J. Pearson
Analyst · Nomura Securities International
Based on our recent acquisitions and other external events, many of you have been asking if our strategy has changed. Our mission remains the same as it always has. We will always put patients and physicians first while taking our responsibility for our employees and communities we do business in equally importantly. We also know who our owners are. We listen to you and work hard for you every day.
Our focus also remains the same. We concentrate on high-growth markets, both therapeutically and geographically. We prefer durable products sold to concentrated specialist populations, where physician education matters. We focus on products where consumer pay or commercial reimbursement is significant. And finally, we are committed to remain diversified where no one product or small set of products disproportionally impacts our earnings.
What has changed is that our portfolio has shifted over time to newer and higher-growth products, making pricing a smaller part of our growth looking forward. Given the evolution of our product mix coupled with the recent events, it is likely that we will pursue fewer, if any, transactions that are focused on mispriced products.
Now let me shift to some modifications to our strategy. First, our Neuro & Other portfolio, which is dependent on price, will represent approximately 10% of our revenues in 2016 but will continue to shrink as a percentage of the company. We have and are seriously considering spinning off or selling this piece of our business.
Second, due to our increasing success in internal R&D, especially in the areas of dermatology, contact lenses, surgical and OTC products, internal R&D will become more of a focus.
Third, if our stock price remains at current levels, share repurchases will be seriously considered.
My final note would be that we always believe -- we have always believed that any company strategy must be agile and flexible in order to navigate in an ever-changing world. During my 23 years at McKinsey, we found that companies that were successful over long periods of time had one thing in common: they were willing to move in and out of geographic and business areas over time, and they have modified or changed their strategy with the environment change. We plan to be one of these companies.
With the turmoil over the past few weeks from both governmental and media scrutiny and erroneous research reports, we thought it would be useful if we addressed your questions upfront. You can clearly see the slide -- the questions on the slide, so I won't read each one, but let's move on to the answers.
Valeant's price volume growth. In the 8-K we furnished a few years ago, we tried to lay out our various business units and the impact price has had on them. Contrary to what is reflected in the media and certain research reports, our business is not 100% pharmaceuticals. Breaking down the business into ex U.S., U.S. devices in consumer, U.S. branded pharmaceuticals and U.S. generics, one gets a much better picture of our business breakdown.
For our 2015 year-to-date, you can see that although price did play a part in our branded pharmaceutical unit's growth, which accounts for roughly 43% of our revenue, revenue has grown almost 20%, but volume has grown almost 20%. In the remaining 57% of our business, price does not play much of a role. In the end, of the 16% same-store organic growth we have realized so far across our entire portfolio this year, our price volume mixture was roughly 50-50.
Focusing on our U.S. branded pharmaceutical portfolio, you can see that Valeant's price volume mix has changed over time. In 2014, we had organic growth of 20%, with volume contributing 8% and price contributing 12%. Year-to-date, in 2015, our organic growth has increased to 41%, with volume contributing 17%. For this last quarter, volume growth has increased to 19%.
You can clearly see this trend in the past 7 quarters as volume growth is accelerating and our average net realized price per script peaking in the fourth quarter of 2014 and slowly declining in 2015. It is important to note that we realize only approximately $300 in revenues for each 30-day prescription product that we sell.
Slide 24 bridges the price volume dynamic for the third quarter from the previous year, with 19% of our growth in the U.S. branded portfolio coming from volume and 15% from price. It is important to note that growth from price where a generic alternative is not available accounts for less than $75 million a quarter.
As most of the commentary around price centers on the wholesale price or list price, we wanted to provide a more clear picture of what Valeant actually realizes from the price action, which is considerably different than what has been portrayed. If you look at the top 10 dermatology products, which represent approximately 62% of our dermatology portfolio, we took, on average, a 14% gross price increase on these products this year, yet we realized less than a 2% price increase on a net basis.
Doing the same exercise for ophthalmology, you can see we realized a little bit more of price, but all these products were only raised 10% on a gross basis.
Turning to our U.S. Neuro & Other portfolio, a portfolio that is predominantly made up of legacy products from acquisitions we made over the years, our year-to-date volume declined 7% over that time period. We realized 30% on a net price basis. It is important to note that 61% of this portfolio has generic alternatives in the market, providing doctors and patients with lower-cost alternatives.
Going forward, this portfolio will represent a smaller and smaller portion of our U.S. business. We expect it to be approximately 10% of the portfolio in 2016 and continuing to decline thereafter.
As I mentioned before, there have been several research reports that have contributed to the overall misinformation about our pricing. While these reports represent the individuals' own opinions, when incorrect numbers begin to be quoted widely by others in media, we feel compelled to correct this misinformation.
A recent report from Deutsche Bank looked at the products that were over $10 million in sales. It reported that we raised prices on 56 of our 69 products, representing 81% of our portfolio. It further suggested that we took an average -- on average a price increase of 66% on each of these products.
In reality, we increased price on 85 of our 156 branded pharmaceutical products, or 54% of our products, and our average gross price increase was 36%. It is important to note that our realized price increase was 24%.
While we have listened to our shareholders to provide more price volume disclosure, we also took a look at what other companies provide. When looking at the top 15 pharma companies, only 4 provided or provide quantitative disclosure on their full portfolio.
Historically, Valeant has provided qualitative disclosure on its full portfolio. Going forward, we will provide quantitative price volume disclosure on our full portfolio. Specifically, we're committing to provide the chart on Slide 20 and the chart on Slide 21 every quarter. We believe this disclosure should address your concerns.
More important than the look back is the influence of price as we move forward. As I mentioned in the memo a few weeks back, price flexibility is very limited outside the U.S.
In the U.S. our business units such as contact lenses, surgical, consumer, Solta and Obagi also have limited price flexibility. In the pharmaceutical portfolio, we assumed low single-digit price increases looking into 2016 and beyond.
Furthermore, our mix is evolving. So the U.S. Neuro & Other portfolio will only represent approximately 10% of our sales, and our U.S. branded pharmaceuticals will represent approximately 40% of our total sales.
Turning to our approach to U.S. drug distribution. I want to clearly state that all of Valeant's drugs are available to all patients. Most of our U.S. pharmaceutical products are available through the big 3 distributors. Our distribution is not designed to restrict access to our products.
Turning to, how does Valeant work with specialty pharmacies, especially Philidor? The topic of specialty pharmacies has not been a focus of ours on past calls because we believe this was a competitive advantage that we did not want to disclose to our competitors. But given all the incorrect assertions by some, we will provide an update on this call.
Similar to many pharmaceutical companies in the U.S., an increasing percentage of our revenue is coming from products dispensed through multiple specialty pharmacies. We find specialty pharmacies improve patients' access to medicines at an affordable price and help ensure physicians are able to prescribe the medications they believe most appropriate for their patients. In almost all cases, our inventory with specialty pharmacies in this channel and the title to our medicine only transfers to the pharmacy when the actual prescription is filled. We find this significantly reduces our distribution fees and product returns.
Currently, only $15 million of inventory at WAC, or gross price, sits in our U.S. specialty pharmacy channel. This is a small fraction, less than 5%, of our total in channel inventory. The largest component of this specialty inventory is Arestin.
Philidor, one of our specialty pharmacy partners, provides prescription services to patients across the country and provides administrative services for our co-pay cards and is a dispensary that fills prescriptions. We have a contractual relationship with Philidor, and late last year, we purchased an option to acquire Philidor if we so choose.
Given accounting rules, we consolidate Philidor's financials. Inventory held at Philidor remains on Valeant's books and is not included in the specialty pharmacy channel inventory. For many of our dermatology products, Philidor and other specialty pharmacies dispense our medicines before adjudication of the reimbursement is finalized to ensure patients get the medicines prescribed quickly. As a result, we take on the risk for nonreimbursement.
We understand that Philidor provides services under our programs for commercially insured and cash-paying claims only. Any claim that would be reimbursed in whole or in part by government insurance is not eligible for our co-pay subsidy programs. It does not restrict prescriptions it fills to any particular manufacturer. It dispenses generic products as specified in the patient's prescription or as requested by the patient.
Any non-Valeant prescriptions dispensed by Philidor are recorded as other revenue in our income statement, not product sales, and are therefore excluded from our organic growth calculations. The revenue for non-Valeant products is approximately $1 million per quarter.
Since we do not recognize the revenue of our products until the prescriptions are filled, this consolidation has the impact of delaying revenue recognition as compared to products that are sold through traditional pharma -- traditional distribution channels.
The next question: Why did Valeant's General Counsel send a letter to R&O? R&O is one of the specialty pharmacies in our network, and Valeant has shipped approximately $69 million at wholesale prices to them. This represents approximately $25 million at net prices.
Any products R&O dispensed to patients were recognized as our revenues and are reflected in our receivables. Any products still held by R&O remain -- are reflected in our inventory. R&O is currently improperly holding significant amounts it receives from payers. We will refrain from comment on active litigation and look forward to showing in court that we are owed the money.
Valeant's patient assistant programs are administered by a reputable third party, and we fund outside foundations that have multiple donors. Eligibility is determined by the independent foundations. It is also important to note that eligibility for our in-house commercial access programs is limited to patients not covered by government programs.
Looking at history, our commitment to patient assistance programs is growing at an annual compound rate of 128%, from $53 million in 2012 to approximately $1 billion we expect to spend in 2016.
Recent government inquiries. As you all know, Valeant has responded to Senator McCaskill and addressed her questions regarding Nitropress and Isuprel. In a letter to her last Wednesday, we discussed the history of Nitropress and Isuprel, the reimbursement process for hospital procedures involving Nitropress and Isuprel, the analysis and reasons underlying Valeant's pricing decisions and Valeant's programs designed to improve patient access, among other topics. We also noted that we are beginning an outreach to hospitals where the impact of a price change was significantly greater than average.
The company recently received a subpoena from the U.S. Attorney's Office for the District of Massachusetts and a subpoena from the U.S. Attorney's Office for the Southern District of New York. Our counsel is already in touch with the government, and the company intends to cooperate with the investigations. We will not be answering questions or providing more information that was already covered in the press release on these matters.
Our approach to compliance and legal. Like other critical areas, we take both compliance and legal compliance seriously. For the past 5 years, we have been under a Corporate Integrity Agreement started under legacy Biovail, and this CIA was just recently concluded. This CIA required extensive written policies and systems, significant training, a well-functioning compliance committee and an annual audit by an independent organization. We were also required to file annual reports with the OIG. Our final report was filed in early 2015.
In connection with Bausch & Lomb, we assumed compliance commitments made to the DOJ that includes maintaining an effective compliance program and annual certifications. In this industry, we must and we do take the matter of compliance very seriously.
With that, I will open up the call to questions.