Albert Bourla
Analyst · Bank of America
Thank you very much for the question, Colin. Let me provide some insight to help you understand the situation moving forward. In the U.S., obviously we have done an excellent job with the catch-up opportunity. We have achieved 86% markets there, 92% at retailers. We have 90% awareness of the recommendation at healthcare practitioner. And as a result, over the 45 million adults eligible at the time of recommendation for vaccination, we have already captured about a third [ph] of them. Now while many adults remain, this cohort is more difficult to capture, as the low-hanging fruit is gone. It will require more innovative strategies that we all have in place, but even if we assume a similar or higher penetration rate this year, it will be on a much smaller pool of adults. However, we expect this will be mitigated by Europe, which has a very different growth profile. Even with prices lower than U.S., the demographics are very favorable, with much larger eligible population, and who have already received pneumonia in our label in 2015, and we are working to obtain broad recommendations, and following that reimbursement from the authorities. Now this will be phased likely over a two-years window period, because in Europe this is done country-by-country, and sometimes region-by-region within the same country. But all in all, we expect very strong growth in Europe next year. Now let me move on Ibrance, and your question about competition or particularly [indiscernible] drug. Look, [indiscernible] drug, while in the same class, is for any [ph] indication. The refractory patient population, what we have received breakthrough designation, is a very small population with few options available. In fact the average refractory patient undergoes seven lines of treatment. So it's -- they are in high-mid. Now speaking generally on competition, there is only limited clinical data on the public domain, and we need to see more efficacy and safety data to make comparisons. What I can tell you is about our strategic position. We are the only company with a registered product in U.S., and six other countries, and an accepted filing in Europe, where we may obtain registration as early as next year. We have very good clinical experience with the product. Ibrance has been prescribed by 5,000 physicians in more than 20,000 patients. And so far feedback is very positive, particularly on patients' quality of life. We are having a very heavy clinical program. We have two pivotal studies in first-line metastatic breast cancer, two studies in recurrent metastatic breast cancer, and three in early breast cancer, PENELOPE-B, PALLAS, and PEARL [ph]. Ibrance is part of 88 investigational initiated trials, approximately 50 in breast cancer and 38 in other tumor types. So as you can see, we are investing heavily to stay ahead of the competition.