On November 15, 2018, our Board of Directors approved, and we committed to a global restructuring program (the 2019 Restructuring Plan). The 2019 Restructuring Plan is intended to support our effort to improve operating performance and meet anticipated market demands by ensuring that we are appropriately structured and resourced to deliver sustainable value to patients and customers. Key activities under the 2019 Restructuring Plan include supply chain network optimization intended to maximize our global manufacturing and distribution network capacity and building functional capabilities that support business growth. These activities were initiated in 2019, with the majority of activity expected to be complete by the end of 2022, following a one-year extension approved by our Board of Directors on February 22, 2021.

On February 22, 2021, our Board of Directors approved an extension and expansion of the 2019 Restructuring Plan to include additional cost optimization activities, including the centralization of certain functional capabilities within the international regions in which we operate, and a one-year extension of the program to complete these activities along with certain other initiatives that were delayed in 2020 due to restrictions related to the COVID-19 pandemic. In addition, on February 22, 2022, we increased and our Board of Directors approved cost estimates to complete additional activities identified under the program. We continue to expect the majority of activity associated with our 2019 Restructuring Plan, including the recent expansion, to be substantially complete by the end of 2022.

The following table provides a summary of our estimates of total pre-tax charges associated with the 2019 Restructuring Plan, by major type of cost, of which approximately $375 million to $475 million are expected to result in cash outlays:


Type of Cost (in millions)	Total Estimated Amount Expected to be Incurred
Restructuring charges:
Termination benefits	$75	-	$100
Other(1)	25	-	50
Restructuring-related expenses:
Other(2)	325	-	375
	$425	-	$525

(2) Comprised of other costs directly related to the restructuring program, including program management, accelerated depreciation, fixed asset write-offs, and costs to transfer product lines among facilities.

On June 6, 2016, our Board of Directors approved, and we committed to a restructuring initiative (the 2016 Restructuring Plan). The 2016 Restructuring Plan was intended to develop global commercialization, technology and manufacturing capabilities in key growth markets, build on our Plant Network Optimization (PNO) strategy which is intended to simplify our manufacturing plant structure by transferring certain production lines among facilities and expand operational efficiencies in support of our operating income margin goals. Key activities under the 2016 Restructuring Plan included strengthening global infrastructure through evolving global real estate assets and workplaces, developing global commercial and technical competencies,

enhancing manufacturing and distribution expertise in certain regions and continuing implementation of our PNO strategy. These activities were initiated in the second quarter of 2016 and substantially completed in 2019.

The following table provides a summary of total pre-tax charges associated with the 2016 Restructuring Plan by major type of cost, of which approximately $255 million resulted in cash outlays:

(2) Comprised of other costs directly related to the 2016 Restructuring Plan, including program management, accelerated depreciation, fixed asset write-offs and costs to transfer product lines among facilities.

The following presents the restructuring and restructuring-related net charges (credits) by major type and line item within our accompanying consolidated statements of operations (in millions):


Year Ended December 31, 2021	Termination Benefits		Transfer Costs		Other		Total
Restructuring charges	$	20	$	—	$	20	$	40
Restructuring-related expenses:
Cost of products sold	—		79		—		79
Selling, general and administrative expenses	—		—		72		72
Research and development expenses	—		—		—		—
	—		79		72		151
	$	20	$	79	$	92	$	191


Year Ended December 31, 2020	Termination Benefits		Transfer Costs		Other		Total
Restructuring charges	$	27	$	—	$	24	$	52
Restructuring-related expenses:
Cost of products sold	—		64		—		64
Selling, general and administrative expenses	—		—		51		51
Research and development expenses	—		—		4		4
	$	—	$	64	$	55	$	119
	$	27	$	64	$	79	$	171


Year Ended December 31, 2019	Termination Benefits		Transfer Costs		Other		Total
Restructuring charges	$	38	$	—	$	—	$	38
Restructuring-related expenses:
Cost of products sold	—		32		—		32
Selling, general and administrative expenses	—		—		13		13
	—		32		13		44
	$	38	$	32	$	13	$	82

The following table presents cumulative restructuring and restructuring-related net charges incurred as of December 31, 2021, related to our ongoing Restructuring Plans by major type:


(in millions)	2016 Restructuring Plan		2019 Restructuring Plan		Total
Termination benefits	$	86	$	59	$	145
Other(1)	21		44		64
Total restructuring charges	106		102		209
Transfer costs	126		166		292
Other(2)	39		82		121
Restructuring-related charges	164		249		413
	$	271	$	351	$	622


(in millions)	2016 Restructuring Plan		2019 Restructuring Plan		Total
Termination benefits	$	89	$	35	$	123
Transfer costs	125		156		281
Other	41		72		114
	$	255	$	263	$	517

On November 17, 2020, we announced a global, voluntary recall of all unused inventory of our LOTUS Edge™ Aortic Valve System, and our decision to retire the entire LOTUS™ Valve platform. We recorded restructuring and restructuring-related net charges associated with the product discontinuation of $20 million in 2021 and $55 million in 2020, which are included in the tables above for the year ended December 31, 2021 and December 31, 2020. The restructuring activities were completed in 2021 and resulted in total pre-tax restructuring and restructuring-related net charges of approximately $80 million.

In addition, during 2020 we recorded $119 million of inventory charges within Cost of products sold and $8 million of Intangible asset impairment charges associated with the product discontinuation.