Operator
Operator
Good afternoon, ladies and gentlemen, and welcome to the analyst call on the GSK Second Quarter 2020 Results. I will now hand you over to Sarah Elton-Farr, Head of Investor Relations, who will introduce today's session.
GSK plc (GSK)
Q2 2020 Earnings Call· Wed, Jul 29, 2020
$54.66
+0.81%
Same-Day
-0.84%
1 Week
+1.53%
1 Month
-2.44%
vs S&P
-10.27%
Operator
Operator
Good afternoon, ladies and gentlemen, and welcome to the analyst call on the GSK Second Quarter 2020 Results. I will now hand you over to Sarah Elton-Farr, Head of Investor Relations, who will introduce today's session.
Sarah Elton-Farr
Operator
Thank you. Good morning and good afternoon. Thank you for joining us for our Q2 2020 results, which were issued earlier today. You should have received our press release and can view the presentation on GSK's website. For those not able to view the webcast, slides that accompany today's call are located on the Investors section of our website. Before we begin, please refer to Slide 2 of our presentation for our cautionary statements. Our speakers today are Chief Executive Officer, Emma Walmsley; Iain Mackay, Chief Financial Officer; and Dr. Hal Barron, Chief Scientific Officer. We have a broader team available for Q&A. [Operator Instructions]. And with that, I will hand the call over to Emma.
Emma Walmsley
Analyst
Thank you, Sef. And welcome, everybody, to today's call. I hope that you and those around you continue to be well. At this half year mark and in what have been extraordinary circumstances, I am pleased to report that we've mobilized across GSK to respond to the pandemic and have simultaneously advanced our long-term strategic goals at pace. Adjusting rapidly to the new ways of working, we've secured supply, strengthened the pipeline, progressed multiple solutions for pandemic, and our integration and separation programs are all firmly on track. While we have seen some COVID disruption impact to our performance this quarter, we're pleased with half year delivery, and our confidence in our business and its prospects remains high. Hal will give you an update on our innovation progress shortly, but particular highlights in the last few months include, in Oncology, the U.S. approval for Zejula as a first-line monotherapy maintenance treatment for women with ovarian cancer. We were also pleased to see positive opinions from the FDA's ODAC and CHMP on belantamab mafodotin, a medicine, we believe, will be very important for multiple myeloma patients. In Infectious Diseases, we made great progress in HIV with the presentation of truly groundbreaking data for long-acting cabotegravir in the PrEP setting. And in Vaccines, we're poised to move into pivotal studies for very significant opportunities in RSV and meningitis and have just announced our collaboration with CureVac, targeting up to 5 infectious disease pathogens. Despite short-term pressures, our performance fundamentals continue to strengthen with good momentum and strengthening commercial execution on our key growth drivers. We're winning share in Respiratory; in oncology with Zejula; with 2 drug regimens in HIV; and in power brands and consumer, including a notable acceleration in VMS demand. We've seen strong acceleration of our digital capabilities as we've…
Iain Mackay
Analyst
Thanks, Emma. All the comments I'll make today will be on a constant currency basis, except where I specify otherwise. And I'll cover both total and adjusted results. On Slide 10 is a summary of the group's results for Q2 and the half year. In the first half, turnover was up 8% on a reported basis and flat on a pro forma basis. Excluding the impact of disposals, revenues were up 1%. Adjusted operating profit was up 2% reported and down 7% pro forma. Adjusted earnings per share was 56.9p, down 6%. For Q2, turnover declined 3% on a reported basis and 10% on a pro forma basis. Excluding the impact of disposals, revenues were down 8%. As you've heard from Emma, we continue to see strong underlying performance of the business. However, during Q2, we saw turnover adversely impacted by the COVID-19 pandemic, with the most significant impact within Vaccines. I'll go into the business drivers in a moment. Total operating profit was up 90%, with total EPS up over 100%, primarily reflecting the net profit on the disposal of Horlicks and Consumer Healthcare brands. On an adjusted basis, operating profit was down 21% reported and 27% pro forma, while adjusted EPS was down 38%. Earnings were impacted by lower turnover, continued investment in R&D, support of new product launches and increased effective tax rate and a higher noncontrolling interest allocation of Consumer Healthcare profits. These were partially offset by continued tight control of operating costs across the business. We delivered £2.5 billion of free cash flow in the first half, reflecting favorable working capital, timing of RAR payments and proceeds from divestments of intangible assets. And on currency, in the quarter, there was a 1% tailwind on both sales and adjusted earnings per share. Slide 11 summarizes the…
Hal Barron
Analyst
Thank you, Iain, and good afternoon, everyone. It's been 2 years since I shared our new approach to R&D, and I'm very pleased with the progress we are making. Today, I will review this progress and then discuss several very exciting medicines and vaccines in our pipeline. And with that, I'll begin my presentation. Let me start with a brief reminder of our approach to R&D, which I outlined in 2018. That is to strengthen our pipeline through a focus on the science related to the immune system and to use human genetics and advanced technologies such as functional genomics and machine learning to enable us to identify novel targets that have a higher probability for success and a robust life cycle potential. To achieve this, we have focused on 4 key strategic levers: first, to drive organic growth by focusing our research organization on human genetics and on both the adaptive and innate immune system. In development, we have removed numerous projects from the portfolio to enable us to design and execute robust clinical trials on the more promising programs. Second, to effectively leverage business development to augment our pipeline; third, to improve how commercial and R&D work together to maximize the life cycle of our medicines and vaccines; and lastly, to shift our culture in R&D to one that embraces innovation by focusing on smart risk-taking, single-point accountable decision-making and hiring and developing outstanding people. I believe we have made significant progress over the past 2 years. Over 70% of the targets in research are now genetically validated, with nearly 30 therapeutic targets originating from the 23andMe collaboration. We have exceeded industry averages for success in proof-of-concept studies, enabling us to initiate 9 potentially registrational studies. In addition, we've had 17 positive results from pivotal studies. Lastly, we…
Emma Walmsley
Analyst
Thanks, Hal. So in summary, we're confident in the underlying demand for our portfolio despite short-term quarterly impact. GSK has been resilient and agile in its response to the pandemic, and we're successfully navigating the crisis and meaningfully contributing to solutions, while at the same time, making sure we're delivering our long-term priorities of innovation, performance and trust and on our 2020 areas of focus. We're building on the significant progress Hal has spoken to and strengthening our pipeline further. We're driving improvements in our operating performance. We're progressing the consumer JV integration at pace, including the reshaping of our brand portfolio. And we started our program to prepare the group for separation into two new companies with relevant and competitive purpose portfolios and strategies: one, a biopharma company focused on the science of the immune system and genetics, the other dedicated to everyday consumer health. Ultimately, we remain confident in the resilience and sustainability of GSK's business and our ability to deliver very successfully on our strategic goals. So we're now joined for Q&A by Luke, Brian, David and Roger. And with that, operator, the team is ready to take questions.
Operator
Operator
[Operator Instructions]. We now have Matthew Weston from Crédit Suisse.
Matthew Weston
Analyst
Two questions, please. Firstly, for Emma. President Trump's proposed a number of executive orders on U.S. drug pricing, including international best price. As one of the first CEOs who's able to comment immediately after those announcements, I'd be interested in what's GSK's view on the proposals and what you would expect to shake out as we approach the election. And then secondly, probably for Luke, given the need for a vaccine rebound in the second half, can you talk about this year's flu season? How many doses are GSK targeting to ship versus last year? And should we assume price improvements given, I presume, high government demand for immunization across the board?
Emma Walmsley
Analyst
Right. Luke in a second, but just to comment on the executive orders, which, as you said, have just come out. And we're reviewing that and monitoring how things evolve, obviously, being conscious and thoughtful about what can actually happen ahead of the election. I mean these are all fall topics have previously been raised. And our position, frankly, is maintained, it's the same, which is we very much support any shifts that continue to drive access and support innovation that the world has never seen more than now is required for all of the unmet need. And we're very supportive of programs that lower out-of-pockets, particularly for patients that are under economic pressure, and likewise, due governance around access to 340B. We do, however, have concerns about international pricing indices and importation because global systems are not comparable, and the focus should be on maintaining safety and quality of products and also incentivizing innovation. Nonetheless, our #1 priority is continuing to focus on quality, needed, differentiated medicines. You all know that GSK has a strong track record in terms of responsible pricing. And actually, we have continued to innovate for access, and that's visible when you think about 3-in-1 respiratory with Trelegy; the fact that Zejula is a single treatment; or indeed, the whole growth we are seeing and investing in 2-drug regimens; and of course, commitments to price responsibly for any COVID solutions. So Luke, do you want to comment, please, in terms of the focus on the flu season, which we know is very important?
Luke Miels
Analyst
Sure. Thanks, Emma. Thanks, Matthew. So in the U.S., we expect to ship around 50 million doses in the upcoming season. The manufacturing team has done a great job, and we expect those to be in the market shortly. This is a critical part of our acceleration program for Shingrix. And that's up from 46 million in 2019, which back then was about 19% of market share. And the U.S. is where we send 2/3 of our supply.
Operator
Operator
This is Louise Pearson from Redburn.
Louise Pearson
Analyst
I got a couple on the RSV program, please. So firstly, in terms of revenue opportunity in the older adults, do you see this as a vaccine that could potentially support a premium price point like a Shingrix should this program ultimately be successful? And secondly, specifically on the maternal vaccine, is there any reason to believe your vaccine will be differentiated from the Pfizer maternal vaccine, which also recently came through proof-of-concept?
Emma Walmsley
Analyst
Thanks very much, Louise. And I'm going to turn to Roger. But absolutely, we do think that the RSV portfolio has tremendous potential, both in terms of unmet need and our competitive positioning. But Roger, perhaps you'd like -- not least, by the way, with our differentiated adjuvant, which has proven to work on all the people. So Roger, perhaps you would like to give a bit more details on that.
Roger Connor
Analyst
Fantastic. Louise, thank you. Yes, we are completely delighted with the positive data that we saw in the 2 RSV assets that Hal mentioned. I suppose it's worth pointing out both the fast-track designation from the FDA also. Just on RSV older adults, we really think we are likely to be uniquely positioned here because of the pre-F antigen and the adjuvant that Emma referenced as well. The adjuvant system in Shingrix is the AS01 adjuvant, which created greater than 90% efficacy in Shingrix. So again, that's creating a level of excitement because we really believe that, that could offer potentially wider and longer protection. On your pricing point, I think if we do create that level of differentiation and protection, that level of pricing is appropriate. But obviously, that is to be determined as we run through the trials. We're moving into Phase III in early '21. That's one. So we are excited about older adult. On the maternal side, just in terms of -- it's the same antigen as the older adult vaccine. It moves into Phase III in the second half of this year. Two points I'd really note here. Number one, this is likely to complement other CDC-recommended maternal vaccines that we've got in our portfolio as well. So we've got experience in terms of how we operate in this maternal vaccination space. That will be the first one. I do think our vaccine offers potentially also polyclonal coverage versus in the competition. We know also that we'll be up against monoclonal competition. And I think that could offer broader stream protection, which protects us against -- well, protects you against virus mutation or if viruses that are screened actually escape the monoclonal. So yes, excitement in both of those. The good news is we'll share the data on this in Q4 later this year.
Operator
Operator
This is Keyur Parekh from Goldman Sachs.
Keyur Parekh
Analyst
Two, please. First, kind of just on the cost trends that we've seen this quarter, Emma and Iain, would love your thoughts on how do you see the sustainability of the growth in the cost as we go through the rest of the year. I think a lot of your peer groups seem to be reporting margins meaningfully better than expected. I would be keen to hear your perspectives on how long do you think the need for reinvestment continues to be. That's question number one. And then question number two, on Zejula, I think kind of number's a bit below expectations for the quarter. Clearly, some stocking kind of moving from Q1 to Q2 or likewise. But Luke, would love your thoughts on how you think you're doing in the real market please, kind of if you can refer to some market share trends. And when do we anticipate a real pickup that justifies the value you paid for TESARO?
Emma Walmsley
Analyst
Thanks, Keyur. So let's go to Iain first and then over to Luke.
Iain Mackay
Analyst
Okay. Thanks, Emma. Keyur, thanks very much for the question. Look, cost, I think one of the differentiating aspects of our focus around capital allocation is investment behind R&D pipeline. Key assets in the pipeline is absolutely key priority for us, and you continue to see a cost increase in that regard as we invest behind those priority assets. So in the second quarter, Pharma R&D up 13% and year-to-date overall for the company, up 11%. That will remain a focus for us. On the other hand, on the SG&A front, in the quarter, down 5%. Very, very strong focus on all noncustomer-focused activities. So we continue to invest in terms of supporting new product launches and completion of the build-out in terms of specialty. But if you think about the programs that we are delivering savings against, integration of the Consumer Healthcare business, Brian and the team beginning now to deliver savings from that integration, very much in line with the £500 million we expect to deliver between now and 2022. The future-ready program, separation preparation program by another name, beginning very, very early stages of delivery. But again, between now and 2023, $800 million of savings with the lion's share of that delivered by the end of 2022 with meaningful margin improvement. And then in addition to that, just the day-to-day tactical management of costs in the second quarter, we've managed T&E down to a very, very small number. As you would imagine, conferences and meetings down to a very small number. Found ways to continue activity with our customer, with our health care professionals through virtual means. That's been particularly noted in the U.S., which, again, takes costs out of the travel and entertaining, the fleet expenses for the sales force, for example. So there's a very strong focus across noncustomer-facing activities as well as just continuing to deliver productivity through the supply chain and the commercial organization. So happy with the progress in terms of 5% down on SG&A in the quarter. Continued focus in that area, but we'll continue to invest behind SG&A -- sorry, SG&A between -- behind priority assets and R&D.
Emma Walmsley
Analyst
Thanks, Iain. Luke, Zejula.
Luke Miels
Analyst
Sure. Yes. Thanks, Keyur. So Keyur, I'll answer this in a few pieces. I mean Iain's covered the inventory effect, which was plus 5% in quarter 1, and then we had a change of wholesale delivery from Monday and Thursday, Wednesday and Thursday, which was $5 million in Q2. So that's a $10 million swing there. But in terms of operational, I guess I'll split this into 2 parts: things that we can control and things that we can't. So in terms of things that we can control, I think we're doing well. So first-line market share jumped 14% to 21%. And again, if you look at the class, it's up 100% or close to 100% in 12 months. And we still only have 15% of women in first-line getting a part. We had the leading share of voice to average at about 39% and actually got up to a peak of 49% because we rapidly changed our model when COVID hit. And then we also -- as soon as we had state-level clearance and government clearance, we got straight back out there. If we look at message recall tracking, this is translating to strong and clear recall of our key messages, which, again, is encouraging. And then if we look at probably the most dynamic measure, which is the average new patient starts in the U.S., this is actually at an all-time high. So if you look at Q1 versus Q2, it's up 50% -- 58%. And that's despite a big drop in late March and then most of April. And then finally, on things we can control, we've seen -- just over the last month, we've seen more than 400 new unique writers since PRIMA. So these are the things which I think were within our gift, and I think we're competitive there. In terms of what we can't control, what is very clear when you look at the oncology market, there is a very dynamic trend here in terms of you've got slower progressing tumors, then the referrals, the new patient starts. And in-office treatment rates are lower, and ovarian is in that category. So if we look at new patient diagnosis, they're down about 10% in April. Debulking surgeries are around 25% in the last data that I saw. So these are factors that are part of our control. But in the end, we launched PRIMA bang in the middle of COVID. And I think now our focus is to keep executing like we are, growing the class and making sure that we're getting our fair share.
Operator
Operator
This is now Tim Anderson from Wolfe Research.
Unidentified Analyst
Analyst
This is Richard Wagner [ph] with Wolfe Research for Tim Anderson. Question on the COVID vaccine. It's commonly understood that there are 3 major diversified vaccines players: GSK, Sanofi and Merck. Yet all of the leading, the vanguard, COVID-19 vaccine initiatives are by none of the 3 biggies. Instead, they're led by companies that don't at all have the same level of experience in the space. How did we end up in this place? I appreciate that GSK has multiple vaccine collaborations underway, but these are not commonly described as one of the leading programs. Was it because of the traditional vaccine companies feeling like vaccine development would be on the usual protracted time line or something like that? That's the first question. On belantamab, I know GSK doesn't give single product guidance, but can you at least tell us whether you think this product has the potential to achieve blockbuster levels of sales, meaning crossing the £1 billion or $1 billion threshold at some point?
Emma Walmsley
Analyst
Well, thanks, Richard. And I can just say yes to your second question, subject to the program of work that Hal outlined. And maybe I'll ask Luke in a moment to just comment a bit further as we prepare for the launch on that. In terms of vaccine, I think it's interesting that you described the leading programs as being from -- and I understand why, from not the -- I suppose the largest vaccine manufacturers today. I actually think -- I would qualify a bit by saying the first. All of us, I'd say, across the industry, large and small, believe that more than one vaccine will be required to address this. And that's exactly why our decision right from the beginning was, a, a vaccine is the priority exit here, but treatments will still be required because, as you know, the FDA has also said they will consider approving vaccines with 50% efficacy. And even if an extraordinary vaccine means that we're still going to require treatments, not just in the near term but for long term, which is why we invest in the areas that Hal talked about and excited actually about our prospects there. But it's also why the choice that we made in terms of technology play was to bring an adjuvant, and that is important because it's proven at scale. It's safe, and we know it can add both efficacy and antigen-sparing benefits as well as allowing us to have multiple shots on goal, if I can call it that. And you can see that evidenced by the way governments are engaging in contracting now is there's still a lot of uncertainty about what is going to play out in terms of results. We should all be encouraged by the early readouts with this offering on totally new technologies that haven't ever been licensed yet. They are encouraging, but there's still a lot to see on duration of response and particularly on efficacy on different cohorts. And one of the big outstanding questions is what's going to happen with the older cohorts and the readouts there. So we, alongside others across the industry, are still very much engaged in the programs we're in. As Hal said, we've got 2 already in the clinic, another just about to start. And we're very confident in being able to supply, subject to positive results, 1 billion doses of the adjuvant, importantly, while still continuing and accelerating our existing pipeline and indeed investing in the exciting new technologies that are becoming more visible, be that in-house or with our CureVac deal. So I think a lot more to come on in terms of where the vaccine solutions will conclude. But Luke, is there anything else you'd like to add in terms of how you think about the upcoming commercial execution and prospects of bela?
Luke Miels
Analyst
Yes. Thanks, Emma. So I mean, look, I think the key thing to anchor on here is that the -- I mean there is striking single-agent activity. And we believe that the side effect profile is manageable, and it's an attractive infusion regimen. I think we can execute a good plan in terms of managing -- optimally managing corneal event. And I think also, just when we talk to physicians that use the drug, again, the efficacy is attractive. When -- in terms of managing the tox profile, let's see how that evolves and whether that's consistent with what we see with investigators once they get the drug in their hands and use it in patients and understand how it works. I think also, you can see with programs that Hal highlighted like DREAMM-5, we're also being [indiscernible] minded in terms of the pathways through this drug in earlier lines. So short answer is we remain very confident about the asset.
Operator
Operator
This is Andrew Baum from Citi.
Andrew Baum
Analyst
A couple of questions. COVID-19 is obviously going to have lots of impacts on the industry, but one that seems obvious to us is the importance of the government as a stakeholder is going to be materially greater going forward than it's been historically. With that in mind, to what extent does that influence your capital allocation? I'm obviously thinking of areas that you're already in such as vaccines, but in addition, areas where you have been in historically, maybe thinking antimicrobial and anti-infectors more broadly. Is this a driver for you to increase your investment there? And then second, on the announced deal in relation to vaccines, thinking about your pricing strategy for your COVID-19, there's obviously a divergence between the AstraZeneca approach being pro bono during the pandemic period and, obviously, Pfizer and BioNTech going for profit. How are you thinking about pricing your vaccine for the pandemic period should there be safety and efficacy to meet approval?
Emma Walmsley
Analyst
Well, thanks, Andrew. And I would definitely concur that the world and many governments have recognized the strategic importance of our industry and innovation within that and all in the context of the geopolitics that we know. I think in terms of how it's influencing our capital allocation choices, Hal laid out very clearly in his presentation the mix of the portfolio of our pipeline. But also it's worth underpinning GSK's strength in infectious diseases, be that prevention, which frankly is -- if there's one thing despite any quarterly impact that we should all believe is that fundamentally, the -- we should be absolutely confident in the strategic relevance and prospects of vaccination, which is an area that GSK has tremendous strength, a growing pipeline and increasing competitive capabilities. But we also do have a broad infectious disease portfolio, continuing to pioneer in HIV innovation. And I think it's really important to underline the opportunity we see with cab, both in prevention and treatment. But also there's growing focus on antimicrobial resistance. And we have, again, as Hal mentioned, an asset in [indiscernible] there as well, which we believe does have appealing economic returns. So I think that's been clear. In terms of the pricing of vaccines, this is a business that we have long led in and understood both the responsibility to drive access and the necessity to drive profitable returns. And therefore, to keep funding innovation and what -- and our position, we're not -- there's no publication from the government in terms of the specific detailed terms of that, is that any short-term profits generated during the pandemic period would be reinvested in pandemic preparedness and those donations for access. And pandemic preparedness is a combination of technology, new -- support for new pathogen work but also the funding of ever warm capacity, very much with thoughtfulness, for your first comment, of the global footprint in terms of manufacturing and supply.
Operator
Operator
It's Laura Sutcliffe from UBS.
Laura Sutcliffe
Analyst
I've got two questions on RSV vaccine. Firstly, what sort of time line do you think you might be looking at for Phase III readout for both of your assets that you're taking forward? And secondly, your older adult vaccine is obviously adjuvanted. I think previously, the evidence has suggested there was little to no benefit from adding an adjuvant to vaccines that are going into this setting. Should we assume that since you're going forward, you have seen something remarkably different here? I know the data will be presented later this year, but any color you can offer us would be very helpful.
Emma Walmsley
Analyst
Yes. I'm not sure you're going to get a huge amount of preview of data that's later to be presented. But Roger, would you like to follow up for Laura, please, on those questions?
Roger Connor
Analyst
Yes. Laura, thank you. I'd say just on the older -- I won't share the data we will publish and present later in the year. However, what I would say is that we have seen AS01 obviously in Shingrix performing incredibly well in the older adult population where we know the age-related decline in the immune system is critical. So that's all I would say on that. In terms of timing, we are going to take RSV older adult into the clinic early in '21. Maternal will be going into Phase III in the second half of this year. And these are going to be quite large trials. We'd expect them to take a few years to complete with regulatory approval to follow on from that if it's positive. What I would say is that certainly in the COVID environment, we're looking at clinical trial execution approach, regulatory engagement. And we'll be taking any learning in terms of how we do this effectively and efficiently into these priority programs.
Operator
Operator
This is now James Gordon from JPMorgan.
James Gordon
Analyst
Two questions. The first one was just that your 2020 guidance is now caveated around the recovery in vaccination rates. And we are -- depending what we see in Q3, and we're a month into the quarter. So could you talk about how much better things are looking for July and maybe what the exit rate is towards the end of this month? Is Shingrix, for instance, a good proxy for what's going on overall for vaccines? Or do we need to be careful reading through from that? And then the second question was just the Consumer spin-off. I think when the spin-off was first announced, there was a plan for 3.5x or 4x levered and the base case was you dividend the whole company to GSK and Pfizer shareholders in '22. Is that still sort of the concrete plan or default plan? Or might you do some other creative stuff like IPO-ing part of the business? Might you consider not putting quite so much debt in the business? Are there any other sort of things being considered there?
Emma Walmsley
Analyst
So thanks, James. I'll ask Iain to unpack the guidance and assumptions a bit more for you. But just so there's no change in terms of our position on Consumer separation, be that former leverage or timing. So Iain, any...
Iain Mackay
Analyst
Yes. Thanks, Emma. And maybe Luke can add some color on this. But I think as Emma mentioned, James, what we are seeing through July is a significant recovery of pediatric vaccinations back pretty much to pre-COVID-19 levels. Certainly, in the adult and adolescent vaccination, we're seeing encouraging activity. It's not back to the levels that it was pre-COVID. But as we've pointed out in our guidance, that is the recovery that we are beginning to see, and we need to see that happen in the third quarter with a very strong performance coming through in the fourth quarter. So we're encouraged by what we see so far, and our very strong view is it's not a question of if this demand comes back but when the demand comes back. And certainly, what we've seen through the 24th of July, which is the most recent -- 24th July is the data that we've seen most recently, certainly encouraged by what we see.
Emma Walmsley
Analyst
Luke, do you want to talk a bit more about the activity that's ongoing? Thanks.
Luke Miels
Analyst
Yes. Yes. Just to build on Iain's point, I mean there's a clear difference when you look at the U.S. and Europe. I mean Europe is -- the bulk of our business is pediatric vaccines, and that was -- rebounded relatively quickly. In the U.S. pediatrics, if you look at the industry as a whole, in February, it was about 500,000 a week, and that dropped by 50% for 4 weeks in March and April. And then it rebounded pretty quickly. So it was a V-shape recovery. So it's about minus 40% in late April and minus 10% in June. So it came back quickly, whereas adults, it dropped the same way, but it's been slower to recover. And so in early May, we're still around minus 50% plus overall for adult vaccinations, whereas pedia at that point was minus 30%. So it's just a longer area under the curve. In terms of just wellness visits as well, we've seen the same path. There's a very strong rebound amongst pediatrics and 11- to 12-year-olds and 13- to 18-year-olds. It's a slow recovery for older people. I think also when older people are going back into their physician, there's going to be a hierarchy that the physician is going to focus on initially, so blood pressure, [indiscernible] acute dimensions. In terms of what we're doing about it, again, we've not sat and been passive. So there's a series of things we've done. We've initiated some -- well, firstly, we've linked the early flu doses I mentioned earlier because people come into the flu shot. That's a prime opportunity for the pharmacists to bring up Shingrix. We've also -- the field activity with our retail customers is back to the pre-COVID levels. And with retailers, we've got a lot of signage volume goals and some other things that I don't want to disclose. And we've also been chasing people for their second dose and getting them back there, and that's holding up quite well. We're also doing DTC at point of sale. And there's similar things, again, that I won't cover. But we're doing everything we can, including targeted TV and some branded digital and print-based media as well. And as Iain said, I think we now need to see how that goes with the dynamics in the U.S.
Operator
Operator
This is Geoffrey Porges from Leerink.
Geoffrey Porges
Analyst
Apologies for jumping on the call later. I may ask the question you've already answered. But first, on flu, could you just give us a sense of your timing for shipments to the U.S. market, the volume change you expect compared to last year, most importantly, whether you see any net positive price due to mix of contracts? And then just a follow-up on the COVID program. When can we expect publication of your preclinical data, particularly primary data? And could you comment on the mix of CD8 and CD4 responses that you've seen with AS0 in your other studies relevant to COVID?
Emma Walmsley
Analyst
Thanks. So Luke, I mean, we had the question on flu before. Perhaps if you can just repeat what we're aiming for in terms of volumes roughly. And then, Roger, I don't know if there's any further disclosure you want to bring on the -- or how long the COVID programs.
Roger Connor
Analyst
I can make a very quick comment, Emma, if you come to me.
Emma Walmsley
Analyst
Yes.
Luke Miels
Analyst
Okay. So Geoffrey, shipping in July, linking and lining it up with the Shingrix acceleration program, we're targeting 50 million doses. And also getting them in earlier, which is something I didn't say earlier, is very important. It reduces the return rate that you see later in the year because physicians tend to over-order. And that's up from 46 million in 2019, which is just down to 20% of the market, and we sold 2/3 of it in the U.S. In terms of pricing flexibility, no, it's very limited for this year in the U.S.
Emma Walmsley
Analyst
Okay. Roger, [indiscernible]?
Roger Connor
Analyst
Yes. I just -- I'm not going to go into any of the detail in terms of the data that we have seen. I'd make more of a generic comment around -- I do think one of the things that is to play out in COVID-19 is this idea of immune response and T cell contribution to the performance of the vaccine then having potentially an impact on the population and the reaction of the vaccine in the population. What I would say is that adjuvanted vaccines have got that historic delivery and track record of delivering both humoral and cellular immune response, which we think could be very important for COVID. Too soon to tell, though, and that will all play out over the coming months as more data on our vaccines and on the other vaccines comes to light.
Emma Walmsley
Analyst
Hal, anything else to add from your point of view on that?
Hal Barron
Analyst
No. I just -- maybe to highlight something Roger said, which is I think that the cellular response, it could very well be important in the success of vaccines. And I think in addition to measuring some of the classic markers that you referred to, I think GSK's vaccine research organization has put a lot of effort and I think a lot of innovation in actually what to measure what is actually predictive in the clinic as to what you want to look for, for surrogates for that. So I think it's not only when but the quality of what you might see is going, I think, to be interesting.
Operator
Operator
Kerry Holford from Berenberg.
Kerry Holford
Analyst
A couple of questions. Just quickly on the flu vaccine. I'm just interested to know whether there's any upside to your ability to deliver more than 50 million doses into the U.S. market. Sanofi is committed to ship, I think, 80 million. Just interested to see whether there's any upside to capacity for you. And then just more broadly on the pipeline refresh. Hal, just is this something we should now expect to continue to see from you over the next -- on a 6-monthly basis going forward? And I wonder if you can talk to the reasons why you elected to deprioritize certain assets in the portfolio, the CLL for PI3 kinase and the HIV [indiscernible].
Emma Walmsley
Analyst
Thanks very much, Kerry. And so, Roger, just quickly from you in terms of capacity on flu and then Hal to conclude, please.
Roger Connor
Analyst
Yes. Thanks, Kerry. Look, I think 50 million is going to end up being one of our highest volume, the highest volume in the U.S. as well. We are very close to maximum capacity here. So there's limited upside going forward in terms of this ag-based technology because it's not somewhere, as you know, as we have allocated a lot of our capital to. So you're not going to see much more in terms of upside above the 50 million number within the U.S. supply.
Emma Walmsley
Analyst
Thanks. So Hal?
Hal Barron
Analyst
Yes. Thanks, Kerry. I think, yes, the answer is we will continue to focus our efforts in R&D on the most promising assets. And sometimes the science will translate out nicely, and we'll double down and be aggressive about developing assets. And sometimes, the data will emerge to suggest that we should abandon projects. And of course, the risk is very high in the industry. 10% of projects that enter the clinic will ultimately succeed. And we think the most important thing is to follow the science and rigorously evaluate what the data in the clinic tells us. We think by this focus on human genetics, functional genomics, machine learning, and particularly, the focus on immunology will allow us to develop a portfolio that has a higher probability of success. And of course, by focusing, we have the opportunity to be developing and designing robust clinical trials to give us insights so we're not faced with deep uncertainty that sometimes plagues the industry at the end of Phase II. So I think the refresh is just our attempt to be rigorous scientifically and focus on the most promising assets.
Emma Walmsley
Analyst
Thanks, Hal. And thank you to all of you for dialing in. We look forward to talking to you soon. Thank you very much.
Operator
Operator
Everyone, all the speakers, thank you. That concludes your conference call for today. Thank you for joining, and all take care.