Stryker
Annual Report 2019

Plain-text annual report

Annual Review 2019 When the breast cancer surgeon becomes the patient, expertise, emotions and empathy come together Stryker’s technology improves outcomes for patient and physician On the day oncoplastic surgeon Dr. Anne Peled was getting ready to perform a double mastectomy and breast reconstruction, her phone rang. She wasn’t thinking about her own health, but the news was grim — the disease she spent her life treating had found her. “I was so shocked,” says Dr. Peled, a 38-year-old vegetarian triathlete who suspected the lump she discovered, and had biopsied, was just a cyst. “There were no words, even though I tell women about breast cancer diagnoses many times a week. I had to remind myself what I tell my patients — that this is very treatable and, in many cases, curable.” With her knowledge and experience, she was able to put together “an amazing team of caring and talented clinicians who really listened to me and what I wanted,” including her parents, who are radiation oncologists, and sister, a medical oncologist. “I felt incredibly grateful for the care and support I received, and I got through my treatment smoothly and relatively easily” — thanks, in part, to the type of hidden scar surgery she performs on her own patients. Getting back to feeling whole During surgery, big scars can appear at the cancer site, many times in highly visible locations. While some women may see their scars as an empowering symbol, many do not. Research shows that breast surgery scars may impact a woman’s psychological and emotional well-being, as well as quality of life after surgery.1 This is where Stryker comes in with a growing women’s health and breast cancer portfolio. Case in point: Stryker’s illuminated instruments for hidden scar surgery, which can be used for everything from skin sparing mastectomies to breast-conserving procedures (lumpectomy) to total reconstruction. With the help of this technology, breast and plastic surgeons can minimize scarring with access and visualization to achieve optimal surgical and aesthetic outcomes, which help women move forward feeling more whole and empowered — and without seeing reminders of the cancer every day. “Stryker’s illuminated instrument technology makes a huge difference in performing hidden scar techniques,” says Dr. Peled. “I believe it’s safer and more efficient than other products on 1. Gass J, et al. How do breast cancer surgery scars impact survivorship? Findings from a nationwide survey in the United States. BMC Cancer (2019) 19:342. https://doi.org/10.1186/s12885-019-5553-0. Accessed 10/2019. Stryker | 2019 Annual Review 2 the market, with superior design and quality. And patients look as good, if not better, than before, so they can more easily move past treatment.” “This technology provides surgeons access and visualization during surgery to achieve optimal surgical and aesthetic outcomes, including minimally invasive surgeries,” says Charles Henkel, Stryker Sales Manager, Surgical Technologies. Moving on with life and career As an advocate of hidden scar surgery — as well as a new procedure she developed with her husband, plastic surgeon Ziv Peled, to preserve nerve sensation in the breast — Dr. Peled travels the country to train colleagues in the surgical technique she experienced as a patient. She also talks about the technique on social media and invites surgeons to come to her practice to watch and learn. Dr. Peled has found that sharing her story can be especially helpful for her younger patients, because the fears, challenges and decision-making around breast cancer can be very different than for older women, and peer support can be even more important. “I can share ‘insider tips’ on getting through the care,” she explains. “Many patients who know about my own diagnosis will reach out to ask questions about my experience as they go through their treatment, and I love the way this connects me to them in a totally different way.” With colleagues, Dr. Peled has learned to carefully draw from her personal experience to make productive, patient- focused suggestions, which she believes may carry some weight. “As I settle into these dual and simultaneous roles of breast cancer surgeon and breast cancer survivor, I’m gradually balancing the interplay of these parts of myself into my relationships with both patients and colleagues,” she says. “For now, I take it one interaction at a time and bask in the deeply connecting moments of shared understanding when they happen.” Charles Henkel Stryker Sales Manager, Surgical Technologies “ I had to remind myself what I tell my patients — that this is very treatable and, in many cases, curable.” — Dr. Anne Peled Stryker | 2019 Annual Review 3 SYK 2019 Annual Review 022317 SYK_AR19_v14 03/17/20 page 4 “ Patients look as good, if not better than before, so they can more easily move past treatment.” — Dr. Anne Peled SPY Fluorescence: improving visualization in breast reconstruction When two of her sisters had breast cancer, 51-year-old Barbara Pink, the baby of the family, was aware that she might be next, knowing that women with “first degree” relatives with breast cancer are at an increased risk. Barbara learned about her diagnosis following a mammogram. “Because of my sisters, I wasn’t shocked,” Barbara says. “I was around the same age as they were when they were diagnosed.” But with an aggressive form of breast cancer, Barbara made the decision to get a bilateral mastectomy and bilateral breast reconstruction, an increasingly common choice for many women. In fact, the number of breast cancer patients opting for implant reconstruction after a mastectomy has increased by two-thirds.1 Barbara’s plastic surgeon, Dr. Charles Kays, from Wilmington Plastic Surgery, in Wilmington, North Carolina, says the number of cases where the mastectomy and implant reconstruction are done at one time, rather than two separate surgeries, is also becoming more common. “There’s a lot of emotional trauma to having your breasts removed and not completing your reconstruction at the time of surgery. When we perform both at the same time, patients are relieved to get the procedure over with and their overall recovery is shorter,” he says. Dr. Kays took advantage of Stryker’s innovative SPY fluorescence imaging technology during the complicated operation. With SPY fluorescence, surgical teams can better visualize anatomy and blood flow in vessels and related tissue, which may improve outcomes in the operating room.2 After the surgery, Barbara was up and around in just a few days and fully back in action after only four weeks. “I was thrilled and my sisters were thrilled,” says Barbara. “I had amazing care, and I’m just so happy to move ahead with my life.” 1. U.S. Agency for Healthcare Research and Quality 2009. 2. SPY clinical bibliography available upon request. Stryker | 2019 Annual Review 5 Dear shareholders, We had an excellent year in 2019, as we reached 40 consecutive years of sales growth and recorded our seventh consecutive year of accelerated organic sales growth. We also posted strong adjusted net earnings per share and continued to execute on our strategy of customer focus, innovation, globalization and cost transformation. We will have one change to our Board of Directors as Louise Francesconi has announced that she will not stand for re-election in May 2020. Louise has made strong contributions during her 14 years on our Board and we thank her for her dedicated service (see page 20). Culture and leadership The bedrock of our company is our mission — Together with our customers, we are driven to make healthcare better — and values: Integrity, Accountability, People and Performance. We hire people who are driven, team-oriented and humble. We continue to be regarded as a great place to work (see page 16) and are honored by the accolades that reflect our inclusive culture. We’re pleased to have been rated #1 best workplace for diversity in the U.S. by Fortune and Great Place to Work. Financial performance Our U.S. and international organic sales growth were both 8.1 percent, with strong international performances in emerging markets and Europe. Reported sales growth was 9.4 percent, including 2.6 percent growth from acquisitions and 9.0 percent growth from increased unit volume, which was partially offset by a 1.3 percent impact from foreign exchange and a 0.9 percent impact from lower prices. “ We had an excellent year in 2019, as we reached 40 consecutive years of sales growth.” — Kevin Lobo Chairman and Chief Executive Officer Stryker | 2019 Annual Review 6 Our cash position remains strong with a year-end cash and marketable securities position of $4.4 billion, enabling us to increase our dividend rate by 10.6 percent for the January 2020 payment. Our reported net earnings decreased 41.4 percent, largely due to tax benefits in 2018, and our adjusted net earnings grew by 13.0 percent. Innovation We continue to drive innovation through R&D and acquisitions with a steady stream of new product introductions and closed several deals in the year. In addition, we signed a definitive agreement to acquire Wright Medical for approximately $5.4 billion (including convertible debt), which is expected to close in the second half of 2020. This acquisition should add nearly $1 billion of revenue to our fast-growing Trauma & Extremities business. on track to roll it out to our other businesses across the world over the next few years. We also made significant progress with our finance shared services, including starting up a center in Costa Rica, and continued to drive improvements within our supply chain. Cost transformation We remain committed to systematically reducing costs to enable growth. We were pleased to deliver 40 basis points of adjusted operating margin expansion in 2019 despite significant dilution from acquisitions. We successfully implemented a large-scale enterprise resource planning (ERP) deployment at our Instruments division and are Community We are working to improve healthcare responsibly and sustainably because we believe the health of the world is as important as the people who live in it. Our activities and progress are outlined in our Corporate Responsibility Review, which is available on our website. We are committed to delivering positive results for our employees, customers, communities and the planet. Reflecting on our 2019 accomplishments, I would like to thank our management teams, our Board of Directors and our roughly 40,000 employees worldwide who live our mission and values every day. Our strategy, people and culture will enable us to continue to deliver strong performance in the years ahead. Kevin A. Lobo Chairman and Chief Executive Officer History of net sales growth s n o i l l i B $15 $14 $13 $12 $11 $10 $9 $8 $7 $6 $5 $4 $3 $2 $1 $0 16.2% CAGR in net sales over 40-year period 40 Straight years of sales growth $14.9B 2019 Stryker | 2019 Annual Review 7 2019 acquisitions: growth opportunities and market-leading innovations With a disciplined approach, Stryker strategically acquires businesses and integrates them quickly to accelerate long-term growth opportunities in both existing and new segments of our industry. In 2019, we completed four acquisitions that will bring innovative and complementary products to our portfolio and strengthen our market leadership. Arrinex Based in Menlo Park, California, Arrinex developed ClariFix, a novel cryoablation technology for the treatment of chronic rhinitis. This condition, which affects more than 24 million people in the U.S. each year, may cause runny nose, congestion, sneezing and nasal itching. ClariFix complements and further expands Stryker’s Ear, Nose and Throat (ENT) portfolio with a unique product that meets the needs of a large, underpenetrated segment of the ENT market where we have not competed previously. As a result, ENT physicians have new technologies that deliver more treatment options and better patient outcomes. Stryker | 2019 Annual Review 8 OrthoSpace With the acquisition of Israel-based OrthoSpace, we have added to our sports medicine portfolio a highly differentiated technology for the treatment of massive rotator cuff tears. Called InSpace, the product is a biodegradable sub-acromial spacer, which is designed to realign the natural biomechanics of the shoulder. InSpace has a clinical history of more than 20,000 patients being treated in 30 countries and provides our customers an innovative surgical option to address a complex pathology. The InSpace device is currently investigational and not approved for sale in the U.S. and limited by Federal law to clinical investigational use. Mobius Imaging and Cardan Robotics With expertise in advanced imaging and robotics, as well as a robust product pipeline, Mobius Imaging and Cardan Robotics will strengthen our presence in our key Orthopaedics, Spine and Neurotechnology markets. As a result, we are positioned to make healthcare better by providing more complete procedural solutions, including sales, service, and support, while helping surgeons achieve the best possible outcomes for their patients. SafeAir This Swiss medical device company designs, develops and manufactures innovative surgical smoke evacuation products that help reduce staff and patient exposure to hazards associated with surgical smoke. Highly complementary to our Surgical Technologies business, SafeAir products strengthen our existing smoke evacuation portfolio in both the U.S. and Europe and align with our goal of providing better care and a higher level of safety for both healthcare professionals and patients. Stryker | 2019 Annual Review 9 Mako expands reach in Asia Pacific In both countries, the number of Mako systems and procedures has increased significantly. In Japan, for example, the growth opportunities are considerable. Approximately 60,000 total hip replacements and 82,000 total knee and partial knee replacements are performed annually,11 with the number expected to increase due to the aging population. Stryker has sponsored trainings and participated in surgical conferences and events in Asia Pacific to educate surgeons on the use of Mako technology. A Mako media day in Japan, which focused on innovations in joint replacement surgeries, resulted in local and industry news stories that reached more than 30 million people. Thanks to its demonstrated accuracy and precision1–5 and a concerted marketing effort, Mako enjoyed significant growth in Asia Pacific in 2019. Two key reasons for this growth were the acceleration of China’s Mako Total Hip joint replacement business since it was introduced in 2018, and the 2019 launch of Mako Total Hip and Total Knee in Japan. In both of these large markets, Stryker emphasized clinical evidence, training and education, and media awareness to support this growth. “Because we have been helping surgeons to know more about a patient’s unique anatomy with Mako SmartRobotics™ CT-based planning, and accurately and precisely1–5 cut less6–10 with AccuStop™ haptic technology, healthcare professionals are welcoming Mako with open arms,” says Christopher Roger, Director, Robotics Sales and Support, Japan. See references on page 21. “ In my experience, Mako Total Hip has shown better outcomes after surgery compared to arthroplasty performed manually.1” — Dr. Nao Shibanuma, Deputy Medical Director, Kobe Kaisei Hospital The first hospital to install Mako in Japan ©Kobe Kaisei Hospital Stryker | 2019 Annual Review 10 Making healthcare better with medical education Along with our commitment to delivering innovative and industry- leading technology, Stryker provides extensive medical education and training offerings for healthcare professionals. These offerings are designed to help advance product and procedural knowledge and skills, improve customer competence and confidence, and lead to better patient outcomes. Here are some highlights from across the company: Craniomaxillofacial (CMF) Our CMF medical education programs include national, regional and local courses for neurosurgeons and craniomaxillofacial surgeons who perform trauma, reconstructive and orthognathic (jaw) surgery. Many courses include a cadaveric component taught by surgeons who are leaders in their field, providing an elevated, hands-on experience for attendees. We also emphasize personalized medicine through education on the use of virtual surgical planning and other patient- specific surgical solutions that support improving patient outcomes. On-demand education is also offered online through our surgical video library. colorectal, uro-gynecological, pediatric cardiovascular and cardiothoracic procedures. From symposiums to clinical immersion, we offer customized education, including a fellows textbook program and courses, surgery observation programs and regional trainings so surgeons can avoid travel. Joint Replacement A wide variety of programs are available for joint replacement surgeons, including the highly attended Mako System Certification program. During this comprehensive hands-on program, surgeons must successfully complete two cadaveric joints with each Mako application in order to be certified to perform Mako procedures. Other in- demand educational offerings are our Virtual Surgical Demos and Observations live events, broadcasted to surgeons and OR staff, in which Mako robotic-arm assisted procedures are demonstrated. We also have surgical simulations on both the Mako Partial Knee and Mako Total Knee, which allow surgeons to practice intra-operative balancing at their own pace. Endoscopy With our industry-leading SPY imaging technology, we established a training program to help drive the adoption of fluorescence as a standard of care. Our popular iSPIES program covers Neurosurgical In our Stryker Training Center in Salt Lake City, Utah, neurosurgery residents can take the Neurotechnology National Course, drawing on the wisdom of world- renowned faculty members. 2019 marked the first annual cross-divisional program Stryker | 2019 Annual Review 11 that covered our entire Neurotechnology portfolio, including Spine, Interventional Spine, Neurosurgical, CMF and Neurovascular. We also offer a hands-on National OR Professional Workshop for operating room directors, coordinators, RNs, scrub techs and sterile processing professionals. In 2019 our Mobile Lab, which simulates eight operating rooms, hosted 140 events across the country. Neurovascular Stroke Knowledge Initiatives for Learning and Leadership (SKILL) is a series of innovative, tailored ischemic and hemorrhagic stroke education programs that support our customers’ need to address patient management challenges with the ultimate shared goal of improving lives. SKILL features an e-lab, NeuroElite fellows program, training center initiatives and global centers of excellence. Orthopaedic Instruments and Surgical Technologies Through Stryker’s Learn Program, operating room professionals have access to industry resources designed to enhance the understanding and use of various medical technologies. With programs based on extensive research findings and practical industry knowledge, we are dedicated to empowering and advancing healthcare providers at every stage of their career. Trauma & Extremities TEACH programs (Trauma and Extremities Academic Courses for Healthcare) include training on the effective use of Stryker products in Trauma, Shoulder and Foot and Ankle for the orthopaedic surgeon community, which consists of nurses, residents and fellows, as well as practicing surgeons. TEACH faculty are invited by Stryker to attend a program educating them on Advanced Training Principles to enhance their teaching skills, ultimately contributing to the quality of the TEACH programs. Launched in 2019, the Connect program provides educational resources to residents at teaching institutions and continues as they transition into fellowship and practice. New initiatives such as digital learning platforms and cross-divisional dissection courses were introduced to expand Stryker’s educational resources for residents and fellows at teaching institutions. Stryker | 2019 Annual Review 12 Corporate Responsibility At Stryker, corporate responsibility is an important part of who we are — as individuals, teams and one connected company. Driven by our shared values, it’s built into the way we operate our company. Our mission is to improve healthcare by working with our customers to make the world better for patients, caregivers, employees and the environment. Learn more about our commitment to people and the planet in our Corporate Responsibility Review at stryker.com/CR 2019 achievements through our key focus areas Investing in people for stronger health, safety, talent and inclusion 709+ surgeries funded through our Smile Match campaign where employee donations to Operation Smile are matched until we reach our goal. Stryker | 2019 Annual Review 13 Product lifecycle innovation carefully considering our use of materials across a product’s lifecycle Resource efficiency reducing water, waste and emissions $375.6M saved by customers through reprocessing programs Ethics and accountability because transparency, honesty and fairness should always be paramount 13.4M pounds of waste diverted from landfills Addressing the need for compliant medical waste disposal systems, Cactus Smart Sink System securely captures partially administered or unused controlled substances and renders them non- retrievable and unusable. The system helps reduce drug diversion and improve patient safety while also reducing the impact on the environment. Responsible supply chains managing and sourcing suppliers with the highest standards $225M spent with minority, women, and veteran-owned businesses $700M spent with small businesses In 2019, our Board amended our bylaws to implement proxy access. This permits a shareholder or a group of up to 20 shareholders owning at least 3 percent of Stryker’s common stock for at least three years, to nominate and include in Stryker’s proxy materials director nominees constituting up to the greater of two individuals or 20 percent of the Board. Stryker | 2019 Annual Review 14 to increase our diverse talent pipeline,” says Cindy Carlisle. “We used their feedback to develop an actionable set of recommendations to enhance our Diversity and Inclusion strategy.” Diversity and Inclusion conference To continue strengthening employee engagement, we host inclusion conferences. Our annual inclusion awareness conference, for example, brings together leaders and employees from our five campuses in Kalamazoo, Michigan. This full-day conference focuses on why inclusion matters and equips participants with tools to build a more inclusive environment. Diversity and inclusion: we win together as a team At Stryker, we win together as a team. Our mission and values unite employees around a diverse and inclusive culture that delivers remarkable results. And we create and invest in programs that foster a positive workplace experience. Here are some of our recent activities and programs: Annual engagement survey “We constantly challenge ourselves to achieve more by listening to our employees’ suggestions and taking action to improve our workplace,” says Cindy Carlisle, Vice President, Talent Management and Corporate HR. “For more than 25 years, we’ve used our annual company-wide employee engagement survey to uncover and take action on important issues affecting our work environment.” Unconscious bias training Unconscious biases exist even in the most open-minded people and organizations. We address this proactively through our Think Twice course, a workshop that showcases what bias is, how and where it shows up, and what to do about it. Since launch, more than 4,000 employees across 16 countries have participated in the training, including our CEO and our entire senior leadership team. Focus groups To enhance our efforts to build an inclusive, engaging work environment, we partnered with a global management consortium to conduct conversations with employees aimed at expanding existing initiatives. “Attendees provided their insights and pointed out opportunities Disabilities program in Ireland Patrick O’Brien, an associate at Stryker’s Anngrove facility in Cork, recalled a former co-worker at a previous job who faced some tough employment challenges because he was deaf. So Patrick got involved in developing a Stryker team under the name of ABLE — the Ability and Belief to Leverage Everyone. And over the past two years, the team accomplished a great deal, including: • Hiring individuals with hearing impairments • Installing pocket-sized vibrating alarm systems for hearing- impaired people • Modifying entranceways, desks, coffee stations and dining tables for people in wheelchairs • Working with the local university on a mentorship program for students with disabilities Stryker | 2019 Annual Review 15 Global recognition FORTUNE Best Workplaces (U.S.) For Diversity, 2019 #1 out of 100 companies — recipient for the third consecutive year For Women, 2019 #47 — recipient for the third time Best Workplaces in Europe #14 recipient for the first time Best Workplaces International #1 for Australia, 2019 recipient for the sixth consecutive year Mexico, 2019 recipient for the sixth time Women’s Choice Awards 2020 awards named to two lists: 100 Best Workplaces for Women Best Companies for Diversity Italy, 2019 recipient for the first time Spain, 2019 recipient for the fourth time UK, 2019 recipient for the first time Brazil, 2019 recipient for the sixth consecutive year Canada, 2019 recipient for the tenth consecutive year Greater China, 2019 recipient for the third year France, 2019 recipient for the second consecutive year Japan, 2019 recipient for the second consecutive year Korea, 2019 recipient for the second consecutive year FORTUNE World’s Best Workplaces #8 in 2019 out of 25 companies — recipient for the third time FORTUNE 100 Best Companies to Work For (U.S.) #8 in 2020 recipient for the tenth consecutive year FORTUNE 500 Largest U.S.-Based Companies #233 in 2019 joined the list in 2003 — recipient for the 17th consecutive year FORTUNE World’s Most Admired Companies #5 in 2020 Medical Products and Equipment recipient for the 18th consecutive year Stryker | 2019 Annual Review 16 Financial highlights Net earnings $ Per diluted share Adjusted net earnings 1 $ Per diluted share Financial overview ($ in millions, except per share amounts) 2019 2018 % Change 10.00 8.00 6.00 4.00 2.00 5.48 10.00 8.00 6.00 4.00 2.00 2014 2019 2014 2019 Dividends paid $ Per share of common stock 2.5 2.0 1.5 1.0 0.5 2.08 2014 2019 8.26 Net sales $14,884 $13,601 Earnings before income taxes 2,562 2,356 Income taxes Net earnings Adjusted net earnings1 Net earnings per diluted share of common stock Reported Adjusted1 9.4% 8.7% NM 479 (1,197) 2,083 3,139 $5.48 8.26 3,553 2,779 (41.4)% 13.0% $9.34 (41.3)% 7.31 13.0% Dividends paid per share of common stock Cash, cash equivalents and marketable securities $2.08 $1.88 10.6% 4,425 3,699 19.6% 1. Adjusted net earnings and adjusted net earnings per diluted share are non-GAAP financial measures. Refer to page 21 for a reconciliation to the most directly comparable GAAP financial measures, net earnings and net earnings per diluted share. NM = Not Meaningful Stryker | 2019 Annual Review 17 Leading in medtech MedSurg 44% 15% Medical 14% Instruments 13% Endoscopy 2% Sustainability Solutions Orthopaedics 35% 12% Knees 11% Trauma & Extremities 9% Hips 3% Other Neurotechnology and Spine 21% 14% Neurotechnology 7% Spine n d S p i n e 7% y a g o l o n Neurotec h 14% 15% 3% $14.9B 9% in global sales M e d i c a l a n d 14% S u r g i c a l ( M e d S u r g ) O r t h o p a e 11% d ic s 13% 2% 12% Stryker | 2019 Annual Review 18 Leadership team (In order of appearance in photo, left to right) Kevin A. Lobo Chairman and Chief Executive Officer Glenn S. Boehnlein Vice President, Chief Financial Officer Robert S. Fletcher Vice President, Chief Legal Officer Viju S. Menon Group President, Global Quality and Operations Yin C. Becker Vice President, Communications, Public Affairs and Corporate Marketing Timothy J. Scannell President and Chief Operating Officer J. Andrew Pierce Group President, MedSurg and Neurotechnology Division Presidents Bradford L. Saar Medical Hiroyuki Saeki Japan Businesses Xavier M. C. Berling Trauma & Extremities Brian J. White Sustainability Solutions Dylan B. Crotty Instruments Brent W. Ladd Endoscopy Eric D. Major Spine Mark H. Paul Neurovascular Donald E. Payerle Joint Replacement Regions Maurice Ben-Mayor South Pacific Silvia L. F. Braga Latin America Dragana Bunjevac Eastern Europe, Middle East, Africa Scott A. MacNair Canada Graham A. McLean Asia Pacific Spencer S. Stiles Group President, Orthopaedics and Spine M. Kathryn (Katy) Fink Vice President, Chief Human Resources Officer Katherine A. Owen Vice President, Strategy and Investor Relations Stuart A. J. Silk Europe, Middle East, Africa, Latin America, Canada Other Officers Dean H. Bergy Vice President, Corporate Secretary William E. Berry Jr. Vice President, Corporate Controller Jeanne M. Blondia Vice President, Finance and Treasurer Irene B. Corbe Vice President, Internal Audit William J. Cymbaluk Vice President, Corporate Regulatory Affairs and Quality Assurance David G. Furgason Vice President, Tax Jody K. Powell Vice President, Global RAQA Bronwen R. Taylor Vice President, Compliance and Risk Management Stryker | 2019 Annual Review 19 Board of Directors (In order of appearance in photo, left to right) Andrew K. Silvernail ** Louise L. Francesconi ‡ § Rajeev Suri ** Ronda E. Stryker § Mary K. Brainerd ** Allan C. Golston † ** Srikant M. Datar, Ph.D. ‡ § Roch Doliveux, D.V.M. ‡ § Sherilyn S. McCoy ‡ § Kevin A. Lobo * Chairman Emeritus With appreciation John W. Brown Former Chairman, President and Chief Executive Officer Director Emeritus Howard E. Cox, Jr. * Chairman of the Board † Lead Independent Director ** Audit Committee ‡ Compensation Committee § Governance and Nominating Committee Louise L. Francesconi We want to express our gratitude and appreciation to Louise Francesconi who has served as a director on our board since 2006. Louise has made strong contributions to our strategy and growth during her 14 years on our board and successfully hired many new board members as chair of the governance and nominating committee since 2007. We sincerely thank Louise for her dedication and service. Stryker | 2019 Annual Review 20 Reconciliation of the Most Directly Comparable GAAP Financial Measure to Non-GAAP Financial Measure Reported $515 $1,439 $1,647 $1,020 $3,553 $2,083 $1.34 $3.78 $4.35 $2.68 $9.34 $5.48 Net earnings ($ millions) Net earnings per diluted share 2014 2015 2016 2017 2018 2019 2014 2015 2016 2017 2018 2019 Acquisition and integration-related charges Inventory stepped-up to fair value Other acquisition and integration-related 15 50 4 20 Amortization of purchased intangible assets 133 147 Restructuring-related and other charges Medical device regulations Recall-related matters Regulatory and legal matters Tax matters Adjusted Effective Tax Rate — Reported Effective Tax Rate — Adjusted 23 77 221 98 – 127 (7) 8 20 31 250 155 – 131 25 833 9 90 338 179 10 18 141 (1,559) 51 160 375 180 48 154 (33) 121 0.04 0.13 0.35 0.20 – 0.01 0.05 0.39 0.26 – 0.06 0.20 0.59 0.26 – 1.65 0.55 0.34 – (0.12) (0.02) 1.02 0.20 0.02 0.05 0.09 0.67 0.41 – 0.34 0.06 2.19 0.02 0.24 0.89 0.47 0.03 0.05 0.37 0.13 0.42 0.99 0.47 0.13 0.41 (0.09) (4.10) 0.32 78 – 628 – 391 97 – 210 (46) 78 $1,810 $1,949 $2,194 $2,465 $2,779 $3,139 $4.73 $5.12 $5.80 $6.49 $7.31 $8.26 55.6% 17.1% 14.3% 50.6% (50.8)% 18.7% 22.3% 17.3% 17.3% 15.6% 16.7% 15.8% Weighted average diluted shares outstanding 382.8 380.9 378.5 380.1 380.3 379.9 Refer to our 2019 Annual Report on Form 10-K, available at stryker.com, for additional information regarding our non-GAAP financial measures. References from page 10 1. Illgen R, Bukowski B, Abiola R, Anderson P, Chughtai M, Khlopas A, Mont M. Robotic-assisted total hip arthroplasty: Outcomes at minimum two year follow up. Surgical Technology International. 2017 July 25; 30:365-372. 2. Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS. Robotic arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. The Bone and Joint Journal. 2018;100-B:930-7. 6. Suarez-Ahedo C; Gui C; Martin T; Chandrasekaran S; Domb B. Robotic arm assisted total hip arthroplasty results in smaller acetabular cup size in relation to the femoral head size: A Matched-Pair Controlled Study. Hip Int. 2017; 27 (2): 147-152. 7. Haddad FS, et al. Iatrogenic Bone and Soft Tissue Trauma in Robotic-Arm Assisted Total Knee Arthroplasty Compared With Conventional Jig-Based Total Knee Arthroplasty: A Prospective Cohort Study and Validation of a New Classification System. J Arthroplasty. 2018 Aug;33(8):2496-2501. Epub 2018 Mar 27. 3. Kleeblad LJ, Borus T, Coon T, Dounchis J, Nguyen J, Pearle A. Midterm survivorship and patient satisfaction of robotic-arm assisted medial unicompartmental knee arthroplasty: a multicenter study. The Journal of 8. Hozack WJ. Multicentre analysis of outcomes after robotic-arm assisted total knee arthroplasty. Orthop Proc. 2018;100-B(SUPP_12):38. Arthroplasty. 2018:1-8. 4. Anthony I, Bell SW, Blyth M, Jones B, et al. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty. J Bone Joint Surg Am. 2016;98-A(8):627-35. 5. Mahoney O, Kinsey T, Mont M, Hozack W, Orozco F, Chen A. Can computer generated 3D bone models improve the accuracy of total knee component placement compared to manual instrumentation: a prospective multi- center evaluation? International Society for Technology in Arthroplasty 32nd Annual Congress. Toronto, Canada. October 2-5, 2019. 9. Banks, Scott A, PhD. Haptic Robotics Enable a Systems Approach to Design of a Minimally Invasive Modular Knee Arthroplasty. Am J Orthop. 2009;38(2 suppl):23-27. February 2009. 10. Hampp E, Chang TC, Pearle A. Robotic partial knee arthroplasty demonstrated greater bone preservation compared to robotic total knee arthroplasty. Annual Orthopaedic Research Society. Austin, TX. 2-5 Feb 2019. 11. Japan Ministry of Health, Labour and Welfare. The 4th NDB Open Data Japan (Cases from Apr 2017 to Mar 2018). 2019. Stryker | 2019 Annual Review 21 m o c . i n o s d d a . w w w i n o s d d A y b i n g s e D Orthopaedics Hips Knees Robotic-Arm Assisted Technology Trauma Extremities Sports Medicine Medical and Surgical equipment Power Tools and Surgical Equipment Advanced Guidance Technologies Minimally-Invasive and Open Surgical Visualization Solutions Infrastructure and Integration Emergency and Acute Care Reprocessing and Remanufacturing Neurotechnology and Spine Craniomaxillofacial Interventional Spine Neurosurgical and ENT Neurovascular Spinal Implants and Biologics © 2020 Stryker | 2825 Airview Boulevard | Kalamazoo, MI 49002 USA | stryker.com | SYK Corp 2020-02-03 Products may not be available in all markets. Product availability is subject to the regulatory and/or medical practices in individual markets. Our Annual Review contains many of the valuable trademarks owned and/or used by Stryker and our subsidiaries and affiliates in the U.S. and internationally to distinguish products and services of outstanding quality. All other trademarks featured herein are the property of their respective owners. This document is governed solely by applicable U.S. laws and governmental regulations. Stryker | 2019 Annual Review 22 Additional information Independent registered public accounting firm Ernst & Young LLP Grand Rapids, Michigan Transfer agent and registrar American Stock Transfer & Trust Company, LLC New York, New York Shareholders needing information regarding their certificates or dividends should contact: American Stock Transfer & Trust Company, LLC Operations Center 6201 15th Avenue New York, New York 11219 800 937 5449 info@amstock.com Investor contact Katherine A. Owen Vice President, Strategy and Investor Relations Media contact Yin C. Becker Vice President, Communications, Public Affairs and Corporate Marketing Business development contact Bryant S. Zanko Vice President, Business Development Annual meeting The virtual Annual Meeting of Shareholders of Stryker Corporation will be held on Tuesday, May 5, 2020, at 2:00 p.m. ET. Access the meeting online at: www.virtualshareholdermeeting.com/ SYK2020 Or by phone, listen only: U.S. (toll free): 1-877-328-2502 International: 1-412-317-5419 Stock listing The company’s common stock is traded on the New York Stock Exchange under the symbol SYK. Form 10-K The company files an Annual Report on Form 10-K with the Securities and Exchange Commission. Shareholders may view the 2019 report at www.stryker.com or www.sec.gov. Forward-looking statements This Annual Review contains information that includes or is based on forward-looking statements within the meaning of the federal securities law that are subject to various risks and uncertainties that could cause our actual results to differ materially from those expressed or implied in such statements. Such factors include, but are not limited to: the failure to satisfy any of the closing conditions to the acquisition of Wright Medical, including the receipt of any required regulatory clearances (and the risk that such clearances may result in the imposition of conditions that could adversely affect the expected benefits of the transaction); delays in consummating the acquisition of Wright; unexpected liabilities, costs, charges or expenses in connection with the acquisition of Wright; the effects of the proposed Wright transaction (or the announcement thereof) on the parties’ relationships with employees, customers, other business partners or governmental entities; the impact of the coronavirus (COVID-19); weakening of economic conditions that could adversely affect the level of demand for our products; pricing pressures generally, including cost-containment measures that could adversely affect the price of or demand for our products; changes in foreign exchange markets; legislative and regulatory actions; unanticipated issues arising in connection with clinical studies and otherwise that affect U.S. Food and Drug Administration approval of new products, including Wright products; potential supply disruptions; changes in reimbursement levels from third-party payors; a significant increase in product liability claims; the ultimate total cost with respect to recall-related matters; the impact of investigative and legal proceedings and compliance risks; resolution of tax audits; the impact of the federal legislation to reform the United States healthcare system; costs to comply with medical device regulations; changes in financial markets; changes in the competitive environment; our ability to integrate and realize the anticipated benefits of acquisitions in full or at all or within the expected timeframes, including the acquisition of Wright; and our ability to realize anticipated cost savings. Additional information concerning these and other factors is contained in our filings with the U.S. Securities and Exchange Commission, including our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q. 

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