursement from Novartis.

(2)  Audit-related fees consisted principally of fees for international audit coordination and audits of financial statements of certain employee benefit plans.

(3)  Tax fees represent fees for professional services related to tax compliance and tax planning/advisory consultation.

(4)  All other fees represent professional services provided for services not directly supporting financial statement audits.

The above professional services are covered within the scope of audit and permitted non-audit services as defined by SEC regulations.  All fees disclosed for the fiscal years ended December 31, 2010 and 2009 have been approved by the Audit Committee, subject to the policy and procedures described below.

Audit Committee Pre-Approval Policy and Procedures

Policy

The Audit Committee will pre-approve the following professional services provided to Alcon, Inc. and its subsidiaries as rendered by the primary Alcon Group external auditors and additional external auditors specific to the Company subsidiary ("external auditors"):

(1)  All auditing services (which may entail providing comfort letters in connection with securities underwritings or statutory audits); and

(2)  All non-audit services, including tax services.
Procedures

1.  On an annual basis, the Audit Committee will review and approve the specific financial/statutory audits for the fiscal year ending to be rendered by the external auditors prior to the engagement of the service.

2.  Specifically related to permitted tax services, the Audit Committee annually pre-approves such particular services for all Company subsidiaries rendered by the external auditors.  All other tax services to be performed

139
        by the external auditors as needed or incremental to the annual pre-approved services list will be approved by the Audit Committee prior to engagement of the service.
3.  Any other non-audit service by the external auditors not prohibited by Company policy or SEC regulation will be pre-approved on a case-by-case basis by the Audit Committee.

4.  The Audit Committee may delegate to one or more designated members of the Audit Committee the authority to grant pre-approvals required by this policy/procedure.  The decisions of any Audit Committee member to whom authority is delegated to pre-approve a service shall be presented to the full Audit Committee at its next scheduled meeting.

ITEM 16D.     EXEMPTIONS FROM THE LISTING STANDARDS FOR AUDIT COMMITTEES

None.

ITEM 6E. 
PURCHASES OF EQUITY SECURITIES BY THE ISSUER AND AFFILIATED PURCHASERS

The following table provides information with respect to purchases made during the year ended December 31, 2010 by or on behalf of Alcon or any "affiliated purchaser," of its common shares that are registered pursuant to Section 12 of the Exchange Act.

ISSUER PURCHASES OF EQUITY SECURITIES

       Total Number of    
       Shares Purchased  Maximum Number of 
  Total Number of  Average Price as Part of Publicly  Shares That May Yet 
  Shares Purchased  Paid Announced Plans or  Be Purchased under the 
Period (a)(b)(c)  per Share Programs (a)(b)(c)  Plans or Programs (d)(e) 
            
January 1 to 31, 2010 4,369  155.67 4,369  1,759,660 
February 1 to 28, 2010 41,175  157.58 41,175  1,718,485 
March 1 to 31, 2010 10,204  162.33 10,204  1,708,281 
April 1 to 30, 2010 19,028  152.88 19,028  1,689,253 
May 1 to 31, 2010 1,174  151.76 1,174  1,688,079 
June 1 to 30, 2010 820  148.21 820  1,687,259 
July 1 to 31, 2010 1,560  152.89 1,560  1,685,699 
August 1 to 31, 2010 74,600  160.28 74,600  1,611,099 
September 1 to 30, 2010 28,456  165.21 28,456  1,582,643 
October 1 to 31, 2010 9,679  167.21 9,679  1,572,964 
November 1 to 30, 2010 6,531  167.12 6,531  1,566,433 
December 1 to 31, 2010 9,493  161.28 9,493  1,556,940 
Total 207,089  160.18 207,089  N/A 

(a)  Based on settlements occurring within the month.

(b)  Shares purchased include shares withheld to cover employee taxes under provisions of employee share-based compensation plans.

(c)  In addition to the purchases disclosed in this table, during 2010 the Company also acquired 239 treasury shares from forfeitures of restricted shares by employees who terminated employment with the Company before vesting in such shares.

(d)  On September 7, 2007, Alcon's board of directors authorized the purchase in the market of up to 2,000,000 Alcon common shares.  The Company plans to use the acquired shares to cover the expected future exercises of employee share-based awards.  From time to time, the Company may purchase shares in the open market.

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(e)  In 2008, as a result of the agreement between Nestlé and Novartis discussed in note 16 to the consolidated financial statements, the Company halted the purchase of Alcon common shares in the open market under all share repurchase programs.  However, the Company has continued to acquire shares withheld from employees' exercises of share-based awards to cover their taxes.

ITEM 16F.    CHANGES IN REGISTRANT'S CERTIFYING ACCOUNTANT

      None.
ITEM 16G.    CORPORATE GOVERNANCE
Compliance with NYSE Listing Standards on Corporate Governance

On November 4, 2003, the SEC approved rules proposed by the NYSE intended to strengthen corporate governance standards for listed companies.  These corporate governance listing standards supplement the corporate governance reforms already adopted by the SEC pursuant to the Sarbanes-Oxley Act of 2002.

Alcon has adopted Corporate Governance Guidelines, which are publicly available on its website, www.alcon.com.  Alcon will provide a printed copy of its Corporate Governance Guidelines to its shareholders upon request.

These rules did not change the NYSE's traditional approach of permitting listed companies that are foreign private issuers, such as Alcon, to follow their home jurisdiction governance practices where such practices differ from the NYSE requirements.  However, listed companies that are foreign private issuers must disclose any significant ways in which their corporate governance practices differ from those followed by U.S. companies under NYSE listing standards.  These are identified in the first table below.

In addition, certain of the NYSE's corporate governance standards allow for an exemption for "controlled companies," as defined under the NYSE listing standards.  The NYSE listing standards require a controlled company that chooses to take advantage of any or all of these exemptions must disclose that choice, that it is a controlled company and the basis for the determination.  Alcon has determined that it is a controlled company for purposes of the NYSE listing standards, as approximately 77% of the outstanding common shares of Alcon are owned by Novartis AG, and Novartis has the right to appoint six of the eleven members of our board of directors.  The second table below identifies the NYSE listing standards from which Alcon has elected to use the controlled company exemption.

141


NYSE rules applicable to
U.S. listed companies
Alcon's practice
A U.S. listed company's compensation committee must have a written charter providing the committee with responsibility for approving corporate goals and objectives relevant to Chief Executive Officer ("CEO") compensation.
Alcon's compensation committee charter gives it the responsibility for reviewing and assessing the corporate goals and objectives relevant to CEO compensation, but in accordance with Swiss law the board of directors is responsible for actually approving those goals and objectives.
A U.S. listed company must assign the responsibility to determine and approve the CEO's compensation level to the compensation committee.
Pursuant to Swiss law, the determination of CEO compensation is the responsibility of the board of directors.  Alcon's compensation committee evaluates CEO compensation and makes a recommendation to the board of directors.
All listed companies must have an audit committee that satisfies the requirements of Rule 10A-3 under the Exchange Act.
Rule 10A-3 of the Exchange Act requires the audit committee of a U.S. company to be directly responsible for the appointment of any registered public accounting firm engaged for the purpose of preparing or issuing an audit report or performing other audit review or attest services.  There is an exception for foreign private issuers that are required under home country law to have statutory auditors selected pursuant to home country requirements.
Swiss law requires that Alcon's statutory auditors be appointed by the shareholders at the annual general meeting of the shareholders and that the board of directors recommends to the shareholders whether to approve the statutory auditors.  Alcon's audit committee is responsible for evaluating the statutory auditors and advising the board of directors of its recommendation regarding their appointment.
A U.S. listed company must obtain shareholder approval of amendments to employee plans involving the stock of the company that are deemed material pursuant to NYSE Listed Company Manual Section 303A.08.
The Amended 2002 Alcon Incentive Plan was amended by action of the board of directors without necessity of obtaining shareholder approval.  Pursuant to Swiss law, shareholder approval is not required to make material amendments to employee equity incentive plans.  Rather, the authority to do so lies with the board of directors.  However, shareholder approval is required to increase conditional capital if the number of shares required to satisfy the Amended 2002 Alcon Incentive Plan exceeds the existing conditional capital and the treasury shares available.
NYSE rules under which Alcon claims exemption as a controlled company
Alcon's practice
A majority of the directors of a U.S. listed company's board must be independent.
Alcon's board consists of (i) three independent directors, (ii) six directors that were designated by Novartis, (iii) the vice chairman and (iv) the CEO of Alcon Laboratories, Inc.
A U.S. listed company's nominating/corporate governance committee must be composed entirely of independent directors.
Alcon's nominating/corporate governance committee is composed of at least two independent directors and at least one director designated by Novartis as long as Novartis remains as Alcon, Inc.'s majority shareholder.
A U.S. listed company's compensation committee must be composed entirely of independent directors.
Alcon's compensation committee is composed of at least two independent directors and at least one director designated by Novartis as long as Novartis remains as Alcon, Inc.'s majority shareholder.

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          PART III

ITEM 17. FINANCIAL STATEMENTS

Not Applicable.


ITEM 18. FINANCIAL STATEMENTS


INDEX TO FINANCIAL STATEMENTS

Page
Reference
ALCON, INC. AND SUBSIDIARIES:
  Management's Report on Internal Control over Financial ReportingF-2
  Reports of  Independent Registered Public Accounting FirmF-3
  Consolidated Balance Sheets - December 31, 2010 and 2009F-5
  Consolidated Statements of Earnings - Years ended
     December 31, 2010, 2009 and 2008
F-6
  Consolidated Statements of Shareholders' Equity and
     Comprehensive Income - Years ended December 31,
     2010, 2009 and 2008
F-7
  Consolidated Statements of Cash Flows - Years ended
     December 31, 2010, 2009 and 2008
F-8
  Notes to Consolidated Financial Statements
F-9



143
ITEM 19.  EXHIBITS

EXHIBIT INDEX

Exhibit
No.Description
1.1
Registrant's Articles of Association, as of January 20, 2011
(Incorporated by reference to Exhibit 99.1 of Registrant's Report on
Form 6-K filed on February 10, 2011)
1.2
Registrant's Organizational Regulations, as of February 2, 2011
2.1
The Registrant agrees to furnish copies of any instruments defining the
rights of holders of long term debt of the Registrant and its
consolidated subsidiaries to the Commission upon request.
4.1
Amended 2002 Alcon Incentive Plan effective January 1, 2010
(Incorporated by reference to Exhibit 99.1 to the Registrant's Registration
Statement on Form S-8 filed on October 29, 2009, File No. 333-162738)
4.2
Alcon Executive Deferred Compensation Plan
(Incorporated by reference to Exhibit 99.1
of Registrant's Report on Form 6-K filed on March 5, 2009)
4.3
Alcon 401(k) Retirement Plan and Trust
(Incorporated by reference to Exhibit 99.1 to the Registrant's Registration
Statement on Form S-8 filed on October 29, 2009, File No. 333-162736)
4.4
Alcon Excess 401(k) Plan
(Incorporated by reference to Exhibit 99.5
of Registrant's Report on Form 6-K filed on March 5, 2009)
4.5
Alcon Supplemental Executive Retirement Plan for Alcon Holdings, Inc.
and Affiliated Entities
(Incorporated by reference to Exhibit 99.2 of Registrant's Report
on Form 6-K filed on March 5, 2009)
4.6
Alcon Supplemental Executive Retirement Plan for Alcon, Inc. as
Successor to Alcon Holdings, Inc. and Affiliated Entities
(Incorporated by reference to Exhibit 99.3 of Registrant's Report
on Form 6-K filed on March 5, 2009)
4.7
Alcon Supplemental Executive Retirement Plan II for Alcon, Inc. as
Successor to Alcon Holdings, Inc. and Affiliated Entities
(Incorporated by reference to Exhibit 99.4 of Registrant's Report
on Form 6-K filed on March 5, 2009)
4.8
Amended and Restated Registration Rights Agreement dated as of
December 10, 2009 between Alcon, Inc. and Nestlé S.A.
(Incorporated by reference to Exhibit 99.2 of Registrant's Report
on Form 6-K filed on March 11, 2010)
4.9
Registration Rights Agreement dated as of December 10, 2009 between
Alcon, Inc. and Novartis AG
(Incorporated by reference to Exhibit 99.3 of Registrant's Report
on Form 6-K filed on March 11, 2010)
4.10
Shareholder Coordination Letter Agreement dated December 10, 2009
between Alcon, Inc., Nestlé S.A. and Novartis AG
(Incorporated by reference to Exhibit 99.1 of Registrant's Report
on Form 6-K filed on March 11, 2010)
4.11
Stock Purchase Agreement between Alcon Holdings Inc. and LenSx Lasers
Inc. and the Shareholders Listed Herein and William Link and James
Garvey as the Sellers' Representatives dated July 6, 2010
(Incorporated by reference to Exhibit 99.1 to the Registrant's Report on
Form 6-K filed on July 9, 2010)
4.12
Alcon Litigation Trust Agreement dated July 7, 2010, between Alcon, as
grantor, and Thomas G. Plaskett, Joan W. Miller and Lodewijk J.R. de
Vink, as trustees.

144

EXHIBIT INDEX (continued)



Exhibit
No.Description
4.13
Merger Agreement dated December 14, 2010 between Novartis AG and
Alcon, Inc.
(Incorporated by reference to Exhibit 99.1 to the Registrant's 
Report on Form 6-K filed on December 16, 2010)
8.1
Significant Subsidiaries of the Registrant
(Incorporated by reference to Exhibit 8.1 to the Registrant's Annual Report
on Form 20-F filed on March 17, 2009)
12.1
Certification of Chief Executive Officer Required by
Rule 13a-14(a) (17 CFR240.13a-14(a)) or Rule 15d-14(a)
(17 CFR240.15d-14(a))
12.2
Certification of Chief Financial Officer Required by
Rule 13a-14(a) (17 CFR240.13a-14(a)) or Rule 15d-14(a)
(17 CFR240.15d-14(a))
13.1
Certification Furnished Pursuant to 18 U.S.C. Section 1350 as
adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
15.1
Consent of Independent Registered Public Accounting Firm
101.INSXBRL Instance Document
101.SCHXBRL Taxonomy Extension Schema Document
101.CALXBRL Taxonomy Extension Calculation Linkbase Document
101.LABXBRL Taxonomy Extension Label Linkbase Document
101.PREXBRL Taxonomy Extension Presentation Linkbase Document
101.DEFXBRL Taxonomy Definition Linkbase Document

145


          SIGNATURES

The registrant hereby certifies that it meets all the requirements for filing on Form 20-F and that it has duly caused and authorized the undersigned to sign this annual report on its behalf.

Alcon, Inc.
(Registrant)
/s/ Robert Karsunky 
Robert Karsunky, Senior Vice President, Finance,
Chief Financial Officer and Corporate Strategy Officer
        Date:
        March 18, 2011



146



INDEX TO FINANCIAL STATEMENTS


Page
Reference
ALCON, INC. AND SUBSIDIARIES:
Management's Report on Internal Control over Financial ReportingF-2
Reports of Independent Registered Public Accounting FirmF-3
Consolidated Balance Sheets - December 31, 2010 and 2009F-5
Consolidated Statements of Earnings - Years ended
December 31, 2010, 2009 and 2008                                                                                    F-6
Consolidated Statements of Shareholders' Equity and
Comprehensive Income - Years ended December 31,
2010, 2009 and 2008                                                                                    F-7
Consolidated Statements of Cash Flows - Years ended
December 31, 2010, 2009 and 2008                                                                                    F-8
Notes to Consolidated Financial Statements                                                                                      F-9
F-1

MANAGEMENT'S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING

Alcon, Inc.'sOur management is responsible for establishing and maintaining adequate internal control over financial reporting.  Alcon, Inc.'sreporting (as defined in Rule 13a-15(f) under the Exchange Act). Because of its inherent limitations, internal control system was designed to provide reasonable assurance to the Company's management regarding the reliability ofover financial reporting and the preparation and fair presentation of its published consolidated financial statements.

All internal control systems, no matter how well designed, have inherent limitations.  Therefore, even those systems determined to be effective may not prevent or detect misstatements and can provide only reasonable assurance with respect to financial statement preparation and presentation.misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. Internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles.

Alcon, Inc.'sOur management, assessedincluding our Chief Executive Officer and Chief Financial Officer, conducted an evaluation of the effectiveness of internal control over financial reporting using the Company'scriteria set forth in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission. Based on the results of this evaluation, our management concluded that our internal control over financial reporting was effective as of December 31, 2021.
Our independent registered public accounting firm, PricewaterhouseCoopers LLP, audited the effectiveness of our internal control over financial reporting. PricewaterhouseCoopers LLP's attestation report on our internal control over financial reporting as of December 31, 2010.2021 is included in Item 18 of this Annual Report.
Changes in Internal Control Over Financial Reporting
There were no changes in our internal control over financial reporting (as defined in Rule 13a-15(f) under the Exchange Act) that occurred during the fiscal year ended December 31, 2021 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
150


ITEM 16A.    AUDIT COMMITTEE AND FINANCIAL EXPERT
Our Board has determined that Lynn D. Bleil, Scott Maw, Karen May and Dieter Spälti, each of whom serves on our Audit and Risk Committee ("ARC"), are independent for purposes of serving on the audit committee under Rule 10A-3 and the listing standards promulgated by the New York Stock Exchange and are audit committee financial experts.
ITEM 16B. CODE OF ETHICS
Our Chief Executive Officer, Chief Financial Officer and Chief Accounting Officer are bound to adhere to our Code of Business Conduct, which applies to all of our associates and members of our Board. Our Code of Business Conduct is available on our website at www.alcon.com/about-us/responsible-business-practice.
ITEM 16C. PRINCIPAL ACCOUNTANT FEES AND SERVICES
The information set forth under “Item 6. Directors, Senior Management and Employees—6.C. Board Practices—Corporate Governance—Auditors—Auditing Fees and Additional Fees" is incorporated by reference.
Policy on Audit and Risk Committee Pre-Approval of Services of Principal Accountant
The Audit and Risk Committee has established a written policy to pre-approve, on an annual basis, all anticipated audit and non-audit services provided by our independent auditors (“Pre-Approval Policy”). These services may include audit services, audit-related services, tax services and other services. Pre-approval is generally provided for up to 12 months from the date of pre-approval, and any pre-approval is detailed as to the particular service or category of services and is generally subject to a specific budget.
The Pre-Approval Policy provides that the independent auditors may not perform any services for Alcon unless the independent auditors are engaged pursuant to the Pre-Approval Policy. In addition, the Pre-Approval Policy prohibits the Audit and Risk Committee from pre-approving certain non-audit services that are prohibited from being performed by the independent auditors by applicable securities laws. Management is required to periodically report to the Audit and Risk Committee regarding the extent of services provided by the independent auditors. In 2021, approximately 97% of audit-related, tax and other services provided by PwC were pre-approved.
In connection with its review and evaluation of non-audit services, the Audit and Risk Committee is required to and does consider and conclude that the provision of the non-audit services is compatible with maintaining the independence of the independent auditor.
151


ITEM 16D.    EXEMPTIONS FROM THE LISTING STANDARDS FOR AUDIT COMMITTEES
Not applicable.
ITEM 16E.    PURCHASES OF EQUITY SECURITIES BY THE ISSUER AND AFFILIATED PURCHASERS
Neither we nor any of our affiliated purchasers purchased any of our Ordinary Shares for the fiscal year ended December 31, 2021.

152


ITEM 16F.    CHANGE IN REGISTRANT'S CERTIFYING ACCOUNTANT
Not applicable.
ITEM 16G. CORPORATE GOVERNANCE
The information set forth under “Item 6. Directors, Senior Management and Employees—6.C. Board Practices—Corporate Governance—Differences from Corporate Governance Standards Relevant to US-listed Companies" is incorporated by reference.

153


ITEM 16H.    MINE SAFETY DISCLOSURE
Not applicable.
ITEM 16I.     DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS
Not applicable.

154


PART III
ITEM 17.    FINANCIAL STATEMENTS
See response to "Item 18. Financial Statements."
ITEM 18.    FINANCIAL STATEMENTS
Please refer to the financial statements beginning on page F-1 of this Annual Report.
155


ITEM 19.    EXHIBITS
Exhibit
Number
Description
1.1
1.2
2.1
2.2The total amount of long-term debt securities authorized under any instrument does not exceed 10% of the total assets of Alcon and its subsidiaries on a consolidated basis. We hereby agree to furnish to the SEC, upon its request, a copy of any instrument defining the rights of holders of long-term debt of Alcon or of its subsidiaries for which consolidated or unconsolidated financial statements are required to be filed.
4.11
4.12 
4.13 
4.14 
4.15 
4.16 
4.17*
4.18*
8.1For a list of all principal subsidiaries of Alcon Inc., see "Item 18. Financial Statements-Note 28. Alcon subsidiaries".
12.1
12.2
13.1
13.2
15.1
101.SCHInline XBRL Taxonomy Extension Schema
156


101.CALInline XBRL Taxonomy Extension Calculation
101.DEFInline XBRL Taxonomy Extension Definition
101.LABInline XBRL Taxonomy Extension Label
101.PREInline XBRL Taxonomy Extension Presentation
104 Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)
*Certain portions of this exhibit have been redacted pursuant to Instruction 4(a) as to Exhibits of Form 20-F. The Company agrees to furnish supplementally an unredacted copy of the exhibit to the SEC or its Staff upon request.
157


Signatures
The registrant hereby certifies that it meets all of the requirements for filing on Form 20-F and that it has duly caused and authorized the undersigned to sign this registration statement on its behalf.
Alcon Inc.
By:/s/ David J. Endicott
Name:David J. Endicott
Title:Authorized Representative
By:/s/ Timothy C. Stonesifer
Name:Timothy C. Stonesifer
Title:Authorized Representative
Date: February 15, 2022

158


CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC.
Audited Consolidated Financial Statements
Consolidated Income Statement
F-2
Consolidated Statement of Comprehensive Income/(Loss)
F-3
Consolidated Balance Sheet
F-4
Consolidated Statement of Changes in Equity
F-5
Consolidated Statement of Cash Flows
F-6
Notes to Consolidated Financial Statements
F-7
Report of Independent Registered Public Accounting Firm
F-65
F-1


CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC.

Consolidated Income Statement
(For the years ended December 31, 2021, 2020 and 2019)
($ millions except earnings/(loss) per share)Note202120202019
Net sales to third parties8,222 6,763 7,362 
Other revenues69 70 146 
Net sales and other revenues8,291 6,833 7,508 
Cost of net sales(3,577)(3,830)(3,719)
Cost of other revenues(62)(63)(127)
Gross profit4,652 2,940 3,662 
Selling, general & administration(3,076)(2,694)(2,847)
Research & development(842)(673)(656)
Other income43 235 55 
Other expense(197)(290)(401)
Operating income/(loss)580 (482)(187)
Interest expense(120)(124)(113)
Other financial income & expense(42)(29)(32)
Income/(loss) before taxes418 (635)(332)
Taxes(42)104 (324)
Net income/(loss)376 (531)(656)
Earnings/(loss) per share ($)
Basic0.77 (1.09)(1.34)
Diluted0.76 (1.09)(1.34)
Weighted average number of shares outstanding (millions)
Basic490.0 489.0 488.2 
Diluted493.4 489.0 488.2 
The accompanying Notes form an integral part of the Consolidated Financial Statements.
F-2


CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

Consolidated Statement of Comprehensive Income/(Loss)
(For the years ended December 31, 2021, 2020 and 2019)
($ millions)202120202019
Net income/(loss)376 (531)(656)
Other comprehensive income to be eventually recycled into the Consolidated Income Statement:
Currency translation effects, net of taxes(1)
(58)19 (4)
Total of items to eventually recycle(58)19 (4)
Other comprehensive income never to be recycled into the Consolidated Income Statement:
Actuarial gains/(losses) from defined benefit plans, net of taxes(2)
26 (14)(55)
Fair value adjustments on equity securities, net of taxes(3)
— (7)(2)
Total of items never to be recycled26 (21)(57)
Total comprehensive income/(loss)344 (533)(717)
(1)Amount is net of tax benefit of $6 million in 2021.
(2)Amounts are net of tax expense of $11 million in 2021, and net of tax benefits of $13 million and $11 million in 2020 and 2019, respectively.
(3)Amounts are net of tax benefits of $3 million and $5 million in 2020 and 2019, respectively.

The accompanying Notes form an integral part of the Consolidated Financial Statements.
F-3


CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

Consolidated Balance Sheet
(At December 31, 2021 and 2020)
($ millions)Note20212020
Assets  
Non-current assets  
Property, plant & equipment3,711 3,425 
Right-of-use assets16 372 358 
Goodwill10 8,905 8,905 
Intangible assets other than goodwill10 8,765 9,097 
Deferred tax assets11 409 399 
Financial assets12 217 218 
Other non-current assets12 234 211 
Total non-current assets22,613 22,613 
Current assets
Inventories13 1,899 1,644 
Trade receivables14 1,496 1,361 
Income tax receivables21 
Cash and cash equivalents18 1,575 1,557 
Other current assets15 407 404 
Total current assets5,386 4,987 
Total assets27,999 27,600 
Equity and liabilities
Equity
Share capital8.120 20 
Reserves19,236 18,802 
Total equity19,256 18,822 
Liabilities
Non-current liabilities
Financial debts17 3,966 3,949 
Lease liabilities16 339 315 
Deferred tax liabilities11 1,026 1,196 
Provisions & other non-current liabilities19 940 1,060 
Total non-current liabilities6,271 6,520 
Current liabilities
Trade payables903 876 
Financial debts17 114 169 
Lease liabilities16 67 70 
Current income tax liabilities187 149 
Provisions & other current liabilities20 1,201 994 
Total current liabilities2,472 2,258 
Total liabilities8,743 8,778 
Total equity and liabilities27,999 27,600 


The accompanying Notes form an integral part of the Consolidated Financial Statements.
F-4


CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

Consolidated Statement of Changes in Equity
(For the years ended December 31, 2021, 2020 and 2019)
($ millions)Share capitalOther reservesFormer parent net investmentFair value adjustments on equity securitiesActuarial gains/(losses) from defined benefit plansCumulative currency translation effects
Total value adjustments(1)
Equity
Balance as of December 31, 2018 — 22,650 (23)(17)29 (11)22,639 
Net (loss)(547)(109)— (656)
Other comprehensive (loss)(2)(55)(4)(61)(61)
Total comprehensive (loss) (547)(109)(2)(55)(4)(61)(717)
Movements of financing provided to former parent, net(2,658)— (2,658)
Other transactions with former parent(46)— (46)
Reclassification of deferred equity-compensation(7)— (7)
Distribution by former parent of share capital2019,812 (19,832)— — 
Equity-based compensation87 — — 87 
Other movements(2)
— 
Total other movements20 19,902 (22,541)    (2,619)
Balance as of December 31, 201920 19,355  (25)(72)25 (72)19,303 
Net (loss)(531)— — (531)
Other comprehensive income/(loss)(7)(14)19 (2)(2)
Total comprehensive (loss) (531) (7)(14)19 (2)(533)
Equity-based compensation70 — — 70 
Other movements(2)
— (23)(23)(18)
Total other movements 75   (23) (23)52 
Balance as of December 31, 202020 18,899  (32)(109)44 (97)18,822 
Net income376  — 376 
Other comprehensive income/(loss)— 26 (58)(32)(32)
Total comprehensive income 376   26 (58)(32)344 
Dividends(53)— — (53)
Equity-based compensation124 — — 124 
Other movements(2)
10 — 19 
Total other movements 81   9  9 90 
Balance as of December 31, 202120 19,356  (32)(74)(14)(120)19,256 
(1)     "Total value adjustments" are presented net of the corresponding tax effects.
(2)     Activity includes hyperinflationary accounting (see Note 3 to the Consolidated Financial Statements). The current year primarily includes an adjustment to actuarial gains to recognize plan assets related to the separation of a pension plan in the Spin-off from Novartis but which were not previously recorded. The year ended December 31, 2020 includes an adjustment to actuarial (losses) for other post-employment benefit obligation assumption changes directly related to the Spin-off on April 9, 2019 but which was not recorded at that time.

The accompanying Notes form an integral part of the Consolidated Financial Statements.
F-5


CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

Consolidated Statement of Cash Flows
(For the years ended December 31, 2021, 2020 and 2019)
($ millions)Note202120202019
Net income/(loss)376 (531)(656)
Adjustments to reconcile net income/(loss) to net cash flows from operating activities
Depreciation, amortization, impairments and fair value adjustments21.11,220 1,626 1,456 
Equity-based compensation expense138 105 83 
Non-cash change in current and non-current provisions and other non-current liabilities57 (106)(4)
Losses on disposal and other adjustments on property, plant & equipment and other non-current assets, net13 42 
Interest expense120 124 113 
Other financial income & expense42 29 32 
Taxes42 (104)324 
Interest received
Interest paid(108)(105)(67)
Other financial payments(7)(5)(18)
Taxes paid(175)(97)(224)
Net cash flows before working capital changes and net payments out of provisions and other non-current liabilities1,721 983 1,051 
Net payments out of provisions and other cash movements in non-current liabilities(62)(115)(83)
Change in net current assets and other operating cash flow items21.2(314)(45)(48)
Net cash flows from operating activities1,345 823 920 
Purchase of property, plant & equipment(700)(479)(553)
Proceeds from sale of property, plant & equipment— — 
Purchase of intangible assets(480)(88)(123)
Purchase of financial assets(19)(11)(59)
Proceeds from financial assets— 
Purchase of other non-current assets— — (1)
Acquisition of business, net21.3— — (283)
Net cash flows used in investing activities(1,198)(572)(1,011)
Dividends paid to shareholders of Alcon Inc.8.2(54)— — 
Movements of financing provided to former parent, net— — (2,658)
Proceeds from non-current financial debts, net of issuance costs21.452 744 3,724 
Proceeds from Bridge Facility, net of issuance costs— — 1,495 
Repayment of non-current financial debts— — (509)
Repayment of Bridge Facility— — (1,500)
Change in current financial debts21.4(43)(139)202 
Lease payments21.4(72)(69)(52)
Change in other financial receivables from former parent— — 39 
Change in other financial liabilities to former parent— — (67)
Other financing cash flows(6)(70)(15)
Net cash flows (used in)/from financing activities(123)466 659 
Effect of exchange rate changes on cash and cash equivalents(6)18 27 
Net change in cash and cash equivalents18 735 595 
Cash and cash equivalents at January 11,557 822 227 
Cash and cash equivalents at December 311,575 1,557 822 
The accompanying Notes form an integral part of the Consolidated Financial Statements.
F-6



NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC.
1.     Description of business
Alcon Inc. (the "Company") and the subsidiaries it controls (collectively "Alcon") is a leading eye care company. Alcon is a multinational company specializing in the research, development, manufacturing and marketing of a broad range of eye care products within 2 businesses: Surgical and Vision Care. Alcon is a stock corporation organized under the laws of Switzerland, domiciled in Fribourg, Switzerland, with global headquarters located in Geneva, Switzerland.
On February 28, 2019, Novartis AG (“Novartis” or “Former Parent”) shareholders at their Annual General Meeting approved the proposed 100% spin-off of Alcon through the distribution of a dividend in kind of new Alcon shares to Novartis shareholders and Novartis American Depository Receipt ("ADR") holders (the “Spin-off”), subject to completion of certain conditions precedent to the distribution. Amendment No. 6 to the Company's Registration Statement on Form 20-F filed with the Securities and Exchange Commission ("SEC") on March 22, 2019, ("2018 Form 20-F"), was declared effective by the SEC on that same day. On April 9, 2019, Novartis completed the Spin-off, which resulted in the Company becoming an independent, publicly-traded company. Each Novartis shareholder of record as of April 8, 2019 and each holder of Novartis’ ADR of record as of April 1, 2019 received one share of Alcon common stock for every five shares of Novartis common stock or Novartis ADR held. The shares of the Company are listed on the SIX Swiss Stock Exchange ("SIX") and on the New York Stock Exchange ("NYSE") under the symbol “ALC”.
The Consolidated Financial Statements of Alcon are comprised of the Consolidated Balance Sheet as of December 31, 2021 and 2020 and the Consolidated Income Statement, Consolidated Statement of Comprehensive Income/(Loss), Consolidated Statement of Changes in Equity and Consolidated Statement of Cash Flows for each of the years ended December 31, 2021, 2020 and 2019.
The country of operation and percentage ownership of the legal entities with "Total assets" or "Net sales to third parties" in excess of $5 million included in the Consolidated Financial Statements are disclosed in Note 28.

2.     Basis of preparation
The accompanying Consolidated Financial Statements present our historical financial position, results of operations, comprehensive income/(loss), and cash flows in accordance with International Financial Reporting Standards (“IFRS”) as issued by the International Accounting Standards Board (“IASB”), including the basis of preparation as described in this Note and with the selected accounting policies as described in Note 3 to these Consolidated Financial Statements.
The preparation of Consolidated Financial Statements requires management to make certain estimates and assumptions, either at the balance sheet date or during the year that affect the reported amounts of assets and liabilities as well as revenues and expenses. Actual outcomes and results could differ from those estimates and assumptions.
Relationship with Former Parent and affiliates prior to Spin-off
For the period in 2019 prior to the Spin-off, the financial statements were prepared on a combined basis for carve-out financial statements and were derived from Novartis’ Consolidated Financial Statements and accounting records, which were prepared in accordance with IFRS. Through the date of the Spin-off, all revenues and expenses as well as assets and liabilities directly associated with Alcon have been included in the financial statements. For the period in 2019 prior to the Spin-off, the financial statements also included allocations of certain expenses for services provided by Novartis to Alcon and allocations of related assets, liabilities, and the Former Parent’s invested capital, as applicable. The allocations were determined on a reasonable basis; however, the amounts are not necessarily representative of the amounts that would have been reflected in the financial statements had Alcon been an entity that operated independently of Novartis during the applicable periods. Refer to Note 25 to these Consolidated Financial Statements for additional disclosures.
The financial statements for the period in 2019 prior to the Spin-off include all Alcon subsidiaries and all Alcon business operated within Novartis Group subsidiaries over which Alcon has control, by applying the principles of IFRS 10, Consolidated Financial Statements. Alcon controls an entity when it is exposed to, or has rights to, variable returns from its involvement with the entity and has the ability to affect those returns through its power over the entity.
Both before and after the Spin-off, Alcon's associates participated in defined benefit pension and other postretirement plans sponsored by Novartis; in some countries these were single employer plans dedicated to the Alcon business associates and in other countries these were plans where associates of Alcon and associates of the Novartis Group are
F-7

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
participants. As of December 31, 2021, all defined benefit pension and other postretirement plans have been separated from Novartis. Refer to Note 23 to these Consolidated Financial Statements for additional disclosure on post-employment benefits for associates.
Income taxes attributable to the Alcon business in the financial statements were determined using the separate return approach, under which current and deferred income taxes are calculated as if a separate tax return had been prepared in each tax jurisdiction. In various tax jurisdictions, Alcon and Novartis businesses operated within the same legal entity and certain Alcon subsidiaries were part of a Novartis tax group. This required an assumption that the subsidiaries and operations of Alcon in those tax jurisdictions operated on a standalone basis and constitute separate taxable entities. Actual outcomes and results could differ from these separate tax return estimates, including those estimates and assumptions related to realization of tax benefits within these Novartis tax groups. Refer to Note 7 to these Consolidated Financial Statements for additional disclosures on income taxes.
Alcon's Equity in the financial statements for the periods prior to Spin-off represents the excess of total assets over total liabilities and was impacted by the following:
Currency translation adjustments of the Novartis Group multi-divisional subsidiaries were allocated between Alcon and the Novartis retained businesses by applying allocation keys based on net assets of each respective business.
Other transactions with Novartis Group as shown on the Consolidated Statement of Changes in Equity represent the movements in Equity resulting from the preparation of the financial statements in accordance with the basis of preparation described in this Note.
Movements of financing provided to Novartis Group as shown on the Consolidated Statement of Changes in Equity and on the Consolidated Statement of Cash Flows primarily represent the net contributions from Alcon to Novartis Group.
Following the Spin-off, the Consolidated Financial Statements include the accounts of Alcon and no longer include any allocations from Novartis.

3.     Selected accounting policies
Principles of consolidation
The Consolidated Financial Statements include the accounts of the Company and its wholly owned subsidiaries. In the event that the Company has an interest in another entity that is not wholly owned, the assets, liabilities, results of operations and cash flows of such entity are included in the Company's Consolidated Financial Statements, if the Company is exposed or has rights to variable returns from its involvement with the entity and has the ability to affect those returns through its power over the entity. The Consolidated Financial Statements of the Company are prepared in accordance with IFRS as issued by the IASB. They are prepared in accordance with the historical cost convention except for items that are required to be accounted for at fair value. All intercompany transactions and accounts within Alcon were eliminated.
The Company's financial year-end is December 31, which is also the annual closing date of the individual entities' financial statements incorporated into the Consolidated Financial Statements.
Impact of the COVID-19 pandemic
In March 2020, the World Health Organization declared the outbreak of COVID-19 as a pandemic. The pandemic triggered widespread shelter-in-place orders, business shutdowns and the deferral of non-urgent surgical procedures. Outbreaks of COVID-19 cases continued to occur in 2021 and localized responses remain unpredictable. The COVID-19 pandemic continued to have an impact on our financial results and operations in 2021, and it may continue to have an adverse effect on our net sales, operating results and cash flow. The extent to which the COVID-19 pandemic and the related economic impact may continue to affect our financial condition or results of operations is uncertain.
We have analyzed the impact of the COVID-19 pandemic on our financial statements for the twelve months ended December 31, 2021 and 2020, respectively. We have assessed various accounting estimates and other matters, including those that require consideration of forecasted financial information, in the context of the unknown future impacts of COVID-19 using information reasonably available to us at this time. The accounting estimates and other matters assessed included, but were not limited to, provisions for expected credit losses, goodwill and other intangible assets, financial instruments, inventory provisions, associate benefits, income taxes and revenue recognition. Based on our assessment performed, the resulting provisions recorded were not material to our Consolidated Financial Statements for the twelve months ended December 31, 2021 or 2020, respectively. However, the inherent uncertainties of COVID-19 including the
F-8

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
duration, scope, and severity of the pandemic may result in actual outcomes that differ materially from our current assumptions and estimates.
Foreign currencies
The Consolidated Financial Statements are presented in US dollars ("USD"). The functional currency of individual entities incorporated into the Consolidated Financial Statements is generally the local currency of the respective entity. The functional currency used for the reporting of certain Swiss entities is USD instead of their respective local currencies. This reflects the fact that the cash flows and transactions of these entities are primarily denominated in these currencies.
For entities not operating in hyperinflationary economies, the entities results, financial position and cash flows that do not have USD as their functional currency are translated into USD using the following exchange rates:
Income, expense and cash flows using for each month the average exchange rate with the USD values for each month being aggregated during the year.
Balance sheet using year-end exchange rates.
Resulting exchange rate differences are recognized in other comprehensive income/(loss).
The hyperinflationary economies in which Alcon operates are Argentina and Venezuela, both of which were hyperinflationary for all years presented.
The impact of the restatement of the non-monetary assets and liabilities with the general price index at the beginning of the period an economy becomes hyperinflationary is recorded in "Other reserves" in equity. The subsequent gains or losses resulting from the restatement of non-monetary assets and liabilities are recorded in "Other financial income & expense" in the Consolidated Income Statement.
Acquisition of assets
Assets separately acquired are initially recognized on the balance sheet at cost if they meet the criteria for capitalization. The capitalized cost of the asset includes the purchase price and any directly attributable costs for bringing the asset into the condition to operate as intended. Expected costs for obligations to dismantle and remove property, plant and equipment when it is no longer used are included in their cost.
Property, plant and equipment
Property, plant and equipment are depreciated on a straight-line basis over their estimated useful lives. Freehold land is not depreciated. The related depreciation expense is included in the costs of the functions using the asset or "Cost of net sales" in the Consolidated Income Statement.
Property, plant and equipment are assessed for impairment at the cash generating unit ("CGU") level whenever there is an indication that the balance sheet carrying amount may not be recoverable using cash flow projections for the useful life.
The following table shows the respective useful lives for property, plant and equipment:
Useful life
Buildings and improvements10 to 40 years
Machinery and other equipment
Machinery and equipment5 to 20 years
Furniture and vehicles5 to 10 years
Computer hardware3 to 7 years
Business combinations
Effective January 1, 2020, Alcon adopted Amendments to IFRS 3, Business Combinations. The acquisition method of accounting is used to account for all business combinations, regardless of whether equity instruments or other assets are acquired. The consideration transferred for the acquisition of a subsidiary may include:
Fair values of the assets transferred;
Liabilities incurred to the former owners of the acquired business;
Equity interests issued by the Company;
F-9

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
Fair value of an asset or liability resulting from a contingent consideration arrangement; and
Fair value of any pre-existing equity interest in the subsidiary.
Identifiable assets acquired and liabilities assumed in a business combination are measured initially at their fair values at the acquisition date. The excess of the consideration transferred over the fair value of the net identifiable assets acquired is recorded as goodwill, or directly in the income statement if it is a bargain purchase. Alcon primarily uses net present value techniques, utilizing post-tax cash flows and discount rates in calculating the fair value of identifiable assets acquired when allocating the purchase consideration paid for the acquisition. The estimates used in calculating fair values involve significant judgment by management and include assumptions with measurement uncertainty such as, the amount and timing of projected cash flows, long-term sales forecasts, the timing and probability of regulatory and commercial success, and the discount rate.
Acquisition related costs are expensed as incurred.
Alcon may elect on a transaction-by-transaction basis to apply the optional concentration test to assess whether a transaction qualifies as a business. Under the test, when substantially all of the fair value of the gross assets acquired is concentrated in a single identifiable asset or a group of similar identifiable assets, Alcon will account for the transaction as an asset purchase and not a business combination.
If the concentration test is not met, or Alcon elects not to apply this optional test, Alcon will perform an assessment focusing on the existence of inputs and processes that have the ability to create outputs to determine whether the transaction is an asset purchase or a business combination.
Goodwill and intangible assets
The annual impairment testing date is Alcon's financial year-end, December 31.
Goodwill
Goodwill arises in a business combination and is the excess of the consideration transferred to acquire a business over the underlying fair value of the net identified assets acquired. It is allocated to groups of CGUs which are usually represented by the reportable segments, which are the same as Alcon's operating segments. Goodwill is tested for impairment annually at the level of these groups of CGUs, and any impairment charges are recorded under "Other expense" in the Consolidated Income Statement.
Intangible assets available for use
Alcon has the following classes of available-for-use intangible assets: Currently marketed products, Marketing know-how, Technologies, Other intangible assets (including computer software) and the Alcon brand name.
Currently marketed products represent the composite value of acquired intellectual property, patents, and distribution rights and product trade names.
Marketing know-how represents the value attributable to the expertise acquired for marketing and distributing Alcon surgical products.
Technologies represent identified and separable acquired know-how used in the research, development and production processes.
Significant investments in internally developed and acquired software are capitalized and included in the "Other" category and amortized once available for use.
The Alcon brand name is shown separately as it is the only Alcon intangible asset that is available for use with an indefinite useful life. Alcon considers it appropriate that the brand name has an indefinite life since the branded products have a history of strong revenue and cash flow performance, and Alcon has the intent and ability to support the brand with spending to maintain its value for the foreseeable future.
Except for the Alcon brand name, intangible assets available for use are amortized over their estimated useful lives on a straight-line basis and evaluated for potential impairment whenever facts and circumstances indicate that their carrying value may not be recoverable. The Alcon brand name is not amortized, but evaluated for potential impairment annually.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
The following table shows the respective useful lives for available-for-use intangible assets and the location in the Consolidated Income Statement in which the respective amortization and any potential impairment charge is recognized:
Useful lifeIncome statement location for
amortization and impairment charges
Currently marketed products5 to 20 years"Cost of net sales"
Marketing know-how25 years"Cost of net sales"
Technologies10 to 20 years"Cost of net sales" or "Research and Development"
Other (including software)3 to 10 yearsIn the respective functional expense
Alcon brand nameNot amortized, indefinite useful life"Other expense"
Acquired In-Process Research & Development ("IPR&D")
Acquired research and development intangible assets, which are still under development and have accordingly not yet obtained marketing approval, are recognized as IPR&D.
IPR&D is not amortized, but evaluated for potential impairment on an annual basis or when facts and circumstances warrant. IPR&D is considered impaired when its balance sheet carrying amount exceeds its estimated recoverable amount, which is defined as the higher of its fair value less costs of disposal ("FVLCOD") and its value in use ("VIU"). Usually, Alcon applies the FVLCOD method for its impairment assessments. Under this approach when evaluating IPR&D for potential impairment, FVLCOD is estimated using net present value techniques utilizing post-tax cash flows and discount rates as there are no direct or indirect observable prices in active markets for identical or similar assets. The estimates used in calculating the net present values involve significant judgment by management and include assumptions with measurement uncertainty such as, the amount and timing of projected cash flows, long-term sales forecasts, discount rate, and the timing and probability of regulatory and commercial success. In the limited cases where the VIU method would be applied, net present value techniques would be applied using pre-tax cash flows and discount rates.
Any impairment charge is recorded in the Consolidated Income Statement under "Research & development".
Once a project included in IPR&D has been successfully developed it is transferred to the "Currently marketed products" category.
Impairment of goodwill, Alcon brand name and definite lived intangible assets
A CGU to which goodwill has been allocated (reportable segments) is considered impaired when its carrying amount, including the goodwill, exceeds its recoverable amount, which is defined as the higher of its FVLCOD and its VIU. If the recoverable amount of the reportable segment is less than its carrying amount, an impairment loss shall be recognized. The impairment loss shall be allocated to reduce the carrying amount of any goodwill allocated to the reportable segment first, with any remaining impairment loss allocated to other assets of the reportable segment on a pro-rata basis of their carrying amount.
An intangible asset other than goodwill is considered impaired when its balance sheet carrying amount exceeds its estimated recoverable amount, which is defined as the higher of its FVLCOD and its VIU. If the recoverable amount of an asset is less than its carrying amount, the carrying amount of the asset shall be reduced to its recoverable amount. That reduction is an impairment loss. Usually, Alcon applies the FVLCOD method for its impairment assessment. In most cases, no direct or indirect observable market prices for identical or similar assets are available to measure the FVLCOD. Therefore, an estimate of FVLCOD is based on net present value techniques utilizing post-tax cash flows and discount rates. In the limited cases where the VIU method would be applied, net present value techniques would be applied using pre-tax cash flows and discount rates.
FVLCOD reflects estimates of assumptions that market participants would be expected to use when pricing the asset or CGUs, and for this purpose management considers the range of economic conditions that are expected to exist over the remaining useful life of the asset.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
The estimates used in calculating the net present values involve significant judgment by management and include assumptions with measurement uncertainty, such as the following:
Amount and timing of projected cash flows;
Long-term sales forecasts for periods of up to 25 years including sales growth rates;
Royalty rate for the Alcon brand name;
Terminal growth rate; and
Discount rate.
Other assumptions used in the net present values calculation include:
Future tax rate;
Actions of competitors (launch of competing products, marketing initiatives, etc.); and
Outcome of R&D activities and forecast of related costs (future product developments).
Generally, for intangible assets with a definite useful life Alcon uses cash flow projections for the whole useful life of these assets. For goodwill and the Alcon brand name, Alcon generally utilizes cash flow projections for a five-year period based on management forecasts, with a terminal value based on cash flow projections considering the long-term expected growth rates and impact of demographic trends of the population to which Alcon products are prescribed, for later periods. Probability-weighted scenarios are typically used.
Discount rates used consider Alcon estimated weighted average cost of capital adjusted for specific country and currency risks associated with cash flow projections to approximate the weighted average cost of capital of a comparable market participant. Actual cash flows and values could vary significantly from forecasted future cash flows and related values derived using net present value techniques.
Cash and cash equivalents
Cash and cash equivalents includes cash on hand, deposits held at call with financial institutions, and other short-term and highly liquid investments with original or weighted-average maturities of three months or less which are readily convertible to known amounts of cash and which are subject to an insignificant risk of changes in value. Bank overdrafts are usually presented within current financial debts on the Consolidated Balance Sheet except in cases where a right of offset has been agreed with a bank which then allows for presentation on a net basis.
Financial assets
Non-current financial assets such as loans and long-term receivables from customers, primarily related to surgical equipment sales arrangements, advances and other deposits, are carried at amortized cost, which reflects the time value of money, less any allowances for uncollectable amounts.
Alcon assesses on a forward-looking basis the expected credit losses associated with its non-current financial assets valued at amortized cost.
For loans, advances and other deposits valued at amortized cost, impairments, which are based on their expected credit losses, and exchange rate losses are included in "Other expense" in the Consolidated Income Statement and exchange rate gains and interest income, using the effective interest rate method, are included in "Other income" in the Consolidated Income Statement.
For long-term receivables from customers, provisions for uncollectable amounts, which are based on their expected credit losses, are recorded as marketing and selling costs recognized in the Consolidated Income Statement within "Selling, general & administration" expenses.
Fund investments are valued at fair value through profit and loss ("FVPL"). Unrealized gains and losses, including exchange gains and losses, are recognized in the Consolidated Income Statement in "Other income" for gains and "Other expense" for losses.
Equity securities and convertible notes receivable held as strategic investments are generally designated at the date of acquisition as financial assets valued at fair value through other comprehensive income ("FVOCI") with no subsequent recycling through profit and loss. Unrealized gains and losses, including exchange gains and losses, are recorded as a fair value adjustment in the Consolidated Statement of Comprehensive Income/(Loss). They are reclassified to "Other reserves" when the equity security is sold. If these equity securities and convertible notes receivable are not designated at the date of acquisition as financial assets valued at FVOCI, they are valued at FVPL, as described above for fund
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
investments. Changes in fair value of options to acquire development stage companies are charged to research and development expense.
Derivative financial instruments are initially recognized in the Consolidated Balance Sheet at fair value and are remeasured to their current fair value at the end of each subsequent reporting period. The valuation of forward exchange rate contracts and foreign exchange swaps are based on the discounted cash flow model, using interest curves and spot rates at the reporting date as observable inputs. Unsettled forward contracts and swaps are measured at fair value at quarter-end with changes in fair value recorded to the Consolidated Income Statement as unrealized gains or losses in "Other financial income & expense". Settled forward contracts and swaps are measured at maturity date at fair value with corresponding realized gains or losses recognized in the Consolidated Income Statement in "Other financial income & expense". No hedge accounting is applied for these arrangements.
Inventories
Inventory is valued at the lower of acquisition or production cost determined on a first-in, first-out basis and net realizable value. This value is used for the "Cost of net sales" and "Cost of other revenues" in the Consolidated Income Statement. Unsalable inventory is fully written off in the Consolidated Income Statement under "Cost of net sales" and "Cost of other revenues".
Trade receivables
Trade receivables are initially recognized at their invoiced amounts, including any related sales taxes less adjustments for estimated revenue deductions such as chargebacks and cash discounts.
Provisions for expected credit losses are established using an expected credit loss model ("ECL"). The provisions are based on a forward-looking ECL, which includes possible default events on the trade receivables over the entire holding period of the trade receivable. These provisions represent the difference between the trade receivable's carrying amount and the estimated net collectible amount. Charges for doubtful trade receivables are recorded as marketing and selling costs recognized in the Consolidated Income Statement within "Selling, general & administration" expenses.
Leases
Effective January 1, 2019, Alcon adopted IFRS 16, Leases. As lessee, Alcon assesses whether a contract contains a lease at inception of a contract based on whether the contract conveys the right to control the use of an identified asset for a period of time in exchange for consideration. Alcon recognizes a right-of-use asset and a corresponding lease liability for all arrangements in which it is a lessee, except for leases with a term of twelve months or less (short-term leases) and low value leases for which Alcon has elected the recognition exemptions allowed under IFRS 16.
Right-of-use assets
Right-of-use assets are initially recognized at cost, which is comprised of the amount of the initial measurement of the corresponding lease liabilities, adjusted for any lease payments made at or prior to the commencement date of the lease, lease incentives received and initial direct costs incurred, as well as any expected costs for obligations to dismantle and remove right-of-use assets when they are no longer used.
Right-of-use assets are depreciated on a straight-line basis over the shorter of the useful life of the right-of-use asset or the end of the lease term.
Right-of-use assets are assessed for impairment whenever there is an indication that the balance sheet carrying amount may not be recoverable using cash flow projections for the useful life.
Lease liabilities
Lease liabilities are accounted for at amortized cost and are initially measured at the present value of future lease payments and are classified as current or non-current based on the due dates of the underlying principal payments. In determining the lease term, Alcon evaluates the renewal options and termination options reasonably certain to be exercised. Lease payments are discounted using the interest rate implicit in the lease or, if not readily determinable, the incremental borrowing rate Alcon would be expected to pay within the respective markets, on a borrowing with a similar term and security. Interest in the period is recorded within "Interest expense" in the Consolidated Income Statement.
Lease liabilities are remeasured for changes in estimated lease term, future lease payments arising from a change in an index or rate, amounts expected to be payable under a residual value guarantee, or in assessment of whether Alcon will exercise a purchase, extension or termination option. Changes to initial lease contract terms are assessed to determine their impact on the scope of lease, and any modifications increasing the scope of the lease are treated as new contracts
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
under the initial measurement principles, while modifications that do not increase or that decrease the scope of the lease result in an adjustment to the right-of-use asset which is remeasured as of the date of the modification.
Principal payments made on lease liabilities and any initial direct costs paid are classified as financing cash outflows, while interest payments are classified as operating cash outflows.
Payments associated with short-term leases and leases of low-value assets are recognized on a straight-line basis as an expense in the Consolidated Income Statement and are classified as cash flows from operating activities.
Legal liabilities
Alcon is subject to contingencies arising in the ordinary course of business such as patent litigation and other product-related litigation, commercial litigation, and governmental investigations and proceedings. Provisions are recorded where a reliable estimate can be made of the probable outcome of legal or other disputes.
Contingent consideration
In a business combination, it is necessary to recognize contingent future payments to previous owners representing contractually defined potential amounts as a liability. Usually for Alcon, these are linked to development or commercial milestones related to certain assets and are recognized as a financial liability at their fair value, which is then re-measured at each subsequent reporting date.
For the determination of the fair value of a contingent consideration, various unobservable inputs are used. A change in these inputs might result in a significantly higher or lower fair value measurement. The inputs used are, among others, the timing and probability of regulatory and commercial success, sales forecast and assumptions regarding the discount rate, timing and different scenarios of triggering events. The significance and usage of these inputs to each contingent consideration may vary due to differences in the timing and triggering events for payments or in the nature of the asset related to the contingent consideration. These estimations typically depend on factors such as technical milestones or market performance and are adjusted for the probability of their likelihood of payment, and if material, appropriately discounted to reflect the impact of time.
Changes in the fair value of contingent consideration liabilities in subsequent periods are recognized in the Consolidated Income Statement in "Cost of net sales" for currently marketed products and in "Research & development" for IPR&D.
The effect of unwinding the discount over time is recognized in "Interest expense" in the Consolidated Income Statement.
Defined benefit pension plans and other post-employment benefits
The liability or asset recognized in the balance sheet in respect of defined benefit pension plans and other post-employment benefits is the present value of the defined benefit obligation at the end of the reporting period less the fair value of plan assets. The defined benefit obligation is calculated annually by independent actuaries using the projected unit credit method.
The present value of the defined benefit obligation is determined by discounting the estimated future cash outflows using interest rates of high-quality corporate bonds that are denominated in the currency in which the benefits will be paid, and that have terms approximating the terms of the related obligation. In countries where there is no sufficient market for such bonds, the market rates on government bonds are used.
The current service cost for such post-employment benefit plans is included in the personnel expenses of the various functions where the associates are employed. The net interest on the net defined benefit liability is recognized as "Other expense" or "Other income". The net interest cost is calculated by applying the discount rate to the net balance of the defined benefit obligation and the fair value of plan assets. Past service cost is recognized as "Other expense" or "Other income" in the Consolidated Income Statement for the change in the present value of a defined benefit obligation for employee service in prior periods resulting from a plan amendment or a curtailment.
Remeasurement gains and losses arising from experience adjustments and changes in actuarial assumptions are recognized in the period in which they occur, directly in other comprehensive income/(loss).
Defined contribution plans
For defined contribution plans, Alcon contributes to publicly or privately administered plans. Alcon has no further payment obligations once the contributions have been paid. The contributions are included in the personnel expenses of the various functions where the associates are employed.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
Financial debts
Financial debts are initially recognized at fair value, net of transaction costs incurred. Financial debts are subsequently measured at amortized cost. Any difference between the proceeds (net of transaction costs and discounts) and the redemption amount is recognized in the Consolidated Income Statement over the period of the financial debts using the effective interest method. Fees paid on the establishment of credit facilities are recognized as transaction costs of the financial debt to the extent that it is probable that some or all of the facility will be drawn down. In this case, the fee is deferred until the draw down occurs. To the extent that there is no evidence that it is probable that some or all of the facility will be drawn down, the fee is capitalized as a prepayment for liquidity services and amortized over the period of the facility to which it relates, and is recognized in "Other financial income & expense" in the Consolidated Income Statement.
Financial debts are derecognized from the balance sheet when the obligation specified in the contract is discharged, cancelled or expired. The difference between the carrying amount of a financial debt that has been extinguished and the consideration paid, including any non-cash assets transferred or liabilities assumed, is recognized in "Other financial income & expense" in the Consolidated Income Statement.
Interest paid on financial debts is classified as operating activities in the Consolidated Statement of Cash Flows. Financial debts are classified as current liabilities unless Alcon has an unconditional right and intent to defer the settlement of the liability for at least twelve months after the reporting period.
Revenue
Net sales to third parties
Revenue on the sale of Alcon products and services, which is recorded as "Net sales to third parties" in the Consolidated Income Statement, is recognized when a contractual promise to a customer (i.e., a performance obligation) has been fulfilled by transferring control over the promised goods and services to the customer, substantially all of which is at the point in time of shipment to or receipt of the products by the customer or when the services are performed. If contracts contain customer acceptance provisions, revenue would be recognized upon the satisfaction of acceptance criteria. The amount of revenue to be recognized is based on the consideration Alcon expects to receive in exchange for its goods and services. If a contract contains more than one performance obligation, the consideration is allocated based on the relative standalone selling price of each performance obligation.
Surgical equipment may be sold together with other products and services under a single contract and may be structured as an outright cash sale, an installment sale, or lease. Surgical equipment installment sales and leases have a fixed payment amount which the customer may pay either in fixed intervals or as the customer purchases consumables and/or implantables. Revenues are recognized upon satisfaction of each of the performance obligations in the contract and the consideration is allocated based on the relative standalone selling price of each performance obligation.
Surgical equipment revenue from outright cash sales and installment sales arrangements is recognized at the point in time when control is transferred to the customer. The current portion of long-term receivables from customers and long-term receivables from customers for installment sales arrangements are recorded in "Other current assets" (see "Current portion of long-term receivables from customers" in Note 15 of these Consolidated Financial Statements) and "Financial assets" (see "Long-term receivables from customers" in Note 12 of these Consolidated Financial Statements), respectively. Financing income for installment sales arrangements longer than twelve months is recognized over the term of the arrangement in "Other income". Alcon applies the practical expedient under IFRS 15 to installment sales arrangements that are twelve months or less in duration.
In addition to cash and installment sales, revenue is recognized under finance and operating lease arrangements. Leases in which Alcon transfers substantially all the risks and rewards incidental to ownership to the customer are treated as finance lease arrangements. Revenue from finance lease arrangements is recognized at amounts equal to the fair value of the equipment, which approximates the present value of the minimum lease payments under the arrangements. As interest rates embedded in lease arrangements are approximately market rates, revenue under finance lease arrangements is comparable to revenue for outright sales. Finance income for arrangements longer than twelve months is deferred and subsequently recognized based on a pattern that approximates the use of the effective interest method and recorded in "Other income". Operating lease revenue for equipment rentals is recognized on a straight-line basis over the lease term in "Net sales to third parties".
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
The consideration Alcon receives in exchange for its goods or services may be fixed or variable. Variable consideration is only recognized when it is highly probable that a significant reversal of cumulative sales will not occur. The most common elements of variable consideration are listed below:
Rebates and discounts granted to government agencies, wholesalers, retail pharmacies, managed health-care organizations and other customers, as well as chargebacks are provisioned and recorded as a deduction from revenue at the time the related revenues are recorded or when the incentives are offered. They are calculated on the basis of historical experience, regulations, the specific terms in the individual agreements, product pricing, channels and payors.
Cash discounts are offered to customers to encourage prompt payment and are provisioned and recorded as revenue deductions at the time the related sales are recorded.
Sales returns provisions are recognized and recorded as revenue deductions when there is historical experience of Alcon agreeing to customer returns and Alcon can reasonably estimate expected future returns. In doing so, the estimated rate of return is applied, determined based on historical experience of customer returns and considering any other relevant factors. This is applied to the amounts invoiced, also considering the amount of returned products to be destroyed versus products that can be placed back in inventory for resale. Where shipments are made on a re-sale or return basis, without sufficient historical experience for estimating sales returns, revenue is only recorded when there is evidence of consumption or when the right of return has expired.
Provisions for revenue deductions are adjusted to actual amounts as rebates, discounts, chargebacks and returns are processed. The provision represents estimates of the related obligations, requiring the use of judgment when estimating the effect of these sales deductions.
Other revenues
"Other revenues" include revenue from contract manufacturing services provided to the Former Parent which are recognized over time as the service obligations are completed and third party royalty income. Associated costs for contract manufacturing services are recognized in "Cost of other revenues".
Research & development
Internal research & development ("R&D") costs are fully charged to "Research & development" in the Consolidated Income Statement in the period in which they are incurred. Alcon considers that regulatory and other uncertainties inherent in the development of new products preclude the capitalization of internal development expenses as an intangible asset until marketing approval from a regulatory authority is obtained in a major market such as the United States, the European Union, Switzerland, China or Japan.
Payments made to third parties to in-license or acquire intellectual property rights and products, including initial upfront and subsequent milestone payments, are capitalized as intangible assets. If additional payments are made to the originator company to continue to perform R&D activities, an evaluation is made as to the nature of the payments. Such additional payments will be expensed if they are deemed to be compensation for subcontracted R&D services not resulting in an additional transfer of intellectual property rights to Alcon. Such additional payments will be capitalized if they are deemed to be compensation for the transfer to Alcon of additional intellectual property developed at the risk of the originator company. Subsequent internal R&D costs in relation to IPR&D and other assets are expensed until such time that technical feasibility can be proven, as demonstrated by the receipt of marketing approval for the related product from a regulatory authority in a major market.
Equity-based compensation
Each of the periods presented include expense related to incentive compensation provided to eligible Alcon associates in the form of equity-settled or equity-based awards including restricted stock units ("RSUs") and performance stock units ("PSUs").
Alcon expenses the fair values of RSUs and PSUs granted to associates as compensation over the related vesting periods within the various functions where the associates are employed. The fair values of the awards are determined on their grant dates and are adjusted to account for the specific provisions of each of the corresponding grant agreements.
Alcon RSUs do not entitle the recipients to dividends. As such, the fair value upon grant is based on the Alcon share price at the grant date adjusted for potential future dividends to be paid within the holding period. The fair value of these grants, after making adjustments for assumptions related to their forfeiture during the vesting period, is expensed on a straight-line basis over the respective vesting period.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
PSUs are subject to certain performance criteria being achieved during the vesting period and require plan participants to provide services during the vesting period. PSUs granted under Alcon's plans are subject to performance criteria based on internal performance metrics. The expense is determined taking into account assumptions concerning performance during the period relative to targets and expected forfeitures due to plan participants not meeting their service conditions. These assumptions are periodically adjusted. Any change in estimates for past services is recorded immediately as an expense or income in the Consolidated Income Statement and amounts for future periods are expensed over the remaining vesting period. As a result, at the end of the vesting period, the total charge during the whole vesting period represents the amount that will finally vest. The number of equity instruments that finally vest is determined at the vesting date.
If a plan participant leaves Alcon for reasons other than retirement, disability or death, then unvested restricted shares, RSUs and PSUs are forfeited, unless determined otherwise by the provision of the plan rules or by the Compensation Committee of the Alcon Board of Directors, for example, in connection with a reorganization.
Restructuring charges
Restructuring provisions are recognized for the direct expenditures arising from the restructuring, where the plans are sufficiently detailed and where appropriate communication to those affected has been made.
Charges to increase restructuring provisions are included in "Other expense" in the Consolidated Income Statement. Corresponding releases are recorded in "Other income" in the Consolidated Income Statement.
Taxes
Taxes on income are expensed in the same periods as the revenues and expenses to which they relate and include any interest and penalties incurred during the period. Deferred taxes are determined using the comprehensive liability method and are calculated on the temporary differences that arise between the tax basis of an asset or liability and its carrying value in the balance sheet prepared for purposes of these Consolidated Financial Statements, except for those temporary differences related to investments in subsidiaries where the timing of their reversal can be controlled and it is probable that the difference will not reverse in the foreseeable future. Since the retained earnings are reinvested, withholding or other taxes on eventual distribution of a subsidiary's retained earnings are only taken into account when a dividend has been planned.
The estimated amounts for current and deferred tax assets or liabilities, including any amounts related to any uncertain tax positions, are based on currently known facts and circumstances. Tax returns are based on an interpretation of tax laws and regulations and reflect estimates based on these judgments and interpretations. The tax returns are subject to examination by the competent taxing authorities which may result in an assessment being made requiring payments of additional tax, interest or penalties. Inherent uncertainties exist in the estimates of the tax positions.
Earnings/(loss) per share
Basic earnings/(loss) per share is based on the weighted average number of common shares outstanding. Diluted earnings/(loss) per share is based on the weighted average number of common shares outstanding and all dilutive potential common shares outstanding.
New standards and interpretations not yet adopted
There are no IFRS standards, interpretations or amendments not yet effective that would be expected to have a material impact on Alcon.

4.     Significant transactions
Significant transactions in 2021
Acquisition of Simbrinza US commercialization rights
On April 28, 2021, Alcon executed an Asset Purchase Agreement (“Agreement”) to acquire exclusive US commercialization rights to a pharmaceutical ophthalmic eye drop, Simbrinza (brinzolamide/brimonidine tartrate ophthalmic suspension) 1%/0.2% from Novartis. Under the terms of the Agreement, Alcon paid $355 million at closing on June 8, 2021 and recognized the intangible asset acquisition as currently marketed products within the Vision Care reportable segment. After closing, Alcon and Novartis immediately began a transition period during which Novartis sold Simbrinza on Alcon's
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
behalf. The transition period concluded during the third quarter of 2021 and Alcon has started to fully commercialize Simbrinza for the US market. Novartis retains all rights to Simbrinza® outside of the US.
Significant transactions in 2020
Series 2030 notes issuance
On May 27, 2020, Alcon, through its wholly owned subsidiary Alcon Finance Corporation (“AFC”), completed an offering of $750 million of non-current financial debt consisting of 2.600% senior notes due 2030. The senior notes are described in Note 17 of these Consolidated Financial Statements.
Significant transactions in 2019
Refinancing of Bridge Facility and Facility A financial debts
On September 23, 2019, Alcon, through its wholly owned subsidiary AFC, refinanced $2 billion of the bridge and term loans, which had been issued in April 2019, with $500 million of 2.750% senior notes due 2026, $1 billion of 3.000% senior notes due 2029, and $500 million of 3.800% senior notes due 2049. The bridge and term loans, notes, and refinancing are described in Note 17 of these Consolidated Financial Statements.
Completion of Spin-off from Novartis through a dividend in kind distribution to Novartis shareholders
The Spin-off was executed on April 9, 2019 as described in Note1 of these Consolidated Financial Statements. The below transactions occurred in April 2019, immediately preceding the Spin-off.
On April 2, 2019, Alcon borrowed $3.2 billion against the bridge and other term loans which were executed on March 6, 2019 and are described in Note 17 of these Consolidated Financial Statements. These borrowings increased Alcon's third party financial debts to $3.5 billion at the date of Spin-off. Through a series of intercompany transactions, Alcon then paid approximately $3.1 billion in cash to Novartis and its affiliates prior to the Spin-off, decreasing Alcon's net assets to approximately $20.0 billion at the date of Spin-off.
Surgical - Acquisition of PowerVision, Inc.
On March 13, 2019, Alcon acquired 100% of the outstanding shares and equity of PowerVision, Inc. ("PowerVision"), a privately-held, US-based company focused on developing accommodative, implantable intraocular lenses. This technology allows the intraocular lens to respond to natural muscular movements in the eye to alter shape and focus. The PowerVision acquisition was executed as part of Alcon's commitment to innovation in advanced technology intraocular lenses ("AT-IOLs").
The fair value of the total purchase consideration was $424 million. This amount consisted of an initial cash payment of $289 million and the fair value of the probability weighted contingent consideration of $135 million due to PowerVision shareholders, which they are eligible to receive upon the achievement of specified regulatory and commercialization milestones. The purchase price allocation resulted in net identifiable assets of $418 million, which consisted of in-process research & development intangible assets of $505 million, a net deferred tax liability of $93 million, and other net assets of $6 million. Goodwill of $6 million was also recognized which is attributable to the assembled workforce. Cash paid for the acquisition, net of cash acquired, was $283 million. The 2019 results of operations following the date of acquisition and transaction costs for the acquisition were not material.

5.     Segment information
The segment information disclosed in these Consolidated Financial Statements reflects historical results consistent with the identifiable reportable segments of Alcon and financial information that the Chief Operating Decision Maker ("CODM") reviews to evaluate segmental performance and allocate resources among the segments. The CODM is the Executive Committee of Alcon.
The businesses of Alcon are divided operationally on a worldwide basis into 2 identified reportable segments, Surgical and Vision Care. Alcon's reportable segments are the same as its operating segments as Alcon does not aggregate any operating segments in arriving at its reportable segments. As indicated below, certain income and expenses are not allocated to segments.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
Reportable segments are presented in a manner consistent with the internal reporting to the CODM. The reportable segments are managed separately due to their distinct needs and activities for research, development, manufacturing, distribution, and commercial execution.
The Executive Committee of Alcon is responsible for allocating resources and assessing the performance of the reportable segments.
In Surgical, Alcon researches, develops, manufactures, distributes and sells ophthalmic products for cataract surgery, vitreoretinal surgery, refractive laser surgery and glaucoma surgery. The surgical portfolio also includes implantables, consumables and surgical equipment required for these procedures and supports the end-to-end procedure needs of the ophthalmic surgeon.
In Vision Care, Alcon researches, develops, manufactures, distributes and sells daily disposable, reusable, and color-enhancing contact lenses and a comprehensive portfolio of ocular health products, including products for dry eye, glaucoma, contact lens care and ocular allergies, as well as ocular vitamins and redness relievers.
Alcon also provides services, training, education and technical support for both the Surgical and Vision Care businesses.
The basis of preparation described in Note 2, and the selected accounting policies mentioned in Note 3 of these Consolidated Financial Statements, are used in the reporting of segment results.
The Executive Committee of Alcon evaluates segmental performance and allocates resources among the segments primarily based on net sales and segment contribution.
Net identifiable assets are not assigned to the segments in the internal reporting to the CODM, and are not considered in evaluating the performance of the business segments by the Executive Committee of Alcon.
Segment contribution excludes amortization and impairment charges for acquired product rights or other intangibles, general and administrative expenses for corporate activities, spin readiness and separation costs, transformation costs, fair value adjustments of contingent consideration liabilities, past service costs primarily for post-employment benefit plan amendments, and certain other income and expense items.
General & administration (corporate) includes the costs of the Alcon corporate headquarters, including all related corporate function costs. For a portion of the historical comparative periods only, the related corporate function costs were allocated to Alcon from its Former Parent.
Other income and expense items excluded from segment contribution include fair value adjustments of financial assets in the form of options to acquire a company carried at FVPL, net gains and losses on fund investments and equity securities valued at FVPL, restructuring costs, legal provisions and settlements, integration related expenses and other income and expense items not attributed to a specific segment.
F-19

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
Net sales and other revenues by segment
($ millions)202120202019
Surgical
Implantables1,522 1,126 1,210 
Consumables2,388 1,952 2,304 
Equipment/other793 632 660 
Total Surgical net sales to third parties4,703 3,710 4,174 
Vision Care
Contact lenses2,139 1,838 1,969 
Ocular health1,380 1,215 1,219 
Total Vision Care net sales to third parties3,519 3,053 3,188 
Total net sales to third parties8,222 6,763 7,362 
Vision Care other revenues69 70 146 
Total net sales and other revenues8,291 6,833 7,508 
Segment contribution and reconciliation to income/(loss) before taxes
($ millions)202120202019
Segment contribution:
Surgical1,184 672 957 
Vision Care604 419 580 
Total segment contribution1,788 1,091 1,537 
Not allocated to segments:
Amortization of intangible assets(590)(1,078)(1,084)
Impairment charges on intangible assets(225)(167)— 
General & administration (corporate)(251)(232)(216)
Separation costs(36)(217)(237)
Spin readiness costs— — (72)
Transformation costs(68)(49)(52)
Fair value adjustments of contingent consideration liabilities42 63 75 
Past service costs for post-employment benefit plan amendments18 154 (2)
Other(98)(47)(136)
Operating income/(loss)580 (482)(187)
Interest expense(120)(124)(113)
Other financial income & expense(42)(29)(32)
Income/(loss) before taxes418 (635)(332)

F-20

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
Included in segment contribution are:
($ millions)202120202019
Depreciation of property, plant & equipment:
Surgical(129)(122)(112)
Vision Care(194)(171)(155)
Total depreciation of property, plant & equipment(323)(293)(267)
Depreciation of right-of-use assets:
Surgical(50)(47)(42)
Vision Care(31)(32)(24)
Total depreciation of right-of-use assets(81)(79)(66)
Impairment charges on property, plant & equipment, net:
Surgical— (6)(3)
Vision Care— — (5)
Total impairment charges on property, plant & equipment, net (6)(8)
Equity-based compensation:
Surgical(74)(55)(55)
Vision Care(60)(45)(44)
Not allocated to segments(17)(13)(15)
Total equity-based compensation(151)(113)(114)
Geographical information
The following table shows the United States, International and countries that accounted for more than 5% of at least one of the respective Alcon totals, for net sales for the years ended December 31, 2021, 2020 and 2019, and for selected non-current assets at December 31, 2021 and 2020:
 
Net sales(2)
Total of selected
non-current assets(3)
($ millions unless indicated otherwise)(1)
20212020201920212020
 
Country          
United States3,651 44 %2,975 44 %3,055 41 %10,200 47 %10,309 47 %
International4,571 56 %3,788 56 %4,307 59 %11,553 53 %11,476 53 %
thereof:
Switzerland (country of domicile)60 %55 %56 %9,762 45 %9,737 45 %
Japan621 %650 10 %656 %46 — %63 — %
China486 %383 %377 %16 — %16 — %
Other3,404 41 %2,700 40 %3,218 44 %1,729 %1,660 %
Company total8,222 100 %6,763 100 %7,362 100 %21,753 100 %21,785 100 %
(1)International percentages may not sum due to rounding.
(2)Net sales from operations by location of third-party customer.
(3)Includes property, plant & equipment, right-of-use assets, goodwill and other intangible assets.
No customer accounted for 10% or more of Alcon's net sales.
F-21

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)
6.    Interest expense and other financial income & expense
Interest expense
($ millions)202120202019
Interest expense on financial debts(95)(94)(81)
Interest expense from discounting long-term liabilities(12)(17)(21)
Interest expense on lease liabilities(13)(13)(11)
Total interest expense(120)(124)(113)
Other financial income & expense
($ millions)202120202019
Interest income
Loss on extinguishment of financial debt— — (4)
Other financial expense(10)(9)(18)
Monetary loss from hyperinflation accounting(6)(4)(2)
Currency result, net(29)(22)(16)
Total other financial income & expense(42)(29)(32)

7.     Taxes
Income/(loss) before taxes
($ millions)202120202019
Switzerland680 (585)(274)
Foreign(262)(50)(58)
Total income/(loss) before taxes418 (635)(332)
Current and deferred income tax (expense)/income
($ millions)202120202019
Switzerland(118)(14)(34)
Foreign(116)(105)(168)
Current income tax expense(234)(119)(202)
Switzerland45 96 (246)
Foreign147 127 124 
Deferred tax income/(expense)192 223 (122)
Total income tax (expense)/income(42)104 (324)
F-22

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

Analysis of tax rate
Alcon's overall applicable tax rate can change each year since it is calculated as the weighted average tax rate based on pre-tax income/(loss) of each subsidiary. The main elements contributing to the difference between Alcon's overall applicable tax rate and the effective tax rate are summarized in the below table.
 202120202019
($ millions unless indicated otherwise)%%%
Applicable tax rate(39)9.3 %98 15.4 %39 11.7 %
Effect of disallowed expenditures(10)2.4 %(20)(3.1)%(23)(6.9)%
Effect of equity-based compensation(7)1.7 %(5)(0.8)%(1)(0.3)%
Effect of income taxed at reduced rates(0.2)%0.6 %0.6 %
Effect of tax credits and allowances(2.2)%1.4 %2.1 %
Effect of deductibility of a statutory expense in Switzerland(1)
38 (9.1)%— — %— %
Effect of adjustments to contingent consideration and other liabilities(1.7)%17 2.7 %11 3.3 %
Effect of option payments(2)0.5 %(6)(0.9)%(12)(3.6)%
Effect of tax rate changes(2)
(3)0.7 %10 1.6 %(342)(103.0)%
Effect of changes in uncertain tax positions(3)
(39)9.3 %(8)(1.3)%10 3.0 %
Effect of other items(3)0.7 %(10)(1.6)%(2)(0.6)%
Effect of prior year items(1.4)%15 2.4 %(13)(3.9)%
Effective tax rate(42)10.0 %104 16.4 %(324)(97.6)%
(1)Effect of deductibility of a statutory expense in Switzerland relates to an agreement for fiscal year 2021. It is uncertain whether Alcon will obtain a similar benefit in future years.
(2)Effect of tax rate changes in 2019 relates primarily to the adoption of the Swiss Tax Reform which resulted in a non-cash tax increase in tax expense of $304 million for the re-measurement of the Swiss deferred tax balances anda $31 million re-measurement of US deferred tax balances as a result of rate changes in the US following legal entity reorganizations executed related to the Spin-off.
(3)Effect of changes in uncertain tax positions in 2021 primarily relate to international transfer pricing and a partial reserve for the deductibility of a statutory expense in Switzerland.
Alcon has a substantial business presence in many countries and is therefore subject to different income and expense items that are non-taxable (permanent differences) or are taxed at different rates in those tax jurisdictions. This results in a difference between Alcon's applicable tax rate and effective tax rate as shown in the table above.
The applicable tax rate in 2021, 2020 and 2019 was impacted by pre-tax losses in certain tax jurisdictions. The fluctuation in taxes and effective tax rates, excluding Swiss tax reform, is primarily due to the geographical pre-tax income and loss mix across certain tax jurisdictions relative to Alcon's consolidated income/(loss) before taxes, changes in uncertain tax positions and certain non-recurring items.
F-23

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

8.     Share capital, dividend and earnings/(loss) per share
8.1    Share capital
The share capital of the Company as of December 31, 2021 is CHF 20 million, which is comprised of 499.7 million registered shares, nominal value of CHF 0.04 per share.
The following table shows the movement in the shares:
(shares in millions)Common stock shares outstandingTreasury stock sharesTotal shares
January 1, 2019— — — 
Distribution by former parent of share capital at Spin-off488.2 0.5 488.7 
Issuance of additional registered shares— 3.0 3.0 
Settlement of equity-based awards0.1 (0.1)— 
December 31, 2019488.3 3.4 491.7 
Issuance of additional registered shares— 8.0 8.0 
Settlement of equity-based awards0.9 (0.9)— 
December 31, 2020489.2 10.5 499.7 
Settlement of equity-based awards0.9 (0.9) 
December 31, 2021490.1 9.6 499.7 
On November 10, 2020 and November 19, 2019, the Company's Board of Directors approved increases of CHF 320,000 and CHF 120,000, respectively, out of the Company’s authorized share capital through the issuance of 8.0 million and 3.0 million additional registered shares, respectively, nominal value CHF 0.04 per share, to fulfill the future vesting of existing and future equity-based awards. These additional shares were issued as treasury shares as part of the Company's authorized share capital according to the authority granted by the shareholders at the Company’s Annual General Meeting held on January 29, 2019 and reflected in the Company’s Articles of Incorporation as amended. While the transactions increased the number of shares available for issuance under the Company’s equity-based compensation plans, there was no immediate impact on the number of shares outstanding or earnings per share calculations at the time of the transactions. The number of shares outstanding and earnings per share calculations will be impacted as shares are delivered to plan participants over the course of the next several years. All of the Company's 9.6 million shares held in treasury may only be used to fulfill the future vesting of existing and future equity-based awards. The authority to issue additional registered shares under the authorized share capital expired on January 29, 2021.
8.2 Dividend
On February 23, 2021, the Alcon Board of Directors proposed a dividend of CHF0.10 per share which was subsequently approved by the shareholders at the Annual General Meeting on April 28, 2021 and paid in May 2021 for an amount of $54 million.
8.3 Earnings/(loss) per share
Basic earnings/(loss) per share is computed by dividing net income/(loss) for the period by the weighted average number of common shares outstanding during the period. For the years ended December 31, 2021, 2020, and 2019 the weighted average number of shares outstanding was 490.0 million, 489.0 million and 488.2 million shares, respectively.
The only potentially dilutive securities are the outstanding unvested equity-based awards under the Company's equity-based incentive plans, as described in Note 24 to these Consolidated Financial Statements. Except when the effect would be anti-dilutive, the calculation of diluted earnings per common share includes the weighted average net impact of unvested equity-based awards. For the year ended December 31, 2021, the weighted average diluted number of shares outstanding was 493.4 million, which includes the potential conversion of 3.4 million unvested equity-based awards. For the years ended December 31, 2020 and 2019, 2.8 million and 1.9 million unvested equity-based awards, respectively, have been excluded from the calculation of diluted loss per share as their effect would be anti-dilutive.
The average market value of the Company's shares for the purposes of calculating the potentially dilutive effects of unvested equity-based awards was based on quoted market prices for the period that the unvested awards were outstanding.

F-24

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

9.     Property, plant & equipment
The following table summarizes the movements of property, plant & equipment in 2021:
($ millions)LandBuildings & improvementsConstruction
in progress
Machinery &
other equipment
Total
Cost
January 1, 202135 1,884 573 3,425 5,917 
Additions(1)
654 57 721 
Disposals and derecognitions(2)
— (7)(8)(93)(108)
Reclassifications for assets placed in service— 146 (410)264 — 
Currency translation effects(1)(44)(19)(106)(170)
December 31, 202136 1,987 790 3,547 6,360 
Accumulated depreciation
January 1, 2021 (716)(8)(1,768)(2,492)
Depreciation charge— (107)— (216)(323)
Disposals and derecognitions(2)
— 83 95 
Currency translation effects— 16 — 55 71 
December 31, 2021 (802)(1)(1,846)(2,649)
Net book value at December 31, 202136 1,185 789 1,701 3,711 
(1)Includes $52 million in non-cash additions.
(2)Derecognition of assets that are no longer used and are not considered to have a significant disposal value or other alternative use.
As of December 31, 2021, commitments for purchases of property, plant & equipment were $186 million.
F-25

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

The following table summarizes the movements of property, plant & equipment in 2020:
($ millions)LandBuildings & improvementsConstruction
in progress
Machinery &
other equipment
Total
Cost
January 1, 202033 1,628 755 2,906 5,322 
Additions(1)
479 74 562 
Disposals and derecognitions(2)
— (7)(10)(105)(122)
Reclassifications for assets placed in service— 215 (705)490 — 
Other reclassifications— 11 — (11)— 
Currency translation effects— 30 54 71 155 
December 31, 202035 1,884 573 3,425 5,917 
Accumulated depreciation
January 1, 2020 (618)(8)(1,583)(2,209)
Depreciation charge— (80)— (213)(293)
Impairment charge— — — (6)(6)
Disposals and derecognitions(2)
— — 70 74 
Other reclassifications— (7)— — 
Currency translation effects— (15)— (43)(58)
December 31, 2020 (716)(8)(1,768)(2,492)
Net book value at December 31, 202035 1,168 565 1,657 3,425 
(1)Includes $83 million in non-cash additions.
(2)Derecognition of assets that are no longer used and are not considered to have a significant disposal value or other alternative use.

As of December 31, 2020, commitments for purchases of property, plant & equipment were $136 million.
F-26

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

10.     Goodwill and other intangible assets
The following table summarizes the movements of goodwill and other intangible assets in 2021:
 Intangible assets other than goodwill
($ millions)GoodwillAlcon
brand
name
Acquired
research &
development
TechnologiesCurrently
marketed
products
Marketing
know-how
Other
intangible
assets
(including
software)
Total
Cost
January 1, 20218,905 2,980 727 5,369 4,440 5,960 556 20,032 
Additions— — 20 — 359 — 104 483 
Reclassifications— — (10)— 10 — — — 
Disposals and derecognitions(1)
— — — — (6)— (2)(8)
December 31, 20218,905 2,980 737 5,369 4,803 5,960 658 20,507 
Accumulated amortization
January 1, 2021   (5,199)(3,197)(2,384)(155)(10,935)
Amortization charge— — — (39)(235)(238)(78)(590)
Disposals and derecognitions(1)
— — — — — 
Impairment charges— — (180)— (45)— — (225)
December 31, 2021  (180)(5,238)(3,471)(2,622)(231)(11,742)
Net book value at December 31, 20218,905 2,980 557 131 1,332 3,338 427 8,765 
(1)     Derecognitions of assets that are no longer used or being developed and are not considered to have a significant disposal value or other alternative use.
The following table summarizes the allocation of the net book values of goodwill and other intangible assets by reportable segment at December 31, 2021:
Intangible assets other than goodwill
($ millions)GoodwillAlcon
brand
name
Acquired
research &
development
TechnologiesCurrently
marketed
products
Marketing
know-how
Other
intangible
assets
(including
software)
Total
Surgical4,544 — 555 131 229 3,338 251 4,504 
Vision Care4,361 — — 1,103 — 176 1,281 
Not allocated to segments— 2,980 — — — — — 2,980 
Net book value at December 31, 20218,905 2,980 557 131 1,332 3,338 427 8,765 
The Surgical and Vision Care reportable segments' CGUs, to which goodwill is allocated are comprised of a group of smaller CGUs. The valuation method of the recoverable amount of the CGUs, to which goodwill is allocated, is based on the FVLCOD.
The Alcon brand name is an intangible asset with an indefinite life. The intangible asset is not allocated to the reportable segments as it is used to market the Alcon-branded products of both the Surgical and Vision Care businesses. Net sales of these products together are the grouping of CGUs, which is used to determine the recoverable amount. The valuation method is based on the FVLCOD.
F-27

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

The following assumptions were used in the calculations for the recoverable amounts of goodwill and the Alcon brand name at December 31, 2021 and 2020:
20212020
(As a percentage)SurgicalVision CareSurgicalVision Care
Terminal growth rate3.0 3.0 3.0 3.0 
Discount rate (post-tax)7.0 6.5 7.5 7.0 
The Surgical and Vision Care reportable segments' terminal growth rate assumption of 3.0% takes into consideration how the industry is expected to grow, analysis of industry expert reports, and expected relevant changes in demographics for various markets. The discount rates for both Surgical and Vision Care reportable segments consider Alcon's weighted average cost of capital, adjusted to approximate the weighted average cost of capital of comparable market participants. Both the terminal growth rates and the discount rates are consistent with external sources of information.
The FVLCOD, for all groupings of CGUs containing goodwill or indefinite life intangible assets, is reviewed for the impact of reasonably possible changes in key assumptions. In particular Alcon considered an increase in the discount rate, a decrease in the terminal growth rate and certain negative impacts on the forecasted cash flows. These reasonably possible changes in key assumptions did not indicate an impairment.
Refer to "Impairment of goodwill, Alcon brand name and definite lived intangible assets" and "Acquired In-Process Research & Development ("IPR&D")" in Note 3 in these Consolidated Financial Statements for additional disclosures on how Alcon performs goodwill and intangible asset impairment testing.
The following table summarizes the movements of goodwill and other intangible assets in 2020:
Intangible assets other than goodwill
($ millions)GoodwillAlcon
brand
name
Acquired
research &
development
TechnologiesCurrently
marketed
products
Marketing
know-how
Other
intangible
assets
(including
software)
Total
Cost
January 1, 20208,905 2,980 728 5,369 4,440 5,960 611 20,088 
Additions— — — — — 118 120 
Disposals and derecognitions(1)
— — (3)— — — (173)(176)
December 31, 20208,905 2,980 727 5,369 4,440 5,960 556 20,032 
Accumulated amortization
January 1, 2020— — (3)(4,692)(2,842)(2,146)(174)(9,857)
Amortization charge— — — (507)(249)(238)(84)(1,078)
Disposals and derecognitions (1)
— — — — — 164 167 
Impairment charges— — — — (106)— (61)(167)
December 31, 2020   (5,199)(3,197)(2,384)(155)(10,935)
Net book value at December 31, 20208,905 2,980 727 170 1,243 3,576 401 9,097 
(1)     Derecognitions of assets that are no longer used or being developed and are not considered to have a significant disposal value or other alternative use.
F-28

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

The following table summarizes the allocation of the net book values of goodwill and other intangible assets by reportable segment at December 31, 2020:
Intangible assets other than goodwill
($ millions)GoodwillAlcon
brand
name
Acquired
research &
development
TechnologiesCurrently
marketed
products
Marketing
know-how
Other
intangible
assets
(including
software)
Total
Surgical4,544 — 723 170 247 3,576 237 4,953 
Vision Care4,361 — — 996 — 164 1,164 
Not allocated to segments— 2,980 — — — — — 2,980 
Net book value at December 31, 20208,905 2,980 727 170 1,243 3,576 401 9,097 
Intangible asset impairment charges
The following table shows the intangible asset impairment charges in 2021, 2020 and 2019:
($ millions)202120202019
Surgical(178)(66)— 
Vision Care(47)(101)— 
Total(225)(167) 
For the year ended December 31, 2021, impairment charges recognized in the Consolidated Income Statement amounted to $225 million. Impairments of $180 million were recognized in Research & development in 2021. Of that amount, an impairment charge of $178 million was recognized in the third quarter of 2021 in Research & development to fully impair a CGU in the Surgical reportable segment upon a decision to suspend research and development efforts and commercialization of the product as Alcon prioritizes other products in the portfolio. An additional impairment charge of $2 million was recognized in the fourth quarter of 2021 in Research & development to fully impair a licensed technology in the Vision Care reportable segment, which will no longer be used in any future research and development activities. The remaining amount of $45 million relates to an impairment charge recognized in the first quarter of 2021 in Cost of net salesfor a currently marketed product CGU in the Vision Carereportable segment due to lower expected sales. The CGU was reduced to its recoverable amount of $48 million at the time of impairment.
For the year ended December 31, 2020, impairments amounted to $167 million. An impairment of $61 million was recognized in the third quarter of 2020, primarily to fully impair a CGU within the Vision Care reportable segment upon termination of the associated licensing agreement. The impairment was recognized in Research & development in the Consolidated Income Statement. The remaining amount relates to additional impairments of $106 million, which were recognized in Cost of net sales in the Consolidated Income Statement in 2020. Of that amount, an impairment of $41 million was recorded for a currently marketed product CGU within the Vision Care reportable segment due to lower expected sales. The CGU was reduced to its recoverable amount of $88 million at the time of impairment in the second quarter of 2020. An additional $65 million relates to impairments of a currently marketed product CGU in the Surgical reportable segment recognized in the first and fourth quarters of 2020 due to lower expected sales. This CGU was also reduced to its recoverable amount of $65 million at the time of impairment at December 31, 2020.
The recoverable amount of each CGU was determined based on the FVLCOD method. FVLCOD was estimated using net present value techniques utilizing post-tax cash flows and discount rates as there are no direct or indirect observable prices in active markets for identical or similar assets. The estimates used in calculating the net present value involve significant judgment by management and include assumptions with measurement uncertainty. The estimates used are considered to be consistent with market participant assumptions and include cash flow projections for a five-year period based on management forecasts, sales forecasts beyond the five-year period extrapolated using long-term expected growth rates, discount rates, and future tax rates. Since the cash flow projections are a significant unobservable input, the fair value of the CGUs were classified as Level 3 in the fair value hierarchy. Actual cash flows and values could vary significantly from forecasted future cash flows and related values derived using net present value techniques.
There were no intangible asset impairment charges during the year ended December 31, 2019.
F-29

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

11.     Deferred tax assets and liabilities
($ millions)Property, plant & equipmentIntangible assetsPensions and other benefit obligations of associatesInventoriesTax loss carry-forwardsOther assets, provisions and accrualsTotal
Gross deferred tax assets at December 31, 202024 128 381 174 314 1,026 
Gross deferred tax liabilities at December 31, 2020(215)(1,519)— (23)— (66)(1,823)
Net deferred tax balance at December 31, 2020(191)(1,514)128 358 174 248 (797)
At December 31, 2020(191)(1,514)128 358 174 248 (797)
(Charged)/credited to income(27)137 (9)86 192 
(Charged)/credited to equity— — (2)— 
(Charged)/credited to other comprehensive income— — (11)— (12)(20)
Net deferred tax balance at December 31, 2021(218)(1,377)116 349 188 325 (617)
Gross deferred tax assets at December 31, 202128 116 372 188 452 1,161 
Gross deferred tax liabilities at December 31, 2021(246)(1,382)— (23)— (127)(1,778)
Net deferred tax balance at December 31, 2021(218)(1,377)116 349 188 325 (617)
The below table presents the Net deferred tax balance as of December 31, 2021 after offsetting $752 millionof deferred tax assets and liabilities within the same tax jurisdiction.
($ millions)At December 31, 2021
Deferred tax assets409 
Deferred tax liabilities(1,026)
Net deferred tax liabilities(617)
F-30

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

($ millions)Property, plant & equipmentIntangible assetsPensions and other benefit obligations of associatesInventoriesTax loss carry-forwardsOther assets, provisions and accrualsTotal
Gross deferred tax assets at December 31, 201913 151 371 110 281 932 
Gross deferred tax liabilities at December 31, 2019(172)(1,713)(10)(23)— (46)(1,964)
Net deferred tax balance at December 31, 2019(159)(1,707)141 348 110 235 (1,032)
At December 31, 2019(159)(1,707)141 348 110 235 (1,032)
(Charged)/credited to income(32)193 (33)10 59 26 223 
Credited/(charged) to equity— — — (16)(4)
Credited to other comprehensive income— — 13 — — 16 
Net deferred tax balance at December 31, 2020(191)(1,514)128 358 174 248 (797)
Gross deferred tax assets at December 31, 202024 128 381 174 314 1,026 
Gross deferred tax liabilities at December 31, 2020(215)(1,519)— (23)— (66)(1,823)
Net deferred tax balance at December 31, 2020(191)(1,514)128 358 174 248 (797)
The below table presents the Net deferred tax balance as of December 31, 2020 after offsetting $627 million of deferred tax assets and liabilities within the same tax jurisdiction.
($ millions)At December 31, 2020
Deferred tax assets399 
Deferred tax liabilities(1,196)
Net deferred tax liabilities(797)
The below table presents deferred tax assets and deferred tax liabilities expected to have an impact on current taxes payable after more than twelve months.
($ billions)At December 31, 2021At December 31, 2020
Deferred tax assets0.8 0.6 
Deferred tax liabilities1.7 1.8 
For foreign unremitted earnings retained by consolidated entities for reinvestment, which amounted to $9 billion as of December 31, 2021, no provision is made for income taxes that would be payable upon the distribution of these earnings. If these earnings were remitted, an income tax charge could result based on the tax statutes currently in effect.
IFRS exceptions to recognizing taxable temporary differences include an exception to recognizing a deferred tax liability arising on the initial recognition of goodwill from acquisitions. As such, we have not provided a deferred tax for goodwill from acquisitions which amounted to $9 billion as of December 31, 2021 and 2020.
The gross value of capital loss carryforwards for which no deferred tax assets were recognized amounted to $103 million at December 31, 2021 and will expire in five years. There were no capital loss carryforwards at December 31, 2020.
The gross value of tax loss carryforwards capitalized as deferred tax assets amounted to $1,047 million at December 31, 2021 ($921 million at December 31, 2020), of which $2 million will expire in five years. Of the remaining $1,045 million, approximately $677 million have an indefinite carryforward period, and approximately $368 million have a carryforward period that ranges from six to twenty years. All tax loss carryforwards have been capitalized as deferred tax assets in 2021 as it is probable that sufficient taxable income will be available for the foreseeable future.
No tax losses carried forward have expired in 2021, 2020 or 2019.
F-31

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

Swiss tax reform
On June 30, 2019, Swiss voters approved the Swiss Tax Reform and Old Age Insurance financing bill ("Swiss tax reform"). As a result, the corporate income tax rate applicable to Alcon’s Swiss profits as of January 1, 2020 increased from approximately 9.4% in 2019 to approximately 14.2% beginning in 2020. This change resulted in a non-cash increase in tax expense of $304 million related to the re-measurement of Swiss deferred tax assets and liabilities in 2019.

12.     Financial and other non-current assets
The below tables provide details related to Financial assets and Other non-current assets as of December 31, 2021 and 2020.
Financial assets
($ millions)20212020
Long-term financial investments measured at FVOCI46 28 
Long-term financial investments measured at FVPL12 
Long-term receivables from customers110 117 
Non-current minimum lease payments from finance lease agreements35 39 
Long-term loans, advances and security deposits20 22 
Total financial assets217 218 
Minimum lease payments from finance lease agreements
The following table shows the receivables of the gross investments in finance leases and the net present value of the minimum lease payments, as well as unearned finance income, related to surgical equipment lease arrangements. The finance income is recorded in "Other income".
20212020
($ millions)Total future paymentsUnearned interest incomePresent
value
ProvisionNet
book
value
Total future paymentsUnearned interest incomePresent
value
ProvisionNet
book
value
Not later than one year(1)
32 (2)30 (2)28 33 (3)30 (1)29 
Between one and five years47 (2)45 (12)33 55 (3)52 (18)34 
Later than five years— — 32 — 32 (27)
Total81 (4)77 (14)63 120 (6)114 (46)68 
(1) The current portion of the minimum lease payments is recorded in trade receivables or other current assets (to the extent not yet invoiced).
Other non-current assets
($ millions)20212020
Deferred compensation plans155 137 
Prepaid post-employment benefit plans25 24 
Other non-current assets54 50 
Total other non-current assets234 211 

F-32

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

13.     Inventories
The amount of inventory recognized as an expense in "Cost of net sales" in the Consolidated Income Statement during 2021 amounted to $2.5 billion (2020: $2.1 billion, 2019: $2.2 billion). The amount of inventory recognized as an expense in "Cost of other revenues" in the Consolidated Income Statement during 2021 amounted to $62 million (2020: $63 million, 2019: $127 million).
($ millions)20212020
Raw material, consumables336 278 
Work in progress169 136 
Finished products1,394 1,230 
Total inventories1,899 1,644 
Alcon recognized inventory provisions and write-downs amounting to $220 million in 2021 (2020: $304 million, 2019: $181 million) and reversed inventory provisions amounting to $83 million in 2021 (2020: $91 million, 2019: $65 million). Inventory provisions mainly relate to the adjustment of inventory balances to their net realizable value based on the forecasted sales. Reversals are made when the products become salable.

14.     Trade receivables
Trade receivable balances include sales to wholesalers, retailers, doctor groups, private health systems, government agencies, pharmacy benefit managers, managed health-care organizations and government-supported healthcare systems. The following tables provide details related to Trade receivables as of December 31, 2021 and 2020, including trade receivables that are not overdue as specified in the payment terms and conditions established with Alcon's customers, as well as an analysis of overdue amounts, expected credit loss rates and related provisions for doubtful trade receivables:
2021
($ millions)Gross trade receivablesProvisionTrade receivables, netExpected credit loss rates
Not overdue1,273 (2)1,271 0.2 %
Past due for not more than one month96 (1)95 1.0 %
Past due for more than one month but less than three months74 (1)73 1.4 %
Past due for more than three months but less than six months43 (2)41 4.7 %
Past due for more than six months but less than one year23 (13)10 56.5 %
Past due for more than one year42 (36)85.7 %
Total1,551 (55)1,496 
2020
($ millions)Gross trade receivablesProvisionTrade receivables, netExpected credit loss rates
Not overdue1,137 (2)1,135 0.2 %
Past due for not more than one month109 (1)108 0.9 %
Past due for more than one month but less than three months67 (2)65 3.0 %
Past due for more than three months but less than six months36 (2)34 5.6 %
Past due for more than six months but less than one year31 (18)13 58.1 %
Past due for more than one year49 (43)87.8 %
Total1,429 (68)1,361 

F-33

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

The following table summarizes the movement in the provision for doubtful trade receivables:
($ millions)202120202019
January 1(68)(48)(54)
Provisions for doubtful trade receivables charged to the Consolidated Income Statement(20)(48)(17)
Utilization of provisions for doubtful trade receivables15 
Reversal of provisions for doubtful trade receivables23 14 15 
Currency translation effects(1)
December 31(55)(68)(48)
Closely monitored countries include Greece, Italy, Portugal, Spain, Brazil, Russia, Turkey, Saudi Arabia, and Argentina. The majority of the outstanding trade receivables from Greece, Italy, Spain, Saudi Arabia and Argentina are due directly from local governments or from government-funded entities. We evaluate trade receivables in these countries for potential collection risk. Should there be a substantial deterioration in our economic exposure with respect to those countries, we may increase our level of provisions by updating our expected loss provision or may change the terms of trade on which we operate.
The following table shows the gross trade receivables balance from these closely monitored countries as of December 31, 2021 and 2020, the amounts that are past due for more than one year and the related amount of the provisions for doubtful trade receivables that have been recorded:
($ millions)20212020
Total balance of gross trade receivables from closely monitored countries252 211 
Past due for more than one year10 14 
Provisions for doubtful trade receivables(11)(15)
Trade receivables include amounts denominated in the following major currencies:
($ millions)20212020
US dollar (USD)526 477��
Euro (EUR)243 214 
Japanese yen (JPY)160 168 
Chinese yuan (CNY)122 121 
Indian rupee (INR)36 30 
Canadian dollar (CAD)39 32 
Australian dollar (AUD)24 29 
British pound (GBP)29 21 
Russian ruble (RUB)35 28 
South Korean won (KRW)38 31 
Other currencies244 210 
Total trade receivables, net1,496 1,361 

F-34

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

15.     Other current assets
The following table provides details related to Other current assets as of December 31, 2021 and 2020:
($ millions)20212020
Current portion of long-term financial investments measured at FVPL— 12 
Current portion of long-term receivables from customers97 107 
Current portion of minimum lease payments from finance lease agreements28 29 
Prepaid expenses92 93 
Other receivables, security deposits and current assets79 88 
Derivative financial instruments
VAT receivables105 72 
Equity securities in public companies— 
Total other current assets407 404 

16.     Right-of-use assets and Lease liabilities
Right-of-use assets
Right-of-use assets as of December 31, 2021 and 2020 were comprised of the following:
($ millions)20212020
Land17 20 
Buildings326 310 
Machinery & equipment and other assets29 28 
Total right-of-use assets372 358 
Depreciation charges of $81 million and $79 million for the years ended December 31, 2021 and 2020, respectively, are shown in the table below by underlying class of asset:
($ millions)20212020
Land
Buildings60 59 
Machinery & equipment and other assets20 19 
Total depreciation of right-of-use assets81 79 
Additions to right-of-use assets amounted to $115 million and $107 million for the years ended December 31, 2021 and 2020, respectively.
Lease liabilities
Lease liabilities totaled $406 million as of December 31, 2021, including $67 million in current lease liabilities and $339 million in non-current lease liabilities. The contractual maturities of the undiscounted lease liabilities as of December 31, 2021 and 2020, are as follows:
Lease liabilities undiscounted
($ millions)20212020
Not later than one year80 82 
Between one and five years197 203 
Later than five years237 203 
Total lease liabilities undiscounted514 488 
F-35

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Lease liabilities
($ millions)20212020
Not later than one year6770
Between one and five years157 168 
Later than five years182 147 
Total lease liabilities406 385 
Additional disclosures
The following table provides additional disclosures related to right-of-use assets and lease liabilities:
($ millions)20212020
Interest expense on lease liabilities13 13 
Expense on short-term, low value and variable leases
Total cash outflows for leases92 85 
Thereof:
Lease liability payments(1)
72 69 
Interest payments(2)
13 12 
Short-term, low value and variable lease payments(2)
(1)     Reported as cash outflows from financing activities net of lease incentives received
(2)     Included within total net cash flows from operating activities

17.     Non-current and current financial debts
The below table summarizes non-current and current Financial debts outstanding as of December 31, 2021 and 2020.
($ millions)20212020
Non-current financial debts
Facility B796 794 
Facility C395 429 
Local facilities (Japan)47 — 
Series 2026 notes496 496 
Series 2029 notes993 992 
Series 2030 notes745 744 
Series 2049 notes494 494 
Revolving facility— — 
Total non-current financial debts3,966 3,949 
Current financial debts
Local facilities:
Japan84 101 
All others17 49 
Other short-term financial debts12 
Derivatives
Total current financial debts114 169 
Total financial debts4,080 4,118 
F-36

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Interest expense recognized for Financial debts, excluding lease liabilities, was $95 million, $94 million and $81 million for the years ended December 31, 2021, 2020 and 2019, respectively. The weighted average interest rate on Financial debts was 2.3%in 2021 and 2020.
Bridge Loan, Term Loan and Revolving Credit Facilities
On March 6, 2019, Alcon entered into a $1.5 billion unsecured 364-day bridge loan facility with 2 extension options, each for a period of 180 days (the "Bridge Facility"), a $0.5 billion unsecured three-year term loan facility ("Facility A"), a $0.8 billion unsecured five-year term loan facility ("Facility B"), a $0.4 billion (or the equivalent in EUR) unsecured five-year term loan facility ("Facility C") and a $1.0 billion unsecured five-year committed multicurrency revolving credit facility (the "Revolving Facility" and, together with the Bridge Facility, Facility A, Facility B and Facility C, the "Facilities"). On April 2, 2019, Alcon borrowed $3.2 billion against the bridge and other term loans. In February 2021, the $1.0 billion Revolving Facility was extended to March 2026. The Revolving Facility remained undrawn as of December 31, 2021.
Alcon and certain of its subsidiaries are the borrowers under the Facilities and Alcon guarantees the borrowings of such subsidiaries under the Facilities. In addition, the Revolving Facility includes a mechanism through which certain subsidiaries, as approved by the lenders, can accede as a borrower.
Alcon is permitted to voluntarily prepay loans under the Facilities, in whole or in part, without penalty or premium subject to certain minimum prepayment amounts and the payment of accrued interest on the amount prepaid and customary breakage costs. The Bridge Facility had a mandatory prepayment provision, pursuant to which Alcon would have to apply proceeds from relevant debt capital markets transactions in prepayment under the Bridge Facility.
The terms of the Facilities include certain events of default and covenants customary for investment grade credit facilities, including restrictive covenants that will limit, among other things, the grant or incurrence of security interests over any of Alcon's assets, the incurrence of certain indebtedness and entry into certain fundamental change transactions. The Facilities do not contain any financial covenants.
Refinancing of Bridge Facility and Facility A
On September 23, 2019, AFC issued Senior Notes ("Notes") with maturity dates in 2026, 2029, and 2049, which are guaranteed by the Company. The Notes are unsecured senior obligations of AFC issued in a private placement. The total principal amount of the Notes is $2.0 billion. The Notes were issued at a discount totaling $7 million, which was recorded as a reduction to the carrying value of the Notes and will be amortized to Interest expense over the term of the Notes. AFC incurred $15 million of debt issuance costs, which were recorded as a reduction to the carrying value of the Notes and will be amortized to Other financial income & expense over the term of the Notes.
The Notes consist of the following:
Series 2026 Notes - $0.5 billion due in 2026 issued at 99.5%, 2.750% interest is payable twice per year in March and September, beginning in March 2020.
Series 2029 Notes - $1.0 billion due in 2029 issued at 99.6%, 3.000% interest is payable twice per year in March and September, beginning March 2020.
Series 2049 Notes - $0.5 billion due in 2049 issued at 99.8%, 3.800% interest is payable twice per year in March and September, beginning March 2020.
The funds borrowed through the issuance of the Notes were used to repay the $1.5 billion Bridge Facility and $0.5 billion Facility A. The transaction was accounted for as an extinguishment of a liability. Alcon recognized a loss of $4 million associated with the write-off of unamortized deferred financing costs due to extinguishment of the original financing. This loss on extinguishment was recognized in Other financial income & expense.
Interest rate benchmark reform
Facility B and Facility C ("Term Loan Facilities") and the Revolving Facility (collectively, the "Remaining Facilities") originally bore interest rates equal to the interest rate benchmark (prevailing Euro Interbank Offered Rate (“EURIBOR”) in the case of loans denominated in EUR, USD prevailing London Interbank Offered Rate (“LIBOR”) in the case of loans denominated in USD and CHF LIBOR in the case of loans denominated in CHF), plus an applicable margin. On December 14, 2021, Alcon amended the terms of the Remaining Facilities in response to interest rate benchmark reform which includes the replacement of certain interbank offered rates (“IBOR”) with alternative benchmark rates. The amended terms incorporate a mechanism to switch from the Remaining Facilities' original interest rates to compounded risk-free rates ("RFR"), including any relevant credit adjustment spread. The practical expedient in Interest Rate Benchmark Reform – Phase 2: Amendments to IFRS 9, IAS 39, IFRS 4 and IFRS 16 will be applied which allows the effective interest rate to be updated to
F-37

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


reflect the change in interest rate benchmark from IBOR to RFR without adjusting the carrying amount. Consequently, there was no change in the carrying value of the Remaining Facilities as a result of the amendment.
Series 2030 notes issuance
On May 27, 2020, AFC issued senior notes due in 2030 (“Series 2030 Notes”), which are guaranteed by the Company. The Series 2030 Notes are unsecured senior obligations of AFC issued in a private placement and rank equally in right of payment with the Series 2026, Series 2029, and Series 2049 notes. The total principal amount of the Senior 2030 Notes is $750 million. The Senior 2030 Notes were issued at 99.843% with 2.600% interest payable twice per year in May and November, beginning in November 2020. The Series 2030 Notes were issued at a discount totaling $1 million, which was recorded as a reduction to the carrying value of the Series 2030 notes and will be amortized to Interest expense over the term of the Series 2030 Notes. AFC incurred $5 million of debt issuance costs, which were recorded as a reduction to the carrying value of the Series 2030 Notes and will be amortized to Other financial income & expense over the term of the Series 2030 Notes.
Local bilateral facilities
In February 2019, Alcon entered into a number of local bilateral facilities in different countries, with the largest share of borrowings in Japan. Two local bilateral facilities in Japan matured in February 2021 and were refinanced by three facilities with one and two year maturities. As of December 31, 2021, a total of $131 million was drawn in Japan, including $84 million classified as current and $47 million classified as non-current. There was $90 million undrawn on the facilities in Japan as of December 31, 2021.
Maturity of contractual undiscounted cash flows and interest payment commitments
The following table provides details on the maturity of the contractual undiscounted cash flows for Alcon's borrowings as of December 31, 2021 and 2020:
20212020
($ millions)Nominal amount - Current and non-current financial debtDerivativesTotalNominal amount - Current and non-current financial debtDerivativesTotal
Not later than one year107 114 162 169 
Between one and five years1,743 — 1,743 1,231 — 1,231 
Later than five years2,250 — 2,250 2,750 — 2,750 
Total contractual undiscounted cash flows4,100 7 4,107 4,143 7 4,150 
Unamortized debt discount and issuance costs(27)— (27)(32)— (32)
Total carrying value4,073 74,0804,11174,118 

The following table provides details on the maturity of the future contractual interest payments commitments as of December 31, 2021 and 2020:
($ millions)20212020
Not later than one year94 96 
Between one and five years340 357 
Later than five years583 687 
Total cash flows1,017 1,140 
F-38

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)

18.     Financial instruments - additional disclosures
The below table provides detail related to financial instruments as of December 31, 2021 and December 31, 2020.
($ millions)Note20212020
Cash and cash equivalents
Cash in current accounts246 262 
Cash held in time deposits and money market funds1,329 1,295 
Total cash and cash equivalents1,575 1,557 
Financial assets - measured at fair value through other comprehensive income ("FVOCI")
Long-term financial investments1246 28 
Total financial assets - measured at FVOCI46 28 
Financial assets - measured at amortized costs(1)
Trade receivables141,496 1,361 
Income tax receivables21 
Other current assets (excluding prepaid expenses and other current assets measured at FVPL)15309 296 
Long-term receivables from customers12110 117 
Non-current minimum lease payments from finance lease agreements1235 39 
Long-term loans, advances and security deposits1220 22 
Total financial assets - measured at amortized costs1,979 1,856 
Financial assets - measured at fair value through profit and loss ("FVPL")
Equity securities of public companies15— 
Deferred compensation assets12155 137 
Current portion of long-term financial investments15— 12 
Derivative financial instruments15
Long-term financial investments1212 
Total financial assets - measured at FVPL167 164 
Total financial assets3,767 3,605 
Financial liabilities - measured at amortized cost or cost(1)
Current financial liabilities
Financial debts17107 162 
Lease liabilities1667 70 
Trade payables903 876 
Total current financial liabilities - measured at amortized cost or cost1,077 1,108 
Non-current financial liabilities
Financial debts173,966 3,949 
Lease liabilities16339 315 
Total non-current financial liabilities - measured at amortized cost or cost4,305 4,264 
Total financial liabilities - measured at amortized cost or cost5,382 5,372 
Financial liabilities - measured at FVPL
Contingent consideration liabilities19/20112 157 
Derivative financial instruments17
Total financial liabilities - measured at FVPL119 164 
Total financial liabilities5,501 5,536 
Net financial assets and financial liabilities(1,734)(1,931)
(1)The carrying amount is a reasonable approximation of fair value, with the exception of the Series 2026, 2029, 2030 and 2049 notes recorded in Non-current financial debts with a fair value of $2,891 million and carrying value of $2,728 million as of December 31, 2021 and a fair value of $3,036 million and carrying value of $2,726 million as of December 31, 2020. The fair value of notes was determined using Level 2 inputs. The notes were valued using a quoted market price for such notes, which have low trading volumes.
F-39

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Fair value by hierarchy
As required by IFRS, financial assets and liabilities recorded at fair value in the Consolidated Financial Statements are categorized based upon the level of judgment associated with the inputs used to measure their fair value. There are three hierarchical levels, based on an increasing amount of judgment associated with the inputs to derive fair value for these financial assets and liabilities, which are as follows:
Financial assets and liabilities carried at Level 1 fair value hierarchy are listed in active markets.
Financial assets and liabilities carried at Level 2 fair value hierarchy are valued using corroborated market data.
Level 1 financial assets include money market funds, equity securities of public companies and deferred compensation assets. There were no financial liabilities carried at Level 1 fair value, and Level 2 financial assets and liabilities include derivative financial instruments.
Investments in money market funds are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices. The investments are classified as Cash & cash equivalents within the Consolidated Balance Sheet.
Investments in equity securities of public companies are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices.
Deferred compensation investments for certain employee benefit plans are held in a rabbi trust and dedicated to pay the benefits under the associated plans but are not considered plan assets as the assets remain available to creditors of Alcon in certain events, including bankruptcy. Rabbi trust assets primarily consist of investments in mutual funds. These assets are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices.
Level 3 inputs are unobservable for the financial asset or liability. The financial assets and liabilities generally included in the Level 3 fair value hierarchy are equity securities and convertible notes receivable of private companies measured at FVOCI, fund investments, options to acquire private companies, and contingent consideration liabilities measured at FVPL.
F-40

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


The following tables summarize financial assets and liabilities measured at fair value on a recurring basis or at amortized cost or cost as of December 31, 2021 and December 31, 2020.
 December 31, 2021
($ millions)Level 1Level 2Level 3Valued at amortized cost or costTotal
Non-current financial assets
Long-term financial investments measured at FVOCI— — 46 — 46 
Long-term financial investments measured at FVPL— — — 
Long-term receivables from customers— — — 110 110 
Deferred compensation assets(1)
155 — — — 155 
Non-current minimum lease payments from finance lease agreements— — — 35 35 
Long-term loans, advances and security deposits— — — 20 20 
Non-current financial assets155  52 165 372 
Current financial assets
Money market funds624 — — — 624 
Equity securities of public companies(2)
— — — 
Current portion of long-term receivables from customers(2)
— — — 97 97 
Current portion of minimum lease payments from finance lease agreements(2)
— — — 28 28 
Other receivables, security deposits and current assets(2)
— — — 79 79 
VAT receivables(2)
— — — 105 105 
Derivative financial instruments(2)
— — — 
Current financial assets627 3  309 939 
Financial assets at fair value and amortized cost or cost782 3 52 474 1,311 
Financial liabilities
Contingent consideration liabilities— — (112)— (112)
Non-current financial debt— — — (3,966)(3,966)
Current financial debt— — — (107)(107)
Derivative financial instruments— (7)— — (7)
Financial liabilities at fair value and amortized cost (7)(112)(4,073)(4,192)

(1)Recorded in Other non-current assets.
(2)Recorded in Other current assets.

F-41

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


December 31, 2020
($ millions)Level 1Level 2Level 3Valued at amortized cost or costTotal
Non-current financial assets
Long-term financial investments measured at FVOCI— — 28 — 28 
Long-term financial investments measured at FVPL— — 12 — 12 
Long-term receivables from customers— — — 117 117 
Deferred compensation assets(1)
137 — — — 137 
Non-current minimum lease payments from finance lease agreements— — — 39 39 
Long-term loans, advances and security deposits— — — 22 22 
Non-current financial assets137  40 178 355 
Current financial assets
Money market funds625 — — — 625 
Current portion of long-term financial investments measured at FVPL(2)
— — 12 — 12 
Current portion of long-term receivables from customers(2)
— — — 107 107 
Current portion of minimum lease payments from finance lease agreements(2)
— — — 29 29 
Other receivables, security deposits and current assets(2)
— — — 88 88 
VAT receivables(2)
— — — 72 72 
Derivative financial instruments(2)
— — — 
Current financial assets625 3 12 296 936 
Financial assets at fair value and amortized cost or cost762 3 52 474 1,291 
Financial liabilities
Contingent consideration liabilities— — (157)— (157)
Non-current financial debt— — — (3,949)(3,949)
Current financial debt— — — (162)(162)
Derivative financial instruments— (7)— — (7)
Financial liabilities at fair value and amortized cost (7)(157)(4,111)(4,275)
(1)Recorded in Other non-current assets.
(2)Recorded in Other current assets
There were notransfers of financial instruments between levels in the fair value hierarchy during the years ended December 31, 2021 and December 31, 2020.

F-42

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Level 3 financial instruments measured at fair value on a recurring basis
Financial assets
Long-term financial investments measured
at FVOCI
Financial investments
measured at FVPL
($ millions)2021202020212020
Balance as of January 128 31 24 61 
Additions18 — 
(Losses) recognized in Consolidated Statement of Comprehensive Income/(Loss)— (10)— — 
Unrealized (losses) in Consolidated Income Statement— — (3)(5)
Amortization— — (12)(34)
Settlement— — (3)— 
Balance as of December 3146 28 6 24 
If the pricing parameters for the Level 3 inputs were to change for Long-term financial investments measured at FVOCI by 10% positively or negatively, this would change the amount recorded in the 2021 Consolidated Statement of Comprehensive Income/(Loss) by $5 million.
Financial liabilities
Contingent consideration liabilities
($ millions)20212020
Balance as of January 1(157)(243)
Accretion for passage of time(12)(17)
Adjustments for changes in assumptions42 63 
Payments15 40 
Balance as of December 31(112)(157)
Changes in contingent consideration liabilities in the current year include adjustments for changes in assumptions of $42 million, primarily due to revised expectations for achievement of commercial milestones related to the impaired CGU in the Surgical reportable segment discussed in Note 10 and timing of settlement for development and commercial milestones. The current year also included a payment of $15 million related to achievement of a development milestone. As of December 31, 2021, the probability of success for various development and commercial milestones ranges from 55% to 80% and the maximum remaining potential payments related to contingent consideration from business combinations is $395 million, plus other amounts calculated as a percentage of commercial sales in cases where there is not a specified maximum contractual payment amount. The estimation of probability typically depends on factors such as technical milestones or market performance and is adjusted for the probability of payment. If material, probable payments are appropriately discounted to reflect the impact of time.
Changes in contingent consideration liabilities in the prior year included adjustments for changes in assumptions of $63 million primarily related to revised expectations for achievement of development and commercial milestones and timing of settlement for milestones, and payments of $40 million related to achievement of development milestones. As of December 31, 2020, the probability of success for various development and commercial milestones ranged from 55% to 100% and the maximum remaining potential payments related to contingent consideration from business combinations was $470 million, plus other amounts calculated as a percentage of commercial sales in cases where there is not a specified maximum contractual payment amount.
Contingent consideration liabilities are reported in “Provisions & other non-current liabilities" based on the projected timing of settlement which is estimated to range from 2025 through 2033 for contingent consideration obligations as of December 31, 2021.
For the determination of the fair value of a contingent consideration various unobservable inputs are used. A change in these inputs might result in a significantly higher or lower fair value measurement. The inputs used are, among others, the probability of success, sales forecast and assumptions regarding the discount rate, timing and different scenarios of
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


triggering events. The significance and usage of these inputs to each contingent consideration may vary due to differences in the timing and triggering events for payments or in the nature of the asset related to the contingent consideration.
As the most significant Level 3 input, if the probability of success were to change by 10% positively or negatively, this would change the amount recorded for contingent consideration payables in the 2021 Consolidated Income Statement by $19 million.
Derivatives
As of December 31, 2021 and December 31, 2020, the net value of unsettled positions for derivative forward contracts and swaps was $4 million, including $3 million of unrealized gains in Other current assets and $7 million of unrealized losses in Current financial debts. There are master agreements with several banking counterparties for derivatives financial instruments, however, there were no derivative financial instruments meeting the offsetting criteria under IFRS as of December 31, 2021 or December 31, 2020.
Nature and extent of risks arising from financial instruments
Market risk
Alcon is exposed to market risk, primarily related to foreign currency exchange rates, interest rates and the market value of investments of liquid funds. Alcon actively monitors and seeks to reduce, where it deems it appropriate to do so, fluctuations in these exposures. It is Alcon policy and practice to enter into a variety of derivative financial instruments to manage the volatility of these exposures and to enhance the yield on the investment of liquid funds. Alcon does not enter into any financial transactions containing a risk that cannot be quantified at the time the transaction is concluded. In addition, Alcon does not sell short assets it does not have, or does not know it will have, in the future. Alcon only sells existing assets or enters into transactions and future transactions (in the case of anticipatory hedges) that it confidently expects it will have in the future, based on past experience. In the case of liquid funds, Alcon writes call options on assets it has, or writes put options on positions it wants to acquire and has the liquidity to acquire. Alcon expects that any loss in value for these instruments generally would be offset by increases in the value of the underlying transactions.
Foreign currency exchange rate risk
Alcon uses the US Dollar as its reporting currency and is therefore exposed to foreign currency exchange movements, primarily in Euros, Japanese Yen, Chinese Renminbi, Swiss Francs, and emerging market currencies. Fluctuations in the exchange rate between the US Dollar and other currencies can have a significant effect on both Alcon’s results of operations, including reported sales and earnings, as well as on the reported value of Alcon's assets, liabilities and cash flows. This, in turn, may significantly affect the comparability of period-to-period results of operations.
Alcon manages its global currency exposure by engaging in hedging transactions where management deems appropriate (forward contracts and swaps). Specifically, Alcon enters into various contracts that reflect the changes in the value of foreign currency exchange rates to preserve the value of assets.
Interest rate risk
Alcon's exposure to cash flow interest rate risks arises mainly from non-current financial debts at variable rates. Alcon may enter into interest rate swap agreements, in which it exchanges periodic payments based on a notional amount and agreed-upon fixed and variable rate interests. If the interest rates had been higher / lower by 1%, the income before taxes would have been lower / higher by $14 million from the impacts of interest expense based on the change in the interest rate.
Commodity price risk
Alcon is currently experiencing inflation and supply chain challenges due to COVID-19 in certain components and has exposure to price risk related to anticipated purchases of certain commodities used as raw materials by Alcon's businesses. A change in those prices may alter the gross margin of a specific business, but generally by not more than 10% of the margin and thus below Alcon's risk management tolerance levels. Accordingly, Alcon does not enter into significant forward and option contracts to manage fluctuations in prices of anticipated purchases.

Credit risk
Credit risks arise from the possibility that customers may not be able to settle their obligations as agreed. To manage this risk, Alcon periodically assesses credit risk, assigns individual credit limits, and takes actions to mitigate credit risk where appropriate.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


With the continued adverse economic conditions in relation to the COVID-19 pandemic which vary by region, there is an ongoing credit risk due to expected credit losses. Provisions for expected credit losses have been reflected in the Consolidated Financial Statements as of December 31, 2021. Alcon will continue to assess forward-looking estimates of potential increased default rates and potential increase in lifetime expected credit losses. For further information, refer to Note 14 of these Consolidated Financial Statements.
No customer accounted for 10% or more of Alcon's net sales in 2021, 2020 or 2019.
Liquidity risk
Liquidity risk is defined as the risk that Alcon may not be able to settle or meet its obligations on time or at a reasonable price. Alcon Treasury is responsible for liquidity, funding and settlement management. In addition, liquidity and funding risks, and related processes and policies, are overseen by management. Alcon manages its liquidity risk on a consolidated basis according to business needs, tax, capital or regulatory considerations, if applicable, through numerous sources of financing in order to maintain flexibility. Management monitors Alcon's net debt or liquidity position through rolling forecasts on the basis of expected cash flows.
While collections stabilized in 2021, with the continued adverse economic conditions in relation to the COVID-19 pandemic which vary by region, there is an ongoing liquidity risk due to potential delays or reductions in collections from our customers or increased difficulties in accessing the capital or debt markets. In response to the increased liquidity risk, on May 27, 2020, AFC completed an offering of $750 million of 2.600% senior notes due in 2030, increasing Alcon's overall liquidity. In addition, Alcon’s revolving credit facility with total availability of $1 billion remained undrawn as of December 31, 2021 with no current limitations on borrowing, and management has not identified any changes in Alcon's ability to access the capital or debt markets.
For further information on maturity of the contractual undiscounted cash flows for Alcon's borrowings and interest on borrowings, refer to Note 17 of these Consolidated Financial Statements.

19.     Provisions and other non-current liabilities
The below table provides details related to Provisions and other non-current liabilities as of December 31, 2021 and 2020.
($ millions)Note20212020
Accrued liability for employee benefits:
Defined benefit pension plans23295 339 
Other long-term employee benefits and deferred compensation177 152 
Other post-employment benefits23300 332 
Provisions for litigation and other legal matters— — 
Contingent consideration18112 142 
Other non-current liabilities56 95 
Total provisions and other non-current liabilities940 1,060 
Alcon believes that its total provisions are adequate based upon currently available information; however, given the inherent difficulties in estimating liabilities in this area, Alcon may incur additional costs beyond the amounts provided. Management believes that such additional amounts, if any, would not be material to Alcon's financial condition but could be material to the results of operations or cash flows in a given period.
Provisions for litigation and other legal matters
Alcon has established provisions for certain litigation and other legal matters, where a potential cash outflow is probable and a reliable estimate can be made of the amount of the outflow. These provisions represent the current best estimate of the total financial effect for these matters. Potential cash outflows reflected in a provision may be fully or partially off-set by insurance in certain circumstances.
Alcon has not established provisions for potential damage awards for certain additional legal claims if Alcon currently believes that a payment is either not probable or cannot be reliably estimated. A number of other legal matters are in such early stages or the issues presented are such that Alcon has not made any provisions since it cannot currently estimate either a potential outcome or the amount of any potential losses. For these reasons, among others, Alcon generally is
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


unable to make a reliable estimate of possible loss with respect to such cases. It is therefore not practicable to provide information about the potential financial impact of those cases.
There might also be cases for which Alcon was able to make a reliable estimate of the possible loss or the range of possible loss, but Alcon believes that publication of such information on a case-by-case basis would prejudice Alcon's position in ongoing legal proceedings or in any related settlement discussions. Accordingly, in such cases, information would be disclosed with respect to the nature of the contingency, but no disclosure is provided as to an estimate of the possible loss or range of possible loss.
Note 26 contains additional information on contingencies.
Summary of significant legal proceedings
A number of Alcon companies are, and will likely continue to be, subject to various legal proceedings and investigations that arise from time to time, including proceedings regarding product liability, sales and marketing practices, commercial disputes, employment, and wrongful discharge, antitrust, securities, health and safety, environmental, tax, international trade, privacy, and intellectual property matters. As a result, Alcon may become subject to substantial liabilities that may not be covered by insurance and could affect Alcon's business, financial position and reputation. While Alcon does not believe that any of these legal proceedings will have a material adverse effect on its financial position, litigation is inherently unpredictable and large judgments sometimes occur. As a consequence, Alcon may in the future incur judgments or enter into settlements of claims that could have a material adverse effect on its results of operations or cash flow. The following is a summary as of February 15, 2022 of significant legal proceedings of the Alcon business to which Alcon or any of its subsidiaries are a party.
Contact lenses class actions
Since the first quarter of 2015, more than 50 class action complaints have been filed in several courts across the US naming as defendants contact lens manufacturers, including Alcon, and alleging violations of federal antitrust law, as well as the antitrust, consumer protection and unfair competition laws of various states, in connection with the implementation of unilateral price policies by the defendants in the sale of contact lenses. The cases have been consolidated in the Middle District of Florida by the Judicial Panel on Multidistrict Litigation and the claims are being vigorously contested. Trial is set for March 28, 2022.
JJSVI patent dispute
On June 23, 2020, Johnson & Johnson Surgical Vision, Inc. ("JJSVI"), acting through its subsidiaries, filed a patent infringement action in the US District Court in Delaware alleging that the manufacture, use, sale, offer for sale, and/or importation of Alcon’s LenSx Laser System willfully infringes, directly and/or indirectly, one or more claims of 12 US patents. JJSVI subsequently amended its complaint to include copyright infringement claims relating to source code used in the LenSx Laser System as well as additional claims of patent infringement. Also beginning on June 23, 2020, JJSVI filed claims in Mannheim, Germany, alleging that Alcon directly infringes certain European patents through its manufacture and sale of LenSx. In these cases, JJSVI seeks monetary and injunctive relief.Alcon intends to defend all of these cases vigorously and has asserted various patent infringement and invalidity claims against JJSVI in Europe and the United States. The Delaware court has stayed the parties' US patent claims pending final written decisions by the Patent Trial and Appeal Board of the US Patent and Trademark Office in various ongoing inter partes review proceedings pertaining to the patents in the suit. Trial on the copyright claims in the Delaware action is set for February 2023.
Hoya patent dispute
On December 11, 2020, Hoya Corporation and one of its affiliates filed suit against Alcon in the US District Court for the Northern District of Texas alleging that Alcon's UltraSert Pre-Loaded Delivery System infringes six of Hoya's US patents. The court denied in part Alcon’s motion to dismiss Hoya’s complaint on September 20, 2021. Trial is set for April 2023. Alcon intends to defend the case vigorously.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Asia / Russia investigation
In 2017 and 2018, Alcon and Novartis Group companies, as well as certain present and former executives and associates of Alcon and Novartis, received document requests and subpoenas from the US Department of Justice (“DoJ”) and the SEC requesting information concerning Alcon accounting, internal controls and business practices in Asia and Russia, including revenue recognition for surgical equipment and related products and services and relationships with third party distributors, both before and after Alcon became part of the Novartis Group. The Investigations by the DoJ and the SEC have concluded. On June 25, 2020, Alcon entered into a three-year Deferred Prosecution Agreement with the DoJ regarding a charge that Alcon Pte Ltd. conspired to falsify financial books and records in violation of the US Foreign Corrupt Practices Act. The charge relates to payments made by a former distributor to health care providers in Vietnam between 2007 and 2014. Alcon agreed to pay the DoJ a penalty of $8.925 million, for which Novartis has indemnified Alcon.
Litigation and other legal matters provision movements
($ millions)202120202019
January 1  42 
Additions to provisions54 — 
Cash payments(1)(9)(40)
Releases of provisions— — (2)
December 3153   
Less current portion(53)— — 
Non-current provisions for litigation and other legal matters at December 31   
Alcon believes that its total provisions for litigation and other legal matters are adequate based upon currently available information. However, given the inherent difficulties in estimating liabilities, additional liabilities and costs may be incurred beyond the amounts provided.

20.     Provisions and other current liabilities
The following table provides details related to Provisions and other current liabilities as of December 31, 2021 and 2020:
($ millions)Note20212020
Taxes other than income taxes93 110 
Restructuring provisions17 10 
Accrued expenses for goods and services received but not invoiced76 61 
Accruals for royalties10 11 
Accruals for deductions from revenue264 217 
Accruals for compensation and benefits including social security489 352 
Deferred income108 110 
Provisions for litigation and other legal matters1953 — 
Accrued equity-based payments14 
Accrued interest on financial debts19 19 
Contingent consideration18— 15 
Other payables58 80 
Total provisions and other current liabilities1,201 994 
Provisions and accruals are based upon management's best estimate and adjusted for actual experience. Such adjustments to the historical estimates have not been material.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Accruals for deductions from revenue
The following table shows the movement of accruals for deductions from revenue:
($ millions)202120202019
January 1217 212 194 
Additions677 540 662 
Payments/utilizations(619)(537)(646)
Changes in offset against gross trade receivables(5)(2)
Currency translation effects(6)
December 31264 217 212 
Restructuring provisions
The following table shows the movement of restructuring provisions:
($ millions)202120202019
January 110 28 8 
Additions21 22 32 
Cash payments(14)(40)(10)
Releases— — (2)
December 3117 10 28 
In 2021, 2020 and 2019, additions to restructuring provisions of $21 million, $22 million and $32 million, respectively, were primarily related to the multi-year transformation program announced by Alcon on November 19, 2019 andwere mainly related to accrued severance for the associates whose positions will be eliminated.

21.     Consolidated Statement of Cash Flows - additional details
The Consolidated Statement of Cash Flows was prepared in accordance with IAS 7, Statement of Cash Flows. The below tables provide additional detail supporting select line items in the Consolidated Statement of Cash Flows.
21.1 Depreciation, amortization, impairments and fair value adjustments
($ millions)202120202019
Property, plant & equipment323 299 275 
Right-of-use assets81 79 66 
Intangible assets815 1,245 1,084 
Financial assets31 
Other non-current assets(2)(2)— 
Total1,220 1,626 1,456 
21.2 Change in net current assets and other operating cash flow items
($ millions)202120202019
(Increase) in inventories(326)(159)(108)
(Increase)/decrease in trade receivables(198)43 (115)
Increase/(decrease) in trade payables60 (21)84 
Net change in other operating assets(24)127 (26)
Net change in other operating liabilities174 (35)117 
Total(314)(45)(48)
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


21.3 Acquisitions of businesses, net
($ millions)202120202019
Net assets recognized as a result of business combinations  (418)
Payables contingent consideration— — 135 
Cash flows  (283)
Notes 4 and 22 to these Consolidated Financial Statements provide further information regarding an acquisition of a business in 2019 for cash.
21.4 Reconciliation of assets and liabilities arising from financing activities
Financial Liabilities
($ millions)Non-current financial debtsCurrent financial debtsNon-current lease liabilitiesCurrent lease liabilities
January 1, 20213,949 169 315 70 
Proceeds from non-current financial debts, net of issuance costs52 — 
Additions to leases106 
Change in current financial debts— (43)
Amortization of discounts on financial debts— 
Payments of lease liabilities, net— (72)
Interest payments for amounts included in lease liabilities classified as cash flows from operating activities— (13)
Changes in fair values and other non-cash changes, net— (2)
Currency translation effects(40)(12)(10)(5)
Reclassification from non-current to current— — (70)70 
December 31, 20213,966 114 339 67 
Financial Liabilities
($ millions)Non-current financial debtsCurrent financial debtsNon-current lease liabilitiesCurrent lease liabilities
January 1, 20203,218 261 280 61 
Proceeds from non-current financial debts, net of issuance costs744 — 
Additions to leases96 11 
Change in current financial debts— (139)
Amortization of discounts on financial debts— 
Payments of lease liabilities, net— (69)
Interest payments for amounts included in lease liabilities classified as cash flows from operating activities— (12)
Changes in fair values and other non-cash changes, net(9)(2)
Currency translation effects37 10 
Reclassification from non-current to current(55)55 (69)69 
December 31, 20203,949 169 315 70 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


22.     Acquisitions of businesses
Fair value of assets and liabilities arising from acquisitions
($ millions)202120202019
Property, plant and equipment— — 
Acquired research and development— — 505 
Deferred tax assets— — 28 
Cash and cash equivalents— — 
Deferred tax liabilities— — (121)
Trade payables and other liabilities— — (1)
Net identifiable assets acquired  418 
Acquired liquidity— — (6)
Goodwill— — 
Net assets recognized as a result of business combinations  418 
Note 4 of these Consolidated Financial Statements details a significant acquisition of a business, PowerVision, in 2019. No goodwill from the 2019 acquisition is tax-deductible.

23.     Post-employment benefits for associates
Defined benefit plans
In addition to the legally required social security schemes, Alcon has sponsored numerous independent pension and other post-employment benefit plans. In most cases, these plans are externally funded in entities that are legally separate from Alcon. For certain subsidiaries, however, no independent plan assets exist for the pension and other post-employment benefit obligations of associates. In these cases the related unfunded liability is included in the Consolidated Balance Sheet. The value of the post-employment benefits promised under the pension and other post-employment benefit plans is represented by the defined benefit obligation ("DBO"), which is measured based on the projected unit credit method ("PUC"). Independent actuaries reappraise the DBOs of all major pension and other post-employment benefit plans annually. Plan assets are recognized at fair value.
The major pension and other post-employment benefit plans are based in Switzerland, the United States, Germany, and the United Kingdom. As of December 31, 2021, these plans represent 88% of Alcon's total DBO and are independently sponsored by Alcon. Details of the plans in those significant countries are provided below.
The pension plans in Switzerland represent the most significant portion of Alcon's total pension DBO and the largest component of Alcon's total plan assets. The principal plan in Switzerland is funded and open for new joiners. For the Swiss pension plan, active insured members' benefits are partially linked to the contributions paid into the plan. Certain features of the Swiss pension plan required by law preclude the plan from being categorized as a defined contribution plan. These factors include a minimum interest guarantee on retirement savings accounts, a pre-determined factor for converting the accumulated savings account balance into a pension and embedded death and disability benefits. All benefits granted under a Swiss-based principal pension plan are vested, and Swiss legislation prescribes that the employer has to contribute a fixed percentage of an associate's pay to an external pension foundation. Additional employer contributions may be required whenever the foundation's statutory funding ratio falls below a certain level. The associate also contributes to the plan.
As of December 31, 2021, following the transfer out of the Novartis pension fund effective February 1, 2021, Alcon's Swiss pension obligation is set-up under an Alcon-sponsored arrangement affiliated with Copré La Collective de Prévoyance ("Copré") – a Swiss collective foundation. As a collective foundation, Copré is governed by its own board of trustees which is responsible for the foundation regulations and asset investment strategy for multiple entities participating in the collective foundation. Also effective February 1, 2021, Alcon established its own pension committee, consisting of representatives nominated by Alcon and the active insured associates. During the fourth quarter of 2021, Copré announced the rates to be used to convert participant balances to pension annuities for 2024 to 2026. This announcement resulted in a plan amendment with a benefit of $15 million recognized in Other income and a corresponding decrease in the DBO. During the third quarter of 2020, the selection of Copré resulted in a plan amendment with past service costs of $12 million recognized in Other expense and a corresponding increase in the DBO.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


The United States pension plans represent the second largest component of Alcon's total pension DBO and the third largest component of Alcon's total plan assets. The principal plan (Qualified Plan) is funded, whereas the plans providing additional benefits for executives (Defined Benefit Restoration Plan and Grandfathered Supplemental Executive Plan) are unfunded. Benefits in the Qualified Plan and Restoration Plan are frozen for all participants. Employer contributions are required for the Qualified Plan whenever the statutory funding ratio falls below a certain level. Furthermore, most associates in the United States are covered under other post-employment benefit plans (US OPEB plans) which represent 99% of the total DBO for other post-employment benefit plans. These benefits in the US primarily consist of post-employment healthcare which has been closed to new members since 2015. Effective January 1, 2021, the Alcon sponsored group health plan for current and future eligible retired participants age 65 and over was changed to a private Medicare marketplace while providing an annual notional contribution to a Health Reimbursement Account for each covered member and spouse. The impact of the plan amendment in the fourth quarter of 2020 was a benefit of $164 million recognized in Other income and a corresponding decrease in the DBO in Provisions and other non-current liabilities. There is no statutory funding requirement for the US OPEB plans.
The major pension arrangements in Germany are governed by the Occupational Pensions Act ("BetrAVG") and represent the third largest component of Alcon's total pension DBO and the fifth largest component of Alcon's total plan assets. The plans are partly funded by a Contractual Trust arrangement or direct insurances. The employer is responsible for contributing the premiums to the insurances and paying certain benefits when they fall due. All plans are closed for new entrants and the benefits are fully vested for all participants. For some participants the benefits are based on final salary and length of employment, and for others the benefit is earned each year based on the current salary in the year of service. Associates do not contribute towards the cost of the benefits.
The pension plans in the United Kingdom represent the fourth largest component of Alcon's total pension DBO and the second largest component of Alcon's total plan assets. The plan is closed with only former Alcon associates entitled to current or future benefits. The Alcon United Kingdom Pension Scheme is governed and administered by a board of trustees in accordance with its Trust Deed. United Kingdom legislation requires that pension schemes are funded prudently (i.e., to a level in excess of the "best estimate" expected cost of providing benefits). Funding is assessed on a triennial basis using (prudent) assumptions agreed by the board of trustees and Alcon. The board of trustees is responsible for jointly agreeing with Alcon the level of contributions needed to eliminate any shortfall over a reasonable period of time, typically not exceeding 10 years. Under the governing documentation, if a surplus remains once liabilities have been settled it would be refunded to Alcon.
One of Alcon's pension plans has a surplus that is not recognized on the basis that future economic benefits are not available to the entity in the form of a reduction in future contributions or a cash refund.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


The following tables summarize the funded and unfunded DBO for pension and other post-employment benefit plans of Alcon associates at December 31, 2021 and 2020:
 Pension plansOther post-employment
benefit plans
($ millions)2021202020212020
Benefit obligation at January 1817 723 332 423 
Current service cost24 31 10 14 
Interest cost12 15 
Past service costs and settlements(38)— (165)
Administrative expenses— — 
Remeasurement (gains)/losses arising from changes in financial assumptions(22)38 (12)92 
Remeasurement losses/(gains) arising from changes in demographic assumptions— (4)
Remeasurement losses/(gains) arising from experience-related changes67 (13)(25)(27)
Currency translation effects(35)44 — — 
Benefit payments(37)(36)(17)(25)
Contributions of associates
Benefit obligation at December 31791 817 300 332 
Fair value of plan assets at January 1519 451   
Interest income— — 
Return on plan assets excluding interest income49 32 — — 
Currency translation effects(18)24 — — 
Employer contributions23 25 13 16 
Contributions of associates
Settlements(20)(2)— — 
Benefit payments(37)(36)(17)(25)
Effect of acquisitions, divestments or transfers14 12 — — 
Fair value of plan assets at December 31541 519   
Funded status(250)(298)(300)(332)
Limitation on recognition of fund surplus at January 1(17)(6)
Change in limitation on recognition of fund surplus (including exchange rate differences)(3)(11)
Limitation on recognition of fund surplus at December 31(20)(17)
Net liability in the balance sheet at December 31(270)(315)(300)(332)

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


The reconciliation of the net liability from January 1 to December 31 is as follows:
 Pension plansOther post-employment benefit plans
($ millions)2021202020212020
Net liability at January 1(315)(278)(332)(423)
Current service cost(24)(31)(10)(14)
Net interest expense(3)(5)(7)(15)
Administrative expenses(1)(1)— — 
Past service costs and settlements18 (11)— 165 
Remeasurements36 (61)
Currency translation effects17 (20)— — 
Employer contributions23 25 13 16 
Effect of acquisitions, divestments or transfers14 12 — — 
Change in limitation on recognition of fund surplus(3)(11)— — 
Net liability at December 31(270)(315)(300)(332)
Amounts recognized in the balance sheet
Prepaid benefit cost25 24 — — 
Accrued benefit liability(295)(339)(300)(332)
The following tables provide detail of the DBO for pension plans by geography and type of member and of plan assets based on the geographical locations in which they are held:
2021
($ millions)SwitzerlandUnited
States
GermanyUnited
Kingdom
Rest of
the world
Total
By type of member
Active(295)(43)(64)— (99)(501)
Deferred pensioners(11)(41)(28)(57)(14)(151)
Pensioners(23)(42)(23)(40)(11)(139)
Benefit obligation at December 31(329)(126)(115)(97)(124)(791)
Thereof: unfunded plans47 29 — — 23 99 
Thereof: unfunded portion of funded plans87 94 — 196 
Prepaid benefit costs and assets subject to limitation on recognition of fund surplus— — — (24)(21)(45)
Fair value of plan assets at December 31195 91 21 121 113 541 
Funded status(134)(35)(94)24 (11)(250)
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


 2020
($ millions)SwitzerlandUnited
States
GermanyUnited
Kingdom
Rest of
the world
Total
By type of member
Active(251)(53)(76)— (125)(505)
Deferred pensioners(12)(50)(32)(62)(17)(173)
Pensioners(26)(35)(26)(42)(10)(139)
Benefit obligation at December 31(289)(138)(134)(104)(152)(817)
Thereof: unfunded plans51 30 — — 31 112 
Thereof: unfunded portion of funded plans84 14 115 — 14 227 
Prepaid benefit costs and assets subject to limitation on recognition of fund surplus— — — (23)(18)(41)
Fair value of plan assets at December 31154 94 19 127 125 519 
Funded status(135)(44)(115)23 (27)(298)

The following table shows the principal weighted average actuarial assumptions used for calculating defined benefit plans and other post-employment benefits of Alcon associates:
 Pension plansOther post-employment
benefit plans
 2021202020212020
Discount rate1.4 %1.2 %2.7 %2.3 %
Expected rate of pension increase1.1 %1.1 %00
Expected rate of salary increase2.2 %2.4 %00
Interest on savings account1.3 %1.0 %00
Current average life expectancy for a 65-year-old male (in years)20202120
Current average life expectancy for a 65-year-old female (in years)22232322
The following table shows additional details related to the weighted average discount rates for the principal plan for each significant country:
 Pension plansOther post-employment
benefit plans
 2021202020212020
Switzerland0.2 %0.1 %
United States2.8 %2.4 %2.7 %2.3 %
Germany1.2 %0.8 %
United Kingdom1.9 %1.3 %
Changes in the aforementioned actuarial assumptions can result in significant volatility in the accounting for pension plans and other post-employment benefit plans in the Consolidated Financial Statements. This can result in substantial changes in Alcon's other comprehensive income, non-current liabilities and prepaid pension assets.
The DBO is significantly impacted by assumptions related to the rate used to discount the actuarially determined post-employment benefit liability. This rate is based on yields of high-quality corporate bonds in the country of the plan. Increasing corporate bond yields increase the discount rate. An increase in the discount rate results in a decrease in the DBO and an increase in the funded status.
The impact of increasing interest rates on a plan's assets is more difficult to predict. A significant part of plan assets is invested in bonds. Bond values typically are inversely correlated to interest rates. Bond values usually decrease when interest rates rise and may therefore partially offset the increase in the funded status. Furthermore, pension assets also
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


include significant holdings of equity instruments. Share prices tend to fall when interest rates increase and therefore often offset the positive impact of the decreasing DBO on the funded status (although the correlation of interest rates with returns on equities is not as strong as with bonds, especially in the short term).
The assumption for the expected rate for pension increases significantly affects the DBO of most plans in Switzerland, Germany and the United Kingdom. Such pension increases also decrease the funded status, although there is no strong correlation between the value of the plan assets and pension/inflation increases.
Assumptions regarding life expectancy significantly impact the DBO. An increase in longevity increases the DBO. There is no offsetting impact from the plan assets, as no longevity bonds or swaps are held by the pension funds. Generational mortality tables are used where this data is available.
The following table shows the sensitivity of the defined benefit pension and other post-employment benefit obligations to the principal actuarial assumptions as of December 31, 2021:
($ millions)Change in 2021 year-end
25 basis point increase in discount rate(45)
25 basis point decrease in discount rate38 
1 year increase in life expectancy23 
25 basis point increase in rate of pension increase
25 basis point decrease in rate of pension increase (1)
(11)
25 basis point increase of interest on savings account
25 basis point decrease of interest on savings account(5)
25 basis point increase in rate of salary increase
25 basis point decrease in rate of salary increase(5)
(1)Decrease in rate of pension increase is limited to zero.
The above sensitivity analyses are based on a change in an assumption while holding all other assumptions constant. In practice, this is unlikely to occur, and changes of the assumptions may be correlated. When calculating the sensitivity of the DBO to significant actuarial assumptions the same method (present value of the defined benefit obligation calculated with the PUC method at the end of the reporting period) has been applied as when calculating the net liability recognized in the Consolidated Balance Sheet.
The healthcare cost trend rate assumptions used for other post-employment benefits are as follows:
202120202019
Healthcare cost trend rate assumed for next year6.2 %6.2 %6.5 %
Rate to which the cost trend rate is assumed to decline4.5 %4.5 %4.5 %
Year that the rate reaches the ultimate trend rate202920282028
F-55

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


The following table shows the weighted average plan asset allocation of funded defined benefit pension plans at December 31, 2021, and 2020:
Pension plans
(as a percentage)Long-term
target minimum
Long-term
target maximum
20212020
Equity securities15 40 35 31 
Debt securities20 60 40 46 
Real estate20 11 
Alternative investments20 11 10 
Cash and other investments15 
Total100 100 
Cash and most of the equity and debt securities have a quoted market price in an active market. Real estate and alternative investments, which include hedge fund and private equity investments, usually do not have a quoted market price.
The strategic allocation of assets of the different pension plans is determined with the objective of achieving an investment return that, together with employer contributions and contributions of associates (where applicable), is sufficient to manage the various funding risks of the plans. Based upon the market and economic environments, actual asset allocations may temporarily be permitted to deviate from policy targets.
The weighted average duration of the DBO is 15.5 years as of December 31, 2021 and December 31, 2020.
Alcon's ordinary contribution to the various pension plans is based on the rules of each plan and its respective country. Additional contributions are made whenever required by local statute or law (i.e., usually when statutory funding levels fall below predetermined thresholds).
The following table summarizes expected future cash flows for pension and other post-employment benefit plans as of December 31, 2021:
($ millions)Pension plansOther
post-employment
benefit plans
Employer contributions
2022 (estimated)12 — 
Expected future benefit payments
202231 18 
202329 19 
202431 21 
202532 21 
202633 21 
2027-2031196 103 
Defined contribution plans
In many subsidiaries, associates are covered by defined contribution plans. Contributions charged to the 2021 Consolidated Income Statement for the defined contribution plans were $133 million (2020: $136 million; 2019: $128 million).

F-56

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


24.     Equity-based compensation
For the year ended December 31, 2021, Alcon recorded equity-based compensation expense of $151 million (2020: $113 million, 2019: $114 million).
Liabilities from cash-settled equity-based compensation plans were$14 million as of December 31, 2021 ($9 million as of December 31, 2020).
On April 9, 2019, Alcon adopted various equity-based incentive plans, under which Alcon may grant awards in the form of restricted stock units ("RSUs"), performance-based restricted stock units ("PSUs"), restricted stock awards ("RSAs"), or any other form of award at the discretion of the Board. Certain associates in select countries may also participate in share ownership savings plans.
Prior to the Spin-off, Alcon associates participated in Novartis equity-based participation plans, which included stock options, RSUs, PSUs, RSAs and certain share ownership savings plans. Such awards were settled in shares or options of the Former Parent. Prior to the Spin-off, the Consolidated Income Statement reflects the compensation expense for Novartis’ equity-based incentive plans in which Alcon associates participated.
Replacement awards
Concurrent with the Spin-off, certain outstanding Novartis awards granted to Alcon associates under Novartis’ equity-based incentive plans vested in Novartis equity on a pro rata basis, in proportion to the amount of the vesting period completed. The remaining unvested Novartis awards were replaced and restored with Alcon awards as governed by the Alcon equity restoration plan with terms and vesting schedules substantially similar to the replaced Novartis awards.
The pro rata vesting of Novartis awards and replacement of unvested Novartis awards with Alcon awards represents a modification under IFRS 2, Share-based Payment. Alcon measured the fair value of the awards immediately prior to and subsequent to the modification and concluded that no incremental fair value was provided to associates. Accordingly, Alcon continues to recognize as an expense the amount of unrecognized compensation cost of the original awards over the remaining vesting periods. Alcon issued 4.2 million unvested equity-based awards in connection with the modification at the time of the Spin-off.
The replacement awards consist primarily of RSUs and PSUs, and vest over a period consistent with the original vesting schedule of the awards which they replaced. In addition to the replacement awards, Alcon has granted additional equity-based awards under the newly-established Alcon incentive plans which were also granted in the form of RSUs and PSUs that will settle in Alcon Inc. shares upon vesting.
Summary of unvested share movements
The below table summarizes unvested share movements for all Alcon equity-based incentive plans through December 31, 2021 and 2020:
 20212020
Number of
shares in
thousands
Weighted average
fair value at grant date in $
Fair value at grant date in $ millionsNumber of
shares in
thousands
Weighted average
fair value at grant date in $
Fair value at grant date in $ millions
Unvested shares at January 15,417 54.90297 4,742 51.20243 
Granted
Restricted awards1,456 72.05 105 1,668 60.19 100 
Performance awards429 72.71 31 457 62.03 28 
Vested(1,258)50.94 (64)(1,149)50.55 (58)
Forfeited(417)62.50 (26)(301)54.14 (16)
Unvested shares at December 315,627 60.96 343 5,417 54.90 297 
F-57

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


The remaining weighted-average vesting period of unvested equity-based awards as of December 31, 2021 was 1.1 years.
Alcon equity-based incentive plans
The below table summarizes the number of shares authorized under the plans as of December 31, 2021:
(thousands)Authorized shares
Long-term Incentive Plan20,000 
Deferred Bonus Stock Plan(1)
1,500 
Swiss Employee Share Ownership Plan475 
Other share savings plans275 
Total22,250
(1)    Beginning in 2020, the annual incentives for the Alcon CEO and ATLs no longer include deferrals of compensation in the form of equity-based awards subject to the provisions of this plan. No grants were issued under this plan in 2021 and 2020.
Long-Term Incentive Plan ("LTIP") - Restricted Stock Units and Restricted Stock Awards
Under Alcon's LTIP, certain associates may receive grants of RSUs and RSAs (together "Restricted awards"). The awards generally vest on the third anniversary of the award and are generally forfeited if the employment relationship with Alcon terminates prior to vesting. Recipients of RSU awards do not have any shareholder rights, such as voting or dividend rights, until the shares are delivered. Alcon associates receiving grants of RSAs are entitled to the dividends that may be declared and paid over the vesting period only if the associates vest in such award.
Prior to the Spin-off, Alcon associates participated in the Former Parent's "Select" plan. The Company's LTIP plan is substantially similar to and replaced the Former Parent plan.
LTIP - Performance Stock Units
The Alcon CEO and Alcon Top Leaders ("ATLs") participate in Alcon's long-term performance program. PSUs granted under the LTIP each convert to one unrestricted Alcon Inc. share at vesting, subject to the achievement of performance measures.
PSUs awarded to plan participants are granted at target incentive ranges from 35% to 430% of base compensation and vest over a three-year period. The payout between 0% and 200% of target is dependent upon 4equally weighted performance metrics which are determined at the onset of the performance period by the Alcon Inc. Board of Directors. The metrics include compound annual growth rate of Net sales, compound annual growth rate of core EPS, market share of peers, and innovation. The Alcon Inc. Board of Directors and the Compensation Committee assess the performance against the defined measures, including input from the Innovation Committee for the innovation metric, and approve the final payout. PSUs granted under the performance plan do not carry voting rights, but do carry dividend equivalents that are paid in cash or Alcon Inc. shares at vesting, provided participants remain associates of Alcon.
Prior to the Spin-off, Alcon associates participated in the Former Parent's Long-Term Performance Plan ("LTPP") and Long-Term Relative Performance Plan ("LTRPP"), which were substantially similar to Alcon's LTIP performance program.
Swiss Employee Share Ownership Plan and other share savings plans
Alcon associates in certain countries are encouraged to invest in share savings plans. Under the share savings plans, participants may elect to receive some of their wages or annual incentives in Alcon Inc. shares in lieu of cash. Subject to plan rules and limitations, as a reward for their participation in the share savings plans, at no additional cost to the participant, Alcon may partially match their investments in shares after a holding period of 3 years.
Prior to the Spin-off, Alcon associates participated in the Former Parent's share savings plans, which were substantially similar to and replaced by Alcon's share savings plans.

F-58

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


25.     Related parties transactions
Executive officers
The following table summarizes compensation information for key management personnel:
($ millions)202120202019
Cash and other compensation19.3 12.8 12.5 
Post-employment benefits0.9 1.1 0.9 
Equity-based compensation20.9 9.2 10.7 
Total41.1 23.1 24.1 
Transactions with Novartis (up to April 9, 2019)
Prior to the Spin-off, the Alcon business was a segment of Novartis such that transactions with Novartis were considered related party transactions. In connection with the Spin-off, Alcon entered into a separation and distribution agreement as well as various other agreements governing relationships with Novartis going forward, including manufacturing and supply, transitional services, tax matters, employee matters, and patent and know-how license and brand license agreements. Information included in this Note with respect to Novartis is strictly limited to related party transactions with Novartis prior to the Spin-off on April 9, 2019.
Transactions from trading activities related to products and services invoiced between other Novartis Group companies and Alcon's business, have been retained in the historical Consolidated Financial Statements. The ultimate controlling parent of both, the other Novartis Group companies and Alcon's business, was Novartis AG until the Spin-off.
The following table summarizes amounts for the year ended December 31, 2019:
($ millions)
2019 (1)
Contract manufacturing revenues from former parent47 
Purchases from former parent19 
(1)    Activity presented strictly relates to the period during which Novartis was a related party (up to April 9, 2019).
Sales to and purchases from Former Parent
Beginning in 2019, product sales to Novartis are recorded in Other revenues in line with Alcon's contract manufacturing arrangement executed with Novartis. Other revenues in 2019 prior to the Spin-off were $47 million. Purchases of products from Novartis under the contract manufacturing arrangement totaled $19 million in 2019 prior to the Spin-off.
Services provided by Former Parent
Services provided by Novartis Group to Alcon in 2019 prior to the Spin-off totaled $40 million and primarily related to human resources operations, real estate and facility services, and information technology.
Management believes that the net charges and methods used for allocations to Alcon were performed on a reasonable basis and reflect the services received by Alcon and the cost incurred on behalf of Alcon. Although the Consolidated Financial Statements reflect management's best estimate of all historical costs related to Alcon, this may however not necessarily reflect what the results of operations, financial position, or cash flows would have been had Alcon been a separate entity, nor the future results of Alcon as it exists following completion of the separation on April 9, 2019.

F-59

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


26.     Commitments and contingencies
Commitments
Research & development
Alcon has entered into long-term research agreements with various institutions which provide for potential milestone payments and other payments by Alcon that may be capitalized. As of December 31, 2021, the commitments to make payments under those agreements, and their estimated timing, were as follows:
($ millions)2021
2022
2023
2024— 
2025
2026— 
Thereafter44 
Total55 
Other
Alcon entered into various purchase commitments for services and materials as well as for equipment in the ordinary course of business. These commitments are generally entered into at current market prices and reflect normal business operations. For disclosure of Property, plant and equipment purchase commitments, see Note 9.
Contingencies
The Alcon companies have to observe the laws, government orders and regulations of the country in which they operate.
A number of Alcon companies are, and will likely continue to be, subject to various legal proceedings and investigations that arise from time to time, including proceedings regarding product liability, sales and marketing practices, commercial disputes, employment, and wrongful discharge, antitrust, securities, health and safety, environmental, tax, international trade, privacy, and intellectual property matters. As a result, Alcon may become subject to substantial liabilities that may not be covered by insurance and could affect Alcon's business, financial position and reputation. While Alcon does not believe that any of these legal proceedings will have a material adverse effect on its financial position, litigation is inherently unpredictable and large judgments sometimes occur. As a consequence, Alcon may in the future incur judgments or enter into settlements of claims that could have a material adverse effect on its results of operations or cash flow.
Governments and regulatory authorities around the world have been stepping up their compliance and law enforcement activities in recent years in key areas, including marketing practices, pricing, corruption, trade restrictions, embargo legislation, insider trading, antitrust, cyber security and data privacy. Further, when one government or regulatory authority undertakes an investigation, it is not uncommon for other governments or regulators to undertake investigations regarding the same or similar matters. Responding to such investigations is costly and requires an increasing amount of management's time and attention. In addition, such investigations may affect Alcon's reputation, create a risk of potential exclusion from government reimbursement programs in the United States and other countries, and may lead to (or arise from) litigation. These factors have contributed to decisions by Alcon and other companies in the healthcare industry, when deemed in their interest, to enter into settlement agreements with governmental authorities around the world prior to any formal decision by the authorities or a court. Those government settlements have involved and may continue to involve, in current government investigations and proceedings, large cash payments, sometimes in the hundreds of millions of dollars or more, including the potential repayment of amounts allegedly obtained improperly and other penalties, including treble damages. In addition, settlements of government healthcare fraud cases often require companies to enter into corporate integrity agreements, which are intended to regulate company behavior for a period of years. Also, matters underlying governmental investigations and settlements may be the subject of separate private litigation.
While provisions have been made for probable losses, which management deems to be reasonable or appropriate, there are uncertainties connected with these estimates. Note 19 contains additional information on these matters.
Alcon is involved in legal proceedings concerning intellectual property rights. The inherent unpredictability of such proceedings means that there can be no assurances as to their ultimate outcome. A negative result in any such
F-60

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


proceeding could potentially adversely affect the ability of certain Alcon companies to sell their products, or require the payment of substantial damages or royalties.
Alcon's potential for environmental remediation liability is assessed based on a risk assessment it usedand investigation of the various sites identified by Alcon as at risk for environmental remediation exposure. Alcon's future remediation expenses are affected by a number of uncertainties. These uncertainties include, but are not limited to, the method and extent of remediation, the percentage of material attributable to Alcon at the remediation sites relative to that attributable to other parties, and the financial capabilities of the other potentially responsible parties.
Alcon has no significant environmental liabilities as at December 31, 2021 and 2020 and has incurred no significant remediation costs for the years ended December 31, 2021, 2020 and 2019.

27.     Subsequent events
Surgical - Acquisition of Ivantis, Inc.
On January 7, 2022, Alcon acquired 100% of the outstanding shares and equity of Ivantis, Inc., a privately-held, US-based company and manufacturer of the Hydrus Microstent, a minimally-invasive glaucoma surgery (“MIGS”) device designed to lower intraocular pressure for open-angle glaucoma patients. The acquisition expands Alcon’s surgical portfolio and is expected to help provide a platform for more growth in the glaucoma space. Pursuant to the terms and subject to the conditions of the Option Agreement and Plan of Merger, as amended, Alcon agreed to pay total upfront consideration of $478 million and additional amounts to be potentially paid upon achievement of a development milestone and commercial milestones calculated as a percentage of sales in excess of defined targets that expire in calendar year 2024. The acquisition will be accounted for as an asset acquisition rather than a business combination as substantially all of the fair value of the gross assets acquired on the closing of the acquisition is concentrated in the value of Hydrus Microstent commercially marketed product intangible assets, being a group of identifiable assets. Consequently, a relative fair value approach was taken for allocating the consideration to the acquired assets and liabilities with no goodwill recognized. The preliminary purchase price allocation includes approximately $449 million of intangible assets, primarily related to currently marketed products, $39 million of tangible assets and approximately $10 million of assumed liabilities. Cash paid for the acquisition, net of cash acquired, was $475 million.
Board of Directors approval of AGM agenda
OnFebruary 15, 2022, the Alcon Board of Directors approved the proposal to submit the 2021 financial statements of Alcon Inc. and these Consolidated Financial Statements for approval at the Annual General Meeting on April 27, 2022.Additionally on February 15, 2022, the Board proposed a dividend of CHF 0.20 per share to be approved at the same Annual General Meeting. If approved by the shareholders, the total dividend payments would amount to a maximum of approximately $108 million using the CHF/USD exchange rate as of February 10, 2022.
The Board of Directors has evaluated subsequent events as they relate to Alcon for potential recognition or disclosures from January 1, 2022 to the date of the approval of these Consolidated Financial Statements and has determined there are no additional subsequent events to be reported in these Consolidated Financial Statements.
F-61

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


28.     Alcon subsidiaries
The following table lists the subsidiaries of Alcon Inc. with Total assets or Net sales to third parties in excess of $5 million included in the Consolidated Financial Statements at and for the year ended December 31, 2021, respectively. The equity interest percentage shown in the table represents Alcon's share in voting rights in those entities. Unless otherwise stated, each entity has share capital consisting of equity held directly by the Company or another of its consolidated subsidiaries.
Country of organization/Entity namePlace of businessEquity
interest
Argentina
Alcon Laboratorios Argentina S.A.Buenos Aires100 %
Australia
Alcon Laboratories (Australia) Pty LtdMacquarie Park100 %
Austria
Alcon Ophthalmika GmbHWein100 %
Belgium
Alcon Laboratories Belgium BVBAPuurs100 %
Alcon N.V.Vilvoorde100 %
Brazil
Alcon Brasil Cuidados com a Saúde Ltda.São Paulo100 %
Canada
Alcon Canada Inc.Mississauga, Ontario100 %
Chile
Alcon Laboratorios Chile Ltd.Santiago de Chile100 %
China
Alcon (China) Ophthalmic Product Co., Ltd.Beijing100 %
Alcon Hong Kong LimitedHong Kong100 %
Colombia
Laboratorios Alcon de Colombia S.A.Santafé de Bogotá100 %
Czech Republic
Alcon Pharmaceuticals (Czech Republic) s.r.o.Prague100 %
Denmark
Alcon Nordic A/SCopenhagen100 %
Ecuador
AlconLab Ecuador S.A.Quito100 %
France
Laboratoires Alcon S.A.S.Rueil-Malmaison100 %
Germany
Alcon Deutschland GmbHFreiburg im Breisgau100 %
CIBA Vision GmbHGrosswallstadt100 %
WaveLight GmbHErlangen100 %
Greece
Alcon Laboratories Hellas- Single Member Commercial and Industrial S.A.C.I.Maroussi, Athens100 %
Hungary
Alcon Hungary Pharmaceuticals Trading Limited Liability CompanyBudapest100 %
India
Alcon Laboratories (India) Private LimitedBangalore100 %
Indonesia
PT. CIBA Vision BatamBatam100 %
Ireland
Alcon Laboratories Ireland LimitedCork City100 %
Israel
Optonol Ltd.Neve-Ilan100 %
Italy
Alcon Italia S.p.A.Milano100 %
Japan
Alcon Japan Ltd.Tokyo100 %
Malaysia
Alcon Laboratories (Malaysia) Sdn. Bhd.Petaling Jaya100 %
F-62

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Country of organization/Entity namePlace of businessEquity
interest
CIBA Vision Johor Sdn. Bhd.Johor100 %
Mexico
Alcon Laboratorios, S.A. de C.V.Ciudad de Mexico100 %
Netherlands
Alcon Nederland B.V.Gorinchem100 %
New Zealand
Alcon Laboratories (New Zealand) Ltd.Remuera100 %
Panama
Alcon Centroamerica S.A.Panama City100 %
Peru
Alcon Pharmaceutical del Peru S.A.Lima100 %
Philippines
Alcon Laboratories (Philippines), Inc.Pasig City100 %
Poland
Alcon Polska Sp. z o.o.Warszawa100 %
Portugal
Alcon Portugal-Produtos e Equipamentos Oftalmológicos Lda.Porto Salvo100 %
Puerto Rico
Alcon (Puerto Rico), Inc.Cataño, PR100 %
Romania
Alcon Romania S.R.L.Bucharest100 %
Russian Federation
Alcon Farmacevtika LLCMoscow100 %
Singapore
Alcon Pte LtdSingapore100 %
Alcon Singapore Manufacturing Pte LtdSingapore100 %
CIBA Vision Asian Manufacturing and Logistics Pte Ltd.Singapore100 %
South Africa
Alcon Laboratories (South Africa) (Pty) Ltd.Midrand100 %
South Korea
Alcon Korea Ltd.Seoul100 %
Spain
Alcon Healthcare S.A.Barcelona100 %
Switzerland
Alcon Grieshaber AGSchaffhausen100 %
Alcon Management SAVernier100 %
Alcon Pharmaceuticals Ltd.Fribourg100 %
Alcon Services AGFribourg100 %
Alcon Switzerland SAZug100 %
Thailand
Alcon Laboratories (Thailand) LimitedBangkok100 %
Turkey
Alcon Laboratuvarlari Ticaret A.S.Istanbul100 %
Ukraine
Alcon Ukraine LLCKiev100 %
United Kingdom
Alcon Eye Care UK LimitedFrimley/Camberley100 %
F-63

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS OF ALCON INC. (Continued)


Country of organization/Entity namePlace of businessEquity
interest
United States of America
Alcon Finance CorporationFort Worth, TX100 %
Alcon Laboratories, Inc.Fort Worth, TX100 %
Alcon LenSx, Inc.Fort Worth, TX100 %
Alcon RefractiveHorizons, LLCFort Worth, TX100 %
Alcon Research, LLCFort Worth, TX100 %
Alcon Vision, LLCFort Worth, TX100 %
CIBA Vision, LLCFort Worth, TX100 %
WaveLight, Inc.Fort Worth, TX100 %
PowerVision, Inc.Fort Worth, TX100 %
Tear Film Innovations, Inc.Fort Worth, TX100 %
TrueVision Systems, Inc.Fort Worth, TX100 %
Uruguay
Alcon Laboratorios Uruguay S.A.Montevideo100 %

F-64



REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
To the Board of Directors and Shareholders of Alcon Inc.
Opinions on the Financial Statements and Internal Control over Financial Reporting
We have audited the accompanying consolidated balance sheets of Alcon Inc. and its subsidiaries (the “Company”) as of December 31, 2021 and 2020, and the related consolidated statements of income, comprehensive income/(loss), changes in equity and cash flows for each of the three years in the period ended December 31, 2021, including the related notes (collectively referred to as the “consolidated financial statements”). We also have audited the Company’s internal control over financial reporting as of December 31, 2021, based on criteria established in Internal Control--IntegratedControl - Integrated Framework(2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).  Based on this assessment, management has concluded that, as of December 31, 2010, Alcon, Inc.'s internal control over financial reporting is effective based on those criteria.




/s/ Kevin J. Buehler/s/ Robert Karsunky
Kevin J. BuehlerRobert Karsunky
President andSenior Vice President, Finance,
   Chief Executive Officer   Chief Financial Officer and Corporate Strategy Officer
February 1, 2011









F-2


REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Board of Directors and Shareholders of
Alcon, Inc.:

We have audited the accompanying consolidated balance sheets of Alcon, Inc. and subsidiaries (the Company) as of December 31, 2010 and 2009, and the related consolidated statements of earnings, shareholders' equity and comprehensive income, and cash flows for each of the years in the three-year period ended December 31, 2010.  These consolidated financial statements are the responsibility of the Company's management.  Our responsibility is to express an opinion on these consolidated financial statements based on our audits.

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States).  Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement.  An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements.  An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation.  We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of Alcon, Inc. and subsidiariesthe Company as of December 31, 20102021 and 2009,2020, and the results of theirits operations and theirits cash flows for each of the three years in the three-year period ended December 31, 2010,2021 in conformity with U.S. generally accepted accounting principles.

We also have audited,International Financial Reporting Standards as issued by the International Accounting Standards Board. Also in accordance withour opinion, the standards of the Public Company Accounting Oversight Board (United States), Alcon, Inc.'smaintained, in all material respects, effective internal control over financial reporting as of December 31, 20102021, based on criteria established in Internal Control--IntegratedControl - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO), and our report dated February 1, 2011 expressed an unqualified opinion on the effectiveness of the Company's internal control over financial reporting.COSO.

Basis for Opinions






/s/ KPMG LLP
KPMG LLP


Fort Worth, Texas
February 1, 2011
F-3

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Board of Directors and Shareholders of
Alcon, Inc.:

We have audited Alcon, Inc.'s internal control over financial reporting as of December 31, 2010, based on criteria established in Internal Control--Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).  Alcon, Inc.'sThe Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying Management's Annual Report on Internal Control overOver Financial Reporting. appearing under Item 15. Our responsibility is to express an opinionopinions on the Company’s consolidated financial statements and on the Company's internal control over financial reporting based on our audit.

audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our auditaudits in accordance with the standards of the Public Company Accounting Oversight Board (United States).PCAOB. Those standards require that we plan and perform the auditaudits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects.
Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our auditaudits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audit providesaudits provide a reasonable basis for our opinion.opinions.

Definition and Limitations of Internal Control over Financial Reporting
A company'scompany’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company'scompany’s internal control over financial reporting includes those policies and procedures that (1)(i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2)(ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3)(iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company'scompany’s assets that could have a material effect on the financial statements.

F-65



Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

Critical Audit Matters
InThe critical audit matters communicated below are matters arising from the current period audit of the consolidated financial statements that were communicated or required to be communicated to the audit committee and that (i) relate to accounts or disclosures that are material to the consolidated financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matters below, providing separate opinions on the critical audit matters or on the accounts or disclosures to which they relate.
Goodwill and Alcon Inc. maintained,Brand Name Impairment Assessments
As described in all material respects, effective internal control overNotes 3 and 10 to the consolidated financial reportingstatements, as of December 31, 2010,2021 the Company had $8.9 billion of goodwill, as well as a $3.0 billion indefinite life intangible asset related to the Alcon brand name. An impairment assessment on goodwill and indefinite life intangible assets, which is performed over the groupings of cash generating units containing goodwill or the Alcon brand name, is performed at least annually. A cash generating unit to which goodwill has been allocated is considered impaired when its carrying amount, including the goodwill, exceeds its recoverable amount, which is defined as the higher of its fair value less costs of disposal and its value in use. An intangible asset other than goodwill is considered impaired when its balance sheet carrying amount exceeds its estimated recoverable amount, which is defined as the higher of its fair value less costs of disposal and its value in use. Usually, management applies the fair value less costs of disposal method for its impairment assessment. In most cases, no direct or indirect observable market prices for identical or similar assets are available to measure the fair value less costs of disposal. Therefore, an estimate of fair value less costs of disposal is based on criteria establishednet present value techniques utilizing post-tax cash flows and discount rates. The estimates used by management in Internal Control--Integrated Framework issuedcalculating the net present values involve significant judgment by COSO.management and include assumptions with measurement uncertainty, such as the amount and timing of projected cash flows, long-term sales forecasts, terminal growth rate, discount rate, and additionally for the Alcon brand name, royalty rate.

The principal considerations for our determination that performing procedures relating to the goodwill and Alcon brand name impairment assessments is a critical audit matter are the significant judgment by management when determining the fair value less costs of disposal, which in turn led to a high degree of auditor judgment, subjectivity and effort in performing procedures and evaluating, for (i) goodwill, management’s significant assumptions related to long-term sales forecasts and discount rate, and (ii) the Alcon brand name, management’s significant assumptions related to long-term sales forecasts, discount rate and royalty rate. In addition, the audit effort involved the use of professionals with specialized skill and knowledge.
We also have audited,Addressing the matter involved performing procedures and evaluating audit evidence in accordanceconnection with forming our overall opinion on the standardsconsolidated financial statements. These procedures included testing the effectiveness of controls relating to management’s goodwill and the Alcon brand name impairment assessments, including controls over the determination of the Public Company Accounting Oversight Board (United States),fair value less costs of disposal. These procedures also included, among others, testing management’s process for developing the fair value less costs of disposal estimates; evaluating the appropriateness of the estimates; testing the completeness, accuracy, and relevance of underlying data used; and evaluating the significant assumptions used by management related to long-term sales forecasts, discount rates and royalty rate. Evaluating management’s assumptions related to long-term sales forecasts involved evaluating whether the assumptions used by management were reasonable considering (i) the current and past performance of the business, (ii) the consistency with external market and industry data, and (iii) whether these assumptions were consistent with evidence obtained in other areas of the audit. Professionals with specialized skill and knowledge were used to assist in the evaluation of management's estimation method of fair value less costs of disposal and the discount rate and royalty rate significant assumptions.
In-Process Research and Development and Definite Lived Intangible Asset Impairment Assessments
As described in Notes 3 and 10 to the consolidated balance sheets of Alcon, Inc. and subsidiariesfinancial statements, as of December 31, 20102021 the Company had $557 million of in-process research and 2009,development (IPR&D) intangible assets and $5,228 million of definite lived intangible assets. IPR&D is evaluated for potential impairment on an annual basis or when facts and circumstances warrant. Individual definite lived intangible assets are evaluated for potential impairment whenever facts and circumstances indicate that their carrying value may not be recoverable. An intangible asset is considered impaired when its carrying amount exceeds its estimated recoverable amount, which is defined as the higher of its fair value less costs of disposal and its value in use. Usually, management applies the fair value less costs of disposal method for its impairment
F-66



assessment. In most cases, no direct or indirect observable market prices for identical or similar assets are available to measure the fair value less costs of disposal. Therefore, an estimate of fair value less costs of disposal is based on net present value techniques utilizing post-tax cash flows and discount rates. The estimates used by management in calculating the net present values involve significant judgment by management and include assumptions with measurement uncertainty, such as the amount and timing of projected cash flows, long-term sales forecasts, and discount rates, and additionally for IPR&D intangible assets, the timing and probability of success.
The principal considerations for our determination that performing procedures relating to the IPR&D and definite lived intangible asset impairment assessments is a critical audit matter are the significant judgment by management when determining the fair value less costs of disposal, which in turn led to a high degree of auditor judgment, subjectivity and effort in performing procedures and evaluating for (i) IPR&D intangible assets, management’s significant assumptions related to long-term sales forecasts, discount rate, and probability of success, and (ii) definite lived intangible assets, management’s significant assumptions related to long-term sales forecasts and discount rate. In addition, the audit effort involved the use of professionals with specialized skill and knowledge.
Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing the effectiveness of controls relating to management’s IPR&D and definite lived intangible asset impairment assessments, including controls over the determination of the fair value less costs of disposal. These procedures also included, among others, testing management’s process for developing the fair value less costs of disposal estimates; evaluating the appropriateness of the estimates; testing the completeness, accuracy, and relevance of underlying data used; and evaluating the significant assumptions used by management related to long-term sales forecasts, discount rates and probability of success. Evaluating management’s assumptions related to long-term sales forecasts and probability of success involved evaluating whether the assumptions used by management were reasonable considering (i) the current and past performance of the business, and (ii) whether these assumptions were consistent with evidence obtained in other areas of the audit. Evaluating management’s assumption related to long-term sales forecasts also involved considering consistency with external market and industry data. Professionals with specialized skill and knowledge were used to assist in the evaluation of management's estimation method of fair value less costs of disposal and the related consolidated statements of earnings, shareholders' equity and comprehensive income, and cash flows for each of the years in the three-year period ended December 31, 2010, and our report dated February 1, 2011 expressed an unqualified opinion on those consolidated financial statements.discount rate significant assumptions.



/s/ KPMGPricewaterhouseCoopers LLP
KPMG LLP



Fort Worth, Texas
February 1, 201115, 2022

We have served as the Company’s auditor since 2019.
F-4
F-67

ALCON, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

  December 31, 
  2010  2009 
  (in millions, except share data) 
Assets      
Current assets:      
Cash and cash equivalents                                                                                 $2,525  $3,007 
Short term investments                                                                                  889   479 
Trade receivables, net                                                                                  1,483   1,346 
Inventories                                                                                  693   626 
Deferred income tax assets                                                                                  172   162 
Other current assets                                                                                  307   213 
         
Total current assets                                                                             6,069   5,833 
Long term investments                                                                                     398   73 
Property, plant and equipment, net                                                                                     1,388   1,304 
Intangible assets, net                                                                                     953   255 
Goodwill                                                                                     833   688 
Long term deferred income tax assets                                                                                     261   391 
Other assets                                                                                     171   142 
         
Total assets                                                                            $10,073  $8,686 
         
Liabilities and Shareholders' Equity        
Current liabilities:        
Accounts payable                                                                                 $370  $321 
Short term borrowings                                                                                  337   607 
Current maturities of long term debt                                                                                  62   -- 
Other current liabilities                                                                                  1,022   1,047 
         
Total current liabilities                                                                             1,791   1,975 
         
Long term debt, net of current maturities                                                                                     --   56 
Long term deferred income tax liabilities                                                                                     65   59 
Other long term liabilities                                                                                     965   691 
Contingencies (note 17)        
Shareholders' equity:        
Common shares, par value CHF 0.20 per share, 320,254,200        
shares authorized; 305,044,983 shares issued and 302,390,266        
shares outstanding at December 31, 2010;        
304,016,290 shares issued and 299,550,733 shares        
outstanding at December 31, 2009                                                                               42   42 
Additional paid-in capital                                                                                  1,669   1,535 
Accumulated other comprehensive income                                                                                  98   203 
Retained earnings                                                                                  5,706   4,533 
Treasury shares, at cost; 2,654,717 shares at December 31, 2010;        
and 4,465,557 shares at December 31, 2009                                                                               (263)  (408)
         
Total shareholders' equity                                                                             7,252   5,905 
         
Total liabilities and shareholders' equity                                                                            $10,073  $8,686 
         
See accompanying notes to consolidated financial statements.        

F-5


ALCON, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF EARNINGS

  Years ended December 31, 
  2010  2009  2008 
  (in millions, except share data) 
          
Sales                                                                 $7,179  $6,499  $6,294 
Cost of goods sold                                                                  1,675   1,614   1,472 
             
Gross profit                                                          5,504   4,885   4,822 
Selling, general and administrative                                                                  2,070   1,935   1,961 
Research and development                                                                  747   665   619 
Amortization of intangibles                                                                  60   24   29 
Other operating expenses                                                                  152   --   -- 
             
Operating income                                                          2,475   2,261   2,213 
Other income (expense):            
Gain (loss) from foreign currency, net
  (3)  (3)  (21)
Interest income                                                             29   46   76 
Interest expense                                                             (9)  (16)  (51)
Other, net                                                             35   25   (134)
             
Earnings before income taxes                                                          2,527   2,313   2,083 
Income taxes                                                                  317   306   36 
             
Net earnings                                                         $2,210  $2,007  $2,047 
             
Basic earnings per common share                                                                 $7.34  $6.72  $6.86 
             
Diluted earnings per common share                                                                 $7.27  $6.66  $6.79 
             
Basic weighted average common shares                                                                  300,932,749   298,847,072   298,504,732 
Diluted weighted average common shares
  304,104,272   301,348,181   301,582,676 
             
See accompanying notes to consolidated financial statements.         


F-6

ALCON, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY AND COMPREHENSIVE INCOME
Years Ended December 31, 2010, 2009 and 2008

  Common Shares     Accumulated          
  Number     Additional  Other          
  of Shares     Paid-in  Comprehensive  Retained  Treasury    
  Outstanding  Amount  Capital  Income  Earnings  Shares  Total 
  (in millions, except share data) 
                      
Balance, December 31, 2007  297,662,706  $43  $1,300  $203  $3,392  $(1,563) $3,375 
                             
Comprehensive income:                            
Net earnings  --   --   --   --   2,047   --   2,047 
Change in net unrealized gains                            
 (losses) on investments  --   --   --   (7)  --   --   (7)
    Foreign currency translation                            
 adjustments  --   --   --   (89)  --   --   (89)
   Unrecognized postretirement                            
 benefits losses and prior                            
 service costs, net of taxes  --   --   --   (27)  --   --   (27)
Total comprehensive income                          1,924 
                             
Adjustment for new pension plan                            
 measurement date, net of taxes  --   --   --   --   (1)  --   (1)
Share-based payments  --   --   83   --   --   --   83 
Share award transactions  2,031,562   --   25   --   (8)  108   125 
Tax benefits on share award                             
     transactions  --   --   61   --   --   --   61 
Treasury shares acquired  (1,045,915)  --   --   --   --   (127)  (127)
Share cancellation  --   (1)  (21)  --   (981)  1,003   -- 
Dividends on common shares  --   --   1   --   (750)  --   (749)
Balance, December 31, 2008  298,648,353   42   1,449   80   3,699   (579)  4,691 
                             
Comprehensive income:                            
Net earnings  --   --   --   --   2,007   --   2,007 
Change in net unrealized gains                            
 (losses) on investments  --   --   --   40   --   --   40 
Foreign currency translation                            
 adjustments  --   --   --   71   --   --   71 
    Unrecognized postretirement                            
 benefits losses and prior                            
 service costs, net of taxes  --   --   --   12   --   --   12 
Total comprehensive income                          2,130 
                             
Adjustment for acquisition of                            
 noncontrolling interest  --   --   (12)  --   --   --   (12)
Share-based payments  --   --   74   --   --   --   74 
Share award transactions  977,202   --   5   --   (2)  52   55 
Tax benefits on share award                            
     transactions  --   --   22   --   --   --   22 
Treasury shares acquired  (74,822)  --   --   --   --   (7)  (7)
Share cancellation  --   --   (3)  --   (123)  126   -- 
Dividends on common shares  --   --   --   --   (1,048)  --   (1,048)
Balance, December 31, 2009  299,550,733   42   1,535   203   4,533   (408)  5,905 
                             
Comprehensive income:                            
Net earnings  --   --   --   --   2,210   --   2,210 
Change in net unrealized gains                            
(losses) on investments  --   --   --   (30)  --   --   (30)
Foreign currency translation                            
 adjustments  --   --   --   (43)  --   --   (43)
Unrecognized postretirement                            
     benefits losses and prior                             
 service costs, net of taxes  --   --   --   (32)  --   --   (32)
Total comprehensive income                          2,105 
                             
Share-based payments  --   --   78   --   --   --   78 
Share award transactions  3,046,622   --   (9)  --   --   178   169 
Tax benefits on share award                            
     transactions  --   --   65   --   --   --   65 
Treasury shares acquired  (207,089)  --   --   --   --   (33)  (33)
Dividends on common shares  --   --   --   --   (1,037)  --   (1,037)
Balance, December 31, 2010  302,390,266  $42  $1,669  $98  $5,706  $(263) $7,252 
                             
See accompanying notes to consolidated financial statements.                 

F-7
ALCON, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS

  Years ended December 31, 
  2010  2009  2008 
  (in millions) 
Cash provided by (used in) operating activities:         
Net earnings                                                                    $2,210  $2,007  $2,047 
Adjustments to reconcile net earnings to cash provided            
from operating activities:            
Depreciation                                                                  212   194   167 
Amortization of intangibles                                                                  60   24   29 
Share-based payments                                                                  78   74   83 
Tax benefits from share-based compensation  8   5   8 
Deferred income taxes                                                                  4   51   (146)
Loss (gain) on sale of assets                                                                  (29)  49   12 
Loss on impairment of available-for-sale securities  --   --   37 
Unrealized depreciation (appreciation) on trading            
securities                                                                (6)  (76)  85 
Other, net                                                                  4   1   7 
Changes in operating assets and liabilities, net of            
effects from business acquisitions:            
Trade receivables                                                                (129)  (144)  (121)
Inventories                                                                (54)  (6)  (79)
Other assets                                                                (116)  (13)  25 
           Accounts payable                                                                        49   118   (8)
           Other current liabilities                                                                        (27)  100   62 
           Other long term liabilities                                                                        111   32   (176)
             
Net cash from operating activities                                                             2,375   2,416   2,032 
Cash provided by (used in) investing activities:            
    Purchases of property, plant and equipment  (309)  (342)  (302)
Acquisitions of businesses, net of cash acquired  (529)  (149)  (23)
Purchases of intangible assets                                                                     (137)  (8)  (26)
Purchases of investments                                                                     (2,881)  (1,261)  (1,099)
Proceeds from sales and maturities of investments  2,149   1,362   1,081 
Other, net                                                                     2   8   4 
 
              Net cash from investing activities                                                                      
  (1,705)  (390)  (365)
Cash provided by (used in) financing activities:            
    Net proceeds from (repayment of) short term debt  (306)  (492)  (633)
Repayment of long term debt                                                                     --   (6)  (2)
Dividends on common shares                                                                     (1,037)  (1,048)  (749)
Acquisition of treasury shares                                                                     (33)  (7)  (127)
Proceeds from exercise of stock options                                                                     169   55   125 
Tax benefits from share-based payment            
  arrangements                                                                     57   17   53 
             
Net cash from financing activities                                                             (1,150)  (1,481)  (1,333)
             
Effect of exchange rates on cash and cash equivalents  (2)  13   (19)
             
Net increase (decrease) in cash and cash equivalents  (482)  558   315 
Cash and cash equivalents, beginning of year  3,007   2,449   2,134 
             
Cash and cash equivalents, end of year                                                                       $2,525  $3,007  $2,449 
See accompanying notes to consolidated financial statements.         
F-8
ALCON, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(in millions, except share data)


(1)  Summary of Significant Accounting Policies and Practices

(a)  Description of Business

Alcon, Inc. ("Alcon"), a Swiss corporation, is a majority owned subsidiary of Novartis AG.  During July 2008, Nestlé S.A. sold approximately 74 million of its Alcon common shares to Novartis.  At December 31, 2009, Nestlé owned 156,076,263 common shares of Alcon.  In January 2010, Novartis exercised its call option for Nestlé's remaining Alcon common shares and proposed a merger of Alcon with and into Novartis, as discussed in note 16.  In August 2010, Novartis acquired Nestlé's remaining Alcon shares.  As of December 31, 2010, Novartis had purchased 231,352,279 Alcon common shares.

The principal business of Alcon and all of its subsidiaries (collectively, the "Company") is the development, manufacture and marketing of pharmaceuticals, surgical equipment and devices, contact lens care and other vision care products that treat eye diseases and disorders and promote the general health and function of the human eye.  Due to the nature of the Company's worldwide operations, it is not subject to significant concentration risks.

(b)  Principles of Consolidation

The consolidated financial statements include the accounts of the Company.  All significant balances and transactions among the consolidated entities have been eliminated in consolidation.  All consolidated entities are included on the basis of a calendar year.

(c)Management Estimates

Management of the Company has made a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities to prepare these financial statements in conformity with accounting principles generally accepted in the United States of America ("U.S. GAAP").  Actual results could differ from those estimates.
(d)Foreign Currency
The reporting currency of the Company is the United States dollar.  The financial position and results of operations of the Company's foreign subsidiaries are generally determined using the local currency as the functional currency.  Assets and liabilities of these subsidiaries have been translated at the rate of exchange at the end of each period.  Revenues and expenses have been translated at the weighted average rate of exchange in effect during the period.  Gains and losses resulting from translation adjustments are included in accumulated other comprehensive income (loss) in shareholders' equity.  The impact of subsidiaries located in countries whose economies are considered highly inflationary is insignificant.  Gains and losses resulting from foreign currency transactions are included in nonoperating earnings.  Under Swiss corporate law, Alcon is required to declare any dividends on its common shares in Swiss francs.

(e)Cash and Cash Equivalents

Cash equivalents include demand deposits and all highly liquid investments with original maturities of three months or less.
(f)Inventories
Inventories are stated at the lower of cost or market.  Cost is determined primarily using the first-in, first-out method.

F-9
(g)Investments

The Company holds investments of various types, maturities and classifications.

Trading Securities.  Trading securities are stated at fair value, with gains or losses resulting from changes in fair value recognized currently in earnings.  Gains or losses from changes in fair value of these securities are included in the consolidated statements of earnings in other, net.

Available-for-Sale Investments.  Investments designated as available-for-sale include marketable debt and equity securities.  Investments designated as available-for-sale are reported at fair value, with unrealized gains and losses, net of tax, recorded in shareholders' equity.  The cost of securities sold is based on the specific identification method.  Realized gains and losses on the sale of these securities are recorded in the consolidated statements of earnings in other, net.  Should the decline in value of any investment be deemed to be other-than-temporary, the investment basis is written down to fair value and the write-down is recorded to earnings as a loss in other, net.

Held-to-Maturity Investments.  The Company holds no investments classified as held-to-maturity.

Short Term/Long Term Classification.  The Company considers all liquid interest-earning investments with original maturities of three months or less to be cash equivalents.  Debt securities with maturities greater than three months and less than one year are classified as short term investments.  Generally, debt securities with remaining maturities greater than one year are classified as long term investments.  However, investments with maturities greater than one year may be classified as short term based on their highly liquid nature and because they represent the investment of cash that is available for current operations.
(h)Financial Instruments
The Company uses various derivative financial instruments on a limited basis as part of a strategy to manage the Company's exposure to certain market risks associated with interest rate and foreign currency exchange rate fluctuations expected to occur within the next twelve months.  The Company evaluates the use of interest rate swaps and periodically uses such arrangements to manage its interest risk on selected debt instruments.

The Company regularly uses foreign currency forward exchange contracts to reduce the effect of exchange rate changes on certain foreign currency denominated intercompany and third-party transactions.  The forward exchange contracts establish the exchange rates at which the Company purchases or sells the contracted amount of foreign currencies for specified local currencies at a future date.  The Company uses forward contracts, which are short term in nature, and receives or pays the difference between the contracted forward rate and the exchange rate at the settlement date.

All of the Company's derivative financial instruments are recorded at fair value.  For derivative instruments designated and qualifying as fair value hedges, the gain or loss on these hedges is recorded immediately in earnings to offset the changes in the fair value of the assets or liabilities being hedged.  For derivative instruments designated and qualifying as cash flow hedges, the effective portion of the gain or loss on these hedges is reported as a component of accumulated other comprehensive income (loss) in shareholders' equity, and is reclassified into earnings when the hedged transaction affects earnings.

(i)Property, Plant and Equipment

Property, plant and equipment are stated at historical cost.  Additions, major renewals and improvements are capitalized while repairs and maintenance costs are expensed.  Upon disposition, the book value of assets and related accumulated depreciation is relieved and the resulting gains or losses are reflected in earnings.

F-10

Depreciation on plant and equipment is calculated on the straight-line method over the estimated useful lives of the assets, which are as follows:

Land improvements                                                                                                          25 years
Buildings and improvements                                                                                                          5-50 years
Machinery, other equipment and software                                                                                                          3-12 years

(j)Goodwill and Intangible Assets, Net

Goodwill is not amortized, but instead is tested for impairment at least annually.  Intangible assets with estimable useful lives are amortized over their respective estimated useful lives to their residual values and reviewed for recoverability upon the occurrence of an event that might indicate conditions for impairment could exist.

Intangible assets, net, include acquired customer base, trademarks, patents and licensed technology.  The cost of these intangible assets is amortized on a straight-line basis over the estimated useful lives of the respective assets, which are 3 to 20 years.

Intangible assets, net, also include the costs of purchased in process research and development projects.  The costs of these projects are not amortized but are tested for impairment at least annually and the projects are monitored to determine if commercialization has been achieved.  If these projects reach commercialization, the related costs will be amortized over the useful lives of the respective assets.

(k)Impairment

Long-lived assets and certain identifiable intangible assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable.  Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset.  If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets.  Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell.

(l)Pension and Other Postretirement Plans

The Company sponsors several defined contribution plans, defined benefit retirement plans and a postretirement healthcare plan.

The Company provides for the benefits payable to employees on retirement by charging current service costs to income systematically over the expected service lives of employees who participate in defined benefit plans.  An actuarially computed amount is determined at the beginning of each year by using valuation methods that attribute the cost of the retirement benefits to periods of employee service.  Such valuation methods incorporate assumptions concerning employees' projected compensation and healthcare cost trends.  Prior service costs for plan amendments are generally charged to income systematically over the remaining expected service lives of participating employees.

The overfunded or underfunded status of defined benefit postretirement plans (other than multiemployer plans) is shown as an asset or liability in the balance sheet and changes in the funded status are recognized in the year in which the changes occur through other comprehensive income.  Effective January 1, 2008, the Company adopted a provision to measure the funded status of a plan as of the date of its year-end balance sheet.  The Company utilized the alternate transition method to transition the measurement date for its defined pension benefit plan in Japan from September 30 to December 31.  Under this transition method, the Company charged 3/15ths of the estimated pension cost from October 1, 2007 to December 31, 2008 (or $1, net of taxes) to retained earnings as of January 1, 2008.  Retrospective application was not permitted.

The cost recognized for defined contribution plans is based upon the contribution required for the period.

F-11

(m)Revenue Recognition

The Company recognizes revenue in accordance with the U.S. Securities and Exchange Commission Staff Accounting Bulletin No. 104.

The Company recognizes revenue on product sales when the customer takes title and assumes risk of loss except for surgical equipment sales.  If the customer takes title and assumes risk of loss upon shipment, revenue is recognized on the shipment date.  If the customer takes title and assumes risk of loss upon delivery, revenue is recognized on the delivery date.  Revenue is recognized as the net amount to be received after deducting estimated amounts for rebates and product returns.

The Company recognizes revenue on surgical equipment sales when the customer takes title and assumes risk of loss and when installation and any required training have been completed.  Per procedure technology fees associated with treatment cards related to refractive products manufactured by WaveLight AG are recognized when the treatment cards are delivered and title and risks of ownership are transferred.

When the Company recognizes revenue from the sale of products, certain items, such as cash discounts, allowances and rebates, which are known and estimable at the time of sale, are recorded as a reduction of sales.  To the extent the customer will, or is expected to, reduce its payment on the related invoice amounts, these items are reflected as a reduction of accounts receivable and sales.

In accordance with certain government rebate requirements (such as those under U.S. Medicaid and Medicare) and with certain contractual agreements, the Company is required to pay rebates to customers, their customers or government agencies under provisions that limit the amounts that may be paid for pharmaceuticals and surgical devices.  The amount of accrued product rebates is included in other current liabilities.

The Company records a reduction of sales for estimated discounts, allowances and rebates in the period in which the related sales occur, based upon historical experience of amounts paid and amounts as a percentage of sales.  The Company also considers the effects of changes in product pricing, in sales trends, in contract terms and in laws and regulations.

Value added taxes and other sales taxes are excluded from sales.

(n)Research and Development

Internal research and development costs are expensed as incurred.  Third-party research and development costs are expensed as the contracted work is performed or as milestone results have been achieved.

(o)Selling, General and Administrative

Advertising costs are expensed as incurred. Advertising costs amounted to $128, $129 and $144 in 2010, 2009 and 2008, respectively.

Shipping and handling costs amounted to $76, $70 and $76 in 2010, 2009 and 2008, respectively.

Legal costs are expensed during the period incurred.

(p)Income Taxes

The Company recognizes deferred income tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of the Company's assets, liabilities and expected benefits of utilizing net operating loss and credit carryforwards.  The impact on deferred income taxes of changes in tax rates and laws, if any, are applied to the years during which temporary differences are expected to be settled and reflected in the financial statements in the period of enactment.  Withholding taxes have been provided on unremitted earnings of subsidiaries which are not reinvested indefinitely in such operations.  Taxes have not been provided on permanent
F-12
investments in certain subsidiaries that would be taxable in the event of liquidation.  Dividends paid by subsidiaries to Alcon, Inc. do not result in Swiss income taxes.

(q)Basic and Diluted Earnings Per Common Share

Basic earnings per common share were computed by dividing net earnings by the weighted average number of common shares outstanding for the relevant period.  The unvested portion of restricted common shares was excluded in the calculation of basic weighted average common shares outstanding.  Diluted weighted average common shares reflect the potential dilution, using the treasury stock method, that could occur if employee stock options for the purchase of common shares and share-settled stock appreciation rights were exercised and if share-settled restricted share units and performance share units and contingent restricted common shares granted to employees were vested.

The following table reconciles the weighted average shares of the basic and diluted share computations:

  2010  2009  2008 
          
Basic weighted average common shares outstanding  300,932,749   298,847,072   298,504,732 
Effect of dilutive securities:            
Employee stock options
  1,736,233   1,807,211   2,585,873 
Share-settled stock appreciation rights
  1,050,684   414,799   300,834 
Share-settled restricted share units and            
performance share units
  374,191   187,543   49,786 
Contingent restricted common shares
  10,415   91,556   141,451 
             
Diluted weighted average common shares outstanding  304,104,272   301,348,181   301,582,676 

Certain executives of the Company had deferred the receipt of 70,675 and 118,180 Alcon common shares at December 31, 2010 and 2009, respectively, into the Alcon Executive Deferred Compensation Plan discussed in note 13.  Alcon common shares held in the plan were reflected as outstanding in the consolidated balance sheets and were included in the applicable basic and diluted earnings per share calculations.

The computations of diluted weighted average common shares outstanding for the years ended December 31, 2010, 2009 and 2008 did not include the following instruments, as their exercise prices and unrecognized costs were greater than the average market price of the common shares:

  2010  2009  2008 
          
Stock options
  --   125   497,805 
Share-settled stock appreciation rights
  1,350   5,850   3,628,998 
             
The effect of their inclusion would have been anti-dilutive.

(r)Comprehensive Income

Comprehensive income consists of net earnings, foreign currency translation adjustments, unrealized gains (losses) on investments and the changes in the funded status of defined benefit postretirement plans and is presented in the consolidated statements of shareholders' equity and comprehensive income.

F-13

(s)Share-Based Compensation

U.S. GAAP requires the measurement and recognition of compensation expense for all share-based payment awards made to employees and directors, based on estimated "fair values."

The Company estimates the "fair value" of share-based payment awards as of the date of grant using an option-pricing model.  The value of the portion of the award that is ultimately expected to vest is recognized as expense on a straight-line basis over the requisite service period.  Share-based compensation expenses recognized in net earnings were based on awards ultimately expected to vest, and therefore the amounts were reduced for estimated forfeitures.  The Company estimates forfeitures at the time of grant and revises, if necessary, in subsequent periods if actual forfeitures differ materially from those estimates.  Excess tax benefits related to share-based compensation are reflected as financing cash flows rather than operating cash flows.

The Company records deferred tax assets for share-based awards that result in deductions on the Company's income tax returns, based on the amount of compensation cost recognized and the Company's statutory tax rate in the jurisdiction in which it expects to receive a deduction.  Differences between the deferred tax assets recognized for financial reporting purposes and the actual tax deduction reported on the Company's income tax return are recorded in additional paid-in capital (if the tax deduction exceeds the deferred tax asset) or in the consolidated statement of earnings (if the deferred tax asset exceeds the tax deduction and no additional paid-in capital exists from previous awards).

(t)Treasury Shares

Treasury shares are accounted for by the cost method.  The board of directors has approved the purchase of Alcon common shares for various purposes as described in notes 12 and 6.
(u)Warranty Reserves

The Company generally warrants its surgical equipment against defects for a period of one year from the installation date.  Warranty costs are estimated and expensed at the date of sale and the resulting accrued liability is amortized over the warranty period.  Such costs are estimated based on actual cost experience.


(2)  Cash Flows-Supplemental Disclosures

  2010  2009  2008 
          
Supplemental Disclosure of Cash Flow Information:         
Cash paid during the year for the following:         
          
Interest expense, net of amount capitalized                                                                        $9  $14  $53 
             
Income taxes                                                                        $284  $262  $232 
             
Supplemental Disclosure of Noncash Financing Activities:


During the years ended December 31, 2010, 2009 and 2008, certain individuals terminated employment prior to the vesting of their restricted Alcon common shares and forfeited 239 shares, 5,420 shares and 17,622 shares, respectively.  (See note 12 for discussion of restricted common shares.)  The forfeited shares were recorded as treasury shares during the respective periods.

F-14

(3)  Supplemental Balance Sheet Information

  December 31, 
  2010  2009 
Cash and Cash Equivalents      
Cash                                                                                                $479  $195 
Cash equivalents on deposit with Nestlé                                                                                                 --   10 
Cash equivalents -- other                                           ��                                                     2,046   2,802 
         
Total                                                                                           $2,525  $3,007 

Cash equivalents consisted of interest-bearing deposits and repurchase agreements with an initial term of less than three months.

  December 31, 
  2010  2009 
Trade Receivables, Net      
Trade receivables                                                                                                $1,540  $1,389 
Allowance for doubtful accounts                                                                                                 (57)  (43)
         
Net                                                                                           $1,483  $1,346 
         

  2010  2009  2008 
Allowance for Doubtful Accounts         
Balance at beginning of year                                                                           $43  $45  $34 
Bad debt expense                                                                            19   6   13 
Charge-offs, net of recoveries                                                                            (5)  (8)  (2)
             
Balance at end of year                                                                           $57  $43  $45 
             


  December 31, 
  2010  2009 
Inventories      
Finished products                                                                                                 $434  $375 
Work in process                                                                                                  48   50 
Raw materials                                                                                                  211   201 
         
Total                                                                                            $693  $626 
         


  December 31, 
  2010  2009 
Other Current Assets      
Prepaid expenses                                                                                                 $74  $57 
Prepaid income taxes                                                                                                  139   58 
Receivables from affiliates                                                                                                  3   -- 
Other                                                                                                  91   98 
         
Total                                                                                            $307  $213 
         
F-15

  December 31, 
  2010  2009 
       
Property, Plant and Equipment, Net      
Land and improvements                                                                                                 $28  $29 
Buildings and improvements                                                                                                  879   828 
Machinery, other equipment and software                                                                                                  1,685   1,566 
Construction in progress                                                                                                  278   227 
         
Total                                                                                             2,870   2,650 
         
Accumulated depreciation                                                                                                  (1,482)  (1,346)
         
Net                                                                                            $1,388  $1,304 

Construction in progress at December 31, 2010 consisted primarily of initial construction of a new manufacturing facility in Singapore and various plant expansion and upgrade projects.  Commitments related to these projects at December 31, 2010 totaled $53.

  December 31, 
  2010  2009 
       
Other Current Liabilities      
Deferred income tax liabilities                                                                                                 $9  $9 
Payables to affiliates                                                                                                  --   2 
Accrued warranties                                                                                                  12   9 
Accrued compensation                                                                                                  339   333 
Accrued taxes                                                                                                  217   201 
Accrued product rebates                                                                                                  236   221 
Other                                                                                                  209   272 
         
Total                                                                                            $1,022  $1,047 

  2010  2009  2008 
          
Warranty Reserve         
Balance at beginning of year                                                                       $9  $7  $7 
Warranty expense                                                                        16   12   12 
Warranty payments, net                                                                        (13)  (10)  (12)
             
Balance at end of year                                                                       $12  $9  $7 
             

  December 31, 
  2010  2009 
Other Long Term Liabilities      
Pension plans                                                                                              $543  $423 
Postretirement healthcare plan                                                                                               123   99 
Deferred compensation                                                                                               29   29 
Long term income tax liabilities (note 9)                                                                                               76   57 
Liability for acquisition-related contingent payments                                                                                               160   71 
Other                                                                                               34   12 
         
Total                                                                                         $965  $691 
F-16

  December 31, 
  2010  2009 
       
Accumulated Other Comprehensive Income (Loss)      
Foreign currency translation adjustment                                                                                              $222  $265 
Unrealized gains (losses) on investments, net of income taxes  --   30 
Unrecognized postretirement benefits losses and prior service costs, net of tax        
benefits                                                                                             (124)  (92)
         
Total                                                                                         $98  $203 
         
At December 31, 2010, the portion of retained earnings that was available under Swiss law for the payment of dividends was $3,496.

For the years ended December 31, 2010, 2009 and 2008, the Company declared and paid dividends on common shares in Swiss francs ("CHF") as follows:

  2010  2009  2008  
           
Dividends per common share in Swiss francs                                                                            CHF3.95 CHF3.95 CHF2.63  
           
Dividends per common share measured in U.S. dollars$3.44 $3.50 $2.50  
           
Total dividends on common shares measured in U.S. dollars$1,037 $1,048 $750  
           
(4)  Investments

At December 31, 2010 and 2009, investments were as follows:

  2010  2009 
       
Short term investments:      
Trading securities                                                                                     $6  $22 
Available-for-sale investments                                                                                      883   457 
         
Total short term investments                                                                                  $889  $479 
         
Long term investments—available-for-sale investments                                                                                          $398  $73 
         
At December 31, 2010 and 2009, trading securities were as follows:

  2010  2009 
  Net  Estimated  Net  Estimated 
  Unrealized  Fair  Unrealized  Fair 
  Gains (Losses)  Value  Gains (Losses)  Value 
             
Total trading securities                                                           $(3) 6  $(9) $22 
                 

F-17

At December 31, 2010, available-for-sale investments were as follows:

     Gross  Gross  Estimated 
  Amortized  Unrealized  Unrealized  Fair 
  Cost  Gains  Losses  Value 
Short term investments:
            
U.S. government and agency securities $279  $1  $--  $280 
Mortgage-backed securities  5   --   --   5 
Corporate debt securities                                                                579   1   (2)  578 
Foreign government bonds                                                                17   --   --   17 
Other investments                                                                3   --   --   3 
                 
Total short term investments                                                             883   2   (2)  883 
                 
Long term investments:                
U.S. government and agency securities  280   1   (1)  280 
Mortgage-backed securities                                                                4   --   --   4 
Corporate debt securities                                                                112   --   --   112 
Other investments                                                                2   --   --   2 
                 
Total long term investments                                                             398   1   (1)  398 
                 
Total available-for-sale investments                                                            $1,281  $3  $(3) $1,281 
                 

At December 31, 2009, available-for-sale investments were as follows:

     Gross  Gross  Estimated 
  Amortized  Unrealized  Unrealized  Fair 
  Cost  Gains  Losses  Value 
Short term investments:
            
U.S. government and agency securities $129  $--  $(1) $128 
Mortgage-backed securities fund                                                              75   7   --   82 
Mortgage-backed securities  6   --   --   6 
Senior secured bank loans fund  131   23   --   154 
Corporate debt securities                                                              43   --   --   43 
Equity securities                                                              29   --   --   29 
Other investments                                                              15   --   --   15 
                 
Total short term investments                                                         428   30   (1)  457 
                 
Long term investments:                
U.S. government and agency securities  52   --   (1)  51 
Mortgage-backed securities                                                              10   --   --   10 
Equity securities                                                              2   --   --   2 
Other investments                                                              8   2   --   10 
                 
Total long term investments                                                         72   2   (1)  73 
                 
Total available-for-sale investments $500  $32  $(2) $530 

The senior secured bank loans fund is a professionally managed fund investing in loans made by banks to large corporate borrowers whose assets are pledged as collateral.

F-18

The contractual maturities of available-for-sale investments at December 31, 2010 were as follows:

     Estimated 
  Amortized  Fair 
  Cost  Value 
       
Securities not due at a single maturity date*                                                                                             $1  $1 
Other debt securities, maturing:        
Within one year                                                                                         563   563 
After 1 year through 10 years                                                                                         710   710 
After 10 years through 15 years                                                                                         --   -- 
Beyond 15 years                                                                                         7   7 
         
Total debt securities recorded at market                                                                                      1,281   1,281 
         
Equity and other investments                                                                                              --   -- 
         
Total available-for-sale investments                                                                                     $1,281  $1,281 
         
*Mortgage-backed securities and certain other investments. 

Activities related to available-for-sale investments were as shown below.  The cost of securities was based on the specific identification method.

  Years ended December 31, 
  2010  2009  2008 
          
Proceeds from sales and principal repayments $2,132  $1,068  $10 
             
Gross realized gains on sales  39   22   1 
             
Gross realized losses on sales  (4)  (4)  (2)
             

The net unrealized holding gains (losses) for available-for-sale investments included in accumulated other comprehensive income (loss) in shareholders' equity at December 31, 2010, 2009 and 2008 were less than $1, $30 and $(10), respectively.  Net unrealized holding gains (losses) on trading securities included in earnings for the years ended December 31, 2010, 2009 and 2008 were $6, $76 and $(85), respectively.

The changes in net unrealized gains (losses) on investments, net of taxes, included in accumulated other comprehensive income (loss) were:

  2010  2009  2008 
          
Changes in unrealized holding gains (losses) arising         
during the period $5  $58  $(45)
Reclassification adjustment for losses (gains) included            
in net income  (35)  (18)  38 
             
Changes in net unrealized gains (losses) on investments,            
net of taxes $(30) $40  $(7)


F-19
As of December 31, 2010 and 2009, there were no gross unrealized losses on individual available-for-sale investments greater than $1.

The Company recognized $37 in losses for other-than-temporary impairment in the year ended December 31, 2008, as discussed in note 5.

Investment Income

Other, net, included gains (losses) on investments as follows:

  2010  2009  2008 
          
Realized gains (losses) on sale of investments                                                                            $30  $(49) $(12)
Unrealized gains (losses) on investments            
classified as trading securities                                                                       6   76   (85)
Other-than-temporary impairment                                                                             --   --   (37)
             
Total gains (losses) on investments                                                                            $36  $27  $(134)
             

(5)  Financial Instruments

Foreign Currency Risk Management

A significant portion of the Company's cash flows is denominated in foreign currencies.  Alcon relies on ongoing cash flows generated from foreign sources to support its long term commitments to U.S. dollar-based research and development.  To the extent the dollar value of cash flows is diminished as a result of weakening local currencies relative to the dollar, the Company's ability to fund research and other dollar-based strategic initiatives at a consistent level may be impaired.  The Company has established a foreign currency risk management program to protect against volatility of non-functional currency monetary assets and liabilities and changes in fair value caused by fluctuations in foreign exchange rates.

The Company primarily utilizes forward exchange contracts in countries where they are available and economically beneficial to offset the impact of fluctuations in foreign exchange rates on monetary assets and their related cash flows.  All outstanding foreign exchange forward contracts are entered into to protect the value of assets or liabilities denominated in currencies other than the entity's functional currency.  To the extent hedged, the changes in fair value of the forward contracts offset the changes in the value of the assets or liabilities.  The changes in value of the foreign exchange forward contracts and the assets/liabilities that are being protected are recorded in foreign exchange gains and losses within other income (expense).

The fair values of forward exchange and option contracts are reported in other current assets and other current liabilities.  At December 31, 2010, the fair value hedge derivative instruments have settlement dates in the first half of 2011 and cover a gross notional amount of $680.

The Company believes that, at the balance sheet date, counterparty credit risk was not significant due to the credit quality of the counterparties to the derivatives, which were all large financial institutions in Europe, and the short-term maturities of most derivatives.  The credit exposure related to these financial instruments was represented by the fair value of contracts with a positive fair value at the reporting date.

F-20
For the years ended December 31, 2010 and 2009, the effects of foreign exchange derivative instruments were:

    2010  2009 
Derivatives in Fair Value Hedging Relationships Location of Gain (Loss) Recognized in Earnings on Derivatives Amount of Gain (Loss) Recognized in Earnings on Derivatives  Amount of Gain (Loss) on the Hedged Items  Amount of Gain (Loss) Recognized in Earnings on Derivatives  Amount of Gain (Loss) on the Hedged Items 
               
Foreign exchange forward contracts Gain (loss) from foreign currency, net $(28) $16  $3  $(8)


Interest Rate Risk Management

The Company may use interest rate swaps on certain investing and borrowing transactions to manage its net exposure to interest rate changes and to reduce its overall cost of borrowing.  The Company does not use leveraged swaps and does not leverage any of its investment activities that would put capital at risk.

At December 31, 2010 and 2009, in connection with a long term bank loan, the Company had an interest rate swap fair value hedge outstanding in the notional principal amount of $61 and $54 at the respective year-end exchange rates.  The fair values of interest rate swap agreements are reported in other current assets and other current liabilities.  This interest rate swap did not have a significant effect on results of operations in 2010 and 2009.

Fair Value of Financial Instruments

At December 31, 2010 and 2009, the Company's financial instruments included cash and cash equivalents, investments, trade receivables, accounts payable, short term borrowings, long term debt and the estimated fair value of certain contingent payments.  The estimated fair values of all of these financial instruments were as noted below.  Due to the short term maturities of cash and cash equivalents, trade receivables, accounts payable and short term borrowings, the carrying amounts approximate fair values at the respective balance sheet dates.

At December 31, 2010 and 2009, the Company's cash equivalents included $218 and $30, respectively, of instruments that were tri-party fully collateralized reverse repurchase agreements.  They were transacted on December 31, 2010 and 2009 and matured "overnight" on the first business day in January 2011 and 2010.  The Company utilized this type of transaction to enhance yields on available cash balances, while maintaining liquidity.  These securities were recorded at cost, which approximated fair value.

The Company received debt and equity securities as collateral for its advances under the reverse repurchase agreements.  A financial institution other than the seller held the collateral for the Company's benefit.  The value and the liquidity of the underlying collateral were required to be between 102% and 110%, depending upon the credit of collateral, of the advanced amount and were evaluated by an independent third-party custodian.  The Company recorded only its advances under the agreements as cash equivalents at the time of entering the transactions and recognized the interest income upon settlement.  The collateral value or changes in collateral value were not recorded or recognized.

The fair values of long term debt were based on interest rates then currently available to the Company for issuance of debt with similar terms and remaining maturities.  The fair values of investments and acquisition-related contingent payments were determined as discussed below.

F-21


  December 31, 
  2010  2009 
  Carrying  Fair  Carrying  Fair 
  Amounts  Value  Amounts  Value 
             
Assets:            
Short term trading and available-for-sale investments $889  $889  $479  $479 
Long term available-for-sale investments                                                                   398   398   73   73 
Forward exchange contracts                                                                   --   --   6   6 
Interest rate swaps                                                                   --   --   1   1 
                 
Liabilities:                
Long term debt                                                                   62   62   56   56 
Liability for acquisition-related contingent payments  160   160   71   71 
Forward exchange and option contracts                                                                   12   12   2   2 
                 

Financial instruments, such as equity or fixed income securities, other investments, financial liabilities and derivatives, are presented at fair value.  Fair value is defined as the price at which an asset could be exchanged or a liability could be transferred in an orderly transaction between knowledgeable and willing market participants within the principal or most advantageous market at the measurement date.  Where available, fair value is based on or derived from observable market prices or parameters.  Where observable prices or inputs are not available, pricing for similar financial assets or liabilities, dealer quotes or valuation models are applied.  These valuation techniques involve some level of management estimation and judgment, the degree of which is dependent on the price transparency for the instruments or market and the instruments' complexity.

Financial assets and liabilities recorded at fair value in the consolidated balance sheets were categorized based upon the level of judgment associated with the inputs used to measure their fair value.  These categories, from lowest to highest based on the amount of subjectivity associated with the inputs to fair valuation of these assets and liabilities, are as follows:

Level 1 – Inputs are unadjusted, quoted prices in active markets for identical assets or liabilities at the measurement date.

The types of Company assets carried at Level 1 fair value are equities listed in active markets.

Level 2 – Inputs (other than quoted prices included in Level 1) are either directly or indirectly observable for the assets or liabilities through correlation with market data at the measurement date and for the duration of the instrument's anticipated life.

The Company's assets generally included in this fair value category are various government agency securities, certain investment funds, mortgage backed securities, collateralized mortgage obligations, foreign exchange derivatives and certain interest rate derivatives.  Foreign exchange derivatives and interest rate derivatives are valued using corroborated, observable market data.  The Company's liabilities generally included in this fair value category consist of certain foreign exchange derivatives.

Level 3 – Inputs are unobservable inputs for the asset or liability.  These inputs reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date.  Consideration is given to the risk inherent in the valuation technique and the risk inherent in the inputs to the model.

Generally, the Company's assets carried at fair value included in this category are various investment funds.

The Company's liabilities carried at fair value in this category are acquisition-related contingent payments.

F-22
The Company's Level 3 financial investments are held in funds professionally managed by investment managers.  The net asset values are furnished in statements received from fund custodians whose statements reflect valuations conducted according to their respective fund pricing policies and asset types.  The complete details of the fund holdings of several of the Company's professionally managed funds may be unavailable at times, limiting the Company's ability to look through to the underlying assets at the date the financial statements are prepared.  Because of these constraints, the Company classifies these fund investments as Level 3.

As of December 31, 2010, the Company estimated $160 as the fair value of its obligations to make contingent payments related to acquisitions.  The fair value measurements were based on significant inputs not observable in the market and thus represent a Level 3 measurement.

In connection with an acquisition in 2009, the Company is obligated to make acquisition-related contingent payments of up to $439 based upon the achievement of future research and development milestones that would be expected to create value for Alcon.  At December 31, 2010, the fair value of these payments was estimated to be $71.  Each milestone was assigned a probability based on its current status.  The resultant probability-weighted cash flows were then discounted using a discount rate of 5.3%, which the Company believed was appropriate and representative of a market participant assumption.  The probabilities assigned to payment streams ranged from 5% to 39%.  An increase or decrease of 10 percentage points in the probability assumptions would result in an adjustment to the estimated value of approximately $30.

In connection with acquisitions in 2010, the Company is obligated to make acquisition-related contingent payments of up to $528 upon achieving certain sales objectives through 2015.  The fair values of these payments at December 31, 2010 were estimated to total $89.  The fair values were based on the Company's estimates of the probability and timing of related sales projection streams.  Each revenue projection assumption was assigned a probability and the resultant probability-weighted cash flows were then discounted using discount rates between 4.5% and 6%, which the Company believed was appropriate and representative of market participant assumptions.  Achieving the Company's most optimistic sales assumptions would not increase the estimated total fair value more than $10.

The fair values of these contingent payments are reviewed each reporting period.  Any changes in the estimated value not associated with the original purchase price valuation are recorded in the Company's results of operations.  No such changes were recognized in the current period.

Fair Value by Category

Financial assets and financial liabilities measured at fair value on a recurring basis were categorized in the tables below based upon the lowest hierarchical level of input that is significant to the fair value measurement.
F-23

  Fair Value as of December 31, 2010 
  Level 1  Level 2  Level 3  Total 
             
Financial Assets            
Trading securities - Hedge funds $--  $--  $6  $6 
Available-for-sale securities:                
U.S. government and agency
                
securities
  --   560   --   560 
Mortgage-backed securities
  --   9   --   9 
Corporate debt securities
  --   690   --   690 
Foreign government bonds
  --   17   --   17 
Other investments
  --   5   --   5 
                 
Total
 $--  $1,281  $6  $1,287 
                 
Financial Liabilities                
Liability for acquisition-related contingent payments             $  
payments
 $--  $--  $160  $160 
Foreign exchange and option contracts  --   12   --   12 
                 
Total $--  $12  $160  $172 


  Fair Value as of December 31, 2009 
  Level 1  Level 2  Level 3  Total 
             
Financial Assets            
Trading securities - Hedge funds $--  $--  $22  $22 
Available-for-sale securities:                
U.S. government and agency securities
  --   179   --   179 
Mortgage-backed securities fund
  --   82   --   82 
Mortgage-backed securities
  --   16   --   16 
Senior secured bank loans fund
  --   154   --   154 
Corporate debt securities
  --   43   --   43 
Equity securities
  31   --   --   31 
Other investments
  --   25   --   25 
Forward exchange contracts  --   6   --   6 
Interest rate swaps  --   1   --   1 
                 
Total $31  $506  $22  $559 
                 
Financial Liabilities                
Liability for acquisition-related contingent payments                
payments
 $--  $--  $71  $71 
Foreign exchange and option contracts  --   2   --   2 
                 
Total $--  $2  $71  $73 


Level 3 Gains and Losses

At December 31, 2010, trading securities were the only type of financial assets included in Level 3.  The trading securities were professionally managed investment funds, which included hedge funds of $6.  The fair value of the investment funds classified as Level 3 could not be determined by independent market observation or through the use of other observable valuation techniques.  The valuation was based on net asset values as furnished by the funds'
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custodian.  If more than an insignificant proportion of a particular fund's assets were Level 3, the entire fund was classified as Level 3, although many of the fund's individual holdings may meet the definition of Level 1 or Level 2.  The only liabilities included in Level 3 were the acquisition-related contingency payments, as discussed earlier in this note.

Total gains or losses (realized and unrealized) for financial assets and liabilities classified as Level 3 that were included in earnings before income taxes were a component of other, net, in the consolidated statements of earnings.  For the year ended December 31, 2010, there were net gains (realized and unrealized) of $1 from trading securities, and the Company received proceeds from sales of Level 3 trading securities of $17.  Realized and unrealized net gains during the period were approximately 5% of the beginning balance for Level 3 trading securities and did not negatively affect or materially impact operations, liquidity or capital resources.

The table presented below summarizes the change in carrying values associated with Level 3 financial instruments during the year ended December 31, 2010.

  Assets  Liabilities 
     Acquisition-Related 
  
Trading
Securities
  Contingent Payments 
       
Beginning balance $22  $71 
Total net gains or losses (realized/unrealized)        
Included in earnings before income taxes
  1   -- 
         
Purchases of investments  --   -- 
Acquisition-related activities  --   89 
Proceeds on sales and maturities  (17)  -- 
Transfers in and/or out of Level 3  --   -- 
         
Ending balance $6  $160 
         

Gains and losses (realized and unrealized) on Level 3 financial instruments included in earnings were reported in other, net, as follows:

  2010 
    
Net gains (losses) included in earnings for the period                                                                                                                  $1 
     
Change in unrealized net gains (losses) related to assets still held at reporting date $1 
     

At December 31, 2009, trading securities were the only type of financial assets included in Level 3.  The trading securities were professionally managed investment funds, which included fixed income funds of $22.  The fair value of the investment funds classified as Level 3 could not be determined by independent market observation or through the use of other observable valuation techniques.  The valuation was based on net asset values as furnished by the funds' custodian.  If more than an insignificant proportion of a particular fund's assets were Level 3, the entire fund was classified as Level 3, although many of the fund's individual holdings may meet the definition of Level 1 or Level 2.  The only liabilities included in Level 3 were the acquisition-related contingency payments, as discussed earlier in this note.

Total gains and losses (realized and unrealized) included in earnings before income taxes for financial assets and liabilities classified as Level 3 were a component of other, net, in the consolidated statements of earnings.  For the
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year ended December 31, 2009, there were net gains (realized and unrealized) of $7 from trading securities, and the Company received proceeds from sales of Level 3 trading securities of $246.  Realized and unrealized net gains during the period were approximately 3% of the beginning balance for Level 3 trading securities and did not negatively affect or materially impact operations, liquidity or capital resources.

The table presented below summarizes the change in carrying values associated with Level 3 financial instruments during the year ended December 31, 2009.

  Assets  Liabilities 
     Acquisition-Related 
  
Trading
Securities
  Contingent Payments 
       
Beginning balance $261  $-- 
Total net gains or losses (realized/unrealized)        
Included in earnings before income taxes
  7   -- 
         
Acquisition-related activities  --   71 
Proceeds on sales and maturities  (246)  -- 
Transfers in and/or out of Level 3  --   -- 
         
Ending balance $22  $71 
         

Gains and losses (realized and unrealized) on Level 3 financial instruments included in earnings were reported in other, net, as follows:

  2009 
    
Net gains (losses) included in earnings for the period                                                                                                                  $7 
     
Change in unrealized net gains (losses) related to assets still held at reporting date $2 
     
Valuation Techniques

Valuation techniques used for financial assets and liabilities accounted for at fair value are generally categorized into three types:  market approach, income approach and cost approach.  The Company valued its Level 3 financial assets and liabilities at December 31, 2010 and 2009 primarily using the market approach and, to a lesser extent, the income approach.

Market Approach.  The market approach uses prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities.  Valuation techniques consistent with the market approach include comparables.  A majority of the Company's balances measured at fair value on a recurring basis were valued using the market approach.  Most measurements were market quotes or obtained from other reliable market sources.  The Company did not use market indices for valuing material balances measured at fair value.

Income Approach.  Income approach valuation techniques convert future amounts, such as cash flows or earnings, to a single present or discounted amount.  The measurement is based on the value indicated by current market expectations about those future amounts.  Examples of income approach valuation techniques include present value techniques, option-pricing models, binomial or lattice models that incorporate present value techniques and option-pricing models.  The Company valued certain derivatives, in part or whole, and acquisition-related contingent payments using the income approach.

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Cost Approach.  The cost approach is based on the amount that currently would be required to replace the service capacity of an asset.  The Company did not employ the cost approach for determining fair value of financial assets and liabilities.

The valuation approaches are consistent with generally accepted valuation methodologies.  While all three approaches are not applicable to all assets or liabilities accounted for at fair value, where appropriate and possible, one or more valuation techniques may be used.  Professionally managed investment funds may use a combination of market, income and cost approaches.  The process of selecting which valuation method(s) to apply considers the definition of an exit price and the nature of the asset or liability being valued and significant expertise and judgment is required.

Other-Than-Temporary Impairment of Available-for-Sale Investments

The Company reviews quarterly its available-for-sale investments to identify impaired equity and debt securities.  An individual security is impaired if the fair value of the investment is less than its amortized cost basis.  Impairment may be either temporary or other-than-temporary.

The Company normally reviews securities held in its portfolio that have been in a continuous loss position for twelve months or longer and securities whose fair value is significantly lower than its amortized cost basis.  Impairment is evaluated using a combination of quantitative and qualitative factors such as considering the length of time and extent to which the fair value has been below cost, the financial condition and near-term prospects of the issuer, as well as the Company's ability and intent to hold the investments for an adequate period of time until an anticipated market price recovery or maturity.  In its impairment analysis of debt securities, management assesses whether it does not have the intent to sell the security before maturity and it is more likely than not that it will not have to sell the security before recovery of its cost basis. If an impairment is determined to be other-than-temporary, the investment is written down to fair value, and a loss is recognized immediately through earnings.

In addition, the Company assesses whether there are probable credit losses associated with impaired available-for-sale debt securities.  The portion of an other-than-temporary impairment of an available-for-sale debt security that is related to credit loss is recognized in earnings and the remainder of the difference between the cost basis of the debt security and its fair value is recorded in other comprehensive income.

The Company determined that, at December 31, 2010 and 2009, there were no unrealized losses on available-for-sale investments that were other-than-temporarily impaired and there were no credit losses on any investments.

The Company determined that, at December 31, 2008, unrealized losses on certain available-for-sale equity securities and a senior secured bank loans fund were other-than-temporarily impaired due to deteriorating general market conditions, particularly during the fourth quarter of 2008, coupled with the unlikely near term prospects for achieving a sustainable recovery, uncertainty about future market conditions, and declines in certain quantitative or qualitative factors.  The other-than-temporary impairment recognized for the senior secured bank loans fund also was deemed appropriate to bring a significant portion of the unrealized losses in line with current market conditions for credit default rates and loss recovery rates.  The Company recognized losses for other-than-temporary impairment during the year ended December 31, 2008 of $37.
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Concentrations of Credit Risk

As part of its ongoing control procedures, the Company monitors concentrations of credit risk associated with corporate issuers of securities and financial institutions with which it conducts business.  Credit risk is minimal as credit exposure limits are established to avoid a concentration with any single issuer or institution.  The Company also monitors the creditworthiness of its customers to which it grants credit terms in the normal course of business.  Concentrations of credit risk associated with these trade receivables are considered minimal due to the Company's diverse customer base.  Bad debts have been minimal.  The Company does not normally require collateral or other security to support credit sales.

(6)  Intangible Assets and Goodwill

  December 31, 2010  December 31, 2009 
  Gross     Gross    
  Carrying  Accumulated  Carrying  Accumulated 
  Amount  Amortization  Amount  Amortization 
             
Intangible Assets            
Subject to amortization:            
Licensed technology $467  $(315) $332  $(296)
Patents  290   (40)  111   (24)
Other  562   (115)  121   (93)
                 
              Total subject to amortization  1,319   (470)  564   (413)
                 
Not subject to amortization:                
Purchased in process research and
     development assets
  104   --   104   -- 
                 
Total intangible assets $1,423  $(470) $668  $(413)

During the years ended December 31, 2010 and 2009, the Company added licensed technology, patents and other intangible assets through business acquisitions and asset purchases.  Note 18 provides additional information on changes to intangible assets from significant business acquisitions in 2010 and 2009.

  Years ended December 31, 
  2010  2009  2008 
          
Aggregate amortization expense related to intangible assets $60  $24  $29 
             

Estimated Amortization Expense:   
    
For year ended December 31, 2011                                                                                               $78 
For year ended December 31, 2012                                                                                               $73 
For year ended December 31, 2013                                                                                               $67 
For year ended December 31, 2014                                                                                               $67 
For year ended December 31, 2015                                                                                               $65 
     

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The changes in the carrying amounts of goodwill for the years ended December 31, 2010 and 2009 were as follows:

  United States  International    
  Segment  Segment  Total 
          
Goodwill         
Balance,  December 31, 2008                                                                    $403  $242  645 
Acquisition of business                                                                     18   22   40 
Impact of changes in foreign exchange rates  2   1   3 
             
Balance,  December 31, 2009                                                                     423   265   688 
             
Acquisitions of businesses                                                                     90   64   154 
Impact of changes in foreign exchange rates  (5)  (4)  (9)
             
Balance,  December 31, 2010                                                                    $508  $325  $833 
             

(7)  Short Term Borrowings

  December 31, 
  2010  2009 
       
Lines of credit
 $307  $273 
Commercial paper
  --   286 
From affiliates
  4   7 
Bank overdrafts
  26   41 
         
Total short term borrowings 
 $337  $607 

At December 31, 2010, the Company had several unsecured line of credit agreements with third parties totaling $597 that were denominated in various currencies.  The commitment fees related to unused borrowings under these facilities were less than $1 during 2010, 2009 and 2008.  The weighted average interest rates at December 31, 2010 and 2009 were 2.2% and 2.2%, respectively.  The amounts outstanding under these agreements at December 31, 2010 were due at various dates during 2011.

During the first half of 2010 and all of 2009, the Company had a $2,000 commercial paper facility.  Nestlé guaranteed the commercial paper facility and assisted in its management, for which the Company paid Nestlé an annual fee based on the average outstanding commercial paper balances.  The Company's management believes that any fees paid by the Company to Nestlé for their guarantee of any indebtedness or for the management of the commercial paper program were comparable to the fees that would be paid in an arm's length transaction.  Total fees paid to Nestlé in connection with this facility for the years ended December 31, 2010, 2009 and 2008 were less than $1 per year.

During 2010, the Company entered into an unsecured line of credit agreement denominated in Venezuelan bolivars with a subsidiary of Novartis.  These short term borrowings at December 31, 2010 were due October 15, 2011.  The weighted average interest rate at December 31, 2010 was 10.0%.  The unused portion under the line of credit agreements was $8 at December 31, 2010.

The Company had several unsecured bank overdraft lines of credit denominated in various currencies totaling $248 at December 31, 2010.  The weighted average interest rates on bank overdrafts at December 31, 2010 and 2009 were 4.5% and 4.5%, respectively.
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(8)  Long Term Debt

  December 31, 
  2010  2009 
       
Bank loan                                                                                          $62  $56 
         
Less current maturities of long term debt                                                                                           62   -- 
         
Long term debt, net of current maturities                                                                                     $--  $56 

The Company's Japanese subsidiary has an outstanding bank loan with a fixed interest rate of 1.6%, due in January 2011.  This fixed rate of 1.6% was swapped for floating rate yen LIBOR, which was 0.2% at December 31, 2010.  The bank loan was guaranteed by Nestlé for a fee of less than $1 annually in 2010, 2009 and 2008.  The bank loan contains provisions that may accelerate the obligation in the event that Nestlé's ownership of Alcon falls below 51%.  Although Nestlé's ownership fell below this threshold, the lenders have opted not to call the loan before its maturity date.  The balance of the loan was paid in January 2011.

Interest costs of $1, $1 and $2 in 2010, 2009 and 2008, respectively, were capitalized as part of property, plant and equipment.

(9)  Income Taxes

The components of earnings before income taxes were:

  2010  2009  2008 
          
Switzerland $1,822  $1,339  $1,446 
Outside Switzerland  705   974   637 
             
Earnings before income taxes $2,527  $2,313  $2,083 
             
Income tax expense (benefit) consisted of the following:

  2010  2009  2008 
Current:         
Switzerland $5  $29  $6 
Outside Switzerland  308   226   176 
             
Total current  313   255   182 
             
Deferred:            
Switzerland  --   (1)  (6)
Outside Switzerland  4   52   (140)
             
Total deferred  4   51   (146)
             
Total $317  $306  $36 
             
During the year ended December 31, 2010, the Company recognized a $25 tax charge for the write-off of deferred tax assets as a result of provisions of U.S. healthcare reform laws enacted during the period.

Income tax expense for the year ended December 31, 2008 reflected a net reduction of $271 for period items, including a reduction of $236 related to losses associated with the Company's investment in and advances to its
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former subsidiary, Summit Autonomous, Inc., as well as reductions related to progress in audit settlements, advance pricing agreement negotiations, the lapse of statutes of limitation and other minor items.

Current tax expense does not reflect benefits of $65, $22 and $61 for the years ended December 31, 2010, 2009 and 2008, respectively, related to restricted shares and the exercise of employee stock options, recorded directly to additional paid-in capital.

In 2010, 2009 and 2008, the Company realized certain Swiss tax benefits totaling approximately $194, $145 and $130, respectively, for its commitment to relocate and significantly expand its global administration operations in Switzerland.  The initial term of these benefits is expected to continue from 2008 for a period of five years.  These benefits would be extended for an additional five years if the Company fulfills certain employment commitments and maintains these commitments through 2022.

A reconciliation of income tax expense at the statutory tax rate of 7.8% in Switzerland to the consolidated effective tax rate follows:

  2010  2009  2008 
          
Statutory income tax rate  7.8%  7.8%  7.8%
Effect of different tax rates in various jurisdictions  4.8   4.8   8.2 
Current year research and experimentation credits  (0.6)  (0.9)  (1.1)
Other current year taxes  0.3   0.4   0.2 
Current year nondeductible and excludable items  (0.4)  0.1   (0.4)
Effect of losses on investment in Summit            
Autonomous, Inc  --   --   (11.3)
Effect of provisions of U.S. healthcare reform      ��     
legislation  1.0   --   -- 
Effect of change of majority ownership  (0.3)  --   -- 
Tax impact of prior year audit settlements, amended            
returns and adjustments to estimates  --   1.1   (1.7)
Other  (0.1)  (0.1)  -- 
             
Effective tax rate  12.5%  13.2%  1.7%
             

At December 31, 2010, Alcon's subsidiaries had loss carryforwards that expire as follows:

     
2011
$--  
2012
 --  
2013
 --  
2014
 2  
2015
 --  
2016-2030
 91  
Indefinite
 --  
     
Total loss carryforwards
$93  
     

Deferred income taxes are recognized for tax consequences of temporary differences by applying enacted statutory tax rates, applicable to future years, to differences between the financial reporting and the tax basis of existing assets and liabilities.

Temporary differences and carryforwards at December 31, 2010 and 2009 were as follows:

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  December 31, 
  2010  2009 
       
Deferred income tax assets:      
Trade receivables                                                                              $53  $41 
Inventories                                                                               9   12 
Intangible assets                                                                                50   25 
Accounts payable and other current liabilities                                                                               113   113 
Other liabilities                                                                               232   237 
Share-based payments                                                                               60   81 
Loss carryforwards                                                                               31   3 
         
Gross deferred income tax assets                                                                             548   512 
Unused tax credits                                                                               18   19 
Valuation allowance                                                                               (5)  (6)
         
Total deferred income tax assets                                                                             561   525 
         
Deferred income tax liabilities:        
Property, plant and equipment                                                                               35   34 
Intangible assets   157    -- 
Other                                                                               10   6 
         
Total deferred income tax liabilities                                                                             202   40 
         
Net deferred income tax assets                                                                            $359  $485 
         

The valuation allowances for deferred tax assets as of January 1, 2010 and 2009 were $(6) and $(5), respectively.  The net changes in the total valuation allowance for each of the years ended December 31, 2010 and 2009 were a decrease of $1 and an increase of $1, respectively.  The valuation allowances at December 31, 2010 and 2009 were primarily related to costs for which deductions did not appear to be more likely than not to be realized.  Based on the Company's historical pretax earnings, management believes it is more likely than not that the Company will realize the benefit of the existing net deferred income tax assets at December 31, 2010.  Management believes the existing net deductible temporary differences will reverse during periods in which the Company generates net taxable earnings; however, there can be no assurance that the Company will generate any earnings or any specific level of continuing earnings in future years.  Certain tax planning or other strategies could be implemented, if necessary, to supplement earnings from operations to fully realize tax benefits.

Withholding taxes of approximately $107 have not been provided on approximately $2,133 of unremitted earnings of certain subsidiaries since such earnings are, or will be, reinvested in operations indefinitely.  Taxes of approximately $17 have not been provided on temporary differences of approximately $212 for permanent investments in certain subsidiaries that will be taxable upon liquidation.

The Company or one of its subsidiaries files income tax returns in Switzerland, the U.S. federal jurisdiction, and various state and other foreign jurisdictions.  With few exceptions, the Company is no longer subject to Swiss, U.S. federal, state and local, or non-U.S. income tax examinations by tax authorities for years before 2004.

In June 2009, the Internal Revenue Service ("IRS") commenced an examination of the Company's U.S. income tax returns for 2006 and 2007 that was completed substantially in January 2011.  In May 2009, the IRS and the Company entered the Compliance Assurance Process ("CAP") program for 2009.  In January 2010, the IRS and the Company extended the CAP program to 2010.  The Company also currently is subject to income tax examinations by various state, local and foreign tax authorities.  In addition, in June 2009, the Company and the IRS signed an
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advance pricing agreement ("APA") contract memorializing the mutual agreement letter between Switzerland and the United States for years through 2014 that covers all material intercompany transactions involving the Company and its subsidiaries in these two jurisdictions.  Finally, during the fourth quarter of 2007, the Company submitted a similar request for a bilateral APA between Japanese and Swiss tax authorities that would cover the tax years 2008 through 2012.  The Company received the duly signed Japanese-Swiss APA in the third quarter of 2010.

The Company believes that it takes reasonable positions on its tax returns filed throughout the world; however, tax laws are complex and susceptible to differing interpretations.  Tax authorities throughout the world, from time to time, routinely challenge positions taken by the Company, particularly in the case of transfer pricing issues.  The Company has identified its uncertain tax positions and prepared its reserve for contingent tax liabilities to reflect the associated unrecognized tax benefits (the "Tax Reserves") in accordance with Financial Accounting Standards Board ("FASB") guidance which, among other things, requires that the Company assume that it will be subject to examination in every jurisdiction in which it is subject to tax.  Management believes that the Tax Reserves are fairly stated but believes it is reasonably possible that the total amount of unrecognized tax benefits related to transfer pricing, currency translations and other tax positions reflected in the Tax Reserves will significantly increase or decrease within 12 months of the reporting of this financial statement as the result of, among other things, (i) developments with respect to currently active audits and/or (ii) the further development of tax laws through judicial or administrative actions and/or the actual payment of Tax Reserves.  Although tax laws are complex and significant uncertainty exists with respect to the actual date that any of the currently active audits could reach final resolution or a new audit could commence, management believes it is reasonably possible that unrecognized tax benefits could increase in the next 12 months by at least 10% or decrease by up to 70%.

A reconciliation of the beginning and ending amounts of unrecognized tax benefits, exclusive of interest and penalties, related to uncertain tax positions is as follows:

  2010  2009 
       
Balance at January 1                                                                                         $74  $130 
Additions for tax positions related to prior years                                                                                          19   40 
Reductions for tax positions related to prior years                                                                                          (13)  (16)
Additions for tax positions related to the current year                                                                                          4   10 
Settlements                                                                                          (12)  (90)
Lapse of statutes of limitation                                                                                          (1)  -- 
         
Balance at December 31                                                                                         $71  $74 

During the years ended December 31, 2010 and 2009, the total amount of unrecognized tax benefits excluding interest and penalties, included in the Tax Reserves decreased by $3 to $71 and decreased by $56 to $74, respectively.  The net decrease in unrecognized tax benefits in 2010 reflected progress on audit settlements, APA negotiations, the lapse of statutes of limitation and other minor items.  The net decrease in unrecognized tax benefits in 2009 reflected the resolution of various audits, progress on ongoing audits, APA negotiations, the development of case law, the lapse of statutes of limitations and other minor items.  The amounts of unrecognized tax benefits that would impact the effective tax rate if recognized at December 31, 2010 and 2009 were $64 and $69, respectively.

The Company's policy is to classify interest and penalties in income tax expense.  The gross amount of interest and penalties accrued as part of the Tax Reserves at December 31, 2010 and 2009 were $14 and $9, respectively.  At December 31, 2010, the consolidated balance sheet included $1 in other current liabilities and $76 in other long term liabilities for the Tax Reserves, net of deposits with statutory authorities.  At December 31, 2009, the consolidated balance sheet included $19 in other current liabilities and $57 in other long term liabilities for the Tax Reserves, net of deposits with statutory authorities.  The gross amounts of interest and penalties included in the consolidated statements of earnings for 2010 and 2009 were not significant.
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(10)  Business Segments

The Company conducts its global business through two business segments: Alcon United States and Alcon International.  Alcon United States includes sales to unaffiliated customers located in the United States of America, excluding Puerto Rico.  Alcon United States operating income is derived from operating profits within the United States.  Alcon International includes sales to all other unaffiliated customers.

Each business segment markets and sells products principally in three product categories of the ophthalmic market:  (1) pharmaceutical (prescription drugs), (2) surgical equipment and devices (cataract, vitreoretinal and refractive), and (3) consumer eye care (contact lens disinfectants and cleaning solutions, artificial tears and ocular vitamins).  Business segment operations generally do not include research and development, certain manufacturing and other corporate functions.

Segment performance is measured based on sales and operating income reported in accordance with U.S. GAAP.

Certain manufacturing costs and manufacturing variances are not assigned to business segments because most manufacturing operations produce products for more than one business segment.  Research and development costs, excluding regulatory costs which are included in the business segments, are treated as general corporate costs and are not assigned to business segments.

Identifiable assets are not assigned by business segment and are not considered in evaluating the performance of the business segments.

 Sales Operating Income Depreciation and Amortization   
  2010  2009  2008  2010  2009  2008  2010  2009  2008   
                              
  United States
$3,177 $2,914 $2,807 $1,896 $1,664 $1,554 $64 $47 $46   
  International
 4,002  3,585  3,487  1,728  1,507  1,472  107  90  78   
                              
    Segments total
 7,179  6,499  6,294  3,624  3,171  3,026  171  137  124   
  Manufacturing operations --  --  --  (64) (64) (61) 58  51  46   
  Research and development --  --  --  (687) (579) (527) 24  18  16   
  General corporate --  --  --  (332) (190) (144) 19  12  10   
  Share-based compensation --  --  --  (66) (77) (81) --  --  --   
                              
Total
$7,179 $6,499 $6,294 $2,475 $2,261 $2,213 $272 $218 $196   

During the year ended December 31, 2010, advancements in its sales reporting system permitted the Company to better estimate allowable deductions from sales in the calculation of accrued royalties.  This change in estimate resulted in a $24 addition to U.S. operating income during the period.

In the year ended December 31, 2010, the Company incurred pretax expenses totaling $152 for costs (including $12 in share-based compensation costs) related to the change of majority ownership discussed in note 16 and other costs to support Alcon’s board of directors in its evaluation of Novartis's merger proposal.  In the tables above, these expenses were included with general corporate expenses.

On February 11, 2009, the Company announced that it initiated programs to align its operations with the evolving economic conditions and market environment.  These programs included a staffing reduction of approximately 260 employee positions that resulted in a pre-tax charge of $19 for the year ended December 31, 2009, which was included in general corporate expenses.

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(11)  Geographic, Customer and Product Information

Sales for the Company's country of domicile and all individual countries accounting for more than 10% of total sales are presented below along with long lived assets in those countries.  Sales by ophthalmic market segment are also included. Sales below are based on the location of the customer.  Sales to one customer of the United States business segment represented $661 of the Company's consolidated sales in 2008.  No single customer accounted for more than 10% of total sales in 2010 and 2009.

     Property, Plant and 
  Sales  Equipment 
  For the Years ended December 31,  At December 31, 
  2010  2009  2008  2010  2009 
                
United States                                               $3,177  $2,914  $2,807  $739  $720 
Switzerland                                                50   46   44   20   19 
Rest of world                                                3,952   3,539   3,443   629   565 
                     
Total                                         $7,179  $6,499  $6,294  $1,388  $1,304 
                     
Pharmaceutical                                               $3,066  $2,677  $2,561         
Surgical                                                3,220   2,997   2,881         
Consumer eye care                                                893   825   852         
                     
Total                                         $7,179  $6,499  $6,294         
                     

(12)  Share-Based Compensation Plans

Under the Amended 2002 Alcon Incentive Plan, the Company's board of directors may award to officers, directors and key employees share-based compensation, including stock options, share-settled stock appreciation rights ("SSARs"), restricted shares, share-settled restricted share units ("RSUs"), performance share units and certain cash-settled liability awards.  The total number of shares from conditional capital and treasury shares that may be issued under the plan with respect to such awards cumulatively shall not exceed 40 million Alcon common shares.  The number of shares that may be delivered pursuant to an exercise or after a lapse of a restriction period may not exceed 10% of the total number of shares issued and outstanding at that time.  The grant prices for stock options or stock appreciation rights shall not be lower than the prevailing stock exchange price upon the grant of the award, unless specifically approved by the board.

Individual grants become exercisable generally on or after the third anniversary of the grant and lapse on the tenth anniversary of the grant.  Grants prior to February 2006 also become exercisable upon early retirement at or after age 55.  If there is a change in control (as defined by the plan), the exercise or vesting of the awards accelerates.

Beginning in February 2006, consistent with earlier grants, participants may vest in the stock option and SSAR grants upon early retirement at or after age 55; however, under grants subsequent to January 2006, participants may exercise these instruments only on or after the third anniversary of the grant.  Restricted share and restricted share unit awards are subject to a three-year cliff vesting; furthermore, participants retiring before reaching age 60 for awards granted subsequent to January 2006 through December 2008, or age 62 for awards granted subsequent to January 2009, will forfeit some or all of such awards if the three-year service period has not expired.

The Company intends to satisfy all equity awards granted prior to December 31, 2003 and after December 31, 2007 with the issuance of new shares from conditional capital authorized for the Amended 2002 Alcon Incentive Plan.  At December 31, 2010, the Company had reserved approximately 19.6 million Alcon common shares for issuance pursuant to the Amended 2002 Alcon Incentive Plan.

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The Company's board of directors has authorized the acquisition on the open market of Alcon common shares to, among other things, satisfy the share-based awards requirements granted under the Amended 2002 Alcon Incentive Plan.  At December 31, 2010, outstanding authorizations by the Company's board of directors would have permitted the purchase of approximately 1.6 million Alcon common shares.  The Company has purchased treasury shares on the open market to satisfy the majority of the outstanding equity awards granted subsequent to December 31, 2003 and prior to January 1, 2008.  Additional treasury shares were purchased during 2008 in anticipation of presenting the shares to the shareholders for approval of cancellation (note 16).

Change of Control Provisions

Upon the change of control in the ownership of Alcon to Novartis from Nestlé discussed in note 16, the Company's share-based compensation awards granted to employees prior to January 1, 2009 vested immediately.  However, the vesting of similar awards granted after January 1, 2009 will accelerate only if the respective participant's employment with the Company or its successor is terminated without cause, or by the participant under certain circumstances, within six months preceding or during the two years following a change of control.  The acceleration of vesting increased the cost of share-based payments $8, which was included in other operating expenses in 2010.  If the change of control had not occurred, $6 of that cost would have been recognized in normal attribution during the remainder of 2010.

Upon the completion of the merger discussed in note 16, management expects that Novartis common shares would be substituted for Alcon common shares under the outstanding share-based awards at the merger date.  The substitution ratio would be based on the price of a Novartis share in the merger relative to $168 for an Alcon share, but no cash would be paid.
Equity Awards
Net earnings for the years ended December 31, 2010, 2009 and 2008 reflected the impact of compensation cost for all share-based payments based on the estimated grant-date "fair value."

The effects of share-based equity awards on operating income and net earnings for the years ended December 31, 2010, 2009 and 2008 were as follows:

  2010  2009  2008 
          
Total share-based equity award costs applicable for period $78  $74  $83 
Costs relieved from (capitalized in) inventory                                                                                       --   --   -- 
             
Costs recognized in operating income                                                                                  78   74   83 
Tax benefit recognized in net earnings                                                                                       23   23   27 
             
Reduction to net earnings                                                                                 $55  $51  $56 

Compensation expense for equity awards was calculated on a straight-line basis over the three-year vesting period of the applicable share-based awards, with acceleration of the expense for individuals meeting the requirements for retirement and under the change of control provisions, as described above.

As of December 31, 2010, total unrecognized compensation cost related to nonvested share-based equity compensation arrangements (including share options, SSARs and nonvested share and share unit awards) granted under the plan was $112.  That cost is expected to be recognized over a weighted average period of 1.6 years.

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Options and SSARs

No options or SSARs were granted in 2010.  The "fair values" of each stock option and SSAR granted in 2009 and 2008 were estimated as of the date of grant using the Black-Scholes option-pricing model with the following weighted average assumptions:

  2009  2008 
       
Expected volatility
  31.5%  29.5%
Risk-free interest rate
  1.66%  2.67%
Expected dividend yield
  3.0%  1.5%
Expected term
 5 years  5 years 

The Company based its estimates of expected volatility on daily historical trading data of its common shares from March 2002 through the grant dates and, due to its short history as a public company when compared to length of the term of the instruments, other factors, such as the volatility of the common share prices of other pharmaceutical and surgical companies.

The risk-free interest rate assumptions were based on implied yields, at the grant dates, of U.S. Treasury zero-coupon bonds having a remaining term equal to the expected term of the employee share awards.

The expected dividend yield was estimated generally based upon the Company's historic dividend yield since 2003, projected dividend increases and other relevant information.

The Company estimated the expected term consistent with historical exercise and cancellation activity of its previous share-based grants with a ten-year contractual term, as well as that of other pharmaceutical and surgical companies.

Forfeitures of stock options and SSARs were estimated to be 4.0% in 2010 (6.3% in 2009 and 7.3% in 2008) of the number granted, based on historical experience.

If factors change and the Company employs different assumptions to account for share-based payments in future periods, the compensation expense that the Company records may differ significantly from what the Company has recorded in the current period.

The status of the stock options and SSARs as of December 31, 2010 and the changes during the year then ended are presented below:

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  Stock Options  SSARs 
     Weighted  Weighted        Weighted  Weighted    
     Average  Average        Average  Average    
     Exercise  Remaining        Exercise  Remaining    
     Price  Contractual  Aggregate     Price  Contractual  Aggregate 
     per  Term  Intrinsic     per  Term  Intrinsic 
  Number  Share  (Years)  Value  Number  Share  (Years)  Value 
                         
Outstanding at                        
    beginning of period  5,633,142  $68         5,345,020  $117       
Granted  --   --         --   --       
Forfeited  (26,936)  97         (42,442)  104       
Exercised  (2,448,823)  69         (1,501,331)  130       
Expired                            (617)  133         (1,863)  129       
Outstanding at end                            
    of period  3,156,766   68   3.6  $302   3,799,384   112   7.1  $197 
Exercisable at end                                
    of period  2,965,322   66   3.3  $288   1,991,643   134   6.1  $59 
                                 

The weighted average grant-date "fair values" of stock options granted during the years ended December 31, 2009 and 2008 were $19 and $39 per option, respectively.  The total intrinsic values of the stock options exercised during the years ended December 31, 2010, 2009 and 2008 were $227, $69, and $191, respectively.
The weighted average grant-date "fair values" of SSARs granted during the years ended December 31, 2009 and 2008 were $19 and $38 per SSAR.  The total intrinsic value of SSARs exercised during the years ended December 31, 2010 and 2009 were $244 and $4.  No SSARs were exercised during the year ended December 31, 2008.

The following tables summarize information about stock options and SSARs as of December 31, 2010:

     Options Outstanding Options Exercisable  
     Weighted  Weighted      Weighted  
     Average  Average      Average  
 Range of   Remaining  Exercise Scheduled    Exercise  
 Exercise Number Contractual  Price per Exercisable Number  Price per  
 Prices Outstanding Term (Years)  Share Date Exercisable  Share  
                  
$33 204,431 1.2 $  33 March 21, 2005 204,431 $33  
 36 597,888 2.1    36 February 18, 2006 597,888  36  
 42-50 12,100 2.5    47 Various dates in 2006 12,100  47  
 63 916,083 3.1    63 February 11, 2007 916,083  63  
 67-80 58,000 3.7    77 Various dates in 2007 58,000  77  
 80 5,500 4.0    80 January 18, 2008 5,500  80  
 79 939,838 4.1    79 February 9, 2008 939,838  79  
 98-105 11,000 4.4  101 Various dates in 2008 11,000  101  
 123 61,106 5.1  123 February 8, 2009 61,106  123  
 131 85,510 6.1  131 February 12, 2010 85,510  131  
 148 72,409 7.1  148 February 11, 2011 72,409  148  
 145 125 7.3  145 April 3, 2011 125  145  
 87 192,070 8.1  87 February 17, 2012 1,332  87  
 90 706 8.3  90 April 3, 2012 --     
                  
 Total 3,156,766        2,965,322     

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     SSARs Outstanding SSARs Exercisable  
     Weighted  Weighted      Weighted  
     Average  Average      Average  
 Range of   Remaining  Exercise Scheduled    Exercise  
 Exercise Number Contractual  Price per Exercisable Number  Price per  
 Prices Outstanding Term (Years)  Share Date Exercisable  Share  
                  
$123 599,512 5.1 $123 February 8, 2009 599,512 $123  
 100 6,600 5.3  100 May 2, 2009 6,600  100  
 131 724,509 6.1  131 February 12, 2010 724,509  131  
 133 6,000 6.4  133 May 14, 2010 6,000  133  
 148 627,864 7.1  148 February 11, 2011 627,864  148  
 145-168 21,266 7.3  148 Various dates in 2011 21,266  148  
 87 1,781,786 8.1  87 February 17, 2012 5,892  87  
 90-116 31,847 8.3  97 Various dates in 2012 --     
                  
 Total 3,799,384        1,991,643     
                  
Restricted Shares and RSUs

Restricted shares and RSUs are recognized over the required service period at the closing market price for Alcon common shares on the date of grant.  Forfeitures of restricted shares and RSUs in 2010, 2009 and 2008 were estimated to be 6.0%, 8.3% and 9.8%, respectively, of the number granted, based on historical experience.  The status of the nonvested restricted shares and RSUs as of December 31, 2010 and the changes during the year then ended are presented below:

  Restricted Shares RSUs
     Weighted Weighted     Weighted Weighted  
     Average Average     Average Average  
     Grant-Date Remaining    Grant-DateRemaining  
     Price ContractualAggregate    Price Contractual Aggregate
     per TermMarket    per Term Market
  Number  Share (Years)Value Number  Share (Years) Value
                 
Nonvested at beginning                 
    of period                             125,058  $131     693,782  $110    
Granted                             --   --     790,636   159    
Vested                             (124,819)  131     (288,922)  144    
Forfeited                             (239)  131     (38,353)  127    
                      
Nonvested at end                     
    of period  --   -- --$           --  1,157,143   134 1.53 $                  189
                      

No restricted shares were granted during 2010, 2009 and 2008.  The total market values of restricted shares that vested during the years ended December 31, 2010, 2009 and 2008 were $20, $14 and $4, respectively.

The weighted average grant-date market values of RSUs granted during the years ended December 31, 2010, 2009 and 2008 were $159, $89, and $147 per share, respectively.  The total market values of RSUs that vested during the years ended December 31, 2010, 2009 and 2008 were $50, $6 and less than $1, respectively.

Performance Share Units

In February 2009 and 2008, pursuant to the Amended 2002 Alcon Incentive Plan, the Company's board of directors approved the grants of approximately 47,000 and 37,000 performance share units, respectively, to the senior executive officers and other selected executives.  The performance share units are designed to award
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additional compensation in the form of Alcon shares if certain earnings per share targets are met.  The final awards may be adjusted by a total shareholder return multiplier.  If minimum earnings per share targets are not met, no Alcon shares are delivered under the awards.  These awards do not pay dividend equivalents during the performance period.  The 2009 and 2008 performance share units vest at the end of a three-year service period, with forfeitures if the recipient is not fully vested before age 62 or 60, respectively.

The "fair value" of each performance share unit was estimated at the grant date assuming that the target performance goal will be achieved and using a Monte Carlo simulation approach to model adjustments for total shareholder return modifier provisions.  The following weighted average assumptions were incorporated into the valuation model:
  2009  2008 
       
Expected volatility
  31.5%  29.5%
Risk-free interest rate
  1.22%  2.10%
Expected dividend yield
  3.0%  1.5%
Expected term
 3 years  3 years 
         

In the event that the minimum performance goals are not met, previously recognized compensation cost will be reversed.  The Company recognizes the "fair values" of performance share units over the required service period.

Forfeitures of performance share units were estimated to be 0.8% in 2010 (1.5% in 2009 and 2.3% in 2008) of the number granted, based on historical experience of other types of awards and the limited number of executives receiving them.  The status of the performance share unit awards as of December 31, 2010 and the changes during the year then ended are presented below:

  Performance Share Units
     Weighted Weighted  
     Average Average  
     Grant-Date Remaining Aggregate
     "Fair Value" Contractual Market
  Number  per Unit Term (Years) Value
          
Nonvested at beginning of period  81,155  $114    
Granted                                              --   --    
Vested                                              (8,003)  107    
Forfeited                                              (683)  86    
            
Nonvested at end of period                                              72,469   114 0.7 $                                                 12
            

The weighted average grant-date "fair values" of performance share units granted during the years ended December 31, 2009 and 2008 were $86 and $152 per instrument, respectively.  The total market value of performance share units that vested during the year ended December 31, 2010 was $1.  No performance share units vested during the years ended December 31, 2009 and 2008.  No such instruments were granted in 2010 and prior to 2008.

Liability Awards

The Amended 2002 Alcon Incentive Plan also provides that the board may grant cash-settled stock appreciation rights ("CSARs") whereby the grantee may receive the appreciation in share value over the grant price.  Individual grants become exercisable generally on or after the third anniversary of the grant and lapse on the tenth anniversary of the grant.  In addition to scheduled vesting, shares are fully vested upon meeting the requirements for retirement.

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The Company accounts for CSARs as share-based liability awards that are remeasured each reporting period through the awards' settlement dates using the Black-Scholes option-pricing model and similar assumptions to those used for measuring equity grants.  No CSARs were granted in 2010, 2009 and 2008.  At December 31, 2010 and 2009, all CSARs were fully vested and were measured at their intrinsic value.  The market price for Alcon common shares was $163 per share at December 31, 2010.  At December 31, 2010 and 2009, the Company's liability for CSARs totaled $2 and $3, respectively.  The related activity in 2010, 2009 and 2008 was not significant.

The Company expects to use liability awards minimally in the future.  As of December 31, 2010, there was no unrecognized compensation cost related to CSARs granted under the plan.

(13)  Deferred Compensation

The Alcon Executive Deferred Compensation Plan permits certain executives of the Company to defer receipt of compensation and certain stock gains otherwise payable currently and to accumulate earnings thereon on a tax-deferred basis.  The plan is designed to permit executives' deferral elections to be held and owned by the Company in a Rabbi trust.  During the years ended December 31, 2010, 2009 and 2008, certain executives elected to defer compensation totaling $2, $1, and $1 respectively.  At December 31, 2010 and 2009, other long term liabilities in the accompanying consolidated balance sheets included liabilities under the plan of $12 and $13, respectively.
In 2004, the Company established the Alcon Excess 401(k) Plan, allowing deferral of excess employer contributions that cannot be made to the Alcon 401(k) Retirement Plan because of limitations under the U.S. Internal Revenue Code of 1986.  During the years ended December 31, 2010, 2009 and 2008, deferrals under the plan were $5, $3 and $3 respectively.  At December 31, 2010 and 2009, liabilities under the plan, included in other long term liabilities in the accompanying consolidated balance sheets, were $17 and $13, respectively.

(14)  Related Party Transactions

As of December 31, 2010, Novartis had purchased 231,352,279 common shares of Alcon, and Nestlé no longer owned any common shares of Alcon.

On January 9, 2009, the Company entered into an agreement with Novartis Pharma AG (an affiliate of Novartis) providing for the co-promotion under their license of the Lucentis® product in Japan.  This agreement has a three-year term ending on December 31, 2011.  During the years ended December 31, 2010 and 2009, the Company recognized approximately $10 and $3 in co-promotion fees from this agreement, which fees were more than sufficient to recover the Company's costs under the agreement.

During the year ended December 31, 2010, the Company reimbursed Novartis for certain operating expenses totaling $2 incurred on the Company's behalf.

The Company's other material transactions with related parties during 2010, 2009 and 2008 were with Nestlé and its subsidiaries.  All material related party transactions that are not disclosed elsewhere in these notes are included below.

During 2010, 2009 and 2008, the Company had investments and borrowings with Nestlé and its subsidiaries which resulted in the following impact to earnings before income taxes:

  2010  2009  2008 
          
Interest expense                                                                              $1  $3  $5 
Interest income                                                                              --  Less than $1  Less than $1 
             

The Company continues to lease certain facilities from Nestlé subsidiaries which resulted in rent expense of $3, $3, and $2 in 2010, 2009 and 2008, respectively.  Nestlé provided the Company with certain services, including a portion of the Company's information technology licenses, corporate legal services, certain treasury and cash

F-41
management activities and certain internal audit activities.  Nestlé charged the Company for its portion of the costs of these services based on arm's length prices.  Such charges were less than $3 in each of the three years ended December 31, 2010, 2009 and 2008.

During 2008, Lehman Brothers International (Europe) London filed for administration in England.  At that time the Company's cash and cash equivalents included $707 of short term securities held in a segregated custodial account of Lehman Brothers International (Europe) London pursuant to a Custody Agreement.  Nestlé invoiced the Company in December 2008, and in 2009 the Company reimbursed Nestlé, for a total of $5 in fees paid by Nestlé to the Joint Administrators of Lehman Brothers International (Europe) (in administration) related to the release of the short-term securities held in the custodial account.  This amount of fees is subject to adjustment depending on the final costs incurred to settle the administration of Lehman Brothers International (Europe).

The Company executed certain foreign exchange contracts through Nestlé Finance SA, Cham to benefit from Nestlé's foreign exchange transaction volumes and expertise.  At December 31, 2010 and 2009, the Company had no notional amounts outstanding with Nestlé.

The Company participated with certain Nestlé affiliates in specific cash pooling accounts under which overdraft lines of credit were available and were jointly and severally guaranteed by all participants, including the Company.  At December 31, 2010, these lines of credit were longer available.
The Company was part of the Nestlé Swiss Value-Added Tax Group until October 2010, when a new Swiss Alcon Value-Added Tax Group was formed. Alcon is jointly and severally liable for any value-added tax liabilities of all other Swiss Alcon Group participants effective October 2010.
(15)  Pension and Postretirement Benefits

The Company's pension and postretirement benefit plans, which in aggregate cover substantially all employees in the United States and employees in certain other countries, consist of defined benefit pension plans, defined contribution plans and a postretirement healthcare plan.  The Company's cost of defined contribution plans was $94, $86 and $78 in 2010, 2009 and 2008, respectively.

The information provided below pertains to the Company's defined benefit pension plans and postretirement healthcare plan.  The measurement date used to determine pension and postretirement benefit measurements for all of the benefit plans in 2010, 2009 and 2008 was December 31 of the respective year.

The changes in benefit obligations, fair values of plan assets and funded status for the years ended December 31, 2010 and 2009 were:
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        Postretirement 
  Pension Benefits  Benefits 
  2010  2009  2010  2009 
Change in Benefit Obligation            
Benefit obligation at beginning of year
 $557  $458  $276  269 
Service cost
  28   23   14   13 
Interest cost
  30   29   16   16 
Benefits paid by trust
  (5)  (7)  (11)  (10)
Benefits paid by Company
  (21)  (19)  --   -- 
Employee contributions
  1   1   --   -- 
Foreign currency translation
  7   3   --   -- 
Medicare subsidy
  --   --   1   1 
Conversion of multi-employer plan/acquisition
  --   35   --   -- 
Special termination benefits
  101   --   --   -- 
Curtailment
  (44)  --   --   -- 
Actuarial (gain)/loss
  58   34   45   (13)
                 
Benefit obligation at end of year
  712   557   341   276 
                 
Change in Plan Assets                
Fair value of plan assets at beginning of year
  119   68   177   123 
Actual return on plan assets
  7   10   18   32 
Employer contribution
  12   17   34   32 
Employee contributions
  1   1   --   -- 
Conversion of multi-employer plan/acquisition
  --   29   --   -- 
Foreign currency translation
  4   1   --   -- 
Benefits paid
  (5)  (7)  (11)  (10)
                 
Fair value of plan assets at end of year
  138   119   218   177 
                 
Funded Status at End of Year
 $(574) $(438) $(123) $(99)
                ��
Amounts Recognized in the Consolidated Balance Sheets 
Accrued benefit costs in other current liabilities
 $(31) $(15) $--  $-- 
Pension and postretirement obligation in other long term liabilities  (543)  (423)  (123)  (99)
                 
Net amount recognized in the consolidated balance sheet $(574) $(438) $(123) $(99)
                 

Amounts recognized in accumulated other comprehensive income, net of taxes, at December 31, 2010 consisted of:

  Pension Benefits  Postretirement Benefits 
       
Prior service cost $--  $-- 
Net losses (gains)  82   42 
         
Total $82  $42 
         
The amounts in accumulated other comprehensive income expected to be recognized as components of net periodic benefit cost in the year ended December 31, 2011 were estimated to be:
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  Pension  Postretirement 
  Benefits  Benefits 
       
Prior service cost $--  $-- 
Net losses (gains  4   4 
         
Total $4  $4 
         

The accumulated benefit obligation for all defined benefit pension plans was $605 and $439 at December 31, 2010 and 2009, respectively.

The following table provides information for pension plans with an accumulated benefit obligation in excess of plan assets at December 31, 2010 and 2009:

  Pension Benefits 
  2010  2009 
       
Projected benefit obligation $571  $438 
Accumulated benefit obligation  511   359 
Fair value of plan assets  13   10 
         

        Postretirement 
  Pension Benefits  Benefits 
Weighted Average Assumptions to Calculate Benefit 2010  2009  2010  2009 
Obligations as of December 31
             
Discount rate                                                                      4.8%  5.4%  5.5%  6.0%
Expected return on plan assets                                                                      4.0   4.2   6.6   7.5 
Rate of compensation increase                                                                      4.9   4.9   N/A   N/A 
                 


        Postretirement 
  Pension Benefits  Benefits 
Weighted Average Assumptions to Calculate Net 2010  2009  2010  2009 
Benefit Costs for
             
Discount rate                                                                      5.4%  5.7%  6.0%  6.0%
Expected return on plan assets                                                                      4.2   3.3   7.5   7.5 
Rate of compensation increase                                                                      4.9   5.1   N/A   N/A 
                 

The discount rates for the defined benefit pension plans were determined by matching, as of the respective measurement dates, the expected future cash flows with high-quality fixed-income securities of the same duration.  This resulted in weighted average discount rates for appropriate equivalent annualized rates.

The discount rates for the postretirement benefit plan were determined by matching the expected future cash flows with high quality fixed-income securities of the same duration as of the respective measurement dates.

The expected long term rates of return on plan assets were based on historical market index returns for the applicable asset classes weighted in proportion to the target allocation of the plan.  The return assumption for the
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postretirement benefits plan also took into account the estimated cost of life insurance coverage and insurer profit due to the use of the trust-owned life insurance investment vehicle.

At December 31, 2009, the Company adopted the provisions of the Compensation-Defined Benefits-Disclosure Topic of the ASC, as adopted by the FASB, which enhances disclosure requirements for fair value measurements.  The required hierarchical levels were discussed in note 5.

Pension Plan Assets

The Company's overall investment strategy is to achieve a mix of investments for long-term growth and investments for near-term benefit payments, with a wide diversification of asset types, fund strategies, and fund managers.  The strategies use a variety of asset classes to provide return opportunities that are consistent with the
Company's acceptable risk tolerance.  The majority of the Company's plans are unfunded, with the major funded plans designated for employees in Japan, Belgium and Spain.

The target allocations for plan assets at December 31, 2010 (on a weighted-average basis) were 12% equity securities, 14% debt securities, 41% guaranteed investment contracts and 33% other investments.  Equity securities primarily included investment in large capitalization companies and index funds located in the United States and Japan.  Debt securities were primarily government bonds in Japan.  The guaranteed investment contract was with an insurance company located in Japan used to fund benefits for employees in Japan.  Other investments consisted of investment funds mainly invested in a mix of debt and equity securities for employees in Belgium, the Netherlands and Norway.  Assets previously invested with a Nestlé plan for employees in Spain had been liquidated and the proceeds were in cash and cash equivalents at December 31, 2010.

Expected long-term rates-of-return on assets were based primarily on historical returns and asset-liability modeling studies and considered expected real returns, inflation fluctuations and volatility of each asset category.

At December 31, 2010 and 2009, the Company's asset allocations by asset category were as follows:

  2010  2009 
       
Cash and cash equivalents $31  $8 
Equity securities  5   12 
Debt securities  7   20 
Guaranteed investment contracts  51   40 
Other investments:        
Investment funds
  39   35 
Other
  5   4 
         
Total
 $138  $119 
         

At December 31, 2010, financial assets for pension benefits measured at fair value on a recurring basis were categorized in the table below based upon the lowest level of input that is significant to the fair value measurement as follows:
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  Level 1  Level 2  Level 3  Total 
             
Cash and cash equivalents $31  $--  $--  $31 
Equity securities (a)  --   5   --   5 
Debt securities (b)  --   7   --   7 
Guaranteed investment contracts (c)  --   51   --   51 
Other investments (d):                
Investment funds
  --   39   --   39 
Other
  --   5   --   5 
                 
Total
 $31  $107  $--  $138 
                 

(a)  This category consists mainly of large capitalization companies and index funds in the United States and Japan.
(b)  This category consists mainly of government debt securities primarily in Japan.
(c)  This category is primarily guaranteed investment contracts in Japan administered through insurance companies with guaranteed returns of 0.75%.  The life insurance companies pool pension plan assets together from all the participating companies and generally invest in a relatively conservative asset mix of corporate and government bonds, mostly Japanese, with a minor portion in both domestic and foreign equity, loans and other investments.
(d)  This category includes assets held in a variety of funds primarily managed by Nestlé Capital Management (a Nestlé affiliate) and State Street Global Advisors for the benefit of employees in Belgium and the Netherlands.  Equity funds consist of Robusta European, Common Contractual and Emerging Market funds (operated by Nestlé's investment management company) and State Street Global Advisors Asia Pacific and World Index funds.  Fixed income funds consist of Euro government bonds, Robusta Inflation Linked and Global Credit Bonds (operated by Nestlé's investment management company).  A minor portion of the funds are invested in real estate, commodities and absolute return hedge funds.

The Company maintains an irrevocable Rabbi trust to be held and invested in an unfunded arrangement for the payment of benefits to participants under certain defined benefit pension plans of the Company.  The assets of the trust are restricted to the payment of pension benefits except under certain conditions, such as the Company's insolvency or termination of the trust.  The Alcon Executive Retirement Plans Grantor Trust Agreement provides for the Company to fund the current actuarially determined present value of the aggregate accrued pension benefits of all participants upon the change of control (discussed in note 16).  Based on actuarially determined pension benefit projections and market conditions, the Company contributed $152 during 2010 to satisfy this requirement.  The assets of the trust were primarily the cash surrender value ($279 as of December 31, 2010) of company owned life insurance policies purchased from a related captive insurance company subsidiary and cash equivalents ($152 as of December 31, 2010).

The Company does not anticipate that any assets from defined benefit plans would be returned to the Company during the year ending December 31, 2011.

At December 31, 2009, financial assets for pension benefits measured at fair value on a recurring basis were categorized in the table below based upon the lowest level of input that is significant to the fair value measurement as follows:
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  Level 1  Level 2  Level 3  Total 
             
                 
Cash and cash equivalents $8  $--  $--  $8 
Equity securities (a)  --   12   --   12 
Debt securities (b)  --   20   --   20 
Guaranteed investment contracts (c)  --   40   --   40 
Other investments (d):                
Investment funds  --   35   --   35 
Other  --   4   --   4 
                 
Total $8  $111  $--  $119 

(a)  This category consists mainly of large capitalization companies and index funds in the United States and Europe.
(b)  This category consists mainly of government debt securities in Europe, the United States and Japan.
(c)  This category is primarily guaranteed investment contracts in Japan administered through insurance companies with guaranteed returns of 0.75%.  The life insurance companies pool pension plan assets together from all the participating companies and generally invest in a relatively conservative asset mix of corporate and government bonds, mostly Japanese, with a minor portion in both domestic and foreign equity, loans and other investments.
(d)  This category includes assets held in a variety of funds primarily managed by Nestlé Capital Management (a Nestlé affiliate) and State Street Global Advisors for the benefit of employees in Belgium and the Netherlands.  Equity funds consist of Robusta European, Common Contractual and Emerging Market funds (operated by Nestlé's investment management company) and State Street Global Advisors Asia Pacific and World Index funds.  Fixed income funds consist of Euro government bonds, Robusta Inflation Linked and Global Credit Bonds (operated by Nestlé's investment management company).  A minor portion of the funds are invested in real estate, commodities and absolute return hedge funds.

Postretirement Benefits Assets

The Company's overall investment strategy for these fund assets is to invest in long-term growth assets (excluding necessary cash for near-term benefit payments) with a wide diversification of asset types, fund strategies, and fund managers.  The strategies use a variety of asset classes to provide return opportunities that are consistent with the Company's acceptable risk tolerances.  The post retirement plan is a U.S. plan having assets funded to a Voluntary Employee Benefit Association ("VEBA") trust and to a 401(h) account under the Alcon Retirement Plan.  The blended target allocations for plan assets at December 31, 2010 were 6% cash and cash equivalents, 63% global equity securities, 27% corporate bonds, and 4% other investments.  Equity securities primarily included investment in large cap companies located around the world.  Corporate bonds were primarily investment-grade bonds of companies in diversified industries primarily located in the United States.  Other investments consisted primarily of convertible bonds and real assets, including real estate investments and commodities.  Expected long-term rates-of-return on assets were primarily based on historical returns.

At December 31, 2010 and 2009, the Company's asset allocations by asset category were as follows:
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  2010  2009 
       
Cash and cash equivalents $37  $27 
Equity securities (funds and direct holdings):        
Equity securities - U.S. large cap
  32   28 
Equity securities - large cap located outside United States (a)
  28   26 
Debt securities:        
Debt securities – U.S. Treasuries, Agencies & investment grade corporate (b)
  31   29 
Other investments:        
Alcon Active Balanced Fund (c)
  90   67 
         
Total
 $218  $177 
         

(a)International holdings were largely located in developed countries within Europe, the Far East and Australia.
(b)Debt securities were largely located in the United States, benchmarked to the Barclay's Aggregate Index.
(c)The 401(h) account is invested in a balanced fund offered within the Master Trust for the Defined Contribution Plans for Alcon Laboratories, Inc. and Alcon (Puerto Rico), Inc.

At December 31, 2010, financial assets measured at fair value on a recurring basis were categorized in the table below for postretirement benefits based upon the lowest level of input that is significant to the fair value measurement as follows:

  Level 1  Level 2 Level 3  Total 
             
Cash and cash equivalents $37  $--  $--  $37 
Equity securities:                
Equity securities – U.S. large cap (a)
  --   32   --   32 
Equity securities – large cap located outside United States (b)
  --   28   --   28 
Debt securities:                
Debt securities – U.S. Treasuries, Agencies & investment
                
grade corporate (c)
  --   31   --   31 
Other investments:                
Alcon Active Balanced Fund (d)
  --   90   --   90 
                 
Total
 $37  $181  $--  $218 
                 

(a)This category consists of assets in a U.S. equity index fund through trust-owned life insurance.
(b)This category consists of assets in an international equity index fund through trust-owned life insurance.
(c)This category consists of assets in a U.S. Aggregate Board bond market index fund through trust-owned life insurance.
(d)This category consists of one investment in the Alcon Active Balanced fund.  This fund has a globally balanced mandate to include global equities (primarily developed countries), investment grade U.S. corporate and agency debt, real assets and convertibles.  The fund is highly liquid with the vast majority of assets classified as either Level 1 or Level 2 within the FASB fair value hierarchy.
The Company does not anticipate that any assets from the postretirement benefits plan would be returned to the Company during the year ending December 31, 2011.

At December 31, 2009, financial assets measured at fair value on a recurring basis were categorized in the table below for postretirement benefits based upon the lowest level of input that is significant to the fair value measurement as follows:
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  Level 1  Level 2 Level 3  Total 
             
Cash and cash equivalents $27  $--  $--  $27 
Equity securities:                
Equity securities – U.S. large cap (a)
  --   28   --   28 
Equity securities – large cap located outside United States (b)
  --   26   --   26 
Debt securities:                
Debt securities – U.S. Treasuries, Agencies & investment grade corporate (c)
  --   29   --   29 
Other investments:                
Alcon Active Balanced Fund (d)
  --   67   --   67 
                 
Total
 $27  $150  $--  $177 
                 
(a)This category consists of assets in a U.S. equity index fund through trust-owned life insurance.
(b)This category consists of assets in an international equity index fund through trust-owned life insurance.
(c)This category consists of assets in a U.S. Aggregate Board bond market index fund through trust-owned life insurance.
(d)This category consists of one investment in the Alcon Active Balanced fund.  This fund has a globally balanced mandate to include global equities (primarily developed countries), investment grade U.S. corporate and agency debt, real assets, convertibles and absolute return funds.  The fund is highly liquid with the vast majority of assets classified as either Level 1 or Level 2 within the FASB fair value hierarchy.

Contributions

The Company expects to contribute in 2011 approximately $41 to its pension plans and approximately $27 to its postretirement benefit plan.

Estimated Future Benefit Payments

The following table provides the benefit payments expected to be paid and the anticipated subsidy receipts:

   Pension Benefits  Postretirement Benefits 
      Gross Payments  Subsidy Receipts 
           
2011  $32  $12  $(1)
2012   32   13   (1)
2013   32   15   (1)
2014   33   16   (2)
2015   36   18   (2)
2016 - 2020   204   123   (14)
              

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 Pension Benefits Postretirement Benefits 
  2010  2009  2008  2010  2009  2008 
Components of Net Periodic Benefit Cost                  
                   
Service cost                                                      $28 $23 $24 $14 $13 $13 
Interest cost                                                       30  29  24  16  16  15 
Expected return on assets                                                       (5) (4) (2) (14) (10) (11)
Prior service cost                                                       (5) (1) (1) --  1  1 
Special termination benefits                                                       101  --  --  --  --  -- 
Net losses                                                       6  7  7  2  4  1 
                   
Net periodic benefit cost                                                    155  54  52  18  24  19 
                   
Other Changes in Plan Assets and Benefit                  
Obligations Recognized in Other                  
Comprehensive Income                  
                   
Current year net loss (gain)                                                       56  33  16  40  (35) 47 
Amortization of net (gain)                                                       (6) (7) (6) (2) (4) (1)
Amortization of prior service cost 5  1  1  --  (1) (1)
Curtailment                                                       (44) --  --  --  --  -- 
Foreign currency translation                                                       2  2  (2
)
 --  --  -- 
Net charge to other comprehensive                  
       income 13  29  9  38  (40
)
 45 
                   
      Total recognized in net periodic pension                  
    cost and other comprehensive income$168 $83 $61 $56 $(16
)
$64 
                   


Effective January 1, 2008, the Company adopted a provision to measure the funded status of a plan as of the date of its year-end balance sheet.  The Company utilized the alternate transition method to transition the measurement date for its defined pension benefit plan in Japan from September 30 to December 31.  Under this transition method, the Company charged 3/15ths of the estimated pension cost from October 1, 2007 to December 31, 2008 (or $1, net of taxes) to retained earnings as of January 1, 2008.

Certain U.S. defined benefit plans contain change of control provisions that, among other items, provide for accelerated vesting of benefits.  The Company recognized charges of $97 in special termination benefits and amortization of prior service cost upon the change of control in the ownership of Alcon by Novartis's purchase of Nestlé's common shares of Alcon (discussed note 16).  A curtailment gain of $44 was offset against prior unrecognized losses and no gain was recognized in earnings.  Except for certain key employees, payments of these accelerated benefits began during the fourth quarter of 2010 as provided by the plans.

The healthcare cost trend rate used to measure the expected cost of benefits covered by the postretirement plan is 7.6% at December 31, 2010, declining to 5% in 2017 and after.  The effect of a one percentage point change in assumed medical cost trend rates is as follows:
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  1% Increase  1% Decrease 
       
Effect on total of service and interest cost components $6  $(5)
         
Effect on the postretirement benefit obligation                                                                                       60   (47)
         

In certain countries, the Company's employees participate in defined benefit plans of Nestlé.  No separate valuation for the Company's employees has historically been prepared for the plans, as they are not individually material to the Company or to Nestlé.  Accordingly, these plans are treated as multi-employer plans.  Annual contributions to these plans are determined by Nestlé and charged to the Company.  Company contributions to these plans during 2010, 2009 and 2008 were $10, $9, and $10, respectively.  Future contributions may not reflect past trends.  During 2009, the Company obtained a separate valuation for its Belgium and Netherlands subsidiaries' defined benefit pension plans and converted from multi-employer plans to single-employer plans.  Prior to the change of ownership by Novartis, the Company and Nestlé entered into an agreement outlining the terms to segregate Alcon employees from Nestlé pension plans.  The agreement provides that, except for certain circumstances, all current Alcon pension participants will be migrated from Nestlé pension plans to other, not yet determined Alcon pension plans by January 1, 2011.

(16)  Shareholders' Equity

Share Cancellation

On May 5, 2009, Alcon's shareholders approved the cancellation of 1,043,400 Alcon common shares, which the Company purchased during 2008.  After the fulfillment of certain formal Swiss law requirements, the cancellation became effective in August 2009.

On May 6, 2008, the Company's shareholders approved the cancellation of 7,657,400 Alcon common shares, which the Company purchased during 2007.  After the fulfillment of certain formal Swiss law requirements, the cancellation became effective in August 2008.

Change of Control and Proposed Merger

On April 6, 2008, Nestlé and Novartis executed the Purchase and Option Agreement pursuant to which Nestlé agreed to sell approximately 74 million of its shares of Alcon common stock to Novartis in a cash transaction at a price of $143.18 per share.  That sale was consummated on July 7, 2008, and Novartis acquired a minority stake in Alcon of slightly less than 25% of Alcon's outstanding shares, while Nestlé remained Alcon's majority shareholder with approximately 156 million Alcon shares comprising approximately 52% of the Company's outstanding shares.

The Purchase and Option Agreement between Nestlé and Novartis also contained put and call option rights on the balance of approximately 156 million Alcon shares owned by Nestlé.  The option rights commenced on January 1, 2010.  As outlined by the two parties, these rights granted (i) Novartis a call option to buy all but 4.1 million (or 2.5%) of Nestlé's remaining Alcon shares at a fixed price of $181 per share and the 4.1 million shares at the first stage price of $143.18 per share, and (ii) Nestlé a put option to sell to Novartis all but 4.1 million of its remaining Alcon shares to Novartis at the lower of Novartis's call price of $181 per share or a premium of approximately 20.5% above the then-market price of Alcon shares, calculated as the average market price of Alcon shares during the five trading days immediately preceding the exercise date of the put option, with the 4.1 million share balance to be sold at the first stage closing price of $143.18 per share.

On January 4, 2010, Novartis announced that it had exercised its option to purchase the remaining approximately 156 million Alcon shares owned by Nestlé at a weighted average price of $180 per share in cash, pursuant to the Purchase and Option Agreement.  After consummation of the purchase on August 25, 2010, Novartis owned an approximate 77% interest in Alcon with the 23% balance being the publicly traded shares.

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The consummation triggered certain change of control provisions in certain retirement plans for Company employees, the Company's share-based awards plan (including the vesting of certain outstanding share-based awards) and other agreements.

On January 4, 2010, Novartis also announced that it submitted to the Alcon board of directors a proposal for a merger of Alcon with and into Novartis to be effected under Swiss merger law.  Under the terms of the merger proposal, holders of the Alcon shares that are publicly traded would receive 2.8 Novartis shares for each Alcon share.  The proposed merger would be contingent upon, among other things, approval by the Alcon board of directors.  The Company believes that Alcon's Organizational Regulations provide that the Alcon board of directors may only approve the proposed merger if a majority of the Independent Director Committee so recommends; however, management cannot predict the outcome of any proceeding that might be initiated to interpret or challenge this position.

The Independent Director Committee was formed in 2008 in connection with Novartis's initial purchase of slightly less than 25% of the Alcon shares from Nestlé to evaluate transactions such as the merger proposed by Novartis.  The Independent Director Committee engaged independent financial and legal advisors in connection with its evaluation of the proposed merger.  On January 20, 2010, the Independent Director Committee issued its formal response rejecting the Novartis merger proposal.  The committee rejected the merger proposal based on its assessment that the price offered and other terms were not acceptable and that Novartis's merger proposal was not in the best interests of Alcon and its minority shareholders.

Merger Agreement of December 14, 2010

On December 15, 2010, Alcon announced that its board of directors approved a merger agreement with Novartis, whereby Novartis will pay a total merger consideration valued at $168 per share for the Alcon shares it does not currently own.  Under the terms of the deal, the merger consideration will be comprised of a combination of Novartis shares and, if necessary, a cash contingent value amount to result in a total value of $168 per share.  The exact exchange ratio and cash contingent value amount will be calculated based upon formulas set forth in the merger agreement.

In accordance with Alcon's Organizational Regulations and after receiving a fairness opinion from its independent financial adviser, Greenhill & Co., the Independent Director Committee recommended approval of the merger agreement to the Alcon board.  The board also received a separate fairness opinion rendered by Lazard Frères & Co. LLC in connection with the transaction.  After considering these items and other appropriate information and factors, the Alcon board approved the merger proposal.

The merger will be effected under Swiss merger law.  Completion is conditional, among other things, on two-thirds approval by the shareholders of both Novartis and Alcon voting at their respective meetings, and the registration and listing of Novartis shares on the SIX Swiss Exchange and American Depository Shares on the New York Stock Exchange to be issued as merger consideration.  At December 31, 2010, Novartis owned more than the required two-thirds of the outstanding common shares of Alcon and has agreed, subject to certain conditions, to vote all of its Alcon shares to approve the merger.  The merger is expected to be completed during the first half of 2011.

Upon completion of the merger, Alcon will become the second largest division within Novartis.  Novartis has proposed that its CIBA VISION operations and select Novartis ophthalmic medicines will be integrated into Alcon.

Independent Director Committee Trust

On July 8, 2010, the Independent Director Committee announced the creation and funding of the Alcon Litigation Trust, an irrevocable trust established under New York law pursuant to a resolution of the Alcon board of directors.  The members of the Independent Director Committee were the trustees of the trust.  The trust was created and funded on July 7, 2010 with $50.  The trust was created to provide the financial means to commence, defend or maintain litigation relating to any transaction between Alcon and a majority shareholder, including the transaction contemplated by the merger proposal announced by Novartis on January 4, 2010, and ensure the protection of the interests of Alcon and its minority shareholders in connection with any such transaction.
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In connection with the merger agreement of December 14, 2010, the trust was terminated and the trust property was returned to Alcon in December 2010.

Share Repurchase Agreement Terminated

In March 2008, as a result of the then-pending agreement between Nestlé and Novartis discussed above, the Company halted the purchase of Alcon common shares in the open market under all share repurchase programs, and terminated the pro rata share repurchase agreement with Nestlé that it had entered into following the December 2007 authorization by the board of directors of the share repurchase program that provided for the purchase of up to $1,100 of Alcon common shares.  Prior to its termination, the Company had purchased a total of 150,000 shares under the agreement, comprised of 112,500 shares from the Company's majority shareholder, Nestlé, and 37,500 shares from the market, for a total of $20.  The price for the shares purchased from Nestlé under the agreement was equal to the volume-weighted average price for such shares determined in accordance with Rule 10b-18 of the U.S. Securities Exchange Act of 1934.

The program authorized in December 2007 was in addition to the Company's pre-existing share repurchase program, under which, as of December 31, 2008, the Company had remaining authorization to purchase up to 1.8 million shares.   In September 2008, the Company resumed purchasing from the public under the pre-existing program up to 1 million Alcon common shares to be presented to the shareholders for retirement.  Neither Nestlé nor Novartis participated in this program and their ownership interests did not change materially as a result of these share repurchases.

(17)  Commitments and Contingencies

Minority Shareholder Class Action Lawsuits

On January 4, 2010, Novartis announced that it submitted to the Alcon board of directors a proposal for a merger of Alcon with and into Novartis to be effected under Swiss merger law (note 16).

Certain Alcon minority shareholders filed several class action lawsuits related to Novartis's January 2010 merger proposal concerning the acquisition of the remaining publicly held minority interest.  The claims varied among the cases, but include allegations of: (i) breach of contract against Alcon; (ii) tortious interference with contract against Novartis and Nestlé; (iii) breach of fiduciary duties against the Alcon board of directors, Nestlé and Novartis; (iv) aiding and abetting breaches of fiduciary duties against the Alcon board of directors, Nestlé and Novartis; (v) breach of Section 13(d) of the Exchange Act against Novartis and Nestlé for an alleged failure to disclose that they were acting as a "group;" and (vi) breach of Section 14(d) of the Exchange Act against Novartis and Nestlé for an alleged failure to file with the U.S. Securities and Exchange Commission the materials required in connection with a "tender offer."

Eight cases filed in the U.S. District Courts for the Southern District of New York and the Northern District of Texas were consolidated into one class action case in the Southern District of New York.  A ninth case, which did not name Alcon, Inc. and its board of directors as parties, was filed in the Eastern District of New York but was voluntarily dismissed by the plaintiffs on March 18, 2010.

On April 14, 2010, plaintiffs in the consolidated action dismissed their claims against Nestlé and the five Alcon directors designated by Nestlé.  On May 24, 2010, the court granted a motion by Novartis and dismissed the action in its entirety on the ground that Switzerland was a more convenient forum for the dispute.  On July 14, 2010, the plaintiffs appealed the district court's dismissal to the U.S. Court of Appeals for the Second Circuit.  Plaintiffs moved to dismiss the appeal on January 5, 2011, and the Second Circuit granted their motion the next day.
Two cases filed in District Court, Tarrant County, Texas and two cases filed in the County Court at Law, Dallas County, Texas were consolidated for pre-trial purposes by the Texas Multidistrict Litigation Panel in the Texas District Court, Dallas County.  In November 2010, the court granted Novartis's motion seeking dismissal of these
F-53
actions on the ground that Switzerland is a more convenient forum.  The plaintiffs appealed the court's dismissal, and the appeal is pending.

Other Contingencies

The Company, either alone or jointly with its commercial partners, has filed fourteen North American patent infringement actions against six different generic drug companies.  With the exception of international generic challenges, all of these generic drug companies are seeking U.S. Food and Drug Administration ("FDA") approval to market generic versions of the Company's products, under what are known as Abbreviated New Drug Applications ("ANDAs").

Each infringement action was filed after the Company received notice that one or more of the generic drug companies had filed an ANDA seeking approval to sell a generic version of the Company's product.  As part of its ANDA, each generic drug company challenged one or more patents covering the Company's product.  In the United States, as a result of filing the lawsuits, the FDA must delay approval of the related ANDAs for 30 months unless the litigation is earlier resolved or the court modifies the 30-month stay on FDA approval.  In Canada, filing of the lawsuit secured a 24-month delay in approval from the Minister of Health, which can be shortened if the litigation is earlier resolved or the court modifies the 24-month stay on such approval.  Should any generic drug company succeed in overcoming the Company's patents and secure regulatory approval, it would be entitled to sell a generic product that would compete with the Company's product in the United States or Canada.  Such competition would be expected to impact significantly the Company's sales and profits.

The following table provides a summary of these lawsuits:
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Parties seeking approvalAlcon product(s)No. of patents challengedLongest patent expiration datePatents owned byJurisdiction/Regulatory BodyDate first suit filedStatusIf generic challenger is successful, earliest date that a generic may begin selling
Teva Pharmaceuticals USA, Inc.
Vigamox® antibiotic ophthalmic solution (Moxifloxacin, the primary ingredient in Vigamox®, is licensed to Alcon by Bayer Schering Pharma AG).
3(1)
2020Bayer Schering Pharma AG/the CompanyFDA, U.S. District Court of DelawareApril 5, 2006Trial relative to the Company's patent concluded on March 6, 2008. On October 19, 2009, the court ruled in the Company's favor. Teva has appealed.September 4, 2014
Apotex Inc., Apotex Corp., Barr Laboratories, Inc., Wockhardt Limited, Sandoz Inc. and Sandoz Canada Inc. (the last two parties are affiliates of Novartis)
Patanol® and Pataday anti-allergy ophthalmic solutions
Up to 5 (2), (3), (4),(5), (6), (7)
2015 (Patanol®) and 2023 (Pataday)
Kyowa Hakko Kirin Co., Ltd./the CompanyFDA, U.S. District Court in Indianapolis and Canadian Minister of Health, Federal Court in TorontoNovember 15, 2006One non-jury trial concluded on May 7, 2010. Closing arguments, however, were held August 3, 2010. A ruling has not yet been issued.
June 18, 2011 (2), (3), (4), (5), (8), (9)
Barr Laboratories, Inc., Par Pharmaceutical, Inc., Apotex Corp. and Apotex Inc.
TRAVATAN® and TRAVATAN Z® ophthalmic solutions
Up to 7
2014(8)
The CompanyFDA, U.S. District Court of DelawareApril 30, 2009Trial postponed until May 2, 2011. The parties have requested a further postponement.
December 2011(8)


(1)  Two of the patents are owned by the Company's licensor, Bayer Schering Pharma AG, and the third, which expires in 2020 (including a six-month pediatric extension), is owned by the Company.  The two Bayer Schering Pharma AG patents were also the subject of another Teva ANDA seeking approval to sell a generic version of Bayer Schering Pharma AG's systemic moxifloxacin product, Avelox®.  Suit was filed by the Company and Bayer Schering Pharma AG as co-plaintiffs against Teva relative to the Vigamox® ANDA on April 5, 2006 in the U.S. District Court in Delaware.  Bayer Schering Pharma AG subsequently filed suit in the same court relative to the Avelox® ANDA, and the two suits were merged.  Trial was scheduled to begin February 26, 2008, but the dispute between Bayer Schering Pharma AG and Teva relative to the two Bayer Schering Pharma AG patents was resolved by settlement on the eve of trial.  Under the terms of the settlement, Teva acknowledged the validity and enforceability of both Bayer Schering Pharma AG patents, and further acknowledged that its proposed generic ophthalmic product would infringe both patents.  Teva has therefore relinquished any claim that it is entitled to market the generic ophthalmic product prior to September 4, 2014.  The Company remains the exclusive ophthalmic licensee under the Bayer Schering Pharma AG patents.

The trial relative to the Company's patent concluded on March 6, 2008.  On October 19, 2009, the court ruled in the Company's favor on all counts, finding the Company's patent to be valid and infringed by the proposed generic product.  Since then, the Company received issuance of a related patent with claims that cover the Vigamox® product and Teva's proposed generic product.  U.S. Patent No. 7,761,010 was issued on March 2, 2010 and has been added to the FDA Orange Book relative to the Company's Vigamox® product.  Teva has appealed the trial court ruling.  
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However, even if Teva were to succeed in having the district court decision reversed on appeal, it would still have to address the Company's recently issued second patent before competing with the Company's Vigamox® product in September 2014 when the underlying Bayer patent expires.  If Teva were to win on appeal and overcome the Company's second patent, the resulting generic competition would be expected to impact significantly the Company's sales and profits.  On a related note, the Company's European counterpart patent to the patent-in-suit was determined to be invalid in a European Patent Office Opposition Proceeding.  That invalidity decision was upheld by an Enlarged Board of Appeal on October 22, 2009.  Divisional patent applications on the Company's Vigamox® product remain pending in the European Patent Office.

(2)  The Company's raw material supplier, Kyowa Hakko Kirin Co., Ltd., holds another U.S. patent that has not been challenged in the Apotex ANDA on Patanol® and expires on December 18, 2010.  In addition, the Company has secured a six-month pediatric extension to the patent coverage, which means this generic challenge poses no threat to the Patanol® product market prior to June 18, 2011.

(3)  Unlike the Apotex ANDA on Patanol®, which is challenging only the patent jointly owned by Kyowa and the Company, the Barr ANDA on Patanol® also challenged Kyowa's composition patent on olopatadine, the active agent in Patanol®.  The 30-month period after which the FDA could have approved Barr's generic product would have expired at the end of March 2010.  Trial was scheduled for late April 2010.  However, in September 2009, Barr withdrew its ANDA and subsequently was dismissed from the suit.

(4)  The Barr ANDA on Pataday is challenging the patent jointly owned by Kyowa and the Company, as well as two later issued patents owned by the Company that cover the Pataday formulation.  In this ANDA, Barr is not challenging the Kyowa patent on olopatadine that expires in December 2010 (effectively extended until June 18, 2011 by a pediatric extension). Of the two patents owned solely by the Company, the latest expiry date is November 2023. The 30-month period after which the FDA could approve Barr's generic product should expire in May 2011 but is of no practical effect in view of the unchallenged Kyowa patent, the term of which extends until June 2011.

(5)  Like Barr's ANDA on Pataday, the Apotex ANDA on Pataday is challenging the patent jointly owned by Kyowa and the Company, as well as two later issued patents owned by the Company that cover the Pataday formulation.  Apotex is not challenging the Kyowa patent on olopatadine that expires in December 2010 (June 2011 with the pediatric extension). If Apotex succeeds in overcoming both of the challenged patents and secures FDA approval, then after the expiration of Barr's potential 180-day "first filer" exclusivity period, it would be entitled to begin selling a generic olopatadine product that would compete with the Company's Pataday product in the United States.

(6)  Similar to the Apotex ANDA on Patanol®, the Sandoz Inc. (an affiliate of Novartis) ANDA on Patanol® is challenging only the patent jointly owned by Kyowa and the Company, but not the Kyowa-owned patent on olopatadine, which expires December 2010 (June 2011 with pediatric extension).  Trial was scheduled for April 26, 2010, and consolidation with the above-described Apotex suit (Patanol®) was ordered by the court.  Apotex advised the court of public statements of intent by Novartis to acquire all outstanding shares of Alcon stock, and filed a motion to sever Sandoz from the trial.  On February 22, 2010, the court granted the motion, ordering the suit against Sandoz to proceed separately and confirming the April 26, 2010 trial date with Apotex.  A new trial date for the Sandoz case has not yet been set.  At the request of Sandoz, the court has stayed the litigation against Sandoz until November 2010, and Sandoz has requested a six-month extension of that stay.

The Sandoz Inc. ANDA on Pataday is challenging the patent jointly owned by Kyowa and the Company (described above), as well as two later issued patents owned by the Company that cover the Pataday formulation.  Of the Company's two patents, the latest expiry date is November 2023.  Sandoz is not challenging the Kyowa patent on olopatadine that expires in December 2010 (effectively extended until June 2011 by a pediatric extension).  On January 27, 2010, Alcon and Kyowa filed suit in the Federal District Court in Indianapolis.  This case was consolidated with the other Pataday suits (Barr and Apotex, described above), but at the request of Sandoz, the court has stayed the litigation against Sandoz until November 2010.  Sandoz has requested a six-month extension of that stay.
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(7)  The Sandoz Canada Inc. Abbreviated New Drug Submission (ANDS) is challenging only one of the two patents listed in the Canadian Patent Register for the Patanol® product.  The challenged patent (Canadian Patent No. 2,195,094) is jointly owned by Kyowa and the Company and expires in May 2016.  Trial had been scheduled for March 7, 2011, but was postponed by the court with no new trial having been set.

(8)  In June 2010, Alcon announced its plans to discontinue TRAVATAN® in the United States.  Therefore, competition from generic versions of TRAVATAN® would not be expected to impact significantly the Company's sales and profits.  Apotex then withdrew its ANDA on TRAVATAN® and was dismissed from the suit in July 2010.  In November 2010, Barr advised that it too was withdrawing its ANDA on TRAVATAN®.  That leaves Par as the effective first filer for both TRAVATAN® and TRAVATAN Z®.  If Par succeeds in overcoming all of the challenged patents and/or secures FDA approval, it would be entitled to begin selling a generic travoprost product that would compete with the Company's TRAVATAN Z® product in the United States in December 2011.  Such competition would be expected to impact significantly the Company's sales and profits.  Another Alcon patent application is pending that, if granted, would have an expiration date in 2027.

(9)  Apotex, Inc. notified Alcon Canada that Apotex had filed an ANDS seeking approval from the Canadian Minister of Health to market a generic version of the Company's Patanol® product.  The Apotex ANDS is challenging only one of the two patents listed in the Canadian Patent Register for the Patanol® product.  The challenged patent (Canadian Patent No. 2,195,094) is jointly owned by Kyowa and the Company and expires in May 2016.  The Company and Kyowa, by timely initiating this action, are entitled to a 24-month delay (until April 2012) in the regulatory approval from the Minister of Health, which can only be shortened if the litigation is earlier resolved or the court modifies the 24-month stay on such approval.  Should Apotex succeed in overcoming the challenged patent and secure Minister of Health approval, it would be entitled to begin selling a generic olopatadine product that would compete with the Company's Patanol® product in Canada well before the patent expiration in 2016, but not before expiration of the unchallenged patent in November 2012.

The Company is also enforcing patents against generic challengers in China (Patanol®) and Chile (Vigamox®).

On April 16, 2008, Synergetics USA, Inc., a microsurgical device company, filed a civil antitrust lawsuit in the U.S. District Court for the Southern District of New York against the Company and its subsidiary, Alcon Laboratories, Inc. Synergetics asserted damages that it claimed could exceed $100.  In 2008 and 2009, subsidiaries of the Company filed two suits against Synergetics for patent infringement in the U.S. District Court for the Northern District of Texas in Fort Worth.  Synergetics answered the complaints.  A series of counterclaims and motions followed.  On April 23, 2010, the parties entered a Confidential Settlement and License Agreement together with a Supply Agreement.  Under the agreements, Alcon paid $32 in exchange for worldwide rights to sell Synergetics patented vitreoretinal products.  The products will be manufactured by Synergetics and supplied to Alcon.  The agreements also settled all pending litigation between Alcon and Synergetics, including both the antitrust and the patent litigation, and provide a process for future dispute resolution.

On December 18, 2008, James M. Nielsen, M.D. filed a patent infringement suit against Alcon, Inc. and Alcon Laboratories, Inc. in the U.S. District Court for the Northern District of Texas in Dallas.  Dr. Nielsen is asserting that his U.S. Patent No. 5,158,572 entitled "Multifocal Intraocular Lens" is being infringed by the Company's AcrySof® ReSTOR® intraocular lens.  The patent, which expired at the end of October 2009, was previously licensed to Advanced Medical Optics, Inc.  The Company filed its Answer January 12, 2009.  The Answer included a counterclaim for a declaratory judgment that the patent-in-suit is invalid and not infringed.  The case had been set for trial in August 2010 but has been postponed.  No new trial date has been set.  Summary judgment motions were filed by both parties January 7, 2011.  Alcon is seeking summary judgment of noninfringement, invalidity and laches, while Dr. Nielsen is seeking partial summary judgment on invalidity and laches/estoppels.  On January 10, 2011, the court ordered that both parties' motions be stricken and refiled in a "cross-motion" format, the briefing for which was extended by the court until the end of March 2011.  An adverse ruling by the court, while possible, would not be expected to impact significantly the Company's sales and profits.

On January 22, 2009, Elan Pharma International Ltd. sued two of the Company's subsidiaries, Alcon Laboratories, Inc. and Alcon Research, Ltd., in the U.S. District Court for the Eastern District of Texas in Sherman, alleging infringement of two Elan patents on nanoparticle technology (U.S. Patent Nos. 5,298,262 and 5,429,842).  
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The complaint claims that the Company's Azopt® product and, potentially, other products infringe the two patents.  The Company answered and counterclaimed on May 12, 2009.  Elan then moved to dismiss certain of the Company's affirmative defenses and counterclaims.  The Company has filed an amended answer and counterclaims providing greater detail with respect to the Company's inequitable conduct counterclaims.  The case has been set for trial on October 17, 2011.  The Company believes that it has strong defenses and intends to defend itself vigorously.  An adverse ruling by the court, however, could impact significantly the Company's sales and profits.

The Company and its subsidiaries are parties to a variety of other legal proceedings arising out of the ordinary course of business, including proceedings relating to product liability and patent infringement.  The Company believes that it has valid defenses and is vigorously defending the litigation pending against it.

While the results of the aforementioned contingencies cannot be predicted with certainty, management believes that the ultimate liability, if any, will not have a material adverse effect on the Company's consolidated financial position or results of operations.  Litigation contingencies are subject to change based on settlements and court decisions.

The Company may be subject to future litigation and infringement claims, which could cause the Company to incur significant expenses or prevent the Company from selling its products.  The Company operates in an industry susceptible to significant product liability claims.  Product liability claims may be asserted against the Company in the future arising out of events not known to the Company at the present time.

The Company self-insures through captive insurance subsidiaries almost all of its property, business interruption and liability risks.

The Company was self-insured through its captive insurance subsidiary for damages incurred prior to 2006 at one of its sales and distribution facilities and was involved in legal proceedings to seek recovery of its losses and other incremental operating costs from the third parties responsible for the damages.  In December 2008, the captive insurance subsidiary settled its claim against the third parties involved.  Since no recovery had been recorded previously, the Company recognized a gain in the fourth quarter of 2008 related to the settlement of $15 ($3 in cost of goods sold and $12 in selling, general and administration expenses).

In the normal course of business, the Company has entered into research and development arrangements with third parties that require milestone and royalty payments to the third parties contingent upon certain future events linked to the success of the research and development efforts.

During 2008, Lehman Brothers International (Europe) London filed for administration in England.  At that time, the Company's cash and cash equivalents included $707 of short term securities held in a segregated custodial account of Lehman Brothers International (Europe) London pursuant to a Custody Agreement.  Nestlé invoiced the Company in December 2008 and, in 2009, the Company reimbursed Nestlé, for a total of $5 in fees paid by Nestlé to the Joint Administrators of Lehman Brothers International (Europe) London (in administration) related to the release of the short-term securities held in the custodial account.  This amount of fees is subject to adjustment depending on the final costs incurred to settle the administration of Lehman Brothers International (Europe) London.  In order to receive an expedited return of assets held by Lehman Brothers International (Europe) (in administration), Alcon has agreed to return any assets which the Joint Administrators determine should not have been disbursed in settlement.  The amount of any funds to be returned, if any, would result from the determination by the Joint Administrators that the rights of another claimant in the proceeding have precedence over the Company's claim.

Commitments

The Company leases certain facilities and equipment under operating leases.  The total costs of operating leases (inclusive of any adjustments associated with escalating rent, rent holidays, contingent rent or rent concessions) are expensed ratably over the life of the operating lease.  Leasehold incentives are capitalized and amortized over the shorter of the life of the lease or the associated asset.  Lease expense incurred was $73, $66 and $77 during 2010, 2009 and 2008, respectively.  Future minimum aggregate lease payments under noncancelable operating leases with a term of more than one year were as follows:
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Year Amount 
    
2011                                                                                              $67 
2012                                                                                               50 
2013                                                                                               37 
2014                                                                                               24 
2015                                                                                               21 
Thereafter                                                                                               81 
     
Total minimum lease payments                                                                                         $280 
     

The Company has entered into various fixed and variable purchase commitments and license agreements, requiring future minimum royalties, through 2021.  All commitments are expected to be fulfilled with no adverse consequences to the Company's operations or financial condition.  The total unconditional fixed purchase obligations and future minimum royalties at December 31, 2010 were as follows:

Year Amount 
    
2011                                                                                              $41 
2012                                                                                               21 
2013                                                                                               9 
2014                                                                                               2 
2015                                                                                               1 
Thereafter                                                                                               2 
     
Total                                                                                         $76 
     

Total payments related to the above unconditional purchase commitments and license agreements for the years ended December 31, 2010, 2009 and 2008 were $93, $63 and $97 respectively.  In addition, at December 31, 2010, the Company had entered into various contracts with suppliers to purchase raw materials contingent upon forecasted purchases and other manufacturing requirements.

At December 31, 2010, the Company had guaranteed $7 of debt for certain customers.  At December 31, 2010, the Company had outstanding letters of credit of $27.  The letters of credit typically act as a guarantee of payment to certain third parties in accordance with specified terms and conditions.  Additionally, the Company guaranteed $33 to a third party reinsurer for the Company's captive insurance subsidiaries.


(18)   Acquisitions

LenSx Lasers, Inc.

Acquisition in 2010

On August 18, 2010, the Company acquired 100% of the outstanding common shares of LenSx Lasers, Inc.  LenSx is a privately held company that has developed the first femtosecond laser to receive U.S. Food and Drug Administration clearance for use as a complimentary technology in cataract surgery.  The LenSx® laser will enable surgeons to perform specific steps of the traditional cataract procedure with micron-level laser precision, including anterior capsulorhexis, phacofragmentation and the creation of certain corneal incisions.  Previously these steps were done manually with surgical instruments.

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The Company paid approximately $367 in cash at closing to LenSx shareholders for their shares and agreed to maximum contingent payments of approximately $383 based upon the achievement and over-achievement of future femtosecond unit and procedure fee revenue milestones.

Between the acquisition date and December 31, 2010, LenSx had no revenues and its expenses were not significant.

The following table summarizes the components of the LenSx purchase price:

Cash paid for LenSx shares $367 
Cash paid to a LenSx shareholder for intangible asset integral to the purchase  12 
Estimated fair values of future contingent payments  72 
Total purchase price $451 

The Company engaged a third-party valuation firm to assist it in determining the estimated fair values of identifiable intangible assets and future contingent payments.  Such a valuation requires significant estimates and assumptions including but not limited to estimating future cash flows and developing appropriate discount rates.  The Company is continuing to obtain information and evaluate these fair value estimates.  The Company's fair value estimates for these components of the transaction may change during the allowable allocation period, which is typically up to one year from the acquisition date.


Fair Values of Future Contingent Payments

In addition to the cash paid to the shareholders of LenSx at the time of the acquisition, the Company is obligated to make contingent payments of up to $383 based upon the achievement of certain sales objectives through 2015.  The fair values of these payments were estimated to be $72 and were included as a cost of the acquisition.

There are a number of milestones that could potentially lead to such payments to the former shareholders of LenSx.  This valuation was based on the Company's estimates of the probability and timing of these contingent payments. The fair value measurement was based on significant inputs not observable in the market and thus represents a Level 3 measurement, as described in note 5.  Objectives and milestones were assigned individual probabilities based on the respective current status.  The resultant probability-weighted cash flows were then discounted using a discount rate of 4.5%, which the Company believes is appropriate and representative of a market participant assumption.  The probabilities assigned to payment streams ranged from 10% to 65%.  An increase or decrease of 10 percentage points in the probability assumptions would result in an adjustment to the estimated value of approximately $6.

The fair values of these contingent payments will be reviewed on a periodic basis.  Any future changes in this estimated value not associated with the original purchase price valuation will be recorded in the Company's results of operations.

Purchase Price Allocation

The allocation of purchase price for acquisitions requires use of accounting estimates and judgments to allocate the purchase price to the identifiable tangible and intangible assets acquired, including in process research and development, and liabilities assumed based on their respective fair values.  Additionally, the Company must determine whether an acquired entity is considered to be a business or a set of net assets, because a portion of the purchase price can only be allocated to goodwill in connection with the acquisition of a business.  The Company believes that LenSx's use of inputs and processes qualify it as the acquisition of a business.

The LenSx purchase price was allocated to tangible and intangible assets acquired and liabilities assumed based on their estimated fair values at the acquisition date.

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The valuation of these assets requires significant estimates and assumptions including but not limited to estimating future cash flows and developing appropriate discount rates.

The excess of the purchase price over the fair value of net assets acquired was allocated to goodwill.

The Company believes the estimated fair values assigned to the assets acquired and liabilities assumed were based on reasonable assumptions.  The following table summarizes the estimated fair values of net assets acquired:

    
Current assets $10 
Property, plant and equipment  2 
Identifiable intangible assets  433 
Goodwill  133 
Long term deferred income tax assets  32 
Accounts payable and accrued liabilities  (2)
Long term deferred income tax liabilities  (157)
     
Net assets acquired $451 

The Company's fair value estimates for the purchase price allocation may change during the allowable allocation period, which is typically up to one year from the acquisition date.

Identifiable Intangible Assets

Acquired identifiable intangible assets include rights for the use of proprietary technologies for the development of products.  The estimated amortization period is 15 years based on the projected useful life of the products developed by the use of the technology.

The estimated fair value of the acquired intangible assets was determined based on the use of a discounted cash flow model using an income approach for products developed from the acquired technology.  Estimated revenues were probability adjusted to take into account the stage of completion and the risks surrounding successful development and commercialization.  The estimated after-tax cash flows were then discounted to a present value using discount rates appropriate for the risks associated with these projects.


Goodwill

Goodwill represents the excess of the LenSx purchase price over the sum of the amounts assigned to assets acquired less liabilities assumed. The Company believes that the acquisition of LenSx provides the Company access to improved technology and a highly trained LenSx work force as of the acquisition date.

The Company believes that these factors support the $133 of goodwill recognized as a result of the purchase price paid for LenSx. The goodwill was allocated between the two business segments based on the acquisition models' projected revenues.  The goodwill acquired in the LenSx acquisition is not expected to be deductible for tax purposes.


ESBATech AG

Acquisition in 2009

On September 15, 2009, the Company completed the acquisition of ESBATech AG, a Swiss biotechnology company. Alcon paid ESBATech shareholders $150 in cash at closing. In addition, the Company recorded the estimated fair value of possible contingent payments of up to $439 based upon the achievement of future research and development milestones that would be expected to create value for Alcon. ESBATech is a clinical-stage biotechnology company that has been developing a pipeline of proprietary single-chain antibody fragment
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therapeutics for topical and local delivery for safe and convenient therapy. This acquisition provides the Company with additional research and development capabilities.

The following table summarizes the components of the ESBATech purchase price:

Cash paid for ESBATech shares $150 
Estimated fair values of future contingent payments  71 
     
Total purchase price $221 

The Company engaged a third-party valuation firm to assist it in determining the estimated fair values of in process research and development, identifiable intangible assets and certain tangible assets as well as the future contingent payments.  Such a valuation requires significant estimates and assumptions including but not limited to determining the timing and estimated costs to complete the in process projects, projecting regulatory approvals, estimating future cash flows, and developing appropriate discount rates.

Fair Values of Future Contingent Payments

In addition to the cash paid to the shareholders of ESBATech at the time of the acquisition, the Company is obligated to make contingent payments of up to $439 based upon the achievement of future research and development milestones that would be expected to create value for Alcon. The fair values of these payments were estimated to be $71 and were included as a cost of the acquisition.

There are a number of milestones that could potentially lead to such payments to the former shareholders of ESBATech.  This valuation was based on the Company's estimates of the probability and timing of these contingent payments. The fair value measurement was based on significant inputs not observable in the market and thus represents a Level 3 measurement, as described in note 5.  Each milestone was assigned a probability based on its current status.  The resultant probability-weighted cash flows were then discounted using a discount rate of 6%, which the Company believes is appropriate and representative of a market participant assumption.  The probabilities assigned to payment streams ranged from 5% to 39%.  An increase or decrease of 10 percentage points in the probability assumptions would result in an adjustment to the estimated value of approximately $30.

The fair values of these contingent payments will be reviewed on a periodic basis.  Any future changes in this estimated value not associated with the original purchase price valuation will be recorded in the Company's results of operations.

Purchase Price Allocation

The allocation of purchase price for acquisitions requires use of accounting estimates and judgments to allocate the purchase price to the identifiable tangible and intangible assets acquired, including in process research and development, and liabilities assumed based on their respective fair values.  Additionally, the Company must determine whether an acquired entity is considered to be a business or a set of net assets, because a portion of the purchase price can only be allocated to goodwill in connection with the acquisition of a business.  The Company believes that ESBATech's use of inputs and processes qualify it as the acquisition of a business.

The ESBATech purchase price was allocated to tangible and intangible assets acquired and liabilities assumed based on their estimated fair values at the acquisition date.

The valuation of these assets requires significant estimates and assumptions including but not limited to determining the timing and estimated costs to complete the in process projects, projecting regulatory approvals, estimating future cash flows, and developing appropriate discount rates.

The excess of the purchase price over the fair value of net assets acquired was allocated to goodwill.
The Company believes the estimated fair values assigned to the assets acquired and liabilities assumed were

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based on reasonable assumptions.  The following table summarizes the estimated fair values of net assets acquired:

    
Current assets $1 
Property, plant and equipment  2 
Identifiable intangible assets  77 
In process research and development  104 
Goodwill  40 
Long term deferred income tax assets  40 
Accounts payable and accrued liabilities  (2)
Long term deferred income tax liabilities  (40)
Other long term liabilities  (1)
     
Net assets acquired $221 


Identifiable Intangible Assets

Acquired identifiable intangible assets include rights for the use of proprietary technologies for the development of ophthalmic pharmaceuticals.  The estimated amortization period is 20 years based on the projected useful life of the products developed by the use of the technology.

The estimated fair value of the acquired intangible assets was determined based on the use of a discounted cash flow model using an income approach for products developed from the acquired technology.  Estimated revenues were probability adjusted to take into account the stage of completion and the risks surrounding successful development and commercialization.  The estimated after-tax cash flows were then discounted to a present value using discount rates appropriate for the risks associated with these projects.

In Process Research and Development

In conjunction with the ESBATech acquisition, the Company allocated $104 of the acquisition price to acquire in process research and development assets.

These in process research and development assets are comprised of projects to develop technologies in the field of ophthalmic pharmaceuticals.  These assets were in an early stage of development as of the ESBATech acquisition date of September 15, 2009.

The estimated fair value of the in process research and development assets was determined based on the use of a discounted cash flow model using an income approach for the acquired technologies.  Estimated revenues were probability adjusted to take into account the stage of completion and the risks surrounding successful development and commercialization.  The estimated after-tax cash flows were then discounted to a present value using discount rates appropriate for the risks associated with these projects.

The major risks and uncertainties associated with the timely and successful completion of the acquired in process projects consist of the ability to confirm the safety and efficacy of the technology based on further research, the data from clinical trials, if necessary, and obtaining necessary regulatory approvals.  No assurance can be given that the underlying assumptions used to forecast the cash flows or the timely and successful completion of the projects will materialize as estimated, if at all.  For these reasons, among others, actual results may vary significantly from estimated results.

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Goodwill

Goodwill represents the excess of the ESBATech purchase price over the sum of the amounts assigned to assets acquired less liabilities assumed. The Company believes that the acquisition of ESBATech provides the Company access to improved technology and a highly trained ESBATech work force as of the acquisition date.

The Company believes that these factors support the $40 of goodwill recognized as a result of the purchase price paid for ESBATech. The goodwill was allocated between the two business segments based on the acquisition models' projected revenues, as shown in note 6, "Intangible Assets and Goodwill."  The goodwill acquired in the ESBATech acquisition is expected to be deductible for tax purposes.



(19)  Unaudited Quarterly Information

  Three Months Ended 
  March 31,  June 30,  September 30,  December 31, 
             
2010            
Sales                                                     $1,721  $1,886  $1,760  $1,812 
Operating income                                                      653   751   495   576 
Net earnings                                                      573   670   446   521 
                 
Basic earnings per common share $1.91  $2.23  $1.48  $1.72 
Diluted earnings per common share $1.89  $2.21  $1.47  $1.71 
                 
 
2009
                
Sales                                                     $1,493  $1,677  $1,614  $1,715 
Operating income                                                      514   632   578   537 
Net earnings                                                      452   582   515   458 
                 
Basic earnings per common share $1.51  $1.95  $1.72  $1.53 
Diluted earnings per common share $1.51  $1.94  $1.71  $1.51 
                 

Quarterly sales trends reflect seasonality in several products, including ocular allergy and otic products, in the form of increased sales during the spring months, which occur during the second quarter in the northern hemisphere.

During the three months ended March 31, 2010, advancements in its sales reporting system permitted the Company to better estimate allowable deductions from sales in the calculation of accrued royalties.  This change in estimate resulted in a $24 addition to operating income during the period.  However, the U.S. enactment of the Health Care and Education Reconciliation Act of 2010 caused a $25 write-off of deferred tax assets, reducing net earnings in the three months ended March 31, 2010.
In the three months ended March 31, 2010, June 30, 2010, September 30, 2010 and December 31, 2010, the Company incurred pretax expenses totaling $4, $4, $133 and $11, respectively, for costs related to the change of majority ownership discussed in note 16, other costs to support Alcon's board of directors in its evaluation of Novartis's merger proposal, and certain costs related to integration as a subsidiary of Novartis.

Operating income and net earnings in 2009 included costs related to a staffing reduction of approximately 260 employee positions of $18 in the three months ended March 31, 2009 and of $1 in the three months ended September 30, 2009.

Net earnings in the three months ended December 31, 2009 included $30 in additional tax reserves from new information related to prior years' provisions.

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Operating income and net earnings after September 15, 2009 reflect the operations of ESBATech subsequent to its acquisition effective September 15, 2009, as discussed in note 18.
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