艾伯維 (ABBV) 2023 Q4 法說會逐字稿

Good morning, and thank you for standing by. Welcome to the AbbVie Fourth Quarter 2023 Earnings Conference Call. (Operator Instructions) today's call is also being recorded. If you have any objections, you may disconnect at this time. I would now like to introduce Ms. Liz Shea, Senior Vice President, Investor Relations. Thank you. You may begin.

早安，感謝您的支持。歡迎參加艾伯維 2023 年第四季財報電話會議。 （接線員指示）今天的通話也正在錄音。如果您有任何異議，您可以此時斷開連接。現在我想介紹一下投資者關係資深副總裁Liz Shea女士。謝謝。你可以開始了。

Good morning, and thanks for joining us. Also on the call with me today are Rick Gonzalez, Chairman of the Board and Chief Executive Officer; Rob Michael, President and Chief Operating Officer; Jeff Stewart, Executive Vice President, Chief Commercial Officer; Scott Reents, Executive Vice President, Chief Financial Officer; Carrie Strom, Senior Vice President, AbbVie and President, Global Allergan Aesthetics; and Roopal Thakkar, Senior Vice President, Chief Medical Officer, Global Therapeutics. Joining us for the Q&A portion of the call is Tom Hudson, Senior Vice President, Chief Scientific Officer of Global Research.

早安，感謝您加入我們。今天與我通話的還有董事會主席兼執行長 Rick Gonzalez；羅布·邁克爾，總裁兼營運長； Jeff Stewart，執行副總裁暨商務長； Scott Reents，執行副總裁兼財務長； Carrie Strom，艾伯維資深副總裁兼全球艾爾建美學總裁；以及 Global Therapeutics 資深副總裁兼首席醫療官 Roopal Thakkar。全球研究部高級副總裁兼首席科學官 Tom Hudson 參加了電話會議的問答部分。

Before we get started, I'll note that some statements we make today may be considered forward-looking statements based on our current expectations. AbbVie cautions that these forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those indicated in our forward-looking statements. Additional information about these risks and uncertainties is included in our SEC filings. AbbVie undertakes no obligation to update these forward-looking statements, except as required by law.

在我們開始之前，我要指出的是，根據我們目前的預期，我們今天發表的一些聲明可能被視為前瞻性聲明。艾伯維警告說，這些前瞻性陳述存在風險和不確定性，可能導致實際結果與我們前瞻性陳述中所示的結果有重大差異。有關這些風險和不確定性的更多資訊包含在我們向 SEC 提交的文件中。艾伯維不承擔更新這些前瞻性聲明的義務，除非法律要求。

On today's conference call, non-GAAP financial measures will be used to help investors understand AbbVie's business performance. These non-GAAP financial measures are reconciled with comparable GAAP financial measures in our earnings release and regulatory filings from today, which can be found on our website. In addition to the news release issued this morning, we have also posted slides on our website at investors.abbvie.com that supplement some of the content we'll be covering this morning. Following our prepared remarks, we'll take your questions. So with that, I'll turn the call over to Rick.

在今天的電話會議上，將使用非公認會計準則財務指標來幫助投資者了解艾伯維的業務表現。這些非公認會計原則財務指標與我們今天發布的收益報告和監管文件中的可比較公認會計原則財務指標進行了協調一致，這些資料可以在我們的網站上找到。除了今天早上發布的新聞稿外，我們還在我們的網站 Investors.abbvie.com 上發布了幻燈片，補充了我們今天早上將要介紹的一些內容。在我們準備好的發言之後，我們將回答您的問題。因此，我會將電話轉給 Rick。

Thank you, Liz. Good morning, everyone, and thank you for joining us today. Our performance this quarter tops off another excellent year for AbbVie, with results well above our initial expectations. I'm particularly pleased with the performance of our growth platform, the base business, excluding Humira, which delivered full year sales growth of more than 8%. And with revenue growth accelerating to more than 15% in the fourth quarter.

謝謝你，莉茲。大家早安，感謝您今天加入我們。我們本季的表現為艾伯維（AbbVie）又一個出色的一年畫上了圓滿的句號，其結果遠高於我們最初的預期。我對我們的成長平台（不包括 Humira 的基礎業務）的業績感到特別滿意，該平台全年銷售額增長超過 8%。第四季營收成長加速至 15% 以上。

The strength of our diversified growth platform has not only enabled us to successfully absorb the largest loss of exclusivity event to date across our industry, but has also supported continued investment in our business for long-term growth. These investments include higher adjusted R&D expense, which was increased by nearly $600 million in 2023 and will be ranged substantially again in 2024 to support several promising pipeline programs, like 383 in multiple myeloma; 400, our next-generation ADC for several solid tumor types and [Moody] for HS as well as inflammatory bowel disease. The proposed acquisition of ImmunoGen and their portfolio of ADCs, accelerating our entry into the solid tumor space and strengthening our oncology pipeline. As well as the proposed acquisition of Cerevel, a unique opportunity to augment our presence in neuroscience with a pipeline of differentiated assets.

我們多元化成長平台的優勢不僅使我們能夠成功應對迄今為止整個行業最大的獨家經營權損失事件，而且還支持我們對業務的持續投資以實現長期成長。這些投資包括更高的調整後研發費用，該費用在2023 年增加了近6 億美元，並將在2024 年再次大幅調整，以支持幾個有前途的管道項目，例如多發性骨髓瘤的383 項； 400，我們的下一代 ADC，用於多種實體瘤類型，[Moody] 用於 HS 以及發炎性腸道疾病。擬議收購ImmunoGen 及其 ADC 產品組合，加速了我們進入實體腫瘤領域的步伐，並加強了我們的腫瘤學產品線。除了擬議收購 Cerevel 之外，這也是一個獨特的機會，可以透過一系列差異化資產來增強我們在神經科學領域的影響力。

We also increased our quarterly dividend, which we announced in October. Since our inception, we have grown our dividend by more than 285%.

我們還增加了 10 月宣布的季度股息。自成立以來，我們的股息成長了 285% 以上。

In summary, our operational execution has been outstanding, and we have considerable momentum heading into 2024, including an expected return to operational sales growth just 1 year following the U.S. Humira loss of exclusivity driven by our growth platform. We remain confident in our long-term outlook, including a return to robust growth in 2025 and with a high single-digit CAGR through the end of the decade. With that, I'll turn the call over to Rob for additional comments on our business performance. Rob?

總而言之，我們的營運執行力非常出色，在進入2024 年之前我們有相當大的動力，包括在我們的成長平台推動的美國修美樂(Humira) 失去獨家經營權僅一年後，我們預計將恢復營運銷售成長。我們對長期前景仍然充滿信心，包括在 2025 年恢復強勁成長，並在本十年末實現高個位數複合年增長率。這樣，我會將電話轉給 Rob，以獲取有關我們業務績效的更多評論。搶？

Thank you, Rick. Today, we reported another strong quarter and highly productive year for AbbVie. We delivered full year adjusted earnings per share of $11.11, which is $0.63 above our initial guidance midpoint, excluding the impact of IPR&D expense. Total net revenues were $54.3 billion, roughly $2.3 billion ahead of our initial guidance. Most importantly, each of our five key growth areas outperformed our initial expectations.

謝謝你，瑞克。今天，我們報告了艾伯維 (AbbVie) 又一個強勁的季度和高產的一年。我們的全年調整後每股收益為 11.11 美元，比我們最初指導中點高出 0.63 美元，不包括智慧財產權與研發費用的影響。總淨收入為 543 億美元，比我們最初的指引高出約 23 億美元。最重要的是，我們的五個關鍵成長領域都超出了我們最初的預期。

As it pertains to AbbVie's near-term outlook, we are focused on three key priorities: first, driving strong performance of our ex-Humira growth platform. This platform is the critical driver of our return to robust growth in 2025 and beyond. In our therapeutic portfolio, we have several key brands, including Skyrizi, Rinvoq, Vraylar, Ubrelvy and Qulipta, which are each expected to contribute double-digit sales growth in 2024.

由於涉及艾伯維的近期前景，我們將重點放在三個關鍵優先事項：首先，推動我們的前 Humira 成長平台的強勁表現。該平台是我們在 2025 年及以後恢復強勁成長的關鍵驅動力。在我們的治療產品組合中，我們擁有幾個關鍵品牌，包括 Skyrizi、Rinvoq、Vraylar、Ubrelvy 和 Qulipta，預計這些品牌將在 2024 年貢獻兩位數的銷售額成長。

We also expect meaningful growth for aesthetics this year, driven by improving market trends in the U.S. and continued execution across our international business. We are well positioned to drive strong long-term growth in this highly underpenetrated market.

我們也預計，在美國市場趨勢改善和我們國際業務持續執行的推動下，今年美容業務將出現有意義的成長。我們處於有利地位，可以在這個高度滲透的市場中推動強勁的長期成長。

Second, we are focused on prioritizing investment in our pipeline, which encompasses numerous opportunities to elevate the standard of care for patients. We anticipate updates this year from several important R&D programs, including approvals for Skyrizi in UC, 951 in the U.S. and potentially accelerated approval for Epkinly in third line plus follicular lymphoma. We also anticipate regulatory submissions for BonTE, our novel short-acting toxin and potentially Teliso-V in advanced non-squamous non-small cell lung cancer.

其次，我們專注於優先投資我們的產品線，其中包含許多提高患者護理標準的機會。我們預計今年幾個重要的研發項目將得到更新，包括 Skyrizi 在 UC 中的批准、951 在美國的批准，以及 Epkinly 在三線加濾泡性淋巴瘤中的批准可能會加速。我們也預計將向監管機構提交 BonTE、我們的新型短效毒素以及治療晚期非鱗狀非小細胞肺癌的潛在 Teliso-V。

And third, we are focused on closing and integrating ImmunoGen and Cerevel. These two exciting opportunities represent substantial sources of revenue growth well into the next decade. We remain on track with the anticipated closing of both deals in the middle of the year.

第三，我們專注於關閉和整合ImmunoGen 和Cerevel。這兩個令人興奮的機會代表了未來十年收入成長的重要來源。我們仍有望在今年年中完成這兩筆交易。

Today, we are also reaffirming our long-term sales outlook. Which includes a return to robust revenue growth in 2025 with a high single-digit CAGR through the end of the decade. Included in this outlook is an updated forecast for Skyrizi and Rinvoq. Based on the impressive growth of both therapies, which we expect will collectively generate approximately $16 billion of revenue in 2024, we now anticipate Skyrizi and Rinvoq will collectively exceed more than $27 billion in sales by 2027, with robust growth continuing into the next decade. This updated forecast reflects an increase of more than $6 billion in revenue compared to our prior 2027 guidance.

今天，我們也重申了我們的長期銷售前景。其中包括到 2025 年恢復強勁的收入成長，並在本十年末實現高個位數的複合年增長率。本展望中包括對 Skyrizi 和 Rinvoq 的最新預測。基於這兩種療法的令人印象深刻的成長（我們預計到2024 年將總共產生約160 億美元的收入），我們現在預計Skyrizi 和Rinvoq 的銷售額到2027 年將總共超過270 億美元，並且強勁成長將持續到下一個十年。與我們先前 2027 年的指引相比，更新後的預測反映出收入增加了超過 60 億美元。

We expect global sales for Skyrizi to reach more than $17 billion in 2027, reflecting continued share capture in psoriasis, where we are the clear market leader as well as strong uptake in IBD. And we expect Rinvoq to achieve more than $10 billion of global sales in 2027, reflecting continued market growth and share momentum across each of Rinvoq's approved indications, including 4 in rheumatology, 2 in IBD and atopic dermatitis. This forecast comprehends modest contributions from several new disease areas for Rinvoq, which we anticipate will be launching in the second half of the decade. These new indications have a collective peak sales potential of several billion dollars.

我們預計 Skyrizi 的全球銷售額將在 2027 年達到 170 億美元以上，反映出我們在銀屑病領域的市場份額持續增長（我們是該領域明顯的市場領導者）以及 IBD 領域的強勁增長。我們預計 Rinvoq 到 2027 年的全球銷售額將超過 100 億美元，反映出 Rinvoq 批准的每個適應症的市場持續成長和份額勢頭，包括 4 個風濕病、2 個 IBD 和異位性皮膚炎。這項預測包含了 Rinvoq 幾個新疾病領域的適度貢獻，我們預計 Rinvoq 將在本世紀下半葉推出。這些新適應症的集體高峰銷售潛力可達數十億美元。

Our updated forecast also includes higher estimates for Ubrelvy and Qulipta. We now expect total oral CGRP peak revenue of more than $3 billion, reflecting an increase of more than $1 billion. Our previously issued long-term forecast for aesthetics, Vraylar and 951 remain unchanged.

我們更新的預測還包括對 Ubrelvy 和 Qulipta 的更高估計。我們現在預計口服 CGRP 總收入高峰將超過 30 億美元，增幅超過 10 億美元。我們先前發布的對美學、Vraylar 和 951 的長期預測保持不變。

In summary, this is an exciting time for AbbVie. We are demonstrating outstanding execution across our portfolio, and our long-term outlook remains very strong. With that, I'll turn the call over to Jeff for additional comments on our commercial highlights. Jeff?

總而言之，這對艾伯維來說是一個激動人心的時刻。我們在整個投資組合中展現了出色的執行力，並且我們的長期前景仍然非常強勁。這樣，我會將電話轉給傑夫，請他對我們的商業亮點發表更多評論。傑夫？

Thank you, Rob. I'll start with the quarterly results for immunology, which delivered total revenues of more than $6.9 billion, exceeding our expectations. Skyrizi total sales were approximately $2.4 billion, reflecting operational growth of 51.6%. The Rinvoq total sales were more than $1.2 billion, reflecting operational growth of 62.8%. On a full year basis, Skyrizi and Rinvoq delivered more than $11.7 billion in total combined revenue, an impressive increase of $4 billion year-over-year.

謝謝你，羅布。我將從免疫學的季度業績開始，該季度的總收入超過 69 億美元，超出了我們的預期。 Skyrizi 總銷售額約 24 億美元，營運成長 51.6%。 Rinvoq 總銷售額超過 12 億美元，營運成長 62.8%。全年來看，Skyrizi 和 Rinvoq 的合併總收入超過 117 億美元，年增 40 億美元，令人印象深刻。

And as Rob just described, we see substantial room for continued growth across each of their currently approved indications. You can get a good sense for this momentum by looking at the relationship between the current in-play share which includes new and switching patients and the total prescription share just today. For example, our performance in IBD has been very strong for both Skyrizi and Rinvoq. In Crohn's disease, these two treatments together are already capturing roughly 1 out of every 3 in-play patients across all lines of therapy in the United States, while their combined total prescription share is only in the mid-single digits.

正如 Rob 剛才所描述的，我們看到他們目前批准的每個適應症都有巨大的持續成長空間。透過查看目前的參與份額（包括新患者和轉換患者）與今天的總處方份額之間的關係，您可以很好地理解這種勢頭。例如，Skyrizi 和 Rinvoq 在 IBD 方面的表現都非常強勁。在克隆氏症中，這兩種治療方法已經在美國所有治療方案中約佔每 3 個參與治療的患者中就有 1 個，而它們的總處方份額僅為中個位數。

You see a similar trend happening in ulcerative colitis for Rinvoq, and we anticipate launching Skyrizi for this indication later this year. So significant opportunity remains for revenue inflection in IBD, especially given their respective efficacy, safety and dosing profiles.

您會發現 Rinvoq 在潰瘍性結腸炎方面也出現了類似的趨勢，我們預計將在今年稍後推出針對該適應症的 Skyrizi。 IBD 的收入變化仍然存在重大機會，特別是考慮到它們各自的功效、安全性和劑量情況。

Across some of the other notable indications, Skyrizi is capturing roughly half of the in-play psoriasis patients in the U.S. biologic market relative to a total prescription share, which is in the mid-30s percent. Rinvoq is capturing high-teens in-play share in the atopic dermatitis market, while total share is in the high single digits. Similarly, in rheumatoid arthritis, Rinvoq is capturing mid-teens in place share while total share is roughly 7%.

在其他一些值得注意的適應症中，Skyrizi 佔據了美國生物製劑市場中大約一半的銀屑病患者，相對於總處方份額而言，該份額為 30% 左右。 Rinvoq 正在獲得異位性皮膚炎市場中十幾歲的市場份額，而總份額則處於高個位數。同樣，在類風濕關節炎方面，Rinvoq 佔據了十幾歲左右的市場份額，而總市場份額約為 7%。

So again, we see substantial headroom for share gains in addition to the typical robust market growth across room, derm and gastro. Plus, we are planning to have up to five additional indications for Rinvoq across several sizable markets that will potentially provide another significant revenue inflection in the second half of this decade and into the 2030s.

因此，除了房間、皮膚和胃腸道領域典型的強勁市場成長之外，我們還看到了巨大的份額成長空間。此外，我們計劃在幾個相當大的市場上為 Rinvoq 提供多達 5 種額外的適應症，這將有可能在本世紀下半葉和 2030 年代帶來另一個重大的收入拐點。

Turning now to Humira, which delivered global sales of $3.3 billion, down 40.8% due to biosimilar competition. The erosion impact in the U.S. played out largely in line with our expectations this quarter, while performance across our international markets continues to trend better than expected. In the U.S. we have once again secured broad formulary access for Humira in 2024. While there will be some step down in coverage year-over-year, we will still have parity access to biosimilars for the vast majority of U.S. patient lives.

現在談談 Humira，由於生物相似藥的競爭，該藥物的全球銷售額下降了 40.8%，達到 33 億美元。美國的侵蝕影響在本季基本符合我們的預期，而我們國際市場的表現則持續優於預期。在美國，我們將在 2024 年再次確保修美樂 (Humira) 的廣泛處方准入。雖然覆蓋範圍逐年有所下降，但我們仍將為絕大多數美國患者提供平等的生物仿製藥使用機會。

Turning now to oncology, where total revenues were $1.5 billion, Imbruvica global revenues were $903 million, down 19%, reflecting continued pressure in new patient starts. Venclexta global sales were $589 million, up 13.7% on an operational basis with strong demand for both CLL and AML across our key countries. The early prescription trends for Epkinly in third line plus DLBCL have been encouraging. With commercialization now underway in the U.S., Europe and Japan, we also anticipate the potential label expansion for follicular lymphoma later this year.

現在轉向腫瘤學，該領域的總收入為 15 億美元，Imbruvica 全球收入為 9.03 億美元，下降 19%，反映出新患者入市的持續壓力。 Venclexta 全球銷售額為 5.89 億美元，營運基礎上成長 13.7%，主要國家對 CLL 和 AML 的需求強勁。 Epkinly 在三線加 DLBCL 的早期處方趨勢令人鼓舞。隨著美國、歐洲和日本的商業化正在進行，我們也預計今年稍後濾泡性淋巴瘤的標籤可能會擴大。

Lastly, we have two new and exciting opportunities in oncology. Pending completion of the transaction, we will add Elahere to our portfolio. Elahere is a first-in-class ADC therapy approved for ovarian cancer, which is already demonstrating impressive uptake in the U.S. market. I look forward to welcoming the ImmunoGen commercial team to AbbVie.

最後，我們在腫瘤學領域有兩個令人興奮的新機會。在交易完成之前，我們將把 Elahere 加入我們的投資組合中。 Elahere 是一種獲準用於卵巢癌的一流 ADC 療法，已在美國市場展現出令人印象深刻的接受度。我期待歡迎ImmunoGen 商業團隊來到艾伯維。

And Teliso-V, another novel ADC, which has demonstrated very promising data in lung cancer. Teliso-V would further expand our scale and growth potential in solid tumors.

Teliso-V 是另一種新型 ADC，它在肺癌方面已顯示出非常有前景的數據。 Teliso-V 將進一步擴大我們在實體腫瘤領域的規模和成長潛力。

In neuroscience, our second largest therapeutic area, total full year revenues were more than $7.7 billion, reflecting impressive absolute sales growth of nearly $1.2 billion. In the quarter, total revenues were approximately $2.1 billion, up 22.4% on an operational basis. Vraylar continues to demonstrate robust growth. Global sales of $789 million were up nearly 40%. We continue to see significant momentum in new prescriptions across all indications, following the approval as an adjunctive treatment for major depressive disorder just over a year ago.

在我們的第二大治療領域神經科學領域，全年總收入超過 77 億美元，絕對銷售額成長近 12 億美元，令人印象深刻。本季總營收約 21 億美元，營運收入成長 22.4%。 Vraylar 持續展現出強勁的成長動能。全球銷售額達 7.89 億美元，成長近 40%。繼一年多前被批准作為重度憂鬱症的輔助治療藥物後，我們繼續看到所有適應症的新處方都有顯著增長勢頭。

And our leading oral CGRP portfolio for migraine contributed $348 million in combined sales this quarter, reflecting growth of approximately 40%. We anticipate continued robust demand for both Ubrelvy and Qulipta this year, including the expansion of Qulipta, the only once-daily oral CGRP for prevention of both episodic and chronic migraine into the international markets.

我們領先的偏頭痛口服 CGRP 產品組合本季貢獻了 3.48 億美元的合併銷售額，成長了約 40%。我們預計今年對 Ubrelvy 和 Qulipta 的需求將持續強勁，包括 Qulipta 的擴張，Qulipta 是唯一一種用於預防陣發性和慢性偏頭痛的每日一次口服 CGRP。

Based on the strong momentum, we have raised the outlook for our CGRP portfolio and now expect total peak sales from Ubrelvy and Qulipta combined to exceed $3 billion.

基於強勁的勢頭，我們提高了 CGRP 產品組合的前景，現在預計 Ubrelvy 和 Qulipta 的總峰值銷售額將超過 30 億美元。

Total Botox Therapeutic global sales were $776 million, up 6.7% on an operational basis. reflecting momentum in chronic migraine as well as other approved indications.

Botox Therapeutic 的全球總銷售額為 7.76 億美元，以營運基礎成長 6.7%。反映了慢性偏頭痛以及其他批准的適應症的勢頭。

And lastly, we recently launched 951 in both Japan and Europe, and we are pursuing commercial approval in the U.S. later this year. This treatment represents a potentially transformative next-generation therapy for advanced Parkinson's disease and a $1 billion-plus peak sales opportunity.

最後，我們最近在日本和歐洲推出了 951，並且正在爭取今年稍後在美國獲得商業批准。這種療法代表了針對晚期帕金森氏症的潛在變革性下一代療法，並帶來了超過 10 億美元的高峰銷售機會。

So overall, I'm extremely pleased with the commercial execution across our diversified portfolio, especially the growth platform, which is demonstrating very strong momentum as we head into 2024. And with that, I'll turn the call over to Carrie for additional comments on aesthetics. Carrie?

總的來說，我對我們多元化投資組合的商業執行非常滿意，尤其是成長平台，當我們進入2024 年時，它表現出了非常強勁的勢頭。因此，我會將電話轉給Carrie 以徵求更多意見關於美學。嘉莉？

Thank you, Jeff. Fourth quarter global aesthetic sales were approximately $1.4 billion, an operational increase of 6.9%. In the U.S., aesthetic sales of $884 million increased 5.7%, marked by accelerating market growth and strong key product performance. Fourth quarter U.S. Botox cosmetic sales were $453 million, an increase of 7.3%. We continue to see sustained momentum in the recovery of the U.S. facial toxin market which was a primary driver of growth in the fourth quarter.

謝謝你，傑夫。第四季全球美容銷售額約 14 億美元，營運成長 6.9%。在美國，美容銷售額達 8.84 億美元，成長 5.7%，市場成長加速且關鍵產品表現強勁。第四季美國Botox化妝品銷售額為4.53億美元，成長7.3%。我們繼續看到美國面部毒素市場復甦的持續勢頭，這是第四季度成長的主要推動力。

Botox Cosmetic remains the clear market leader with strong and stable share despite new competitive entrants. U.S. Juvederm sales were $156 million in the fourth quarter, an increase of more than 20% versus the prior year. This robust growth was driven by the strong launches of Volux and SkinVive, which continue to drive new consumers and greater penetration in the dermal filler category.

儘管有新的競爭者進入，Botox Cosmetic 仍然是明顯的市場領導者，擁有強勁而穩定的份額。美國 Juvederm 第四季銷售額為 1.56 億美元，較上年成長超過 20%。這一強勁成長是由 Volux 和 SkinVive 的強勁推出推動的，它們繼續推動新消費者和真皮填充劑類別的更大滲透。

Consistent with our expectations, the U.S. filler market recovery trails out of toxins, but is continuing to show improvement, as year-over-year growth was roughly flat in the fourth quarter. As we look to 2024, we are pleased with the momentum of our U.S. aesthetics portfolio. We expect full year sales growth as our market leadership positions us very well from a competitive perspective, and we anticipate continued recovery in both toxin and filler markets. Internationally, fourth quarter aesthetic sales were $487 million, representing an operational increase of 9%. We experienced strong performance in most regions and growth benefited from the impact of China's COVID lockdowns in late 2022.

與我們的預期一致，美國填充劑市場的復甦雖然已擺脫毒素，但仍在繼續改善，因為第四季度同比增長大致持平。展望 2024 年，我們對美國美學產品組合的發展動能感到滿意。我們預計全年銷售額將成長，因為從競爭角度來看，我們的市場領導地位使我們處於非常有利的地位，並且我們預計毒素和填充劑市場將持續復甦。在國際範圍內，第四季美容銷售額為 4.87 億美元，營運成長 9%。我們在大多數地區都表現強勁，成長受益於 2022 年底中國新冠疫情封鎖的影響。

Within China, the softening economic conditions that emerged in the third quarter continued to impact results. Consistent with what we experienced in the U.S., the economic slowdown has impacted fillers more than toxins based upon their relatively higher price. We anticipate economic headwinds will continue in China over the near term, balanced against our expectations for continued strong performance in other international regions.

在中國國內，第三季出現的經濟狀況疲軟持續影響業績。與我們在美國經歷的情況一致，經濟放緩對填充劑的影響大於對毒素的影響，因為它們的價格相對較高。我們預計短期內中國的經濟逆風將持續，這與我們對其他國際地區持續強勁表現的預期相平衡。

Looking to the long term, aesthetics remains an area with very low market penetration, and we have demonstrated our ability to drive growth through investments in our customers, consumers and innovation. As such, we anticipate aesthetics will be a strong growth portfolio for years to come and remain confident in our ability to deliver more than $9 billion of sales by the end of the decade. With that, I'll turn the call over to Roopal.

從長遠來看，美學仍然是一個市場滲透率非常低的領域，我們已經證明了我們有能力透過對客戶、消費者和創新的投資來推動成長。因此，我們預計美學將在未來幾年成為強勁成長的產品組合，並對在本世紀末實現超過 90 億美元銷售額的能力充滿信心。這樣，我會將電話轉給 Roopal。

Thank you, Carrie. In 2023, we saw significant evolution of our pipeline with multiple data readouts, regulatory submissions and approvals, as well as expansion of our R&D efforts with the announced ImmunoGen and Cerevel transactions. We expect to continue this progress with numerous important clinical and regulatory milestones anticipated this year. In immunology, we recently announced positive top line results for lutikizumab, our anti-IL-1 alpha beta bispecific being evaluated in hidradenitis suppurativa In the Phase II study, lutikizumab demonstrated higher high-score 50 and high-score 75 measures as well as improvement in skin pain compared to placebo. These are very impressive results considering all patients were inadequate responders to anti-TNF therapy and 70% of the patients were Hurley Stage III, which is the most advanced stage of the disease. Based on these results, we plan to begin a Phase III program in HS later this year.

謝謝你，嘉莉。 2023 年，我們看到了我們的產品線的重大演變，包括多項數據讀取、監管提交和批准，以及透過宣布的ImmunoGen 和 Cerevel 交易擴大了我們的研發工作。我們預計今年將繼續取得許多重要的臨床和監管里程碑。在免疫學方面，我們最近宣布了lutikizumab 的陽性頂線結果，我們的抗IL-1 alpha beta 雙特異性抗體正在化膿性汗腺炎中進行評估。在II 期研究中，lutikizumab 表現出更高的高分50 和高分75 指標以及改善與安慰劑相比，皮膚疼痛。考慮到所有患者對抗 TNF 治療的反應均不足，且 70% 的患者處於 Hurley III 期（疾病的最晚期階段），這些結果非常令人印象深刻。根據這些結果，我們計劃今年稍後在 HS 啟動 III 期計畫。

We also plan to evaluate lutikizumab in ulcerative colitis and Crohn's, given the role that IL-1 likely plays in these diseases. Patients with UC who have an IL-1 beta signature have shown resistance to anti-TNFs and other biologics, providing strong rationale for a potential biomarker approach. Additionally, we believe lutikizumab has the potential to be used in combinations to provide transformational levels of efficacy in IBD. We plan to evaluate combo approaches with lutikizumab and Skyrizi as well as with other pipeline assets in Crohn's. Our Phase II studies in IBD are expected to begin later this year.

鑑於 IL-1 可能在潰瘍性結腸炎和克隆氏症中發揮的作用，我們也計劃評估 lutikizumab 在這些疾病中的作用。具有 IL-1 β 特徵的 UC 患者已表現出對抗 TNF 和其他生物製劑的抗藥性，這為潛在的生物標記方法提供了強有力的理由。此外，我們相信 lutikizumab 有潛力聯合使用，以提供 IBD 療效的轉化水準。我們計劃評估 lutikizumab 和 Skyrizi 以及克羅恩病的其他管道資產的組合方法。我們對 IBD 的二期研究預計將於今年稍後開始。

Our regulatory applications are under review for Skyrizi in ulcerative colitis with approval decisions expected in the U.S. and Europe later this year. Once Skyrizi is approved in UC along with Rinvoq, we will have two assets with different mechanisms of action in IBD, both offering very high levels of efficacy. AbbVie will be very well positioned with an industry-leading suite of treatment options for patients suffering from moderate-to-severe ulcerative colitis and Crohn's disease.

我們正在審查 Skyrizi 治療潰瘍性結腸炎的監管申請，預計美國和歐洲將於今年稍後做出批准決定。一旦 Skyrizi 與 Rinvoq 在 UC 中獲得批准，我們將擁有兩種在 IBD 中具有不同作用機制的資產，兩者都提供非常高水平的療效。艾伯維（AbbVie）將處於有利位置，為患有中度至重度潰瘍性結腸炎和克隆氏症的患者提供業界領先的治療方案。

We continue to make very good progress with the second wave of development programs for Rinvoq with Phase III studies underway in five new indications. Giant cell arteritis, lupus, HS, alopecia areata and vitiligo. We anticipate data readouts for these programs over the next 3 years, beginning with data from our GCA study this year.

我們繼續在 Rinvoq 的第二波開發計劃中取得良好進展，針對五個新適應症的 III 期研究正在進行中。鉅細胞動脈炎、狼瘡、熱射病、斑禿和白斑。我們預計這些項目的數據將在未來 3 年讀出，從今年 GCA 研究的數據開始。

Moving to oncology, where we continue to make very good progress across our heme and solid tumor programs. In the area of hematologic oncology, we'll see data in the second half of this year from the Venclexta Phase III VERONA trial in treatment-naive higher-risk MDS patients with regulatory submissions and approvals anticipated in 2025.

轉向腫瘤學，我們在血紅素和實體瘤計畫上繼續取得非常好的進展。在血液腫瘤學領域，我們將在今年下半年看到初治高風險 MDS 患者的 Venclexta III 期 VERONA 試驗的數據，預計將於 2025 年向監管機構提交申請並獲得批准。

For Epkinly, we anticipate regulatory approvals in third line or greater follicular lymphoma later this year in both the U.S. and Europe. We also expect to begin several new Phase III studies in 2024, including studies in second-line DLBCL and frontline follicular lymphoma.

對於 Epkinly，我們預計今年稍後將在美國和歐洲獲得監管部門批准用於三線或大濾泡性淋巴瘤治療。我們也預計在 2024 年開始幾項新的 III 期研究，包括二線 DLBCL 和一線濾泡性淋巴瘤的研究。

At the recent ASH meeting, we presented new data for our BCMA CD3 bispecific, ABBV-383 in multiple myeloma. 383 is engineered for high affinity binding to BCMA on malignant cells and low affinity binding to a unique CD3 epitope on T cells, which has the potential to mitigate some of the adverse events associated with other T cell engaging BCMA-based therapies while preserving high levels of efficacy.

在最近的 ASH 會議上，我們展示了 BCMA CD3 雙特異性 ABBV-383 在多發性骨髓瘤中的新數據。 383 被設計為與惡性細胞上的BCMA 高親和力結合，並與T 細胞上的獨特CD3 表位低親和力結合，這有可能減輕與其他T 細胞參與基於BCMA 的療法相關的一些不良事件，同時保持高水平的功效。

We're very encouraged by the data emerging from our Phase Ib study, which show treatment with 383 is yielding deep and durable responses with a lower incidence and severity of CRS. With this profile, we believe 383 can be a highly effective and tolerable treatment for multiple myeloma, while potentially allowing for outpatient administration, limited or no step-up dosing and monthly administration from the beginning of treatment; all attributes, which would make it very appealing to both patients and physicians.

我們對 Ib 期研究中出現的數據感到非常鼓舞，這些數據表明 383 治療正在產生深入且持久的反應，且 CRS 的發生率和嚴重程度較低。憑藉這一特點，我們相信 383 可以是一種高效且可耐受的多發性骨髓瘤治療方法，同時有可能允許門診給藥、有限或無需逐步給藥以及從治療開始每月給藥；所有屬性，這將使其對患者和醫生都非常有吸引力。

We remain on track to begin a Phase III monotherapy study in third-line multiple myeloma this year, and we plan to begin combination trials in earlier lines of therapy in 2025. In the area of solid tumors, we recently announced positive top line results from the Teliso-V Phase II LUMINOSITY study in previously treated non-small cell lung cancer. Teliso-V demonstrated strong clinical benefits across key endpoints, including overall response rate, duration of response and overall survival with a tolerable safety profile. We believe these results have the potential to support accelerated approval, and we plan to discuss the data with regulators in the coming months. Pending alignment with the FDA, our submission is planned for the second half of this year.

我們仍有望在今年開始針對三線多發性骨髓瘤的 III 期單藥治療研究，併計劃於 2025 年開始早期療法的聯合試驗。在實體瘤領域，我們最近宣布了積極的頂線結果Teliso-V II期LUMINOSITY 研究針對先前治療過的非小細胞肺癌。 Teliso-V 在關鍵終點上表現出強大的臨床優勢，包括整體緩解率、緩解持續時間和整體存活率，並具有可容忍的安全性。我們相信這些結果有可能支持加速批准，我們計劃在未來幾個月與監管機構討論這些數據。在與 FDA 保持一致之前，我們計劃在今年下半年提交申請。

We're also making good progress with our next-generation c-Met ADC ABBV-400, which utilizes the same c-Met blocking antibody as Teliso-V, but has a proprietary TOPO1 warhead to afford deeper and more durable responses with an improved therapeutic index. We remain on track to see data this year from the non-small cell lung cancer and gastroesophageal cohorts from our Phase I study. And based on the progress we're making in our colorectal program, we plan to begin a Phase III study later this year in third-line CRC.

我們的下一代 c-Met ADC ABBV-400 也取得了良好進展，它採用與 Teliso-V 相同的 c-Met 阻斷抗體，但具有專有的 TOPO1 彈頭，可透過改進的治療指數。今年我們仍有望看到第一階段研究的非小細胞肺癌和胃食道癌隊列的數據。根據我們在結直腸計畫中取得的進展，我們計劃在今年稍後開始第三線大腸直腸癌的 III 期研究。

We also continue to make very good progress with our anti-GARP antibody, ABBV-151. Our Phase II study in second-line hepatocellular carcinoma is underway, and we plan to begin several additional Phase II studies this year, including frontline HCC, front-line lung cancer and metastatic urothelial cancer. We look forward to providing updates on these programs as the data matures.

我們的抗 GARP 抗體 ABBV-151 也持續取得良好進展。我們二線肝細胞癌的 II 期研究正在進行中，我們計劃今年開始幾項額外的 II 期研究，包括一線 HCC、一線肺癌和轉移性尿路上皮癌。我們期待隨著數據的成熟提供這些計劃的更新。

Now moving to neuroscience, where we recently announced the European launch of ABBV-951 for patients with advanced Parkinson's disease. We also recently provided our complete response submission to the FDA for 951 with an approval decision anticipated in the second quarter. Our novel subcutaneous Levodopa/Carbidopa delivery system has the potential to offer meaningful benefits over current treatment options and others that are in development.

現在轉向神經科學，我們最近宣佈在歐洲推出 ABBV-951，用於治療晚期帕金森氏症患者。我們最近也向 FDA 提交了針對 951 的完整答复，預計將在第二季做出批准決定。我們的新型皮下左旋多巴/卡比多巴給藥系統有可能比目前的治療方案和其他正在開發的治療方案提供有意義的益處。

951 delivers significant improvements in off time and on time with a less invasive, nonsurgical system. It can deliver high levodopa doses similar to the amount provided by DUOPA, and it doesn't require combination with oral drugs to achieve high efficacy. 951 also provides a full 24-hour benefit, which should result in less morning akinesia. We're extremely excited to bring this transformative therapeutic option to patients in Europe and the U.S. once approved.

951 透過侵入性較小的非手術系統顯著縮短了停機時間和準時時間。它可以提供與DUOPA相似的高左旋多巴劑量，並且不需要與口服藥物聯合使用即可達到高效療效。 951 還提供完整的 24 小時益處，這應該會減少早晨的運動不能。一旦獲得批准，我們非常高興能為歐洲和美國的患者帶來這種變革性的治療選擇。

In our aesthetics pipeline, we recently submitted a regulatory application in the U.S. for Botox and platysma prominence. We anticipate an approval decision in the second half of this year. And we remain on track to complete the remaining CMC work this year for BonTE, a rapid onset, short-acting novel toxin. Following completion of the remaining work, we plan to submit a regulatory application in the second half of the year with approval anticipated near the end of 2025.

在我們的美容產品線中，我們最近在美國提交了一份關於肉毒桿菌和頸闊肌突出的監管申請。我們預計將在今年下半年做出批准決定。我們仍有望完成今年 BonTE 的剩餘 CMC 工作，BonTE 是一種起效快、作用短的新型毒素。完成剩餘工作後，我們計劃在今年下半年提交監管申請，預計 2025 年底獲得批准。

So in summary, we continue to demonstrate significant progress across all stages of our pipeline and anticipate numerous regulatory and clinical milestones again in 2024. And I also look forward to integrating the ImmunoGen and Cerevel teams and pipeline assets into our R&D organizations once those transactions close this year. These two transactions significantly strengthened our oncology and neuroscience pipeline with the addition of several novel assets that have the potential to become innovative new therapies for many patients. With that, I'll turn the call over to Scott.

總而言之，我們將繼續在管道的所有階段展示重大進展，並預計在 2024 年再次實現眾多監管和臨床里程碑。我還期待在這些交易完成後將ImmunoGen 和 Cerevel 團隊以及管道資產整合到我們的研發組織中今年。這兩筆交易顯著加強了我們的腫瘤學和神經科學產品線，增加了一些新資產，這些資產有可能成為許多患者的創新療法。這樣，我會將電話轉給史考特。

Thank you, Roopal. I'm very pleased with AbbVie's strong performance in 2023. We have substantial momentum across the portfolio to support our long-term growth outlook. Starting with our fourth quarter results, we reported adjusted earnings per share of $2.79, which is $0.05 above our guidance midpoint. These results include a $0.15 unfavorable impact from acquired IPR&D expense. Total net revenues were $14.3 billion, $300 million ahead of our guidance and down 5.4%. Most notably, these results reflect 15.3% sales growth from our ex-Humira growth platform.

謝謝你，魯帕爾。我對艾伯維 2023 年的強勁表現感到非常滿意。我們的整個投資組合擁有強勁的動力來支持我們的長期成長前景。從第四季度業績開始，我們公佈的調整後每股收益為 2.79 美元，比我們的指導中位數高出 0.05 美元。這些結果包括收購的 IPR&D 費用帶來的 0.15 美元不利影響。總淨收入為 143 億美元，比我們的指引高出 3 億美元，下降 5.4%。最值得注意的是，這些結果反映出我們的前 Humira 成長平台的銷售額成長了 15.3%。

The adjusted operating margin ratio was 43.8% of sales. This includes adjusted gross margin of 83.9% of sales, adjusted R&D expense of 13.4% of sales, acquired IPR&D expense of 2% of sales and adjusted SG&A expense of 24.7% of sales. Adjusted net interest expense was $363 million. The adjusted tax rate was 17.2%.

調整後的營業利益率為銷售額的43.8%。其中包括調整後的毛利率佔銷售額的83.9%、調整後的研發費用佔銷售額的13.4%、收購的IPR&D費用佔銷售額的2%以及調整後的SG&A費用佔銷售額的24.7%。調整後淨利息支出為 3.63 億美元。調整後的稅率為17.2%。

Turning to our financial outlook for 2024. Our full year adjusted earnings per share guidance is between $11.05 and $11.25. This earnings per share guidance includes dilution related to the ImmunoGen and Cerevel acquisitions of $0.32, which assumes closing in the middle of the year. Please note that this guidance does not include an estimate for acquired IPR&D expense that may be incurred throughout the year.

談到我們 2024 年的財務展望。我們的全年調整後每股收益指引在 11.05 美元至 11.25 美元之間。這項每股收益指引包括與收購ImmunoGen 和Cerevel 相關的0.32 美元稀釋，假設交易將於年中完成。請注意，本指南不包括全年可能發生的收購智慧財產權與研發費用的估計。

We expect total net revenues of approximately $54.2 billion. reflecting a return to modest operational growth. At current rates, we expect foreign exchange to have a 0.5% unfavorable impact on full year sales growth. This revenue forecast contemplates the following approximate assumptions for our key products and therapeutic areas. We expect Global Immunology sales of $25.6 billion, including Humira sales of $9.6 billion, including U.S. erosion of roughly 36%. Skyrizi revenue of $10.5 billion, reflecting growth of more than $2.7 billion due to strong market share performance in psoriasis as well as robust uptake in IBD. And Rinvoq sales of $5.5 billion, reflecting growth of nearly 40% with continued market growth and share momentum across all approved indications.

我們預計總淨收入約為 542 億美元。反映了營運溫和成長的回歸。按照目前的匯率，我們預計外匯將對全年銷售成長產生 0.5% 的不利影響。此收入預測考慮了我們的關鍵產品和治療領域的以下近似假設。我們預計全球免疫學銷售額為 256 億美元，其中 Humira 銷售額為 96 億美元，其中美國銷售額將下降約 36%。 Skyrizi 營收為 105 億美元，由於乾癬市場份額強勁以及 IBD 的強勁增長而實現了超過 27 億美元的增長。 Rinvoq 銷售額為 55 億美元，成長了近 40%，這得益於所有核准適應症的持續市場成長和份額成長勢頭。

On a full year basis, we anticipate that our strong volume growth for Skyrizi and Rinvoq will be modestly offset by low single-digit negative net price. In oncology, we expect sales of $5.7 billion, including Imbruvica revenue of $2.9 billion and Venclexta sales of $2.4 billion as well as contributions from Epkinly and partial year sales from Elahere.

就全年而言，我們預計 Skyrizi 和 Rinvoq 銷售的強勁成長將被較低的個位數負淨價適度抵消。在腫瘤學領域，我們預計銷售額為 57 億美元，其中包括 Imbruvica 收入 29 億美元和 Venclexta 銷售額 24 億美元，以及 Epkinly 的貢獻和 Elahere 的部分年度銷售額。

For aesthetics, we expect sales of $5.7 billion. including $2.9 billion from Botox Cosmetic and mid-single-digit revenue growth from Juvederm. For neuroscience, we expect revenue of $8.9 billion, representing growth of more than 15%, including Vraylar sales of $3.4 billion, Botox Therapeutic sales of $3.2 billion and total oral CGRP revenue of $1.6 billion. For Eye Care, we expect sales of $2.2 billion.

在美學方面，我們預計銷售額為 57 億美元。其中包括來自 Botox Cosmetic 的 29 億美元和來自 Juvederm 的中個位數收入成長。對於神經科學，我們預計營收為 89 億美元，成長超過 15%，其中 Vraylar 銷售額為 34 億美元，Botox Therapeutic 銷售額為 32 億美元，口服 CGRP 總收入為 16 億美元。對於眼部護理，我們預計銷售額為 22 億美元。

Moving to the P&L for 2024. We are forecasting full year adjusted gross margin of 84% of sales, adjusted R&D investment of 14% of sales, adjusted SG&A expense of 23.5% of sales and adjusted operating margin ratio of roughly 46.5% of sales. We expect adjusted net interest expense of $2.1 billion, which includes the partial year cost in 2024 to finance the ImmunoGen and Cerevel transactions. We forecast our non-GAAP tax rate to be approximately 15.7%. Finally, we expect share count to be roughly flat to 2023.

轉向2024 年的損益表。我們預期全年調整後的毛利率將佔銷售額的84%，調整後的研發投資將佔銷售額的14%，調整後的銷售及管理費用將佔銷售額的23.5 %，調整後的營業利潤率將佔銷售額的46.5% 左右。我們預計調整後的淨利息支出為 21 億美元，其中包括 2024 年為 ImmunoGen 和 Cerevel 交易融資的部分年度成本。我們預計非 GAAP 稅率約為 15.7%。最後，我們預計到 2023 年股票數量將大致持平。

Turning to the first quarter. We anticipate net revenues of approximately $11.9 billion. At current rates, we expect foreign exchange to have a 0.5% unfavorable impact on sales growth. This revenue forecast comprehends the following approximate assumptions for our key therapeutic areas. Immunology sales of $5.1 billion, including Skyrizi sales of $1.9 billion and Rinvoq revenue of $1 billion. These estimates reflect typical first quarter seasonality and as well as low single-digit unfavorable net price.

轉向第一季。我們預計淨收入約為 119 億美元。依照目前的匯率，我們預期外匯將對銷售成長產生 0.5% 的不利影響。此收入預測包含對我們的關鍵治療領域的以下近似假設。免疫學銷售額為 51 億美元，其中 Skyrizi 銷售額為 19 億美元，Rinvoq 收入為 10 億美元。這些估計反映了典型的第一季季節性以及低個位數的不利淨價。

We expect Humira global revenue of $2.2 billion, including U.S. sales of $1.7 billion. We also anticipate oncology revenue just above $1.3 billion, aesthetic sales of $1.3 billion, neuroscience revenue of $1.9 billion and eye care sales of $600 million. We are forecasting an adjusted gross margin of approximately 83.5% of sales and an adjusted operating margin ratio of roughly 44.5% of sales. We also modeled a non-GAAP tax rate of 14.8%. We expect adjusted earnings per share between $2.3 and $2.34. This guidance does not include acquired IPR&D expense that may be incurred in the quarter.

我們預計 Humira 全球營收為 22 億美元，其中美國銷售額為 17 億美元。我們也預期腫瘤學收入略高於 13 億美元，美容銷售額為 13 億美元，神經科學收入為 19 億美元，眼部護理銷售額為 6 億美元。我們預期調整後的毛利率約為銷售額的 83.5%，調整後的營業利潤率約為銷售額的 44.5%。我們也模擬了 14.8% 的非 GAAP 稅率。我們預計調整後每股收益將在 2.3 美元至 2.34 美元之間。本指引不包括本季可能發生的收購知識產權與研發費用。

Finally, AbbVie's strong business performance and outlook continues to support our capital allocation priorities. Our cash balance at the end of December was $12.8 billion, and we expect to generate free cash flow of approximately $18 billion in 2024, which includes roughly $1.9 billion in Skyrizi royalty payments. The strong free cash flow will fully support a strong growing dividend, which we have increased by more than 285% since inception, continued debt repayment where we expect to pay down the approximately $7 billion of maturities this year and also provides capacity for continued business development to further augment our portfolio. In closing, AbbVie has once again delivered outstanding results and our financial outlook remains very strong. We'll turn the call back over to Liz.

最後，艾伯維強勁的業務業績和前景繼續支持我們的資本配置優先事項。截至 12 月底，我們的現金餘額為 128 億美元，我們預計到 2024 年將產生約 180 億美元的自由現金流，其中包括約 19 億美元的 Skyrizi 特許權使用費。強勁的自由現金流將充分支持強勁成長的股息（自成立以來我們已增加了285% 以上）、持續的債務償還（預計今年將償還約70 億美元的到期債務），並為持續的業務發展提供了能力進一步擴大我們的產品組合。最後，艾伯維再次取得了出色的業績，我們的財務前景仍然非常強勁。我們會將電話轉回給麗茲。

Thanks, Scott. We will now open the call for questions. (Operator Instructions) Operator, first question please.

謝謝，斯科特。我們現在開始提問。 （操作員指示）操作員，第一個問題請回答。

Yes. The first question comes from Chris Schott with JPMorgan.

是的。第一個問題來自摩根大通的克里斯·肖特。

Just I was looking for a little bit more color on the longer-term immunology outlook. You're targeting $27 billion plus by 2027 and highlighting growth from there. I guess my question was just can you elaborate on how mature the existing indications for these products are going to be by 2027? And what type of growth can we anticipate longer term? And maybe as part of that, it seems like the comments that the growth beyond '27 is more skewed towards Rinvoq given the new indications, but I'm just in a sense of like, is it balanced Rinvoq and Skyrizi has it become more of a Rinvoq-driven franchise in terms of the growth drivers over time?

只是我一直在尋找關於長期免疫學前景的更多資訊。您的目標是到 2027 年達到 270 億美元以上，並強調此後的成長。我想我的問題是您能否詳細說明這些產品的現有適應症到 2027 年將達到何種成熟程度？我們可以預期哪種類型的長期成長？也許作為其中的一部分，鑑於新的跡象，似乎有評論認為 27 年後的增長更傾向於 Rinvoq，但我只是在某種意義上，它是否平衡 Rinvoq 和 Skyrizi 是否變得更加平衡就長期增長驅動力而言，Rinvoq 驅動的特許經營權？

Yes. Chris, it's Jeff. Maybe I'll walk through a little bit of the process there and answer your question. So we can see historically actuals and sort of fast forward in terms of the first thing we look at is the bio penetration of these big indications. And there still remains significant headroom in terms of the ability for moderate-to-severe patients with these diseases to continue to be exposed to these biologics and these advanced orals, absolutely. And we can see for sure that psoriasis still even in the U.S. is about 15%. It's relatively modest. Atopic dermatitis, the penetration rate is only about 7%.

是的。克里斯，是傑夫。也許我會稍微介紹一下該過程並回答您的問題。因此，我們可以看到歷史事實，我們首先關注的是這些重大適應症的生物滲透率。就患有這些疾病的中重度患者繼續接觸這些生物製劑和這些高級口服藥物的能力而言，絕對還有很大的空間。我們可以肯定的是，即使在美國，銀屑病的發生率仍然約為 15%。這是相對溫和的。異位性皮膚炎的普及率只有7%左右。

And then you have higher penetrated markets like IBD, and I'll talk about what's interesting about IBD. That's somewhere in the 40% or 50% range across those. And then we can see clearly, as these markets develop, and I've highlighted this before, that you see line of therapy expansion. So first line becomes less and less important as you move towards second and third line over time. And right now, IBD is a big story about that, that we calculate into our long-term estimates because it's still largely despite the severity a frontline oriented market because physicians just kind of hang on to their frontline agents. That's going to change quite dramatically, I believe, over this midterm and even in the long-term perspective.

然後還有像 IBD 這樣滲透率較高的市場，我將討論 IBD 的有趣之處。這大約在 40% 或 50% 的範圍內。然後我們可以清楚地看到，隨著這些市場的發展，我之前已經強調過這一點，你會看到治療範圍的擴展。因此，隨著時間的推移，當你轉向第二行和第三行時，第一行變得越來越不重要。現在，IBD 是一個大問題，我們將其納入我們的長期估計中，因為儘管情況嚴重，但它仍然很大程度上是一個面向一線的市場，因為醫生只是緊緊抓住他們的一線代理人。我相信，從中期甚至長期來看，這種情況將會發生巨大的變化。

We have a good peg on the market growth rates. Many of these market growth rates are very significant, very stable and we'll have good growth rates going into the next decade because of these dynamics around bio penetration and line of therapy expansion. I highlighted in my remarks around share. Share, we have a very good competitive position, very high capture rates, and we're really in the sort of the low end of the range in terms of the total prescription share that will feed up and catch up to that.

我們對市場成長率有很好的把握。其中許多市場成長率非常顯著、非常穩定，由於圍繞著生物滲透和治療範圍擴展的這些動態，我們將在下一個十年中擁有良好的成長率。我在發言中強調了分享。分享一下，我們擁有非常好的競爭地位，非常高的捕獲率，而且就總處方份額而言，我們確實處於該範圍的低端，將滿足並趕上這一點。

Pricing, I think we talked a little about -- we're not going to give detailed pricing. But certainly, you can see based on Scott's comments that the idea of a high CAGR on high single-digit pricing is not something we've contemplated. So we believe that there's significant room for growth even past '27, especially as we'll have more Rinvoq indications coming that we've talked through. So we think that we're going to see robust growth based on our share capture and also how dynamic these markets are into the next decade.

定價，我想我們已經討論了一些——我們不會給出詳細的定價。但當然，你可以根據斯科特的評論看到，高個位數定價的高複合年增長率的想法並不是我們考慮過的。因此，我們相信，即使在 27 年後，仍有很大的成長空間，特別是我們將有更多我們已經討論過的 Rinvoq 跡象。因此，我們認為，基於我們的份額捕獲以及這些市場在未來十年的活力，我們將看到強勁的成長。

And Chris, this is Rob. I'll just add. If you think about the markets, the Rin market is growing low single digits. Atopic dermatitis is growing mid-teens and IBD is growing high single digits. So they're very strong markets. They will continue to be strong markets for us. And we're also seeing, as Jeff mentioned, there's a lot of headroom in terms of share capture. So we do expect that robust growth to continue beyond '27 into the early part of the next decade.

克里斯，這是羅布。我就補充一下。如果您考慮一下市場，您會發現 Rin 市場的成長速度較低。異位性皮膚炎正在以十幾歲左右的速度增長，而發炎性腸道疾病則以高個位數增長。所以它們是非常強大的市場。它們將繼續成為我們的強大市場。正如傑夫所提到的，我們也看到，在份額獲取方面還有很大的空間。因此，我們確實預期強勁的成長將持續到 20 世紀 20 世紀以後到下一個十年的初期。

I think your observation is correct, given that we would expect up to five new indications for Rinvoq. If you look at the rate of growth, Rinvoq versus Skyrizi, I think it's reasonable to assume that Rinvoq would have a higher rate of growth given the new indications, but both will grow very nicely. So I would certainly encourage you to look at more robust expectations for both therapies, with Rinvoq little bit higher because of the new indications.

我認為您的觀察是正確的，因為我們預計 Rinvoq 最多有五個新適應症。如果你看看 Rinvoq 與 Skyrizi 的成長率，我認為考慮到新的適應症，可以合理地假設 Rinvoq 會有更高的成長率，但兩者都會成長得非常好。因此，我當然鼓勵您對這兩種療法抱有更強烈的期望，由於新的適應症，Rinvoq 的預期會更高一些。

Your next question comes from Terence Flynn with Morgan Stanley.

您的下一個問題來自摩根士丹利的特倫斯·弗林。

Great. Maybe two for me. Rick, I was just wondering if you could give us an update on succession planning and timing. We've been fielding that question from a number of investors recently, given you're now past the Humira LOE and position the company very well here, given Skyrizi and Rinvoq commercial success and also some of the recent pipeline build-out? And then the second question I had on a pipeline on lutikizumab. I know you guys have highlighted this, not a lot of focus from the investor side yet. Maybe you could just talk about the size of the commercial opportunity in HS. And then why you're confident that, that Phase II HS data will translate into success in the IBD side?

偉大的。也許對我來說有兩個。里克，我只是想知道您能否向我們提供有關繼任計劃和時間表的最新資訊。我們最近一直在回答一些投資者提出的這個問題，考慮到您現在已經過了 Humira LOE 的階段，並且考慮到 Skyrizi 和 Rinvoq 的商業成功以及最近的一些管道建設，您對該公司的定位非常好？然後我提出的第二個問題是關於 lutikizumab 的研發管線。我知道你們已經強調了這一點，但投資者方面還沒有太多關注。也許你可以談談 HS 商業機會的規模。那麼為什麼您有信心第二階段 HS 資料將轉化為 IBD 方面的成功？

All right, Terence, this is Rick. So I'll cover the first one. I guess what I would say is I have nothing new to report today. But what it indicate is we've talked about the criteria that we're going to use to make the decision when we're going to make the transition. That criteria is the same. When we believe that we are comfortable, we've navigated the LOE and the rest of the business is performing at a high level, that's the point which we want to make the transition because we think that's the best time to be able to transition the CEO position.

好吧，特倫斯，這是瑞克。所以我將介紹第一個。我想我想說的是我今天沒有什麼新消息要報告。但它表明我們已經討論了我們在進行過渡時將用來做出決定的標準。該標準是相同的。當我們相信我們感到舒適，我們已經掌握了 LOE 並且其他業務也處於高水平時，這就是我們想要進行過渡的點，因為我們認為這是能夠過渡的最佳時機首席執行官職位。

So I understand there's a lot of interest from investors here, that's logical and clear. Maybe what I can do is give you a little better perspective on the process that we're going to use in order to make the decision with the Board. I would say the Board has been actively involved for the last 4 or 5 years with a lot of emphasis around ensuring that our internal candidate would get the experiences that we thought were needed prior to making the transition. I can tell you from my perspective, that's gone extremely well. We have regularly scheduled Board meetings several times a year where we specifically talked about succession and the progress that we're making. At the point in which the business has achieved that criteria that I described before, at the next regularly scheduled board meeting, then I would make a recommendation to the Board that this is the proper time to be able to make the transition. The Board would vote on that recommendation.

所以我知道投資者對此很感興趣，這是合乎邏輯且明確的。也許我能做的就是讓您更了解我們將使用的流程，以便與董事會一起做出決定。我想說的是，董事會在過去四到五年裡一直積極參與，重點是確保我們的內部候選人在過渡之前獲得我們認為需要的經驗。我可以從我的角度告訴你，一切都進展得非常好。我們每年定期召開幾次董事會會議，專門討論繼任者和我們正在取得的進展。當企業達到我先前描述的標準時，在下一次定期召開的董事會會議上，我將向董事會提出建議，認為現在是能夠進行過渡的適當時機。董事會將對該建議進行投票。

At the end of that vote, we would send out an announcement to investors. And what you can expect when you get that announcement is that we would make an announcement that we were going to make the transition out at some point in the future. In all likelihood, 4 to 6 months in the future. And the purpose of that is to make the final transition between myself and that person and that will take 4 or 5 months in order to be able to do that.

投票結束後，我們將向投資者發出公告。當您收到該公告時，您可以期待的是，我們將宣布我們將在未來的某個時候進行過渡。很可能是未來 4 到 6 個月。這樣做的目的是在我和那個人之間進行最終的過渡，這將需要 4 到 5 個月的時間才能做到這一點。

I would say it's also very likely at that time based on the discussions I've been having with the Board, is that I will be named the Executive Chair for a period of time, and the purpose of that will be to make the transition of the full position over a period of time. So I think it's a very well thought out, I think, very well-managed process. And I think that's what you can expect going forward.

我想說，根據我與董事會的討論，屆時我也很可能被任命為執行主席一段時間，其目的是實現董事會的過渡。一段時間內的完整位置。所以我認為這是一個經過深思熟慮、管理得很好的過程。我認為這就是你可以期待的未來。

And Terence, this is Jeff. I'll start off and have Roopal address the second part of your second question. So we established many years ago now, this HS market with the approval of Humira. And we thought it was a relatively small market, and it turned out to be quite a surprise. There's a significant amount of patients around the world that suffer from HS. It's already a multibillion-dollar category and we think it's going to continue to expand. And I say that because we can see that like IBD, there's just some new approvals just coming. So everyone sort of holds on Humira as long as they can if they're exposed to a biologic.

特倫斯，這是傑夫。我會先讓 Roopal 解決你第二個問題的第二部分。所以我們多年前就在 Humira 的批准下建立了這個 HS 市場。我們以為這是一個相對較小的市場，結果卻令人相當驚訝。世界各地有大量患有熱射病的患者。它已經是一個價值數十億美元的類別，我們認為它將繼續擴大。我這麼說是因為我們可以看到像 IBD 一樣，即將有一些新的批准。因此，如果每個人接觸到生物製劑，都會盡可能長時間地服用修美樂。

And so we see the same dynamic as you start to see IL-17 come into the space. And certainly, we're very excited about lutikizumab because of the profile that we're seeing emerge in the clinic. So it's a significant commercial opportunity. And I would say that when we look back over all the Humira indications over the last decade or more, HS was one of the most rapid indications that move to $1 billion-plus business. So it's an exciting opportunity, both commercially and certainly for patients. And Roopal can address your comment on IBD.

因此，當您開始看到 IL-17 進入太空時，我們看到了相同的動態。當然，我們對 lutikizumab 感到非常興奮，因為我們看到臨床上出現的情況。所以這是一個重要的商業機會。我想說的是，當我們回顧過去十年或更長時間的所有 Humira 適應症時，HS 是業務規模超過 10 億美元的最快適應症之一。因此，無論是對於商業還是對患者來說，這都是一個令人興奮的機會。 Roopal 可以回應您對 IBD 的評論。

Yes. Terence, part of it starts, I would say, almost 15 years ago with our Insight in Crohn's disease with Humira, as Jeff was discussing, where we started to see efficacy in patients that had HS, we saw a good amount of overlap between Crohn's and HS. So that's part of it.

是的。特倫斯，我想說，這一部分始於大約15 年前，正如傑夫所討論的那樣，我們對修美樂對克羅恩病的洞察開始了，我們開始看到對HS 患者的療效，我們看到克羅恩病之間有很多重疊。和HS。這就是其中的一部分。

Now that doesn't really pan out for IL-17 but what we've observed with IL-1 beta in particular is that our internal data and external data do show elevated expression signals with 1 beta. So we think we have that opportunity with lutikizumab because it also covers on beta. And we have two shots at this, right? One is to go specifically and look at a biomarker-driven targeted profile where we would be able to distinguish which patients actually have that higher expression. And the other approach, which we maybe weren't talking about years ago because we didn't have a product like Skyrizi, which has high efficacy and very strong safety profile in Crohn's. What we have now is the opportunity to also look at in combination. So a biomarker approach and a combo approach our insights from Humira and preclinical or biopsy-based insights that we have externally and internally.

現在這對 IL-17 來說並沒有真正成功，但我們特別觀察到 IL-1 beta 的情況是，我們的內部數據和外部數據確實顯示 1 beta 的表達訊號升高。因此，我們認為 lutikizumab 有這樣的機會，因為它也涵蓋了測試版。我們有兩次機會，對吧？一是專門研究生物標記驅動的目標概況，我們將能夠區分哪些患者實際上具有更高的表達。另一種方法，幾年前我們可能沒有談論過，因為我們沒有像 Skyrizi 這樣的產品，它對克羅恩病具有高效性和很強的安全性。我們現在有機會結合起來看看。因此，生物標記方法和組合方法可以幫助我們從 Humira 獲得見解，以及我們從外部和內部獲得的臨床前或基於活檢的見解。

Next question comes from Andrew Baum with Citi.

下一個問題來自花旗銀行的安德魯·鮑姆 (Andrew Baum)。

A couple of questions. One, given AbbVie's strength in market access and managed markets, I'd be curious the extent of future contagion from RNA IRA mediated price cuts on the Medicare book spilling over on to the commercial book of business. How much of a concern do you think this is given the payers are basically the same?

有幾個問題。第一，鑑於艾伯維在市場准入和管理市場方面的實力，我很好奇 RNA IRA 介導的醫療保險帳簿降價未來會在多大程度上蔓延到商業帳簿。鑑於付款人基本上相同，您認為這有多大程度的擔憂？

And then second question on lutikizumab. If I remember from the (inaudible) trials, secondary to neutropenia, there was an increase in fatal infections. If you're layering this on top of another immunosuppressive, how are you thinking about the safety concerns in these IBD patients?

然後是關於 lutikizumab 的第二個問題。如果我記得（聽不清楚）試驗中，繼發於嗜中性白血球減少症的致命感染增加。如果您將其與另一種免疫抑制劑疊加使用，您如何考慮這些 IBD 患者的安全性問題？

Andrew, thanks for your question. It's Jeff. And we think that the -- particularly the negotiation aspects of the IRA will be very contained on the Medicare side. And as you can imagine, with government programs over the years, when we have discussions with payers, they'll often say things over -- well, we know what the FSS price is for the VA or the mandated discounts and supplemental discounts in the Medicaid channel.

安德魯，謝謝你的問題。是傑夫。我們認為，特別是 IRA 的談判方面將在醫療保險方面得到嚴格控制。正如你可以想像的那樣，透過多年來的政府計劃，當我們與付款人討論時，他們經常會說一些事情——好吧，我們知道VA 的FSS 價格是多少，或者VA 的強制折扣和補充折扣是多少。醫療補助頻道。

But we think those are really government actions and government rules. And so we see that the market, we believe, will play out largely like it has with the other government channels, that it's a unique dynamic in terms of essentially a force negotiation that we think will be contained largely in the Medicare space. So that's how we view the world.

但我們認為這些確實是政府行為和政府規則。因此，我們認為，市場將在很大程度上像其他政府管道一樣發揮作用，從本質上講，這是一種獨特的動態，我們認為這將主要包含在醫療保險領域。這就是我們看待世界的方式。

It's Roopal. I'll talk about luti in your question around neutrophils. Yes, we do see an impact on neutrophils. It's dose driven. However, I think we think about inflammatory bowel disease, probably lupus, others to have a different tolerance for benefit risk. Because today, in those disease states, despite the success that we've seen with Skyrizi and Rinvoq, there's still substantial headroom to lead to more transformational efficacy. Not every patient is getting into remission, though high levels, not every patient. So we still believe that a combo can get to that and break that efficacy threshold. The other opportunity there is what we'll do with the combination is obviously optimize the dose to assure safety. And thus far, in the HS trial, even at the highest dose, we saw very little infections.

是魯帕爾。我將在您關於中性粒細胞的問題中討論盧蒂。是的，我們確實看到了對中性粒細胞的影響。這是劑量驅動的。然而，我認為我們考慮發炎性腸道疾病，可能是狼瘡，其他疾病對受益風險有不同的耐受性。因為今天，在這些疾病狀態下，儘管我們看到 Skyrizi 和 Rinvoq 取得了成功，但仍然有很大的空間來實現更多的轉化功效。並非每位患者都進入緩解期，儘管程度較高，但並非每位患者都達到緩解狀態。因此，我們仍然相信組合可以達到這一目標並突破功效閾值。另一個機會是我們對組合所做的顯然是優化劑量以確保安全。到目前為止，在 HS 試驗中，即使在最高劑量下，我們也看到很少的感染。

The next question comes from Mohit Bansal with Wells Fargo.

下一個問題來自富國銀行的 Mohit Bansal。

Congrats on all the progress. I just want to go back to the ImmunoGen acquisition and the comments you made before. Can you talk a little bit about the plans to move the drug into earlier lines of ovarian cancer. You talked about maintenance setting, but more we are reading it, I mean, in first-line maintenance, the PFS and OS tends to be really long. So could you talk a little bit about the strategy there? And how do you overcome the existing OS benefit that these drugs provide?

祝賀所有的進展。我只想回顧一下對ImmunoGen 的收購以及您之前發表的評論。您能談談將該藥物用於卵巢癌早期治療的計劃嗎？您談到了維護設置，但我們更多地閱讀它，我的意思是，在一線維護中，PFS 和 OS 往往非常長。那麼您能談談那裡的策略嗎？如何克服這些藥物提供的現有 OS 益處？

It's Roopal. I'll take that. So I think as you've seen in resistance, we've seen the overall survival benefit, a very substantial one unprecedented thus far. And to your point, the plan is to move into earlier lines of therapy. Secondly, it's also a part of the strategy to move into sensitive populations, which is around 55% of the population, resistance is around 45%. And then the third aspect is we've seen encouraging data in medium expressers of FR alpha. And those are approximately 30% of the patients, high is around 35%.

是魯帕爾。我會接受的。因此，我認為正如您在抵抗中所看到的那樣，我們已經看到了整體生存效益，這是迄今為止前所未有的非常重大的效益。就你的觀點而言，計劃是進入早期治療階段。其次，這也是進入敏感族群策略的一部分，敏感族群約佔總人口的55%，抵抗力約45%。第三個面向是我們在 FR α 的中等表現者中看到了令人鼓舞的數據。這些人約佔患者的 30%，最高可達 35% 左右。

So those are the three strategies to go forward. Now how do we get into earlier lines of therapy? Well, a couple of things, insights that we've seen. One is we've seen Elahere been able to combine at full dose with carboplatin. So that's encouraging that gives you an opportunity to upfront combined. And then, as you stated, maintain on Elahere or with Elahere plus BEV.

這就是前進的三個策略。現在我們如何進入早期治療？嗯，有幾件事，我們已經看到的見解。一是我們已經看到 Elahere 能夠與卡鉑以全劑量結合。因此，這是令人鼓舞的，它為您提供了預先合併的機會。然後，正如您所說，繼續使用 Elahere 或使用 Elahere 加 BEV。

So the other approaches that we would do getting the earlier line of maintenance is have that upfront therapy, and then we see patients that go on to BEV, we can combine with BEV at that time point. And we'll be looking at combinations with PARP inhibitors, which is about the other half of the patient populations, which are HRD deficient. So taken all together, we see there's an opportunity. Now the PFS is going to be a little bit longer along with OS. So that is something that we're planning for. We'll start these studies as soon as possible, but they will read out in the later part of the decade and into 2030.

因此，我們獲得早期維持的其他方法是進行前期治療，然後我們看到繼續接受 BEV 治療的患者，我們可以在那個時間點與 BEV 結合。我們將研究與 PARP 抑制劑的組合，這大約是 HRD 缺陷患者群體的另一半。綜上所述，我們看到這是一個機會。現在，PFS 將會與 OS 一起變得更長一些。這就是我們正在計劃的事情。我們將盡快開始這些研究，但它們將在本十年後半段和 2030 年公佈。

Next question comes from Vamil Divan Devon with Guggenheim Security.

下一個問題來自古根漢保全公司的瓦米爾·迪萬·德文 (Vamil Divan Devon)。

This is Jan (inaudible) for Vamil. So my question is on Humira. I was curious, given the recent performance the company has had with the erosion since the interruption of biosimilars, I was wondering if you can now provide maybe a better sense around the company's expectations on Humira's longer-term tail revenues in both the U.S. and ex U.S. markets.

我是瓦米爾的簡（聽不清楚）。所以我的問題是關於 Humira 的。我很好奇，考慮到該公司最近的業績隨著生物相似藥中斷以來的侵蝕，我想知道您現在是否可以更好地了解該公司對 Humira 在美國和前的長期尾部收入的預期美國市場。

It's Rob. I'll take that question. So we do expect that in the U.S., the tail starts to emerge in the '25 or '26 time frame. Keep in mind, '24 is the first full year for U.S. biosimilars. We'll have to see what happens with volume uptake this year and also where interchangeability lands. And ultimately, what does contracting look like next year. So I wouldn't expect us to quantify the tail this year, but it's certainly possible something we would do either in '25 or '26.

是羅布。我來回答這個問題。因此，我們確實預期在美國，尾巴會在 25 或 26 年時間範圍內開始出現。請記住，24 年是美國生物相似藥的第一個全年。我們必須看看今年的銷量會發生什麼以及可互換性的落地。最終，明年的合約會是什麼樣子。所以我不希望我們今年量化尾部，但我們肯定有可能在 25 年或 26 年做一些事情。

As it relates to international, you're seeing, I think, this year, it's a step down of about $400 million, half of that is really the last wave of markets like Canada, Puerto Rico, we're seeing, I'd say, some incremental erosion we would expect this year. And then the other half would be your typical international price erosion you see across therapeutic areas. So not really specific to biosimilars. And then the other 1/4 of it would be -- what we're seeing is just the strength of Skyrizi and Rinvoq as these newer agents elevate standard of care, you see some share go to those newer agents.

就國際而言，我認為今年將減少約 4 億美元，其中一半實際上是最後一波市場，例如加拿大、波多黎各，我們看到，我會比方說，我們預計今年會出現一些增量侵蝕。然後另一半將是您在治療領域看到的典型國際價格侵蝕。所以並不是專門針對生物相似藥。然後剩下的 1/4 是——我們看到的只是 Skyrizi 和 Rinvoq 的實力，因為這些新代理商提高了護理標準，你會看到一些份額流向了這些新代理商。

And so probably the best way to think about international would be if you want to adjust for half of the erosion this year as being more of the final waves and then you get a sense of what could potentially be the ongoing beyond that. But we'll be more specific. I think we need to see really how the U.S. plays out with this being the first full year for biosimilars before we can really give you more color. But we're very, very pleased with the progress we've made so far.

因此，考慮國際的最佳方式可能是，如果你想將今年一半的侵蝕調整為更多的最後一波，然後你就會了解除此之外可能發生的情況。但我們會更具體。我認為我們需要真正了解美國在今年是生物相似藥的第一個完整年中的表現，然後才能真正為您提供更多資訊。但我們對迄今為止所取得的進展感到非常非常滿意。

The next question comes from Carter Gould with Barclays.

下一個問題來自巴克萊銀行的卡特·古爾德。

Two, on the neuroscience portfolio, I guess, first on 951, how should we think about that? Is that more sort of on growing the overall pie of device-aided therapies versus taking share from apomorphine and the gels. And then maybe looking a little bit longer term, AbbVie has sort of three Phase II Alzheimer's studies that are going to read out later this year or by early next year. Fully acknowledging the commercial challenges by the players in the market today and that some of these targets are now validated, how should investors think about these assets, either individually or collectively and your level of excitement?

第二，關於神經科學組合，我想，首先是 951，我們該如何思考？與從阿樸嗎啡和凝膠中獲取份額相比，這更像是擴大設備輔助療法的整體份額。然後，也許從長遠來看，艾伯維（AbbVie）有三項二期阿茲海默症研究，將於今年稍後或明年初公佈。充分認識到當今市場參與者面臨的商業挑戰，而其中一些目標現已得到驗證，投資者應該如何單獨或集體地考慮這些資產以及您的興奮程度？

It's Jeff. I'll take the first question. So what we look at when we see this market at a macro level, you have a significant number of patients, 85% of patients are just on these oral medications, so oral Sinemet, okay? And they essentially need to consume more and more and more orals. And sometimes at the end of it, they're taking 12 pills a day. It's very, very difficult to manage. But then they're faced with a very difficult decision. Which we kind of call like a surgical barrier. And that surgical barrier is to get any sort of more advanced relief, you either have to think about deep brain stimulation, which is a brain surgery or our own DUOPA, which is a GI surgery.

是傑夫。我來回答第一個問題。那麼，當我們從宏觀層面看待這個市場時，我們會看到什麼，你有大量的患者，85% 的患者只服用這些口服藥物，所以口服 Sinemet，好嗎？他們本質上需要消耗越來越多的口服液。有時結束時，他們每天會服用 12 粒藥片。這非常非常難以管理。但隨後他們面臨一個非常困難的決定。我們稱之為外科手術屏障。而手術障礙是為了獲得任何更高級的緩解，你必須考慮深部腦部刺激，這是一種腦部手術，或是我們自己的 DUOPA，這是一種胃腸道手術。

So the way we see this market developing is we see that 951 starts to establish a very nice transition zone because you don't have -- it's a subcu. So a new market segment that starts to emerge before bigger interventions like DBS or DUOPA, and obviously, the ability to basically move quicker to more relief from these chronic oral basically overtreatment. So that's how we see it. And as Roopal highlighted, we're seeing some very nice uptake in Japan, where we launched late last year and also in Germany and some of the first European launches.

因此，我們看到這個市場發展的方式是，我們看到 951 開始建立一個非常好的過渡區，因為你沒有——它是一個 subcu。因此，在 DBS 或 DUOPA 等更大的干預措施之前，一個新的細分市場開始出現，顯然，能夠更快地緩解這些慢性口服過度治療的情況。這就是我們的看法。正如 Roopal 所強調的那樣，我們在日本看到了一些非常好的應用，我們在去年年底在日本推出了這款產品，在德國以及歐洲的一些首批推出的產品中也是如此。

So that's how the market is exactly playing out. We're establishing essentially a new high-efficacy category here with 24 hours of ongoing relief, you can do super specific dosing titration and the pump is much smaller. And again, it's a subcu injection that you move around every 3 days. So it's a nice opportunity for the company.

這就是市場的運作方式。我們在這裡基本上建立了一個新的高效類別，具有 24 小時持續緩解功能，您可以進行超特定劑量滴定，並且泵要小得多。再說一遍，這是一次 subcu 注射，您每 3 天移動一次。所以這對公司來說是一個很好的機會。

And maybe I'll talk about the other assets that you mentioned in Alzheimer's. First, 916, that's our A-beta antibody. What we like about that one thus far that the profile we've seen is a long half-life, which would be good to space out dosing potentially higher potency, if that holds, and we see robust reductions in beta amyloid that could allow for subcutaneous dosing that's based apart. And the other thing we're looking at is potentially lower ARIA. So if we see those three things over the course, I would say, end of this year, early next year, I think that, that would be quite exciting because it would be a differentiated profile, again, a better convenience and potentially better benefit risk profile. So that's 916.

也許我會談談您在阿茲海默症中提到的其他資產。首先，916，這是我們的 A-β 抗體。到目前為止，我們喜歡的一點是我們所看到的半衰期很長，如果這種情況成立的話，這將有利於間隔出潛在更高效力的劑量，並且我們看到β澱粉樣蛋白的大幅減少，這可能會允許皮下給藥是分開的。我們正在關注的另一件事是 ARIA 可能會降低。因此，如果我們在整個過程中看到這三件事，我會說，今年年底、明年初，我認為這將是非常令人興奮的，因為這將是一個差異化的形象，同樣，更好的便利和潛在的更好的利益風險狀況。所以那就是916。

552 is our SV2A that's our oral medication in cognition that's currently in Phase II. And we anticipate readout at the end of this year, early next year. Now that one is being studied in a setting where a patient can be on a therapy already like in Aricept or on nothing. And we would use the typical ADAS-cog assessments along with a variety of others including other neuropsychiatric symptoms like depression. So that's another nice one that could combine with a variety of different assets in Alzheimer's.

552 是我們的 SV2A，這是我們目前處於 II 期的認知口服藥。我們預計將在今年底、明年初公佈結果。現在，一項研究正在一個環境中進行，病人可以接受安理申那樣的治療，也可以不接受任何治療。我們將使用典型的 ADAS-cog 評估以及各種其他評估，包括憂鬱症等其他神經精神症狀。因此，這是另一種很好的方法，可以與阿茲海默症的各種不同資產結合。

The third one I'll mention is around emraclidine, which comes from Cerevel. They are at early stages right now in elderly patients and the goal there would be in Alzheimer's disease psychosis, of the 6 million or so diagnosis, I would say around 40% of these patients present with symptoms of psychosis. So with all the therapies that are in the clinic, we think we have a very nice complementary suite of options that could address numerous symptoms of Alzheimer's because it won't be just one therapy that's going to solve this. But more to come end of this year and into next year.

我要提到的第三個是關於 emraclidine，它來自 Cerevel。目前，老年患者的治療還處於早期階段，目標是阿茲海默症精神病，在大約 600 萬的診斷中，我想說這些患者中大約 40% 出現精神病症狀。因此，透過臨床上的所有療法，我們認為我們有一套非常好的補充選擇，可以解決阿茲海默症的眾多症狀，因為它不僅僅是一種療法可以解決這個問題。但今年年底和明年還會有更多的事情發生。

Next question comes from (technical difficulty)

下一個問題來自（技術難度）

Just on the reaffirmed long-term guide, can I clarify if the Cerevel and ImmunoGen deals are in this '29 guide, given you included them in the '24 guide? And you up Skyrizi and Rinvoq by $6 billion, migraine by $1 billion. If these are the pushes, what are the pulls in reaffirming that long-term guidance?

就重申的長期指南而言，鑑於您已將 Cerevel 和 ImmunoGen 交易納入 '24 指南中，我能否澄清一下它們是否包含在本 '29 指南中？ Skyrizi 和 Rinvoq 增加了 60 億美元，偏頭痛增加了 10 億美元。如果這些都是推動因素，那麼重申長期指導的推動因素是什麼？

This is Rob. I'll take that question. Yes, we did include ImmunoGen and Cerevel in our long-term guide. The thing to keep in mind is high single digits when you think about the range that could represent that's around $10 billion between the low end of the high single digits and the high end of the high single digits. And so there aren't any pulls. What we've updated as we walked you through it, is we've increased the oral CGRP peak revenue. We've increased Skyrizi and Rinvoq and we've reaffirmed the other. So there's nothing that we took down. But just keep in mind that you've got a pretty wide range.

這是羅布。我來回答這個問題。是的，我們確實將ImmunoGen 和Cerevel 納入了我們的長期指南中。當您考慮可以代表高個位數的低端和高個位數的高端之間大約 100 億美元的範圍時，需要記住的是高個位數。所以沒有任何拉力。當我們引導您完成它時，我們更新的是我們增加了口服 CGRP 峰值收入。我們增加了 Skyrizi 和 Rinvoq，並重申了另一個。所以我們什麼也沒拿下來。但請記住，您的範圍相當廣泛。

If you look at Street consensus, we're encouraged that it continues to move up. It has moved up over the course of last quarter, about $3 billion in 2029. It's nice to see that upward movement, but it's still below what we expect. If you think that growth rate for the Street is just under 5%. We expect high single digits. And so even with this update as well as ImmunoGen and Cerevel, we're still high single digits, but keep in mind, it's a pretty wide range and it would be regardless industry-leading growth, and we're set up very well to continue delivering a very strong growth, and we're setting ourselves very well to grow very nicely in the next decade as well.

如果你看看華爾街的共識，我們會很高興看到它的持續上升。它在上個季度有所上升，到 2029 年約為 30 億美元。很高興看到這種上升趨勢，但仍低於我們的預期。如果你認為華爾街的成長率略低於 5%。我們預計高個位數。因此，即使有了這次更新以及ImmunoGen 和Cerevel，我們仍然處於較高的個位數，但請記住，這是一個相當廣泛的範圍，並且無論增長如何，它都將是行業領先的，並且我們已經做好了充分準備繼續實現非常強勁的成長，我們也為自己做好了準備，在未來十年也能實現良好的成長。

Our next question comes from Gary Nachman with Raymond James. .

我們的下一個問題來自加里·納赫曼和雷蒙德·詹姆斯。 。

First on aesthetics, could you talk a bit more why you're confident in what seems to be a pretty decent return to growth in 2024. So how much of a headwind could China be offsetting the U.S. growth? And what are other regions will you be getting somewhat of a lift this year? Just talk about the dynamics on that front. And then secondly, just as you return to more robust revenue growth in 2025, what are reasonable expectations for operating margins directionally in 2025. Can that expand at all? Or is it more likely to be depressed from the ImmunoGen and Cerevel deals? Just give us some directional way to think about that for next year.

首先就美學而言，您能否多談談為什麼您對 2024 年似乎相當不錯的經濟成長恢復充滿信心。那麼，中國可以抵消美國經濟成長的逆風有多大呢？今年還有哪些地區會有所提升？只是談談這方面的動態。其次，當你在 2025 年恢復更強勁的營收成長時，對 2025 年營業利潤率的合理預期是多少。這種成長是否能夠擴大？還是說它更有可能因為ImmunoGen 和Cerevel 交易而受到抑制？請給我們一些思考明年的方向性方法。

This is Carrie. I'll take your first question on aesthetics and the aesthetics market recovery. So I'll start with the U.S., and we have started to see the U.S. toxin market recover at the end of 2023. We expect that recovery to continue and for the market growth for toxins to continue to improve in 2024. For fillers in the U.S. in Q4 after multiple quarters of decline, the filler market in the U.S. was somewhat flat. And so that dynamic of the filler market recovery lagging the toxin market recovery, is playing out, and we do expect that recovery on fillers to also continue to a lesser degree, even toxin is more of a modest growth -- positive growth for 2024. And as we look at the beginning of the year here in 2024, we are seeing our patient demand metrics and Google metrics really supporting our expectations here.

這是嘉莉。我將回答你關於美學和美學市場復甦的第一個問題。因此，我將從美國開始，我們已經開始看到美國毒素市場在 2023 年底開始復甦。我們預計這種復甦將持續，毒素市場成長將在 2024 年繼續改善。美國填充劑市場在經歷了多個季度的下滑之後，第四季表現有些平淡。因此，填充劑市場復甦滯後於毒素市場復甦的動態正在顯現，我們確實預期填充劑的復甦也將繼續較小程度，即使毒素也只是溫和增長——2024 年將出現正增長。當我們展望2024 年在年初的年初時，我們看到我們的病患需求指標和Google 指標確實支持了我們的預期。

In terms of China, we do expect the economic headwind that we saw beginning midyear 2023 to continue in the near term with China. And we expect the China aesthetics market to be flat overall in 2024. That would look like negative market in the first half of the year until the China market starts to recover in the second half of 2024. And we expect that China performance to be balanced against expectations for strong performance in other international regions, including Japan, which has become an important market for aesthetics, and areas of Latin America, like Brazil, which is a highly aesthetically oriented market.

就中國而言，我們確實預計 2023 年中開始的經濟逆風將在短期內持續存在。我們預計 2024 年中國美容市場將整體持平。在 2024 年下半年中國市場開始復甦之前，這看起來像是上半年的負面市場。我們預計中國的表現將會平衡與其他國際地區強勁表現的預期相反，包括已成為重要美學市場的日本，以及巴西等拉丁美洲地區，這是一個高度美學導向的市場。

It's also important to note in terms of Q1 of 2024, in terms of our guidance there, that the growth in the U.S. will be offset by that international decline specifically in China. So not only the China economic headwind, but also a difficult year-over-year comp in Q1, because recall, in Q1 of 2023, there was the post-pandemic reopening in China. So that's really how we see the market growth factors in U.S., China, in other parts of the world playing out in 2024.

同樣重要的是要注意，就 2024 年第一季而言，根據我們的指導，美國的成長將被國際特別是中國的下降所抵消。因此，不僅是中國經濟的逆風，而且第一季的同比比較也很困難，因為回想一下，2023 年第一季度，中國經歷了疫情後的重新開放。這就是我們對 2024 年美國、中國和世界其他地區市場成長因素的看法。

And Gary, this is Rob. To build on the aesthetics story. I said in the past to get to our guidance of greater than $9 billion, we need to deliver annual growth of high single digits on average. And as Carrie just walked you through, we haven't quite seen the recovery for the fillers market yet this year. And we will, but it's not going to be a normal year, we'll see a ramping. And we also had a slowdown in China. But despite that, we're still delivering high single-digit growth. and given how underpenetrated these markets are, we can drive that market growth that's required to achieve the long-term guidance.

加里，這是羅布。以美學故事為基礎。我過去說過，要達到超過 90 億美元的目標，我們需要實現年均高個位數成長。正如嘉莉剛剛向您介紹的那樣，今年我們還沒有完全看到填充劑市場的復甦。我們會的，但這不會是正常的一年，我們會看到成長。中國市場也出現了放緩。但儘管如此，我們仍然實現了高個位數成長。考慮到這些市場的滲透率很低，我們可以推動實現長期指導所需的市場成長。

And then on top of that, we have several innovations that will further support that growth. I've said this before, but the masseter and platysma indications for Botox will add a few hundred million dollars each. Our novel short-acting toxin BoNTE has the potential to activate new patients who have not started toxin due to fear of an unnatural look. So that could drive an inflection in market growth and market share. And then our regional fillers pipeline is really aimed at providing both short- and long-term treatment benefits for consumers. So we have several avenues to get to our greater than $9 billion guide. I have seen consensus estimates at 8 for 2029, but we're very confident in our guidance of greater than 9 by that period.

除此之外，我們還有幾項創新將進一步支持這種成長。我以前說過，但肉毒桿菌的咬肌和頸闊肌適應症將分別增加幾億美元。我們的新型短效毒素 BoNTE 有可能活化因擔心外觀不自然而未開始使用毒素的新患者。因此，這可能會推動市場成長和市場份額的變化。我們的區域填充劑管道真正旨在為消費者提供短期和長期的治療效益。因此，我們有多種途徑來獲取價值超過 90 億美元的指南。我看到 2029 年的共識估計為 8，但我們對這段時期超過 9 的指導非常有信心。

Gary, this is Scott. I'll take your question regarding operating margin expansion. So for '24, as I mentioned in my remarks, we've guided to 46.5%. When we do return to robust growth in 2025, we do see that operating margin will expand and will continue to expand as we grow through the decade. I think that when we think about the pace of that expansion, it will be relatively steady over several years. I would, though, if you're modeling that, I would kind of peak it out at around 50%. I think that's what will hit a peak at the operating margin. But we do see expansion both in '25 on that return to robust growth, including the impact of the two transactions, ImmunoGen and Cerevel, which should presumably be a full year at that point in time. But at a full year impact, we see that expansion. I do think it's worth noting even at our current levels, we have industry-leading operating margin and certainly with the future expansion, we'll continue to have that and only grow that position.

加里，這是斯科特。我將回答你關於營業利潤率擴張的問題。因此，正如我在發言中提到的，24 年我們的目標是 46.5%。當我們在 2025 年確實恢復強勁成長時，我們確實看到營業利潤率將會擴大，並將隨著我們在這十年中的發展而繼續擴大。我認為，當我們考慮擴張的速度時，它將在幾年內相對穩定。不過，如果你對此進行建模，我會將其峰值控制在 50% 左右。我認為這將是營業利潤率達到頂峰的原因。但我們確實看到了 25 年恢復強勁成長的擴張，包括兩筆交易（ImmunoGen 和 Cerevel）的影響，到那時應該是一整年。但從全年影響來看，我們看到了這種擴張。我確實認為值得注意的是，即使在我們目前的水平上，我們也擁有行業領先的營業利潤率，當然，隨著未來的擴張，我們將繼續保持這一水平，並且只會提高這一地位。

Next question comes from Steve Scala with TD Cowen.

下一個問題來自 Steve Scala 和 TD Cowen。

Two questions. Is the current tax rate fully reflecting likely tax changes in the U.S. and outside the U.S. So it represents the high watermark for the foreseeable future. Previously, the company spoke to a 16% tax rate, and we're pretty much there. So I'm wondering if the increases are kind of behind us.

兩個問題。目前的稅率是否完全反映了美國和美國境外可能發生的稅收變化？因此，它代表了可預見的未來的高水位線。此前，該公司談到了 16% 的稅率，我們也差不多做到了。所以我想知道成長是否已經過去了。

And then, Rick, a slightly different kind of question, but there are clear obvious reasons such as the success of Skyrizi and Rinvoq. But I'm curious if you would share with us a few of the externally less visible factors that are leading to AbbVie's success traversing the Humira patent expiration that your pharma peers missed when dealing with their own pressures, I would assume contracting formulary management, allocation of overhead or all part of it. But what would you be willing to share with us?

然後，Rick，這是一個稍微不同的問題，但有明顯的原因，例如 Skyrizi 和 Rinvoq 的成功。但我很好奇您是否願意與我們分享一些外部不太明顯的因素，這些因素導致艾伯維（AbbVie）成功度過了修美樂（Humira）專利到期的困境，而您的製藥同行在處理自己的壓力時錯過了這一點，我認為承包處方管理、分配開銷或全部開銷。但您願意與我們分享什麼？

Steve, this is Scott. I'll start with your tax rate question. So with respect to the tax rate, we were essentially flat between this year and last year at 15.7%. We do see that tax rate over the 3-year period, including this year, increasing about 1% on average. Now that's not going to be a 1% per year. What you'll see is a step up in a couple of years when the U.S. tax rates do increase, the GILTI rate, in particular, will increase. So we see that over a 3-year period, about 1% per year on average. That does include all the impacts of a number of things going on globally with the OECD and some of these OECD minimum taxes and other things.

史蒂夫，這是史考特。我將從你的稅率問題開始。所以就稅率而言，今年和去年基本上持平，為 15.7%。我們確實看到，包括今年在內的三年期間，稅率平均增加了約1%。現在這不會是每年 1%。幾年後，當美國稅率確實提高時，您將看到一個台階，特別是 GILTI 稅率將會提高。所以我們看到，在 3 年期間，平均每年約 1%。這確實包括全球範圍內與經合組織發生的許多事情的所有影響，以及經合組織最低稅收和其他事情的一些影響。

I would say the one thing that does not include , you saw just this week, the House passed a tax bill that includes a provision regarding the R&D expensing. So if that bill were to pass as it's written, we would see a slight step down in our tax rate about 80 basis points from the impact of that on an ongoing basis.

我想說的是，不包括的一件事是，你在本週看到，眾議院通過了一項稅收法案，其中包括有關研發費用的條款。因此，如果該法案按其規定獲得通過，我們的稅率將因該法案的持續影響而小幅下降約 80 個基點。

Steve, this is Rick. I think if you step back and you look over the last, I'd say, 10 years, we were trying to develop a strategy that we fundamentally believe would allow us to be able to offset the Humira LOE and continue to deliver top-tier financial performance as we have for the past 10 years. That was the whole objective. And we knew we had to build a very diversified growth platform in order to be able to do that, to be able to absorb that impact and return to growth as rapidly as possible.

史蒂夫，這是瑞克。我認為，如果你退後一步，回顧過去，我會說，10 年，我們正在努力製定一項戰略，我們從根本上相信該戰略將使我們能夠抵消 Humira LOE 的影響並繼續提供頂級產品我們過去10 年的財務業績。這就是整個目標。我們知道，我們必須建立一個非常多元化的成長平台，才能做到這一點，才能吸收這種影響並儘快恢復成長。

And so we, as an executive team focused a lot of energy around how do we do that, how do we build it? How do we do it in the right markets? I think AbbVie -- I'm obviously biased, I guess, but I would say our commercial execution has always been exceptional, in my opinion. We understand the markets, we're in extremely well. We understand the competitive environment that we compete in those markets extremely well. We understand the patient journey and how that patient journey is affected by access to medicines to ensure that patients can get their medicines routinely and be able to get the benefit of those medicines. It takes all of those things, I think, to end up with the kind of success that we see with assets like Skyrizi and Rinvoq.

因此，作為一個執行團隊，我們將大量精力集中在如何做到這一點、如何建立它？我們如何在正確的市場中做到這一點？我認為艾伯維——我想我顯然有偏見，但我想說，在我看來，我們的商業執行力一直都很出色。我們了解市場，我們的處境非常好。我們非常了解我們在這些市場中競爭的競爭環境。我們了解患者的旅程以及患者的旅程如何受到藥物取得的影響，以確保患者能夠定期獲得藥物並能夠從這些藥物中受益。我認為，需要所有這些因素才能最終獲得 Skyrizi 和 Rinvoq 等資產所取得的成功。

But it also takes, I think, a company that is very good at what I described as read and react. There are always challenges in businesses as big and as complex as this. And I think the difference between companies that can continue to perform at the top tier year in and year out is they're good at seeing issues and then quickly reacting to how they're going to either offset those or deal with those. We had many of those examples. I'd say the label change on Rinvoq was a great example. But look at where Rinvoq is growing now and despite that label change, many would not have predicted that.

但我認為，這還需要一家非常擅長我所說的閱讀和反應的公司。如此龐大、如此複雜的企業總是會面臨挑戰。我認為，能夠年復一年保持頂級表現的公司之間的區別在於，他們善於發現問題，然後迅速對如何抵消或處理這些問題做出反應。我們有很多這樣的例子。我想說 Rinvoq 上的標籤更改就是一個很好的例子。但看看 Rinvoq 現在的發展情況，儘管標籤發生了變化，但許多人都沒有預料到這一點。

Migraine was a very challenging market for a period of time. We look at how we've operated with Ubrelvy and Qulipta and the kind of success we've seen against the competitors in those markets. Neuroscience, very different kind of market with Vraylar. That's all about trying to grow market share and expand your position there with a very good asset. And so we're good at that. And I think that is the real differentiator.

偏頭痛在一段時間內是一個非常具有挑戰性的市場。我們研究了我們如何與 Ubrelvy 和 Qulipta 合作，以及我們在這些市場上與競爭對手相比所取得的成功。神經科學，與 Vraylar 截然不同的市場。這一切都是為了利用非常好的資產來擴大市場份額並擴大您的地位。所以我們很擅長這一點。我認為這是真正的差異化因素。

The other thing I'd say is, I think we have been very efficient at our R&D investment. We obviously don't have the largest R&D investment in the industry. But we produced a tremendous amount of return against that R&D investment. Now having said that, as we go forward, we know we need to increase R&D, as I said in my comments, we did a fairly significant increase last year despite dealing with the Humira LOE and we're going to do another fairly significant increase this year because we have some assets that had very, very significant opportunities, like 383 and like 400 and several others that are going to require a large Phase III, multiple large Phase III studies to be able to get the kind of label that we need. And that's another thing I'd say we're good at, understanding how you have a competitive label and building your clinical programs to get that.

我想說的另一件事是，我認為我們的研發投資非常有效率。我們顯然沒有業界最大的研發投入。但我們的研發投資卻獲得了巨大的回報。話雖如此，隨著我們前進，我們知道我們需要增加研發，正如我在評論中所說，儘管我們處理了修美樂LOE，但去年我們還是取得了相當顯著的增長，我們將再次進行相當顯著的成長今年，因為我們有一些資產有非常非常重要的機會，例如 383 和 400 以及其他一些資​​產，需要進行大量的 III 期、多項大型 III 期研究才能獲得我們需要的標籤。我想說，這是我們擅長的另一件事，了解如何擁有有競爭力的標籤並建立臨床計劃來實現這一目標。

So I think it requires all of those things. I don't think there's one magic formula. I think those are the kinds of things that we have honed here at AbbVie as an executive team, and we execute very well against those.

所以我認為它需要所有這些東西。我不認為有一個神奇的公式。我認為這些都是我們在艾伯維作為執行團隊磨練出來的東西，而且我們在這些方面執行得非常好。

The next question comes from Evan Seigerman with BMO Capital Markets.

下一個問題來自 BMO 資本市場的 Evan Seigerman。

Nocmon for Evan. I wanted to ask, thinking about the upcoming approval for Skyrizi in UC, how is management thinking about how that may or may not impact Rinvoq sales? Obviously, combined AbbVie offers an impressive suite of inflammatory assets. But what is the expectation of cannibalism across these assets potentially?

埃文的諾克蒙。我想問一下，考慮到 Skyrizi 即將在 UC 獲得批准，管理層如何考慮這可能會或可能不會影響 Rinvoq 的銷售？顯然，合併後的艾伯維提供了一系列令人印象深刻的煽動性資產。但這些資產可能會出現同類相食的情況嗎？

It's Jeff. I'll take that one. We've learned a lot from watching Skyrizi and Rinvoq in Crohn's. And to Rick's point, look, we're very careful about how we position these assets, how we basically represent them with our medical teams and our commercial teams. And so what we see, certainly, in our biggest markets, we see that they're actually complementary positioning. So Rick highlighted the label change, right? So Rinvoq in the U.S. is basically indicated for use after a TNF. So it's basically a later line therapy. Skyrizi, if you look at the Skyrizi UC results, it's very, very impressive. We studied some very, very tough patients there. the bio-naive patients, the efficacy is just outstanding. I would say it's best-in-class.

是傑夫。我會接受那個。透過觀察 Skyrizi 和 Rinvoq 在克隆氏症中的表現，我們學到了很多。就里克的觀點而言，我們非常謹慎地對待如何定位這些資產，如何在我們的醫療團隊和商業團隊中基本上代表它們。因此，我們當然可以看到，在我們最大的市場中，我們看到它們實際上是互補的定位。所以瑞克強調了標籤的變化，對吧？所以Rinvoq在美國基本上是在TNF之後才使用。所以這基本上是後期的一線治療。 Skyrizi，如果你看看 Skyrizi UC 的結果，你會發現它非常非常令人印象深刻。我們在那裡研究了一些非常非常難治的病人。對於初次接受生物治療的患者來說，療效非常出色。我想說它是同類中最好的。

So we can see that based on the profile of the agents for many of our representatives, we're able to talk to physicians about the consideration for Skyrizi frontline and then in later lines, Rinvoq. So the cannibalization of the overlap is very manageable and minimal. And what happens is you start to see this very significant build for total AbbVie share because of that complementary positioning. So we're quite confident that we'll be able to navigate this very well just as we see in the larger Crohn's market.

因此，我們可以看到，根據我們許多代表的代理人的資料，我們能夠與醫生討論對 Skyrizi 前線以及後線 Rinvoq 的考慮。因此，重疊的蠶食是非常容易管理的，而且是最小的。由於互補的定位，您開始看到艾伯維總份額的這一非常重要的增長。因此，我們非常有信心能夠很好地應對這項挑戰，就像我們在更大的克羅恩病市場中看到的那樣。

Our next question comes from Tim Anderson with Wolfe Research.

我們的下一個問題來自沃爾夫研究公司的蒂姆·安德森。

I have a question on obesity drug impact on AbbVie's aesthetics business. So the uptake of obesity drugs could be a headwind or a tailwind. It's a potential headwind if patients only have so many dollars to spend on aesthetics and they reallocate their out-of-pocket spending away from dermal fillers and toxins towards obesity drugs, or it's a tailwind if patients using obesity drugs and get things like the so-called Ozempic face and they end up using more toxins and fillers. So what's been the experience thus far? And what do you expect going forward over the next handful of years? .

我有一個關於肥胖藥物對艾伯維美容業務影響的問題。因此，肥胖藥物的使用可能是逆風，也可能是順風。如果患者只有那麼多錢花在美容上，並且他們將自付費用從真皮填充劑和毒素轉向肥胖藥物，那麼這將是一個潛在的逆風，或者如果患者使用肥胖藥物並獲得諸如此類的東西，這將是一個順風-被稱為“臭氧臉”，他們最終會使用更多的毒素和填充劑。那麼到目前為止有什麼經驗呢？您對未來幾年的發展有何期望？ 。

This is Carrie. So the short answer is we have not seen an impact on our aesthetics business, positive or negative, so far. That said, absolutely. Our customers and our consumers are participating in this market. We are seeing it integrated into some of these aesthetic practices. And to your point, there are instances where a patient will make a trade-off in terms of her share of wallet.

這是嘉莉。所以簡短的回答是，到目前為止，我們還沒有看到對我們的美學業務的影響，無論是積極的還是消極的。這就是說，絕對是。我們的客戶和消費者正在參與這個市場。我們看到它融入了一些美學實踐中。就你的觀點而言，在某些情況下，患者會根據自己的錢包份額進行權衡。

But that said, we do see it as a long-term tailwind any time, people are getting more engaged in their appearance. That's a positive thing for aesthetics. And as we ask our consumers and our customers about it, really, what we've learned is that it does reinforce the long-term tailwind because the majority of people who engage in these medical weight loss products, are more interested in aesthetics afterwards than they were before. So that's really how we see it in terms of that dynamic impacting aesthetics.

但話雖如此，我們確實將其視為長期的推動力，人們越來越注重自己的外表。這對於美學來說是一件正面的事情。當我們詢問我們的消費者和客戶時，我們實際上了解到，它確實增強了長期的順風，因為大多數從事這些醫療減肥產品的人，事後對美容更感興趣，而不是對美容更感興趣。他們以前是。這就是我們從動態影響美學角度看待它的方式。

Our next question comes from Tim Lugo with William Blair.

我們的下一個問題來自蒂姆·盧戈和威廉·布萊爾。

After the two announced acquisitions in December, what are the theme talks on M&A in 2024. Some of your peers have given guidance on expected deal sizes? Is that something you can provide the Street or at least talk about your capacity at this point?

繼12月宣布兩起收購之後，2024年併購的主題討論是什麼？您的一些同行對預期交易規模給出了指導？您是否可以向華爾街提供這些信息，或至少談談您目前的能力？

Tim, it's Rob. I'll take that question. So our BD efforts continue to be focused on identifying assets really that can drive growth in the next decade across immunology, oncology, neuroscience, aesthetics and eye care. We have what we need in our current portfolio to deliver on growth expectations in this decade. So our external efforts are really aimed at early stage opportunities, which are typically smaller-sized deals. As we look across the growth areas, if you think about immunology, Skyrizi and Rinvoq will drive robust growth into the next decade. So our focus in immunology in terms of BD is really looking for new mechanisms of action that can elevate standard of care, whether monotherapy or in combination. I'd say there's a lot of interest in combination.

提姆，我是羅布。我來回答這個問題。因此，我們的 BD 工作繼續專注於識別真正能夠推動未來十年免疫學、腫瘤學、神經科學、美學和眼部保健領域成長的資產。我們目前的投資組合擁有實現這十年成長預期所需的一切。因此，我們的外部努力實際上是針對早期機會，通常是規模較小的交易。當我們縱觀成長領域時，如果考慮免疫學，Skyrizi 和 Rinvoq 將推動未來十年的強勁成長。因此，我們在 BD 方面的免疫學重點實際上是尋找可以提高護理標準的新作用機制，無論是單一療法還是聯合療法。我想說，人們對組合很感興趣。

In oncology, ImmunoGen really nicely complements our efforts with ADCs. It gives us a head start by an entry in the solid tumor space that we're not in today. But in addition to ADCs, we're focused on bispecifics, multispecifics, immuno-onc agents. We also recently announced a collaboration with Umoja studying in situ CAR-T therapy. So a lot of focus in oncology, but this, again, would be earlier stage smaller-sized deals.

在腫瘤學領域，ImmunoGen 確實很好地補充了我們在 ADC 的努力。它為我們進入實體瘤領域奠定了先機，而我們今天還沒有涉足這一領域。但除了 ADC 之外，我們還專注於雙特異性、多特異性、免疫癌藥物。我們最近也宣布與 Umoja 合作研究原位 CAR-T 療法。因此，腫瘤學受到了很多關注，但這又將是早期階段的小規模交易。

In neuroscience, several adds depth to our neuropsych pipeline, but we also have a focus on migraine and neurodegeneration. In Eye Care, we're extremely excited about the REGENXBIO program in wet AMD and diabetic retinopathy, but we continue to look for innovation in glaucoma and retinal disease. So you certainly have an interest there.

在神經科學中，有些增加了我們神經心理學管道的深度，但我們也關注偏頭痛和神經退化性疾病。在眼部護理領域，我們對濕性 AMD 和糖尿病性視網膜病變的 REGENXBIO 計劃感到非常興奮，但我們仍在繼續尋求青光眼和視網膜疾病的創新。所以你肯定對那裡有興趣。

And then in aesthetics, it's always about looking for innovation that can drive new consumers into our providers' practices. So our BD group is still very active. We certainly have the financial wherewithal to pursue those opportunities to further bolster our pipeline, but those are the areas that we're most interested in.

然後在美學方面，總是要尋找能夠推動新消費者參與我們提供者實踐的創新。所以我們BD組還是很活躍的。我們當然有財力來尋求這些機會，以進一步加強我們的管道，但這些是我們最感興趣的領域。

The next question comes from James Shin with Deutsche Bank .

下一個問題來自德意志銀行的 James Shin。

I had a question on ovarian cancer (technical difficulty) How do you feel about (technical difficulty) interacting? And how do you feel that market landscape works going forward?

我有一個關於卵巢癌的問題（技術難度），您對（技術難度）互動有何看法？您認為未來的市場格局如何？

Unfortunately, your line is not very clear. Can you maybe try to repeat the question one time?

不幸的是，你的路線不是很清楚。您可以嘗試重複這個問題嗎？

Sorry about that. Hearing better now?

對於那個很抱歉。現在聽力好點了嗎？

It's still a little echoey, it is a little bit better, but go ahead.

還是有點迴聲，好一點了，但繼續吧。

Okay. I was asking about (technical difficulty) competitive dynamic on ovarian cancer?

好的。我問的是卵巢癌的（技術難度）競賽動態？

Yes. Unfortunately, it's just not coming clear -- coming through clearly, happy to address the questions following the call. Apologies for that. Operator, next question please.

是的。不幸的是，這只是不清楚——清楚地表達出來，很高興在電話會議後解決問題。對此表示歉意。接線員，請下一個問題。

The next question comes from David Risinger with Leerink Partners.

下一個問題來自 Leerink Partners 的 David Risinger。

Yes. And congrats on the long-term updates. So with respect to the Alzheimer's commentary, a product was left out of the TREM2 AL002, which has an estimated primary completion in September. If you could comment on that as well, that would be helpful. And then with respect to the GILTI tax change that's coming, could you please provide some more color on that, including the timing and the potential impact?

是的。並祝賀長期更新。因此，關於阿茲海默症的評論，TREM2 AL002 中遺漏了一個產品，預計初步完成時間為 9 月。如果您也能對此發表評論，那將會很有幫助。關於即將到來的 GILTI 稅收變化，您能否提供更多信息，包括時間安排和潛在影響？

This is Tom Hudson. I'll answer the question. The first question. Yes, we do have a partner program with Alector on the TREM2 target. TREM2 was identified in Alzheimer's disease through genetic studies several years ago, very strong link. We have a program with -- TREM2 modulates a neuro inflammatory response in AD. All patients are enrolled in the Phase II, we won't have data later this year. So again, it's an early clinical development, but we will expect to see key data later.

這是湯姆·哈德森。我來回答這個問題。第一個問題。是的，我們確實與 Alector 就 TREM2 目標開展了合作夥伴計劃。幾年前透過基因研究發現TREM2與阿茲海默症有強烈的關聯。我們有一個項目——TREM2 調節 AD 的神經發炎反應。所有患者都已入組第二階段，今年稍後我們不會有數據。再說一次，這是一個早期的臨床開發，但我們預計稍後會看到關鍵數據。

Sure. This is Scott. Regarding the GILTI tax. So this is the U.S. tax, the foreign minimum tax on foreign earnings at the U.S. supplies. That tax rate today is at 10.5%, it's going to move up to 13.1% a little bit more than that. That will occur. The implementation date is a little bit mixed because it depends on fiscal year-ends of legal entities. But let's call it, 2026 is when we can look at that. And only part of our income is subject to that rate. So I would say that's approximately a 1.5% impact to our tax rate. that you would see. And that's baked into my 1% on average over the next 3 years.

當然。這是斯科特。關於 GILTI 稅。這就是美國稅，即對美國供應的外國收入徵收的外國最低稅。目前的稅率為 10.5%，未來將升至 13.1%，略高一點。那將會發生。實施日期有點複雜，因為它取決於法人實體的財政年度結束日期。但我們可以這麼說，到 2026 年我們就能看到這一點。我們的收入中只有一部分需要遵守該稅率。所以我想說這對我們的稅率大約有 1.5% 的影響。你會看到的。在接下來的 3 年裡，這將計入我的平均 1% 中。

Thanks, David. Operator, we have time for one final question.

謝謝，大衛。接線員，我們有時間回答最後一個問題。

Okay. And our final question is Luisa Hector with Berenberg.

好的。我們的最後一個問題是路易莎·赫克托和貝倫貝格。

I wanted to touch on the Part D restructure and IRA. So you have a number of drugs that are likely to be impacted by this. And obviously, you talk about your strong rebound in 2025. So I'd just love to hear your thoughts on how that restructurable impact and to what extent that is already baked into your expectations of the rebound? And maybe just to check, have you now received the initial offer from CMS on Imbruvica?

我想談談 D 部分重組和 IRA。因此，許多藥物可能會受到此影響。顯然，您談到了 2025 年的強勁反彈。所以我很想聽聽您對重組影響如何以及在多大程度上已經融入您對反彈的預期的看法？也許只是想檢查一下，您現在收到 CMS 對 Imbruvica 的初步報價了嗎？

Yes. Thank you, Luisa. It's Jeff. And we have contemplated in our planning and long-term guidance, both the Part D redesign, and of course, the IRA impacts based on our projections over when some of our drugs might be negotiated. To give you some color on the Part D redesign, we have clearly a very good visibility over the pricing dynamics that will take place as you say, many of our brands basically will be under the catastrophic redesign component.

是的。謝謝你，路易莎。是傑夫。我們在規劃和長期指導中考慮了 D 部分的重新設計，當然還有基於我們對某些藥物何時可能進行談判的預測的 IRA 影響。為了讓您對 D 部分重新設計有一些了解，我們顯然對將發生的定價動態有很好的了解，正如您所說，我們的許多品牌基本上將處於災難性的重新設計組件之下。

Now we've also understood based on one of the policy items, which is the [cap and smooth]. We've also countered some of that price with volume offsets based on patients having the ability to acquire these. Now volume does not fully offset the pricing impact. But suffice it to say that that's been very much contemplated into that. I'll let Rob comment over how that sort of feeds into the growth rates.

現在我們也根據其中一項政策來了解了，那就是【封頂平滑】。我們也根據患者是否有能力獲得這些產品，透過數量抵消來抵消部分價格。現在銷售量並不能完全抵銷定價的影響。但我只想說，這是經過深思熟慮的。我會讓羅布評論一下這種情況如何影響成長率。

You asked a very good question. This is Rob. Clearly, and we have contemplated that in the high single-digit CAGR, the impacts of IRA. But as you think about the annual progression, it is important to note that Part D benefit redesign starts in '25. So that is certainly something you should consider for modeling of annual sales. I mean, that impact by itself on a net basis could be worth a few points of growth. As Jeff mentioned, the higher cost share with an offset in volume, we have studied the improvement in abandonment rates as we look at the low-income subsidy part of Part D, which doesn't have the out-of-pocket burden that the standard benefit does. And when we compare the abandonment rates and as you address this issue of out-of-pocket burden, we would expect the abandonment rates to improve across Medicare Part D, but not enough to fully offset the higher cost share. That was something we certainly contemplated.

你問了一個非常好的問題。這是羅布。顯然，我們已經考慮到了 IRA 的影響，複合年增長率高達個位數。但當您考慮年度進度時，重要的是要注意 D 部分福利重新設計從 25 年開始。因此，這當然是您在年銷售額建模時應該考慮的事情。我的意思是，這種影響本身就可以帶來幾個百分點的成長。正如 Jeff 所提到的，較高的成本份額與數量的抵消，我們在研究 D 部分的低收入補貼部分時研究了放棄率的改善，該部分沒有像標準福利確實如此。當我們比較放棄率並解決自付費用問題時，我們預計 Medicare D 部分的放棄率會有所改善，但不足以完全抵消較高的成本份額。這是我們確實考慮過的事情。

But as you think about the progression of growth, the rate of growth will accelerate starting next year through '29. So we'll deliver a high single-digit CAGR, but it's important to note that in '25, you do have that beginning of perky benefit redesign, which adds, I'd say, a couple of points of growth headwind that will still allow us to deliver robust growth, but it won't -- you shouldn't think about the same amount of growth every year. It's going to accelerate over the long-range plan.

但當你考慮成長的進程時，你會發現從明年到 2019 年，成長速度將會加快。因此，我們將實現高個位數的複合年增長率，但重要的是要注意，在25 年，你確實開始了積極的福利重新設計，我想說，這增加了幾個增長點，但這些成長阻力仍然會存在。讓我們能夠實現強勁成長，但事實並非如此——你不應該考慮每年相同的成長量。它將在長期計劃中加速。

And then this is Rick, on the Imbruvica price. Yes, we have received the initial offer on Imbruvica recently. As you know, there is a process that CMS is going through here to set pricing. And because none of us have any experience with this, we don't know exactly how that process will proceed. There will be some back and forth between the manufacturer and CMS. CMS has indicated that they'll have the final price by September 1. It's certainly premature for us to talk about the price now because it's not the final price.

這是 Rick，關於 Imbruvica 的價格。是的，我們最近收到了 Imbruvica 的初步報價。如您所知，CMS 正在經歷一個定價過程。因為我們沒有人有這方面的經驗，所以我們不知道這個過程將如何進行。製造商和 CMS 之間會有一些來回。 CMS 表示他們將在 9 月 1 日之前獲得最終價格。現在談論價格當然還為時過早，因為這還不是最終價格。

I don't know that we'll know the final price until very close to the point at which they're prepared to publish that price, having not had any experience here. So I wouldn't anticipate you will get any updates until either that date or very close to that date.

我不知道我們會在非常接近他們準備發布該價格的時候知道最終價格，因為我們在這裡沒有任何經驗。因此，我預計您在該日期之前或非常接近該日期之前不會收到任何更新。

Thanks, Luisa. And that concludes today's conference call. If you'd like to listen to a replay of the call, please visit our website at investors.abbvie.com. Thanks again for joining us.

謝謝，路易莎。今天的電話會議到此結束。如果您想收聽電話會議的重播，請造訪我們的網站 Investors.abbvie.com。再次感謝您加入我們。