Earnings Labs

Novartis AG (NVS)

Q1 2014 Earnings Call· Thu, Apr 24, 2014

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Transcript

Joseph Jimenez

Management

Thank you. I’d like to welcome everybody here today. Joining me from Novartis are Harry Kirsch, our CFO; David Epstein, Head of the Pharmaceutical Division; Kevin Buehler, Head of Alcon; Jeff George, Head of Sandoz; Andrin Oswald, Head of Vaccines, George Gunn, Head of Animal Health; and Brian McNamara, Head of OTC. So before we start, Samir, can you read the Safe Harbor statement?

Samir Shah

Management

Thank you, Joe. The information presented in this conference call contains forward-looking statements that involve known and unknown risks, uncertainties, and other factors. These may cause actual results to be materially different from any future results, performance, or achievements expressed or implied by such statements. Please refer to the company’s Form 20-F on file with the Securities and Exchange Commission for a description of some of these factors.

Joseph Jimenez

Management

Thanks, Samir. Okay, starting on slide number 4, I’d say we had a solid first quarter. We had sales growth across all divisions and total, our sales were up 3% in constant currencies. We had a very strong innovation, again, in the quarter which sets us up for future growth. On Tuesday, as you know, we announced significant changes to the portfolio where we will be focusing the company on our three big engines. And then today, we announced greater cross-divisional synergies and simplification through the formation of Novartis Business Services. Now, looking at our results in a little bit more detail, as we have said, it’s important for us to deliver leverage. And in the first quarter, we were able to show sales up 3% and core operating income up 6% in constant currency which resulted in a 0.9 point increase in core operating income margin. Harry’s going to go into this in more detail in a minute. In terms of our three strategic priorities, I think we made progress on all three. And let me start by talking about innovation on the next slide. We had several important approvals in the quarter, I think the most significant was XOLAIR which we got approved in both the US and Europe for chronic spontaneous urticaria. This is a debilitating skin disease and we’re often running in terms of getting that launched in the new indication. For Bexsero, we had some very positive news, as you heard, with the recommendation in the UK for routine use in infants. And in the US, we received breakthrough therapy designation from Bexsero. We’re going to be filing as early as this quarter. The news flow from the pipeline beyond the approvals was also very impressive. I think we were disappointed by the news on…

Harry Kirsch

CFO

Thank you, Joe. So quarter one has been a solid quarter with a solid P&L which you can see on Slide 23. In constant currencies, we grew sales by 3%, core operating income by 6% and achieved some core operating leverage. Core earnings per share were also up 6%. But to say it upfront, I’m not happy with the cash flow result. As a reminder, all comparisons are on the pro forma basis which excludes the Blood Transfusion Diagnostics Unit in 2013. We completed that divestment in early January this year. And the divestment gain of $0.9 billion is included in the reported operating income. If you look to Slide 24, you can see that the foundation of our good quarter is underlying volume growth. Let me walk you through the slide. In terms of net sales, underlying volume growth contributed 8%. Price had a slight negative impact of 1% which led to the underlying sales growth of 7%. This is more offsetting the impact of generic competition of 4% or about $0.5 billion and resulted in net sales growth of 3% in constant currencies. FX took another 2% off the top, leading to a US dollar growth of 1% for net sales. You see again a similar but more pronounced picture for core operating income where underlying growth core operating growth of 16% more than offset the 10% of generic competition. FX took us from 6% growth in constant currencies to flat earnings in US dollars. I will provide more detail on FX later but the main drivers continue to be the yen and the emerging markets currencies. Now turning to Slide 25, you can see that our core margin in constant currencies improved by 90 basis points. This improvement was mainly due to pharmaceutical and corporate items. In…

David Epstein

Management

Thank you, Harry. For the quarter, we reported in constant currency 1% top line growth and nice leverage growing 4% in core op inc. and this is despite the negative impact of generics particularly for Zometa. Currency, as Harry described however, was negative on a US dollar basis. Turning now to the next page, you see underlying volume growth was plus 6% and more importantly, growth products grew 17% reaching now 41% of sales. In essence, our portfolio is getting younger and healthier all the time. As you can see on the following page, the emerging markets continue to provide strong growth despite the occasional problem markets; in this case, Venezuela. We’re up 7% overall for the emerging growth markets. And the following slide, you see that our unparalleled growth platform with exclusivity until 2018 and beyond continues to deliver. All products on this list showed very nice growth and in particular, some of the products in the bottom of the list, our respiratory portfolio and Jakavi, are now getting to a side where they start to really contribute to our forward growth. I’d like to mention just a few of the larger brands now as we flip through the next few pages, starting with Gilenya. Gilenya has now exceeded the $2 billion sales mark for the rolling 12 months. Over 91,000 patients have been treated worldwide and you see that the ex US market share growth continues and revenue growth continues with really strong momentum. In the US, the growth was much smaller and it was negatively affected by a temporary effect of a larger and longer than expected yearly benefit reverification process. If you look at the data in more detail, you see that January and February were weak but March was very, very good. So we felt…

Joseph Jimenez

Operator

Thanks, David. So to sum up, we had a solid Q1. Beyond the portfolio transformation, we delivered strong innovation in the quarter and that sets us up for future growth. We grew each of the divisions, and we announced greater anticipated cross divisional synergies through Novartis Business Services. So at this point, I’d like to open the call to questions. Operator.

Operator

Operator

Thank you. (Operator instructions). We’ll take the first question from Narim Niam [ph]. Please go ahead. Andrew Baum – Citibank: It’s actually Andrew Baum here. Thank you for taking my question. Two parts about analysis that firstly, could you just remind us how many of the – what percentage of patients in PARADIGM came from the US? And the reason I’m asking, which you probably might guess is, should we feel comfortable assuming it’s a relatively low contribution that there’s no diversion treatment trends compared to the overall patient population? Obviously thinking of recent experience with Valenda [ph]. And then second, David, perhaps you could comment on the intellectual property and [indiscernible] that in the US market. You put out some punchy comments about you anticipated exclusivity time. Perhaps you could outline what underpinned that confidence.

David Epstein

Management

Okay, so your first question was about the makeup of this multi-country study for LC [ph] that I don’t actually have the number of US patients in front of me, but it was substantial. And we do not expect to see results that are different from the US versus other countries. But you also have to remember, we haven’t actually analyzed all the data ourselves. It has to be collected. So we’ll get back to you on that. I don’t think there’s any issue there. In term of the LCs [ph] at IP [ph] situation. Exclusivity is based on a combination of regulatory data protection as well as several different patent families. We expect a lot of exclusivity in 2026 in the US and Europe and 2030 in Japan. I know some people have questioned whether or not that is sufficient protection given that AHU which is a [indiscernible] component of the drug is an old drug as well as [indiscernible]. Please keep in mind that AHU was never launched. We have a number of combination patents and we also have a series of other patents that we’re not ready to discuss yet. So we feel pretty good about the outlook for this product’s protection. Andrew Baum – Citibank: Thank you.

Joseph Jimenez

Operator

Next question, please.

Operator

Operator

The next question comes from Alexandra Hauber from UBS. Please go ahead. Alexandra Hauber – UBS: Thank you. I’ve got three questions. Firstly, this is a quick follow up on LC [ph] that I just noticed that slide that you put out today on the eligible patient population is slightly different from the one you put out previously as in there was no longer a restriction for patients without renal insufficiency. So whether you could just comment on why that restriction is – was in there originally, there’s no longer there. Second question on Afinitor, you mentioned you’re not getting the expectations based on the outcome of BOLERO. Were you also hearing from the US that [indiscernible] is used. It’s actually considerable proportion of patients considering to go straight from the endocrine therapy to [indiscernible] which is not available generically. [Indiscernible] one thing about your market intelligence tells on that point, but that has contributed to your [indiscernible] expectations. And also, if you’re seeing that happening for Afinitor whether that makes you somewhat more concerning about the Gleevec patent exploration with regards to the Tasigna switch. And then just final question on just looking again on the deals that are announced under consumer JV, if you think about the restructuring which is going to happen in that business, is this going to come out of the consumers’ pockets or out of GSK’s pockets? And how are you actually accessing cash that comes from this business?

Joseph Jimenez

Operator

Okay, let’s start with David on LC [ph] there.

David Epstein

Management

Okay. So I have to go back and find the last slide because I don’t have it in front of me. I don’t expect any significant restrictions around our renal function for the product. So we’ll go back and check and find out what happened for you. Alexandra, I don’t know at this particular point in time. Just to give people a little bit more color on Afinitor, so Afinitor does have stomatitis as a side effect. It can be quite painful for a percentage of patients. And patients can be coached through that pain. And if they stay on for a period of about two months, it tends to go away. And then they can benefit from the full therapy. The problem we had is we expected to have an overall survival benefit which would provide enough encouragement for the physician to work with the patient and get them through. We’ll probably be out to extend the duration of treatment. Without the overall survival benefit, it’s tougher to do that. And as a result, you’re seeing the drug use third and fourth line. Now you mentioned something about I think Gleevec [indiscernible] and I didn’t quite catch that. Alexandra Hauber – UBS: Sorry, David. But the point was what we’re hearing, I don’t know, that is just of course talking to a few doctors, is that because of copayment issues that patients have actually – now that [indiscernible] which was the – which the patient would use before that Afinitor available, that is now generically available and there’s no copay or very low copay compared to Afinitor. That is basically copay considerations which is now on the margins. There’ll be more patients away from Afinitor going straight to the chemotherapy, whether that is also [indiscernible] in your down rate and therefore, just thinking ahead of Tasigna, there may be similar copay consideration at some point in time.

David Epstein

Management

So it is true that some doctors do skip Afinitor and go to chemo. This is the third, fourth line use that I was describing to you. It’s not our sense that copay use are a key driver of that. It’s more the side effects. Alexandra Hauber – UBS: Okay.

Joseph Jimenez

Operator

And on the consumer JV question, Alexandra, was your question around the structure of the JV or was is – I didn’t catch the last part whether you are asking who’s going to pay, whether it was a consumer pay business? Alexandra Hauber – UBS: Yes, there will be some restructuring in this business and there will be restructuring charges associated to that. So I was just wondering, who pays for that? And a more general question, how do you access the cash coming from that business?

Joseph Jimenez

Operator

Harry.

Harry Kirsch

CFO

Yes, as you know, Alexandra, rebuilding [ph] have 36% of the JV. It will be, our income will be reported as income from associated companies. Now the restructuring charges as well as the [indiscernible] benefits will be managed by the JV. We get our cash out in form of dividends. And the minimum of the dividend is 65% of net income.

Joseph Jimenez

Operator

Next question please.

Operator

Operator

The next question comes from Richard Vosser from JP Morgan. Richard Vosser – JP Morgan: Hi, thanks for taking my question [indiscernible]. But [indiscernible] I wonder if you could talk about the statistical [indiscernible] with the trial and whether those [indiscernible] ensured that you met the FDA requirements before approval on a single arm trial. And just on your comments on CV risk reduction, whether you can confirm that that is a statistically significant benefit. Then secondly, just on the portfolio transaction or transformation, it clearly improves the margin of the group quite dramatically. But could you talk about the margin improvement that you’ve been highlighting previously whether this is limited to that effects on the portfolio transformation group or whether we can expect from a margin on an underlying basis outside of the oncology assets I suppose whether they should be improving as well and how we should think of that through [indiscernible] as well. And then finally, just a question on LBH which you highlighted today, just some feedback within guessing that with the drug being on top of Velcade that some doctors are preferring [indiscernible] to single agents [indiscernible] in myeloma. Just your thoughts on the context of that around that product [indiscernible].

Joseph Jimenez

Operator

Okay, I’ll start with the portfolio question because I think you have to repeat the first two for David. But the margin improvement that we modeled in 2013 if you would have taken those results demonstrated that because we are acquiring higher margin businesses and we are divesting the lower margin businesses at least in those years, vaccines and animal health, there was a ratcheting of the core RAS [ph] of about 250 basis points versus where we would have been. But we had said previously that our belief is that we can improve our margins over time. So this would be essentially resetting the margins at a higher level and then growing our margin off of that. Now obviously, it will take some time even with the acquisition of GSK oncology to take it from what is today 25% up to where we think we can go which is substantially above that. So that will also contribute over time. But you should think about this transaction as incremental to what we had said before in terms of our desire to take the margins up on this company. This was not the way to do this. This was on top of what we have previously said. So David?

David Epstein

Management

So the only part we heard was you were asking about the LC [ph] that’s stopping the rules, is that correct? Richard Vosser – JP Morgan: Yes. So stopping rules of whether the – what the stopping rules were and whether the statistical power of those stopping rules I suppose ensure that you meet the FDA’s statistical requirements for approval on a single arm trial. And then the second part of it was whether that statistically you mentioned the CV risk reduction, whether that was statistically significant or not.

David Epstein

Management

Tim Wright is in the room, our Head of Development. I’m going to ask him to answer the questions to the extent he can.

Timothy Wright

Analyst

So Richard, the answer to your question is that the stopping criteria were set such that the level of significance would enable us to file with a single study. And that’s very important because otherwise, it would not have stopped. And it would have stopped early that is. And as far as the CV mortality, that was one of the key criteria. There were two that allowed the study and what it required the study to be able to be stopped. One was meeting the primary end point with a high degree of significance enabling a single file. And the second was a significance in the CV mortality. Richard Vosser – JP Morgan: And LBH, David, the question of [indiscernible] to a single agent about Velcade?

David Epstein

Management

Can you repeat that question? I didn’t quite understand it. Richard Vosser – JP Morgan: It was just that some doctors we’ve been speaking to actually said that they want to use single agent therapy when they’re treating refractory myeloma and the efficacy of the single agent as such, but they don’t want to use Velcade in refractory and obviously LBH is on top of Velcade. So just how you’re thinking about that within the competitive environment.

David Epstein

Management

Yes, so clearly, LBH is not a first line drug for these patients. So there’s about 75,000 multiple myeloma patients around the world that have relapsed or refractory multiple myeloma. So they would have an opportunity to go through this combination at some point during their treatment. Just to give you some rough idea, the brand should probably give you something north of $500 million in sales. Richard Vosser – JP Morgan: Thanks very much.

Joseph Jimenez

Operator

Next question please.

Operator

Operator

The next question comes from Matthew Weston from Credit Suisse. Matthew Weston – Credit Suisse: Good afternoon. Thank you for taking my questions. Three product-related and one pipeline please. Gilenya, the benefit reverification process, can you just please explain what that actually involves? Are we basically thinking that you gave Gilenya away free while people have to get reautorization? And I guess, my only question is why have we never seen that before for any specialty drug that I can think of. What’s different with Gilenya? Secondly, somatostatin, the revenue progression look week in Q1, are you seeking competitive pressure following the positive data in neuroendocrine tumors at the end of last year or is it just a seasonal stocking issue? And then finally on Afinitor, clearly a disappointing to peek where we’ve already had a lot of discussion. I’m just mindful on the GSK transformation call, David specifically said that you were able to deliver on the promise of flat oncology revenue through the Gleevec patent expiry. And so I guess my question is you’ve got Afinitor by $0.5 billion, where is that additional $0.5 billion coming from to meet that expectation. And then finally on pipeline. We never seem to have any discussion on PKC412 in [indiscernible] AML. I think we’re expecting phase III data later this year. Am I right in that expectation and whether we’re likely to see the data?

Joseph Jimenez

Operator

David.

David Epstein

Management

Okay. So let me – I’ll explain a little bit about reverification. Reverification actually is not unusual for a high priced chronic brand. It’s an internal process through which patients are required to confirm their benefits prior to being provided the drug. What has happened here is that it has taken longer than it normally does. And you are correct, what that meant was we had to provide some predrug to patients during that period. If you recall that if you discontinue your Gilenya, then you have to go through the first dose observation period again, something that was not good for us or good for the patients. So you are right about that. But I want you to feel reassured that the brand is doing well in March and in fact even the early April data. We’re seeing very good sales data. The next question was about somatostatin in Q1. It was up about 6% worldwide versus Q1 prior year. Senostag [ph] is an interesting product, all right. And I wish I could you an exact answer. But it often bounces around, and we’ve never been able to fully understand why you see some of those deviations. So I would not read anything special into that. In terms of oncology growth through the Gleevec patent exploration, what we said is assuming Gleevec does go generic in mid ‘15 or which when the US patent is planned to expire, which is our base case. Then we would expect for the oncology business, essentially not to shrink during that period. Of course, if for some reason, generics don’t come in that period, for example, if generics were to come in 2016, you’d have a very different story because 2015 would then be bigger and we’ll get the full impact in 2016.…

David Epstein

Management

So our confidence is the same. As you know there are multiple other patents to go beyond the base case patent. The reason for addressing it is because I’ve been getting the questions of, can you reassure us that you can grow? And I just don’t want people to make the mistake that if it turns out to be a different date that we can hold on to that. So if the date gets pushed out and then if it starts becoming more complicated, actually it would be much more difficult to show the growth. So I want people to understand that a lot is pinging [ph] on this date.

Joseph Jimenez

Operator

Next question please.

Operator

Operator

The next question comes from the Tim Anderson from Sanford Bernstein. Tim Anderson –Sanford Bernstein: Hi, thank you. A couple of questions. Now that you find a multipart deal of Glaxo and it seems you’ll do a business partner with them going forward in a couple of areas, yet in another area of your company specifically with your generic Advair program, you’re trying to take out their lead product at least in the markets where you might argue for substitutability like the US. And I can imagine that this battle between the companies could be ugly. So my question, should we assume that your generic Advair program now somehow gets deprioritized given this new relationship with Glaxo? And then second question is, on your Glaxo oncology products, there’s been a fair amount of criticism about what you paid and what’s in that portfolio, and there’s no leading anchor products. When you look at analyst models for the different products that you’re across to Novartis, which products do you think analysts are underestimating the most?

Joseph Jimenez

Operator

Okay, Tim, starting with the deal that we did with GSK, while we do have the joint venture that is – while we do have the joint venture that’s an OTC combination with GSK, we are looking forward to growing that business. But that is going to be a separate legal entity. They control, we are minority partners. The rest of this combinations is really kind of a surgical strike where we take their oncology business. We do have right of first negotiation on their pipeline. But that’s not really a collaboration. We’ll get an early look at their earlier pipeline. And then they take vaccines and own it 100%. So you should assume that we would be prioritize anything that we’ve confirmed that we’re working on. So any respiratory drug would fall into that. We never really have confirmed that we’re on a generic Advair for the US. But I don’ t think that you should assume that because we have done this surgical deal with GSK that that would deprioritize anything in our pipeline that would generate value for Novartis shareholders. In terms of the onco products, David, do you want to discuss that?

David Epstein

Management

Yes, you asked me a bit about analyst estimates and to use your words back of the anchor, when I look at the analyst estimates, they went out [indiscernible] about 2018. And as I showed you on the slide in my deck, there are multiple ongoing clinical trials for the top three assets – Votrient, Tafinlor and Mekinist. Now a lot of them don’t report out until towards the end of that period. So what happens is that there’s quite a lot of growth after 2018. When you start getting to peak sale of number is that are very, very exciting in my opinion. Three of these drugs, if COMBi-D is positive, three of them become blockbuster assets plus of course, revenue contributions from the other as well. And then you might ask why the products are the fab [ph] they are today, A, some of them have just launched; B, a company like GSK frankly just does not have access to physicians in a way that a company like we do, to get your products prescribed. So you’re getting the immediate synergy once we have the products in our hands that we can grow them much faster than the other. So you have to be willing to look out to 2020, do a sales forecast and then a look at multiple what we pay to that sales number. And also remember that as the products get bigger and as we leverage our infrastructure, the margins will go up substantially as well. And all of a sudden, rather than looking expensive, the deal actually from an oncology perspective looks reasonable if not quit cheap.

Joseph Jimenez

Operator

So I think the only thing I’ll to that is, yes, if you take the current consensus numbers and you continue to project particularly on Mekinist and Tafinlar assuming positive overall survival. And on top of that, you take their margin of 25% more to a reasonable ongoing oncology operating income margin. And then on top of that, you put the tax benefit on it, you quickly get to a very, very nice deal for Novartis. Next question.

Operator

Operator

The next question comes from Graham Parry from Bank of America. Graham Parry – Bank of America: Hi, thanks for taking my questions. Just firstly on a couple of the one offs in the quarter and on the venture fund gain in corporate expenses, can you confirm that that is a one off and quantify exactly how much that was. The $64 million accounting gain in associates, again, can you just quantify how much of that is balance, reevaluation of assets held in the venture funds that wouldn’t be repairing versus a removal of say, share of a loss in a biotech company which would be repairing. And then secondly on deals. Could you try to quantify for us what level of synergy you see from the oncology acquisition? So you talked about taking the business up to a reasonable oncology business margin probably as you give yourself away you see that [indiscernible] and specifically if you’ve identified any actual amount of synergy there. And then a couple of product questions. Exelon Patch generics, I think [indiscernible] has expired. Can you just give us an update on your expectations if and when if ever we would see a generic? And secondly, on Gilenya, with the longer reverification process, why was that longer? I think he going to qualify that. And can you actually recoup any of the payments for the free drug that you are giving away once the patients reverification prices has occurred. Thanks.

Joseph Jimenez

Operator

Okay, starting with Harry on the one offs.

Harry Kirsch

CFO

Thanks, Graham. As I said in my speech earlier and also as we have laid out on page 3 of the additional financial data, now we have made a change in the Novartis venture fund accounting. We had prior the two different accounting principles for participations below and above 20%. We have harmonized this. We have put it to an calming standard that is used in the industry for venture funds. And we have changed from an equity accounting basically to a fair accounting. Now there is has two effects. And one is that there is a onetime reevaluation. As you mentioned, it is [indiscernible] approximately the 64 million. This is reevaluation. Now in the prior quarters, the equity accounting related to pick up of losses was also reported on core. So we did this catch up also in core and transparent related out. So it was one effect and as you say, it’s a onetime effect. Now there was then an IPO of one of the venture funds participations for background. We have basically the biggest corporate venture fund about $800 million under management. This pick up was roughly $40 million in quarter one and then [indiscernible] in corporate cost. Now the corporate cost line as you can imagine and you know is quite volatile, it is average let’s say $170 million of cost per quarter. Now this quarter, it was around $100 million in core, so in other quarters, last year was sometimes 200, sometimes 140, 150. So it was a bit around – but that was a onetime effect of that venture fund IPO related of $40 million. And w have [indiscernible] accounting policies, in several years we say that ups and downs intervention fund because of their core business, we also report on the core. There may also be then limited downs, and we will always transparently disclose that as part of our reporting.

Joseph Jimenez

Operator

And Graham, on top of the – around the oncology synergy, I’ll jump in and then David can go on to other questions also. The way to think about the way we model this is this is a revenue play for us on the three important molecules that are in that basket. But I think what you could do is there will be a combination of cost synergies and revenue synergies described as under our ownership versus let’s say a standalone GSK model. But I think the safest thing to do is just to model out from 25% operating income margin two, an average oncology operating income margin by peak sales, some combination of cost and revenue. David.

David Epstein

Management

Yeah, I think that’s a good way to look at it. And then the other questions, one was around Exelon Patch, when will there be generics? There are actually generics in Europe now. We are in litigation in the US. I’m not going to comment exactly on how that’s likely to play out in the US market. And as soon as we know something, we will let you know. And then you asked me for a little bit more color on, did we have to give away free drug for joining a reverification and how much was that, I don’t have any exact number, but it probably in the order magnitude of high single digit millions. Graham Parry – Bank of America: And just to be clear, you can’t recoup that once a reverification process has happened. [Indiscernible] basically.

David Epstein

Management

No, no, that’s all up to us. Graham Parry – Bank of America: Yes, okay.

David Epstein

Management

But the patients are not, which is the most important thing because they will stay on long-term chronic benefit.

Joseph Jimenez

Operator

Next question.

Operator

Operator

The next question will come from Florent Cespedes from Exane BNP Paribas. Florent Cespedes – Exane BNP Paribas: Good afternoon, gentlemen, thank you for taking my question. First, a question on outcome. Could you give us more color on the trends on the different subdivisions, that would be the cataract surgery ophthalmic products generic environment. And also, when should we start to see some favorable product mixed impact from the new product launches? Second question on emerging pharma deferment, could you elaborate on the trends on the different regions, please? And the last question, a product question on LCZ. Could you tell us a bit more on the other ongoing with LCZ, the PARAGON trial on the preserve to take some fraction population? And are you planning to accelerate the recruitment of this trial given the Ion Med [ph] medical need? And when should we see the first results of this trial? Thank you.

Joseph Jimenez

Operator

Kevin?

Kevin Buehler

Analyst

So in terms of Alcon and the segment growth, I think we were pleased with what we saw in the surgical growth being 9%. We saw a very traditional pharmaceutical growth rate and we saw a little bit stronger growth in vision care. Notably the contact lens segment was up, but it was also positively impacted from a onetime event in terms of the purchasing pattern on a VAT situation in Japan. But as you know, we’ve been talking about our launch cycles of products. And for the most part, we’re very pleased with the CENTURION launch. We continue to grow install base. Now you have to keep in mind that our first priority is against replacing Infinity and obviously we start with our loyal accounts, but we also then start to expand and with the expansion we’re able to look at pulling through additional products. Also, the lensac [ph] launch continues to go quite well both in terms of install based growth where we are getting a disproportionate amount of the units in [indiscernible] second units purchased. But better still is the disposable pull through which is the confirmation of usage. But we are in a ramp mode where the sales are not as significant in the quarter, but really the opportunity as you look out longer term even beyond ‘14 is looking at the two pharmaceutical opportunities with Jetrea and then our combination product with Simbrinza and then a complete line of product launches across daily total one; DACP, structural fee product for torque and multifocal and then AIR OPTIX colors. But those products are more in a launch mode and will take time to develop.

Joseph Jimenez

Operator

And David, on the regions?

David Epstein

Management

Geography. So the US was down 4%. Europe was up 1. Japan was up 2. Asia excluding Japan is up 6. And then Latin America and Canada together were up double digit 10%. That’s where you get the net 1% overall from that breakdown. In terms of LCZ, the PARAGON trial or the preserved objection fraction trial. We’re very excited about starting that trial. And it will start in the second half of this year. And maybe we’ll talk more about it at the next investor day. Florent Cespedes – Exane BNP Paribas: Thank you very much.

Joseph Jimenez

Operator

Next question.

Operator

Operator

The next question will come from Jeff Holford from Jefferies. Jeff Holford – Jefferies: Thanks very much. So as you continue to review your overall pharma businesses, are there any smaller franchises within that that you see as non-core? Secondly, now you’ve completed or begun the journey of completing a big portion of restructuring on the company, can you continue to think about Alcon as a very long-term partners business? Or do you think there’s further room for shareholder value in looking at restructuring options for that business down the line? Thirdly, around Gleevec, if we do lose exclusivity next year and we see generics come into the market, do you hear some noise about potential step therapy on Tasigna? That’s the expectation and follow up positions in the US. Have you had sort of many thoughts about that? And then just lastly, if you can just comment broadly about thoughts on the Sandoz division of our Copaxone and whether there’s opportunities for potentially launching at risk. Was that something the business doesn’t really normally consider. Thank you.

Joseph Jimenez

Operator

Okay, Jeff, I’ll take the first two. In terms of the overall pharma business, and David can jump in, but when we did our portfolio review, we looked at the businesses, not division by division, but really by business unit by business unit. And that led to the action that we announced. So we don’t really see other elements of our businesses being right for divestiture, with the exception of some tailed brands, some mature products, you might see us divest. But not the would be material. In terms of Alcon, we absolutely see it as a long-term play for the company. If you think about the way that we’ve shaped this portfolio with innovative pharma, eye care and then generics, and you think about industry dynamics going forward, this is a place where eye care with the ageing population – I’ve said this before that there’s going to be a million more people on the planet and half of them are going to be over the age of 50. So Alcon is going to have significant ability to growth in the next 10 years. And then you put an innovative pharma business next to that. And a generics business, it allows us to help systems around the world lower their total cost . This is going to be a company that is focused and that is unstoppable. And that’s really what the whole portfolio review was all about. David, on Gleevec?

David Epstein

Management

So your question is once there’s a generic for Gleevec, will there be step therapy? And it’s quite possible there will be to where patients will be put on Gleevec first and then move over Tasigna either due to – well, not efficacy or complete molecular response or due to side effects from Gleevec. We have to remember that the majority of CML patients are in long-term chronic therapy and the number of new patients coming at the market is probably they know around 5% of the total. So the real question is, what happens to the installed base of long-term Gleevec users, not whether the step therapy at the beginning or not. And with that in mind, we’re running two treatment pre remission trials. And the idea is to show the patients when they are on Tasigna can actually at some point discontinue their treatment overall, which makes Tasigna a much better option for patients and maybe even healthcare systems because you won’t have to treat them for life. So a reasonable question, but probably not that relevant for how our revenue will play out over the next couple of years.

Joseph Jimenez

Operator

And Jeff on Copaxone?

Jeff George

Analyst · Bryan Garnier

Yes, so Jeff, while we really don’t comment on our launch strategies in advance, what I can say is that we are definitely pleased that the Chief Justice of the US Supreme Court last week denied the application for a state to prevent the launch of generic Copaxone. We continue to believe that the US Federal Circuit Court of Appeals correctly invalidated the patents as sort of by telling including the [indiscernible] patent which is the one expiring in September 2015. And together with Momenta, we are continuing to work closely with FDA toward the approval of our generic version of Copaxone when the remaining [indiscernible] patents expire in May 24th. And what I can say to your last comment is we do take at risk ones decisions on our first files when they are value creating for shareholders.

Joseph Jimenez

Operator

Thank you. Next question please.

Operator

Operator

The next question will come from Seamus Fernandez from Leerink. Seamus Fernandez – Leerink Swann: Well thanks very much for the questions. Just wondering on LCZ if you can give us a little bit of color on the background use of MRAs, I didn’t see much in the way of baseline evidence in that study. What we’ve heard is is that there is an expectation that you would have at least 30% of the patients also on background MRA therapy both in the control arm and in the active arm. So I was just hoping that you could provide us a little bit of color in that regard. And then separately, as we think about the launches of respiratory generics in Europe, Jeff, could you give us a little bit of color on your expectations for how we should anticipate that rollout with regard to the health of pricings in Europe and just sort of the pace of uptake? Thanks so much.

David Epstein

Management

So, Seamus, it’s David. I thought I knew most of the acronyms in our industry but you’ve just stumped [ph] me on what an MRA, can you tell me what it is? Seamus Fernandez – Leerink Swann: Yes, they’re the mineralocorticoids, so like spironolactone and eplerenone which are part of the guidelines and counterpart of the recommended HFrEF background therapy.

Joseph Jimenez

Operator

David, you want to comment?

David Epstein

Management

Yes. We can’t give you the percentage right now but we can tell you that this is probably one of the most intensively treated population ever studied in heart failure. And that includes both beta blockers and MRAs. Seamus Fernandez – Leerink Swann: Fantastic. Thank you.

Joseph Jimenez

Operator

Jeff, on respiratory.

Jeff George

Analyst · Bryan Garnier

Yes, so Seamus, given that generics in respiratory in Europe are not interchangeable like we see on many drugs or all drugs under the 505(j) pathway or the ANDA pathway in the US, we see more measured uptakes and we’ve always had more measured expectations. Having said that, we’ve been pleased with the uptake that we’ve seen out of the gates. Clearly, the District Court of Cologne which upheld a PI on the lilac or the purple color of our AirFluSal Forspiro device has impeded our marketing in Germany. Having said that, we received – after the approval in Denmark in Q4, we received seven additional approvals in Europe or six in Europe in Q1 and one – or first in Asia and Korea. And we continue to market these products in Denmark and other European countries. And so we’ll continue to contest vigorously the actions that GSK has taken to restrict patients and payer access to this product. And we have good confidence in our prospects for litigation going forward.

Joseph Jimenez

Operator

Okay, next question please.

Operator

Operator

Now we’ll take the next question from Eric Le Berrigaud from Bryan Garnier. Please go ahead. Eric Le Berrigaud – Bryan Garnier: Yes, good afternoon. Three questions please. First, you presented in detail the NVS initiative. For us, obviously, the idea would be to try to quantify the financial benefits that we can expect from it. Could you help us try to make some numbers on that and perhaps on timings as well? Second question, in terms of R&D as a percentage of sales, is there any timing here also to expect R&D to level off and stabilize globally in pharma? And lastly, surgical again at Alcon, when can we expect kind of a different mix and balance that could favor machines versus disposable and in fact again favorably the margin, is it a matter of quarters during this year or longer term effect? Thank you.

Jeff George

Analyst · Bryan Garnier

Okay, I’ll start. The way to think about NVS is as we make this effective on July 1, there’ll be a lot of people who change reporting lines. There won’t be a lot of immediate change. But as Andre Wyss gets in and starts planning how we can improve the efficiency of the operation country by country, then I think you’ll see an effect. And the way to think about this is we’ve committed to 3% to 4% productivity savings going forward. This obviously is part of that and this should allow us to either meet or exceed that I think going forward. The way that I think about the company right now is we’ve got about $60 billion worth of sales, yet I believe that as we grow over the next five years, we should not be adding a heck of a lot of overhead on top of that. So the efficiency that we’re going to get is going to allow us also margin improvement. And we’ve committed to margin improvement as we go forward and it’s going to come from a lot of different places. Productivity is one. NVS will help us to grow and leverage off of an existing cost base plus or minus. And when you go back and you think about the GSK action that we took and what that does for our margin and then on top of that the efficiency that David is getting in the pharmaceutical division, you put all of this together and I think we’ve got a very, very good plan to overall improve margin in the company. Regarding R&D as a percent of sales, David, do you want to comment?

David Epstein

Management

Yes. It was roughly 22.3% in Q1 which was up 0.1% in constant currency. You’ll recall that we had taken a pretty detailed look at our development portfolio and we’ve identified a number of compounds that we believe are good assets that can be partnered [indiscernible] to make that happen now. What happened early this year, it’s pretty interesting with the very good results that we’re seeing on a number of our compounds is actually driving slightly increased cost. So we haven’t seen the savings come through yet but we do anticipate over the medium term that R&D cost will start to take down as a percentage of the sales line.

Joseph Jimenez

Operator

And Kevin on Alcon surgical.

Kevin Buehler

Analyst

I think for clarification, you have to be thinking about a longer term window than individual quarters when you’re replacing an installed base. I mean there’s somewhere in excess of 12,000 installed base units. So when we’re selling a new Phaco unit, obviously it takes multiple years to roll out the pipeline. Now as you start to put the new equipment in and the equipment is being used, there’s a disposable price benefit that you realize as you start to use that machine across the procedures. I think it’s also interesting to note that you’re not selling just one Phaco unit, it’s at the same time, we’re putting LenSx in which is a standard of care change in terms of how to do the procedure. Again, that takes a longer time period. But ultimately, the strategy is that the installed base drives benefit through disposables and intraocular lenses with time. So you should see that benefit over time. But it’s not on a quarterly basis.

Joseph Jimenez

Operator

Okay, next question.

Operator

Operator

We’ll now take the next question from Tim Race from Deutsche Bank. Tim Race – Deutsche Bank: Thank you for taking my questions. First of all on LCZ, you mentioned on the call, David, it potentially could be a mega blockbuster. In November, you gave a range for the heart failure franchise of $2 billion to $5 billion or post $5 billion [ph], now that you’ve got the data in hand and you know pretty much what’s going to happen with serelaxin over the next year or so, could you just tighten that range for us and tell us whether it’s at the lower end or the higher end? Given your comments, I’m expecting higher end or even beyond $5 billion. Then just on LCZ further, you talk about the power of the study and obviously it’s overpowered to get a strong result for filing on one clinical study. Could you just confirm that the clinical benefit we’re seeing is going to be sort of above that 15% to 20% range that most companies aim for given that it’s been difficult for some of the companies even with relatively good data to gain traction in that sort of range? So should we be seeing a clinically meaningful result above that? And then just lastly on Glivec, I’m not sure if you will comment. But assuming yourself have a soon [ph] and definite delay to [indiscernible] last time I looked, is there any update to that and does that actually mean that your negotiations are to be potentially delayed? Thank you.

Joseph Jimenez

Operator

Okay. LCZ, David.

David Epstein

Management

Okay, yes, so we showed a range of $2 billion to $5 billion plus I believe for the heart failure franchise. And of course, when we show you things like that, we probabilize because we didn’t know the outcome of either the serelaxin discussion or the LCZ discussions. Now, of course, we are much more bullish in LCZ and we know with serelaxin at least in the US, there are delays. It would be hard for me to imagine given what we know now with LCZ that we could not verily easily achieve somewhere between that $2 billion to $5 billion plus and more likely the upper end and the lower end. Regarding the powering and what – and how the trial goes on, I can’t comment until we see all the data exactly and all the percentages that you like to see. You’re going to unfortunately have to wait the ESC. All I can tell you, yes, it’s clinically meaningful, otherwise the stopping role [ph] would not have been designed in the way they were. And regarding Glivec and patents and the like, I don’t really want to say anything else. Tim Race – Deutsche Bank: Thank you.

Joseph Jimenez

Operator

Next question, please.

Operator

Operator

We’ll now take the next question from Keyur Parekh from Goldman Sachs. Please go ahead. Keyur Parekh – Goldman Sachs: Good afternoon and thank you for taking my questions. I have two if I may. First on a product related stuff, as you look at the epitopesy [ph] required from Glaxo, you clearly have a CD20 in there with Arzerra. And as you think about the plans for your biosimilar reduction [ph] map, can you help us think about how you will potentially be promoting a second to market anti-CD20 and yet be competing in the biosimilar space for the first anti-CD20? Secondly, Joe, if you can just give us a sense of what kind of the actual kind of bidding process was for the various parts of the asset, were you kind of looking at kind of running a separate sale process for each individual asset or were you much more interested in doing a bigger deal like the one you did execute on Glaxo? Thank you.

Joseph Jimenez

Operator

Okay, David, why don’t you just start on the RJ [ph] or the CD20?

David Epstein

Management

Yes. So, yes, I wouldn’t confuse the two, Rituxan and Arzerra are slightly different drugs, so they’re not going to be competing directly with each other both in terms of epitopesy bind and as well as indications and the like. So I would think about them completely separately.

Joseph Jimenez

Operator

Okay. And in terms of the deal, obviously, when we started this portfolio review, we cast a very wide net. So we essentially talked to everybody and we looked at what we wanted, what we needed to get done surgically and ended with GSK. But even with GSK, each of these three deals, while they’re interdependent, it was very important for me and for our Board of Directors that each deal independently of those three within GSK be good deals for the company. And that is really the criteria that we use relative to what else we could do. So literally, the four deals that we announced Tuesday, we did not sacrifice on any of them relative to what we could have done with some other partner. And I feel very, very confident to be able to say that because we basically talk to everybody. Okay. I think we have time for one last question.

Operator

Operator

We’ll take our final question from Tim Anderson from Sanford Bernstein. Please go ahead. He’s just removed himself from the queue. There’s no further questions in the queue.

Joseph Jimenez

Operator

Okay. I’d like to thank everybody for joining us today. We look forward to keeping you updated. Thanks a lot.