David Epstein
Analyst · UBS. Please go ahead
Thank you, Harry. So the Pharma division had a good quarter with 7% increase in sales growth in constant currency and 18% increase in core operating income in constant currencies, resulting in a core operating income margin of 31.8%. Turning to next page, what you see is that through a big focus on productivity we’ve been able to grow core margin almost every quarter and in fact six of the last seven quarters, benefitting from the establishment of NBS, manufacturing efficiencies, focusing on R&D operational excellence and as well most recently, benefitting from the restructurings we did in the Pharma division last year. Last but not least, a big contribution has been our ability to better allocate resources to the greatest growth opportunities in our business. Turning to the next page, you can see that those growth opportunities are in fact responding with 34% growth of our growth products, representing now 46% of total division sales as of Q3 this year. On the next page you see our attractive growth platform. I want to point out a few things on this chart to you. First of all, Cosentyx and Entresto made their first significant contributions to the quarter with $88 million and $16 million in sales respectively. Several of the products, in particular Gilenya, Tasigna, Galvus our COPD portfolio and Jakavi had strong double-digit growth. And I would say the only real disappointment on this slide is Lucentis which continues to face pressures from the use of Avastin, and via market share gains as well as price pressure in the VEGF segment. That overall segment is growing but nonetheless we are not able to put up sales growth during this quarter. On page 30, we take a look at our oncology business which is now representing 46% of total Pharma sales. You see, as Joe mentioned that oncology franchise grew 27% from the same period last year. And even extracting the newly acquired GSK products, you see the underlying business is growing strongly at 8%. The integration continues to proceed on plan. Looking forward for oncology business on the next slide, I wanted to help with the questions we often get about what will happen to Tasigna after Gleevec loses exclusivity. As you recall, we expect first generics for Gleevec in February of next year in the U.S. and in Europe, towards the end of the year. However in a number of markets Gleevec has already lost its exclusivity. And what we try to show on the chart is what happens to Tasigna in those countries. And you see that in most cases, Tasigna continues to grow. In some cases, Tasigna grows even more strongly. And there are however at least one example where Tasigna growth slowed down a bit. So, we would anticipate looking forward that Tasigna will continue to grow despite the loss of Gleevec’s exclusivity next year. Taking a look at the next page, you see that we’re doing well with our skin cancer drug approvals, Tafinlar and Mekinist as well as Odomzo. Taf and Mek together now have a run rate that’s in excess of $500 million focused on BRAF segment of metastatic melanoma. Odomzo will be a new yet small opportunity in the treatment of basal cell carcinoma. Now turning to Entresto on the following slide, you see we’ve made really excellent regulatory progress. We gained approval in the U.S. in July; in Switzerland in September; Canada in October; and the EU issued a positive opinion, actually the CHMP issued a positive opinion on September the 25th, which brings some of these launches forward from our original plan. While we achieved modest sales during the quarter, we are getting positive qualitative feedback, both from physicians and from patients that have used the drug. Our biggest challenge remains the block that we face in terms of Medicare Part D formularies. As you recall, 65% of the patients are Medicare patients. And until October 1st of this year, no formulary results into patients. That first formulary approval was achieved and we would expect to see more such decisions to come early next year; some may come a bit earlier and some perhaps a bit later. But we think much of the formulary blockage will start to lift as the six-month mandatory Medicare period comes to an end. Turning now to Cosentyx on the next slide, you see that we are doing very well in psoriasis with $88 million in sales in the quarter and $140 million sales year-to-date. In the U.S., we have over 12,000 SRFs that are processed or being processed. And this represents roughly a 6% biologic share which is really a great start for a new product launch. In addition, during the quarter, we also show new long-term data which shows that Cosentyx demonstrates sustained efficacy and safety over a three-year period. As you know, many of the TFCs are efficacy wane over time. We think this is good news for patients, and patients are likely to stay on this drug longer. In addition, we received, in the EU, a positive opinion for ankylosing spondylitis and psoriatic arthritis in October which should mean a full approval towards the end of this year and another big growth opportunity for the brand. On the next slide, I want to give you a little bit of insight to how the product is being used around the world, because as you know, while we launched early this year in the U.S., our launches in Europe really started mid-year. In the U.S., we see about 20% of the patient starts are for what we would call biologically naïve patients. These are patients that have not been on a biologic therapy prior to Cosentyx; and that’s roughly in the U.S. roughly 20% of the patients. Strikingly when you look at Switzerland or you look at Germany, you see it’s more like 40% to 50% of the patients have not been on the biologic before. And you might ask why that’s the case. And I think it comes down to a few things. First of all, physicians are recognizing that Cosentyx is a better product, given the data and given the possibility of having 90% to 100% clear skin. However, in the U.S. the cost of the blocks of formularies put in place, patients often have to pass through another biologic therapy before getting on medication. The good news from all this could mean, and we’ll have to wait for a few more quarters to be sure, but it could mean that the market actually for biologics and Cosentyx in particular -- particularly outside the U.S. may expand, and we may find actually that our ex-U.S. sales come in bigger and better than we had originally hoped for. On the following page, I just want to give you a little bit insight how our strategy translates into action. You’ll recall that about a year and a half ago, we decided to focus more heavily on seven therapeutic franchises, and you see them across the top of the chart. And we wanted to go deeper because we thought that once the company had developed experience whether it’d be in drug development or in commercialization and the category with a particular physician type, there was value in having other products in that basket. Essentially, we developed the drugs more efficiently and sell them more efficiently which would position us to be able to commercialize at a higher profit margin. In addition, we believe in the future increasingly, payers will pay for outcomes and we will need to send patients home with devices which will help with monitoring and such. And to the extent you have multiple products in a therapeutic category that becomes an easier investment to swallow. When we did our analysis however, we realized that despite our success with Gilenya which is well on its way to becoming a $3 billion brand, we didn’t have enough coming in the future. So we acted. We did an acquisition of Spinifex, which gives us a product with good Phase 2 data in neuropathic pain. We acquired or we reached an agreement to acquire the remaining ofatumumab rights from GSK for autoimmune diseases which will allow us to start a Phase 3 pivotal trial and relapse remitting MS, early next year and possibly also PCMS. And we did a partnership with Amgen which allowed us to de-risk our Alzheimer’s investment and also gain access to their, what looks like very good migraine drug ex-U.S. and ex-Japan where we can now put our commercial expertise to good use for their product, thus providing us one of the better I believe neuroscience franchises in the industry. On the following slide, you see our typical checklist of achieved and expected highlights in terms of our newsflow, which has been a very solid this year, the only meaningful disappointment being BKM120 where we hit a primary endpoint but the clinical meaningfulness of that endpoint in terms of numbers of months additional progression-free survival is not where we would like it to be. Also while it doesn’t say on the chart, you noticed, in the first half, we talked about the regulatory filings in the U.S. and Europe for Cosentyx but of course we also were able to achieve the recommended approval this year which puts us almost five months ahead of our timeline. Now, I think it’s worth taking a moment here to give you a little bit of a forward look to see what’s coming because our investment in innovation I believe is really paying off. We have multiple key milestones expected over the next year or so. And you can see across products for AML, the PKC412, we will see the top line results in Q4. The exacerbation study called FLAME for Ultibro and Breezhaler also in that quarter. We have two data points for Promacta coming. The focus here is the Phase 2 ASPIRE trial which potentially could result in a new filing for MDS. The Phase 2 data hopefully, the filing afterwards for Tafinlar and Mekinist in BRAF mutated non-small cell lung cancer; the first pivotal data for BYM, the first pivotal data for BAF312 in secondary progressive MS; Phase 3 trial for Votrient in the adjuvant setting for renal cell carcinoma which would expand that market; two potential analyses dates for Serelaxin in acute heart failure and interim analysis that will occur in Q4; and then a final top line expected result in mid-2016. And last but not least, our oncology, our breast cancer drug LEE011 which will have interim early next year and a readout mid next year. So you can see the future from a development perspective is quite bright. And with that I’d like to turn it back over to Joe.