Bausch Health Companies Inc (BHC) 2020 Q1 法說會逐字稿

Good morning, and welcome to the Bausch Health First Quarter 2020 Earnings Call. (Operator Instructions) Please note, this event is being recorded.

早安，歡迎參加博士倫健康 2020 年第一季財報電話會議。 （操作員指示）請注意，此事件正在記錄中。

I'd now like to turn the conference over to Arthur Shannon. Please go ahead.

現在我想將會議交給亞瑟·香農。請繼續。

Thank you, Grant. Good morning, everyone, and welcome to our first quarter 2020 financial results conference call. Participating on today's call are Chairman and Chief Executive Officer, Mr. Joe Papa; and Chief Financial Officer, Mr. Paul Herendeen.

謝謝你，格蘭特。大家早安，歡迎參加我們2020年第一季財務業績電話會議。參加今天電話會議的有董事長兼首席執行官喬·帕帕先生；和首席財務官 Paul Herendeen 先生。

In addition to this live webcast, a copy of today's slide presentation and a replay of this conference call will be available on our website under the Investor Relations section. Before we begin, we'd like to remind you that our presentation today contains forward-looking information. We would ask that you take a moment to read the forward-looking statement legend at the beginning of our presentation as it contains important information. This presentation contains non-GAAP financial measures. For more information about these measures, please refer to Slide 2 of the presentation. Non-GAAP reconciliations can be found in the appendix to the presentation posted on our website. Finally, the financial guidance in this presentation is effective as of today only. It is our policy to generally not update guidance until the following quarter and not to update or affirm guidance other than through broadly disseminated public disclosure.

除了本次現場網路直播之外，今天的幻燈片簡報的副本和本次電話會議的重播將在我們網站的「投資者關係」部分提供。在開始之前，我們想提醒您，我們今天的演示包含前瞻性資訊。我們希望您花一點時間閱讀我們簡報開頭的前瞻性聲明說明，因為它包含重要資訊。本簡報包含非公認會計準則財務指標。有關這些措施的更多信息，請參閱簡報的第 2 張幻燈片。非公認會計準則對帳表可在我們網站上發布的簡報附錄中找到。最後，本簡報中的財務指導僅自今日起有效。我們的政策一般是直到下個季度才更新指引，並且除非透過廣泛傳播的公開披露，否則不會更新或確認指引。

With that, it's my pleasure to turn the call over to Joe.

現在，我很高興將電話轉給喬。

Thank you, Art, and thank you, everyone, for joining us today. I'm going to begin today's call with some comments on our response to COVID-19 and briefly summarize the first quarter results. Paul Herendeen, our CFO, will then review the first quarter in more detail and update our 2020 guidance. I'll conclude with some closing remarks before opening the line for questions.

謝謝你，阿特，也謝謝大家今天的參與。我將在今天的電話會議上就我們對 COVID-19 的應對措施發表一些評論，並簡要總結第一季的業績。我們的財務長 Paul Herendeen 將更詳細地回顧第一季並更新我們的 2020 年指引。在開始回答問題之前，我將做一些結束語。

Beginning with Slide 5. As we started to see the impact of COVID-19 and the unprecedented market disruption it was creating, our first priority was to make sure that our people were safe. We took appropriate measures to protect our supply chain, the ability to meet customer demand. We reached out to help our customers. We minimize the disruption to our R&D projects and we protected our financial stability. Our team did a great job of implementing business continuity plans across 100 countries and enabled us to remain focused on supporting our customers and health care patients globally.

從第 5 張投影片開始。當我們開始看到 COVID-19 的影響及其造成的前所未有的市場混亂時，我們的首要任務是確保我們的員工安全。我們採取了適當的措施來保護我們的供應鏈，滿足客戶需求的能力。我們竭盡全力幫助我們的客戶。我們最大限度地減少對研發項目的干擾並保護我們的財務穩定。我們的團隊在 100 個國家/地區實施業務連續性計劃方面做得非常出色，並且使我們能夠繼續專注於為全球客戶和醫療保健患者提供支援。

In fact, we have over 10,000 colleagues on the supply chain frontlines who have been and continue to work hard to make sure that Bausch health products remain available for the patients and consumers who rely on them. A big thank you to all of our supply chain employees that enabled us to continue meeting customer demand. Importantly, to date, we have not seen any material COVID-19 related supply disruptions. We have access to multiple sources of API and intermediates, many of our products, at this time, the availability of API intermediates has not had -- is not expected to have a material impact on our supply chain. With respect to our largest product, XIFAXAN, we have 5 months' supply on hand and enough active ingredient to manufacture another 5 months' supply of finished goods.

事實上，我們在供應鏈前線有超過 10,000 名同事，他們一直在努力工作，以確保博士倫健康產品能夠繼續供依賴它們的患者和消費者使用。非常感謝我們所有的供應鏈員工，他們使我們能夠繼續滿足客戶的需求。重要的是，到目前為止，我們還沒有看到任何與 COVID-19 相關的重大供應中斷。我們可以獲得多種 API 和中間體來源，目前，我們的許多產品的 API 中間體的可用性預計不會對我們的供應鏈產生重大影響。就我們最大的產品 XIFAXAN 而言，我們有 5 個月的庫存，並且有足夠的活性成分來生產另外 5 個月的成品。

We've also been able to minimize disruption of our commercial capabilities and R&D efforts. We have been supporting health care professionals virtually where in-person interactions are suspended, and we are working with health authorities and investigators to protect our clinical trial participants and personnel. Also, we believe the steps we took over the last several years to manage our capital structure have placed us in a strong position to weather the storm from a liquidity perspective. We have no amortization payments or debt maturities until 2022 and that we have an undrawn revolving credit facility. To sum up, we have taken actions to keep our colleagues safe, our supply lines intact and to lay the foundation for our company to work through the COVID-19 uncertainties. With these measures in place, our goal was to fulfill our mission of improving people's lives with our health care products.

我們也能夠最大限度地減少對我們的商業能力和研發工作的干擾。在暫停面對面交流的地區，我們透過虛擬方式為醫護人員提供支持，並與衛生當局和研究人員合作，保護我們的臨床試驗參與者和人員。此外，我們相信，過去幾年我們為管理資本結構所採取的措施使我們在流動性角度上處於有利地位，能夠抵禦風暴。我們在 2022 年之前沒有攤銷付款或債務到期，並且我們擁有未使用的循環信貸額度。總而言之，我們已採取行動，確保同事的安全、供應鏈的暢通，並為公司應對 COVID-19 的不確定性奠定基礎。透過這些措施，我們的目標是實現透過我們的保健產品改善人們生活的使命。

On Slide 6, we've outlined the actions we've taken. First and foremost, we are working to advance science to find solutions for COVID-19. We have initiated clinical trial programs in Canada, evaluating investigational use of nebulized antiviral Virazole in combination with standard of care therapy to treat hospitalized adult patients with respiratory distress. And the Salix team is working to initiate trials to evaluate XIFAXAN in combination with established therapies to potentially address the symptoms of gastrointestinal distress and pulmonary compromise associated with COVID-19.

在投影片 6 上，我們概述了我們已經採取的行動。首先，我們正在努力推動科學進步，尋找解決新冠肺炎疫情的方法。我們已經在加拿大啟動了臨床試驗項目，評估霧化抗病毒藥物 Virazole 與標準護理療法相結合住院成人呼吸窘迫患者的治療研究。 Salix 團隊正在進行試驗，評估 XIFAXAN 與現有療法的結合效果，以潛在地解決與 COVID-19 相關的胃腸不適和肺部損害症狀。

Second, Bausch Health is actively donating medicine and health care products to assist in the global fight against COVID-19, including chloroquine, azithromycin, eye drops, daily contact lenses and nebulized Virazole. We will remain focused on doing our part to help end this unprecedented global health pandemic and providing resources to support global health care systems, frontline health care workers and the patients in their care. I am extremely proud of the job that our team has done in facing these challenges and making sure that our business continues to operate during this period with minimal disruption. I thank the entire Bausch Health team for their continued focus and dedication over this critical period.

第二，博士倫醫療積極捐贈醫藥保健品協助全球對抗新冠肺炎疫情，包括氯奎、阿奇黴素、眼藥水、日用隱形眼鏡、霧化病毒唑等。我們將繼續致力於盡自己的一份力量，幫助結束這場史無前例的全球衛生大流行，並提供資源來支持全球衛生保健系統、一線醫護工作者及其護理的患者。我對我們的團隊在面對這些挑戰時所做的工作感到非常自豪，並確保我們的業務在此期間繼續以最小的干擾運作。我感謝整個博士倫醫療團隊在這個關鍵時期的持續關注和奉獻。

Moving now to Slide 7. I want to address the estimated impact that COVID-19 has had on our first quarter results. Paul will cover this in more detail. But at a high level, we estimate that COVID-19 adversely impacted first quarter revenue by roughly $35 million or approximately 2%. This included a positive impact of $30 million from pantry loading, including in Global Consumer and U.S. vision care as customers stocked up on supplies in advance of the shutdown. And it was offset by a negative COVID-19 impact to revenue of approximately $65 million. The postponement of elective medical procedures, as directed by public health authorities, affected our Global Solta and Surgical business units as well as our Ophthalmology Rx business where pre and post-operative prescriptions declined. Our international Vision Care business was impacted by retail store closures, by decline in contact lens wear due to decreased social interactions. Finally, medical office closures in the U.S. resulted in prescription declines in late March, which affected our derm and Dentistry business unit.

現在轉到投影片 7。我想談談 COVID-19 對我們第一季業績的預期影響。保羅將更詳細地介紹這一點。但從總體來看，我們估計 COVID-19 對第一季收入產生了約 3500 萬美元或約 2% 的不利影響。其中包括來自食品儲藏室裝載的 3000 萬美元的積極影響，包括全球消費者和美國視力保健，因為客戶在停工前儲備了物資。但新冠疫情對收入造成的約 6,500 萬美元的負面影響抵消了這一影響。根據公共衛生當局的要求，選擇性醫療程序被推遲，這影響了我們的全球 Solta 和外科業務部門以及眼科 Rx 業務，導致術前和術後處方減少。由於社交互動減少導致零售店關閉、隱形眼鏡配戴量下降，我們的國際視力保健業務受到了影響。最後，美國醫療辦公室關閉導致 3 月底處方量下降，這影響了我們的皮膚病和牙科業務部門。

With these points in mind, let's briefly review the first quarter results on Slide 8. While total company result was flat compared to the prior year, there were a number of first quarter highlights to note. Our largest segment, Bausch + Lomb/International delivered its 14th consecutive quarter of overall organic revenue growth despite headwinds from COVID-19. Sales reported mid-single-digit organic growth, despite approximately $40 million of LOE, loss of exclusivity, headwind primarily from APRISO.

考慮到這些要點，讓我們簡要回顧一下第 8 張投影片上的第一季業績。雖然公司整體業績與去年同期持平，但第一季仍有許多亮點值得注意。我們最大的部門博士倫/國際儘管面臨新冠疫情的阻力，但仍連續 14 個季度實現了整體有機收入成長。儘管損失約 4,000 萬美元、失去獨家經營權以及主要受到 APRISO 的阻力，銷售額仍保持中等個位數有機成長。

XIFAXAN's TRxs grew by approximately 6% and retail extended units saw approximately 6.5% growth versus the first quarter of 2019. TRULANCE generated $19 million of revenue in the first quarter, and TRxs grew by 52% compared to the prior year quarter. RELISTOR revenue increased by 19% as a result of growth in the oral formulation and new market access formulary wins. We are also able to repay approximately $220 million of debt during the quarter using cash generated from operations.

與 2019 年第一季相比，XIFAXAN 的 TRxs 成長了約 6%，零售擴展單位成長了約 6.5%。 TRULANCE 在第一季創造了 1,900 萬美元的收入，TRxs 與去年同期相比增長了 52%。由於口服製劑的成長和新市場准入處方集的成功，RELISTOR 的收入增加了 19%。我們也能夠利用營運產生的現金在本季償還約 2.2 億美元的債務。

On the right, we have called out some notable key developments. First, after we settled with Teva early in 2018, earlier this week, we resolved the outstanding XIFAXAN IP litigation with Sandoz. Under the terms of the agreement, all intellectual property protecting XIFAXAN remains intact, and we preserved market exclusivity until 2028. We also had some commercial access improvements due to new formulary wins, VYZULTA and LOTEMAX SM increased Part D access to 45% and 55%, respectively. On the R&D front, we have completed the QT study for amiselimod, which evaluated the cardiac safety profile. Top line results were positive, and we expect to initiate Phase II study in the second half of 2020. The rifaximin study for overt hepatic encephalopathy was also reported favorable top line results, great news that will help inform further research on our next-generation indications and formulations.

在右側，我們列出了一些值得注意的關鍵發展。首先，在我們於 2018 年初與 Teva 達成和解後，本週早些時候，我們與 Sandoz 解決了未決的 XIFAXAN IP 訴訟。根據協議條款，保護 XIFAXAN 的所有智慧財產權均保持完整，並且我們保留市場獨佔權直至 2028 年。由於獲得新的處方集，我們的商業准入也得到了一些改善，VYZULTA 和 LOTEMAX SM 分別將 D 部分准入提高到 45% 和 55%。在研發方面，我們已經完成了阿米塞莫德的 QT 研究，該研究評估了其心臟安全性。頂線結果是正面的，我們預計將在 2020 年下半年啟動 II 期研究。針對明顯肝性腦病變的利福昔明研究也報告了良好的頂線結果，這個好消息將有助於進一步研究我們的下一代適應症和製劑。

Finally, despite COVID-19 related headwinds, we expect that our planned 2020 launches will remain on track, including the launch of SiHy daily lenses in the U.S., which we are preparing for in the second half of 2020. Overall, we believe these first quarter highlights demonstrate that we have built a sustainable and durable business that is well positioned to weather the uncertainties created by COVID-19.

最後，儘管面臨新冠疫情相關的不利因素，我們預計 2020 年的計劃發布仍將按計劃進行，包括在美國推出 SiHy 日拋隱形眼鏡，我們正在為此做準備，時間是 2020 年下半年。總體而言，我們認為第一季的這些亮點表明，我們已經建立了可持續、持久的業務，完全有能力抵禦新冠疫情帶來的不確定性。

With that, I'll turn it over to Paul.

說完這些，我會把話題交給保羅。

Thanks, Joe. We are off to a great start to the year, and then COVID-19 threw us into a world of uncertainty, about the balance of 2020 and about the potentially lasting impacts of the virus on the way we promote our products in 2021 and beyond. Sitting here today, it's unclear what the new normal might look like, but I'm confident that with our portfolio of durable brands, we will adapt and prosper.

謝謝，喬。我們今年的開局很好，但隨後新冠疫情卻將我們帶入了一個不確定的世界，我們不確定 2020 年該如何平衡，也不確定病毒是否會對我們在 2021 年及以後推廣產品的方式產生持久影響。今天坐在這裡，尚不清楚新常態會是什麼樣子，但我相信，憑藉我們經久不衰的品牌組合，我們一定能夠適應並繁榮發展。

I'll start with Slide 10 showing our revenue by business. Reported revenue was roughly flat versus Q1 of 2019. FX was a 90 basis point headwind. So constant currency, we grew 1%. Organically, we are flat as the synergy acquisition closed during Q1 of 2019. Both Salix and B&L/International posted organic growth. The bulk of the COVID-19 impacts on our Q1 results were in the Asia Pac region. However, social restrictions in the U.S. beginning in March became an immediate headwind for certain of our U.S. businesses as well.

我將從幻燈片 10 開始，展示我們按業務劃分的收入。報告收入與 2019 年第一季基本持平。外匯帶來 90 個基點的逆風。以固定匯率計算，我們成長了 1%。從有機角度來看，由於協同收購於 2019 年第一季完成，我們的有機收入持平。 Salix 和 B&L/International 均實現了有機成長。 COVID-19 對我們第一季業績的影響主要集中在亞太地區。然而，從三月開始，美國實施的社交限制措施也直接對我們某些美國業務造成了阻礙。

The B&L/International segment was plus 2% on an organic basis. COVID-19 negatively impacted our Vision Care, Surgical and Ophtho Rx businesses, while consumer and international pharma saw some pantry loading that increased revenue in the quarter. As consumers in the U.S. and other regions observed how social restrictions played out in Asia, they took steps to ensure that they stocked up on products they wanted to have on hand through a lockdown period. B&L Global Vision Care was down 3% organically. This was a tale of 2 environments. Nearly half of our global lens business is in the Asia Pac region, and it was devastated by COVID-19. China was down some 66% versus Q1 2019 organically. Overall, vision care outside the U.S. was down 16%.

船運/國際業務有機成長了 2%。 COVID-19 對我們的視力保健、外科和眼科處方業務產生了負面影響，而消費者和國際製藥公司的食品儲藏量有所增加，從而增加了本季度的收入。當美國和其他地區的消費者觀察到亞洲的社會限制如何實施時，他們採取措施確保在封鎖期間儲備他們想要的產品。 B&L Global Vision Care 有機下滑 3%。這是關於兩個環境的故事。我們的全球鏡頭業務中有近一半在亞太地區，該地區受到了新冠肺炎疫情的嚴重影響。與 2019 年第一季相比，中國有機銷售額下降了約 66%。總體而言，美國以外的視力保健業務下降了 16%。

The U.S. was another story. The U.S. Vision Care business was up 24% versus Q1 of 2019. The ultra monthly silicone hydrogel brand family was up 49% in the U.S. aided by the mid-March -- excuse me, mid-2019 launch of the multifocal toric. Biotrue ONEday lenses continued to deliver impressive growth, plus 23% in the U.S. versus Q1 2019. The read-through here is that as we gear up for the launch of the daily silicon hydrogel lenses in the U.S., which is still on track for 2H 2020, you are seeing that our Vision Care business, led by John Ferris has in place a high-performing team capable of driving attractive growth in a very competitive category.

美國則是另外一個情況。美國視力保健業務與 2019 年第一季相比成長了 24%。超級月拋矽水凝膠品牌系列在美國成長了 49%，這得益於 3 月中旬——對不起，是 2019 年中期推出的多焦點散光鏡。 Biotrue ONEday 鏡片繼續實現令人矚目的成長，與 2019 年第一季相比，在美國成長了 23%。這裡的解讀是，隨著我們準備在美國推出日拋矽水凝膠鏡片，該鏡片仍有望在 2020 年下半年推出，您會看到，由 John Ferris 領導的視力保健業務已經擁有一支高績效團隊，能夠在競爭激烈的類別中推動可觀的增長。

B&L consumer was up 12% organically. Outside the United States, plus 4% and plus 24% in the U.S. We benefited from consumers pantry loading during the quarter. In the U.S., LUMIFY sales in the quarter were up $9 million or 91% versus Q1 of 2019. And LUMIFY was not one of the brands with significant pantry loading. PreserVision sales in the U.S. were up 26% from Q1 2019 driven by an impactful DTC campaign and successful promotional activities with Costco. Biotrue Multi-Purpose Solution was plus 32% in the U.S. versus Q1 of 2019.

B&L 消費者有機成長了 12%。在美國以外，成長了 4%，在美國成長了 24%。本季我們受惠於消費者食品儲藏室的增加。在美國，LUMIFY 本季的銷售額與 2019 年第一季相比成長了 900 萬美元，增幅為 91%。而且 LUMIFY 並不是食品儲藏量較大的品牌之一。由於有效的 DTC 活動和與 Costco 合作的成功促銷活動，PreserVision 在美國銷售額較 2019 年第一季成長了 26%。與 2019 年第一季相比，Biotrue 多用途解決方案在美國成長了 32%。

My takeaway from the pantry loading is that consumers intend to stick with their B&L consumer products. They loaded up ahead of sheltering at home, and I expect that many found and will find ways to continue to purchase our consumer products, whether that's on trips to the pharmacy, via home delivery or Internet fulfillment. Some brands will be more resilient than others, but overall, there are reasons for optimism for our global consumer portfolio through this situation.

我從食品儲藏室裝載中得到的啟示是，消費者打算堅持使用他們的 B&L 消費產品。他們在居家避難之前就囤滿了貨物，我預計很多人已經找到並將繼續找到繼續購買我們消費品的方式，無論是去藥店、送貨上門還是透過網路購買。有些品牌會比其他品牌更具韌性，但整體而言，我們仍有理由對全球消費者組合在未來的情況下保持樂觀。

B&L Surgical was down 6% organically. Outside the U.S., we were down 8% organically and soft in many markets, but particularly China, where surgical revenues were down more than 40%. In the U.S., we were actually doing quite well until March and ended up down 2% organically. Global Ophtho Rx was down 16% organically, down 10% organically outside U.S. and down 18% in the U.S. Outside United States, the COVID impact in China was a big factor. In the U.S., which accounts for roughly 60% of Global Ophtho Rx revenues, 2 of our major products are most often used pre and post eye surgery. That's LOTEMAX and PROLENSA. Those brands saw rapid declines in TRxs in March as surgeries began to be postponed. Continued erosion from the LOE of LOTEMAX suspension was a big factor versus the prior year quarter as well.

B&L Surgical 有機下滑 6%。在美國以外的地區，我們的有機收入下降了 8%，在許多市場都表現疲軟，尤其是在中國，外科手術收入下降了 40% 以上。在美國，直到 3 月份，我們的業績實際上都相當不錯，但最終有機下降了 2%。全球眼科處方藥有機下降 16%，美國以外地區有機下降 10%，美國國內下降 18%。在美國以外，中國的新冠疫情影響是重要因素。在美國，我們的兩種主要產品最常用於眼科手術前後，而美國約佔全球眼科處方收入的 60%。那就是 LOTEMAX 和 PROLENSA。由於手術開始推遲，這些品牌的 TRxs 在 3 月迅速下降。與去年同期相比，LOTEMAX 懸吊的 LOE 持續下降也是一個重要因素。

On the plus side, prior to the COVID impact being felt in the U.S., VYZULTA had been showing improved momentum in TRxs. Sales reached $13 million in the quarter, plus 56% versus Q1 of 2019, and that was with only about 30% Med D coverage. Beginning July 1, our Med D coverage for VYZULTA will step up to roughly 45%. So things are looking up for VYZULTA.

積極的一面是，在美國感受到 COVID 的影響之前，VYZULTA 在 TRxs 中已經顯示出改善的勢頭。本季銷售額達到 1,300 萬美元，較 2019 年第一季成長 56%，而 Med D 覆蓋率僅 30% 左右。從 7 月 1 日開始，我們對 VYZULTA 的 Med D 覆蓋率將升至約 45%。 VYZULTA 的前景看好。

International pharma was plus 9% or plus $24 million organically versus Q1 of 2019. Canada, Poland and other Eastern European countries delivered the growth. I want you to note that our international pharma businesses are mainly in Eastern Europe, the Middle East, Canada and Latin America. Our international pharma businesses in Asia Pac and Western Europe are much smaller. There was very little COVID impact on international pharma during Q1, and we're expecting these units to be relatively resilient.

與 2019 年第一季相比，國際製藥業務成長 9%，即有機成長 2,400 萬美元。加拿大、波蘭和其他東歐國家實現了成長。我想讓你注意，我們的國際製藥業務主要在東歐、中東、加拿大和拉丁美洲。我們在亞太和西歐的國際製藥業務規模要小得多。第一季度，COVID 對國際製藥業的影響很小，我們預期這些部門將具有相對的彈性。

On to Salix. Salix was up $32 million or 7% on a reported basis. The major growth were XIFAXAN, plus $69 million or 23%. And TRULANCE, which was acquired in March of 2019, which was up $13 million quarter-over-quarter. LOEs, including APRISO and UCERIS, were a growth drag in this segment, $40 million. And Glumetza declined as expected by $17 million or roughly 45%. Of the 23% growth of XIFAXAN, 6% came from increased net selling prices relative to Q1 of last year. That’s the impact of the price increase that we took in January, offset by associated increases in rebates. The 17% increase in XIFAXAN volume came roughly half from -- excuse me, from increased in consumption and half from an increase in wholesale and retail channel inventories relative to Q1 of 2019. There was no plan to increase channel inventories. This was just a normal fluctuation from quarter-to-quarter.

繼續討論 Salix。據報道，Salix 上漲了 3,200 萬美元，漲幅為 7%。主要成長的是 XIFAXAN，成長 6,900 萬美元，成長 23%。 2019 年 3 月收購的 TRULANCE 環比成長 1,300 萬美元。包括 APRISO 和 UCERIS 在內的 LOE 拖累了該領域的成長，損失達 4,000 萬美元。而 Glumetza 則如預期般下降了 1,700 萬美元，降幅約 45%。 XIFAXAN 的銷售額成長了 23%，其中 6% 來自於淨銷售價格相對於去年第一季的上漲。這就是我們一月份價格上漲的影響，但被相關的回扣增加所抵消。 XIFAXAN 銷量成長 17%，大約一半來自於——對不起，來自消費量的增加，另一半來自於與 2019 年第一季相比批發和零售通路庫存的增加。沒有增加渠道庫存的計劃。這只是季度之間的正常波動。

TRULANCE TRx growth was driven by increased promotional effort as well as improved managed care coverage. A quick shout out to the Salix team led by Nicola Kayel and Josh Coyle. Our key brands in the GI space rely on the addition of new patients to sustain and grow prescriptions. Roughly half of XIFAXAN Rxs are for the acute indication of IBS-D. And TRULANCE is in a clear growth phase, so both rely on adding new patients to the funnel. XIFAXAN and TRULANCE Rxs have been fairly durable through the last 8 weeks, and that speaks to the pre COVID success of our Salix team, building awareness and support for our brands amongst physicians. Through the first 4 weeks of April, XIFAXAN TRxs remain at roughly 90% and TRULANCE better than 95% of pre COVID levels.

TRULANCE TRx 的成長得益於促銷力度的加大以及管理式醫療覆蓋範圍的改善。向 Nicola Kayel 和 Josh Coyle 領導的 Salix 團隊致以誠摯的謝意。我們在胃腸道領域的關鍵品牌依靠新患者的加入來維持和增加處方。大約一半的 XIFAXAN Rxs 用於治療 IBS-D 的急性症狀。由於 TRULANCE 正處於明顯的成長階段，因此兩家公司都依賴增加新患者。 XIFAXAN 和 TRULANCE Rxs 在過去 8 週內表現相當強勁，這證明了我們的 Salix 團隊在 COVID 之前的成功，在醫生中提高了我們品牌的知名度和支持度。在 4 月的前 4 週，XIFAXAN TRxs 保持在約 90%，TRULANCE 則高於 COVID 之前的 95%。

The Ortho Derm segment was down $5 million or 4% on a reported basis. Medical derm was down $18 million or 18%, half of that coming from price and half from volume. We had strong growth of Jublia and modest growth from DUOBRII, but those were more than offset by a decline in royalty income from Carac and a number of other products. The onset of COVID-19 in the U.S. had a rapid and dramatic impact on our portfolio of med derm products. Global Solta grew 37% organically versus Q1 of 2019, pretty good. But Solta was up much more than that early in the quarter before COVID-19 took the wind out of Solta sales. Notice some 60% of Global Solta revenues are from the Asia Pacific region.

據報道，Ortho Derm 部門下降了 500 萬美元，即 4%。醫學皮膚科銷售額下降 1800 萬美元，下降 18%，其中一半來自價格，一半來自銷售。 Jublia 實現了強勁成長，DUOBRII 也實現了適度成長，但這些成長被 Carac 和其他一些產品的特許權使用費收入的下降所抵消。美國爆發的 COVID-19 疫情對我們的醫學皮膚產品組合產生了迅速而巨大影響。與 2019 年第一季相比，Global Solta 的有機成長率為 37%，相當不錯。但在 COVID-19 打壓 Solta 銷售之前，本季初 Solta 的漲幅遠高於這個數字。請注意，Solta 全球約 60% 的收入來自亞太地區。

Finally, the diversified segment. That was down $27 million or 9%. Neuro was down $24 million versus the first quarter last year. LOEs accounted for [$31 million] decline, and that was partially offset by Wellbutrin and Aplenzin that together grew 14% versus Q1 of 2019. Our U.S. Generics business was flat with Q1 last year, and Dentistry was down roughly 16%. The onset of COVID in the U.S. also had a rapid and dramatic impact on our Dentistry business. So that's the revenue story in the quarter.

最後，多元化部分。下降了 2700 萬美元，降幅為 9%。與去年第一季相比，Neuro 虧損了 2,400 萬美元。 LOE 導致 [3,100 萬美元] 的下降，但 Wellbutrin 和 Aplenzin 部分抵消了這一下降，這兩款產品與 2019 年第一季相比增長了 14%。我們的美國仿製藥業務與去年第一季持平，牙科業務下降了約 16%。美國新冠疫情的爆發也對我們的牙科業務產生了迅速而巨大影響。這就是本季的營收情況。

So let's move to Slide 11 to cover the rest of the P&L. Our gross margin improved some 80 basis points from Q1 of 2019. Most of this improvement can be traced to the Salix segment, where gross margins increased over Q1 2019 by 330 basis points as we paid lesser royalties on Glumetza and APRISO due to lower sales and a royalty on XIFAXAN net sales expired in Q3 of 2019. Selling, advertising and promotional expenses were unfavorable $7 million or roughly 3% on a constant currency basis due to the addition of sales resources in connection with the synergy acquisition and higher selling costs in the U.S. vision care group that supported the excellent growth that, that team is delivering. G&A expenses were $35 million unfavorable to Q1 of 2019 mainly due to increased IT and legal costs. Note that, as I've said in the past, our G&A run rate is something like $150 million per quarter. So we are right around that level, and the prior year quarter was at a low level and less reflective of our go-forward run rate. R&D was up $5 million as we continue to build out our R&D organization to support a broader plate of development projects.

因此，我們轉到投影片 11 來介紹損益表的其餘部分。我們的毛利率較 2019 年第一季提高了約 80 個基點。這項改進大部分歸功於 Salix 部門，該部門的毛利率較 2019 年第一季增加了 330 個基點，原因是由於銷售額下降導致我們支付的 Glumetza 和 APRISO 特許權使用費減少，且 XIFAXAN 淨銷售額的特許權使用費已於 2019 年第三季度到期。銷售、廣告和促銷費用為不利的 700 萬美元，按固定匯率計算約為 3%，原因是協同收購增加了銷售資源，美國視力保健集團的銷售成本增加，支持了該團隊實現的出色增長。一般及行政開支為 3,500 萬美元，與 2019 年第一季相比不利，主要原因是 IT 和法律成本增加。請注意，正如我過去所說的，我們的 G&A 運行率大約為每季 1.5 億美元。因此，我們目前處於該水平附近，而去年同期的水平較低，不能很好地反映我們的未來運行率。隨著我們繼續建立我們的研發機構以支持更廣泛的開發項目，研發支出增加了 500 萬美元。

So quick summary. Revenue was down $4 million. 80 basis points better gross margin gets you to plus 13% at the gross profit line. OpEx rose $47 million mainly due to an unfavorable comp for G&A, and that gets you to minus 34% decline at the EBITDA -- excuse me, adjusted EBITA and down $38 million at adjusted EBITDA versus Q1 of 2019. Couple things below the operating line. Net interest expense was favorable by $13 million. Going the other way, our income tax rate on adjusted pretax earnings increased from 6.3% to 10.4%. Relative to the expected 8% rate, that reduced adjusted net income by roughly $8 million. I'll point out that our quarterly tax rate can be quite volatile in normal times. And in a world, we're forecasting the balance of 2020 is more challenging than normal, even more so. We continue to believe that the tax rate on adjusted earnings will be 8% for the full year 2020.

簡單總結一下。收入下降了400萬美元。毛利率提高 80 個基點可將您的毛利線增加 13%。營運支出增加了 4,700 萬美元，主要原因是 G&A 的不利比較，這導致 EBITDA 下降 34%——對不起，調整後的 EBITA 和調整後的 EBITDA 與 2019 年第一季相比下降了 3,800 萬美元。營運線以下有幾個項目。淨利息支出有利，增加了1,300萬美元。另一方面，我們調整後的稅前收益的所得稅率從 6.3% 上升到 10.4%。相對於預期的 8% 的利率，調整後的淨收入減少了約 800 萬美元。我要指出的是，在正常時期，我們的季度稅率可能非常不穩定。我們預測，2020 年的世界平衡將比平常更具挑戰性。我們仍然認為，2020 年全年調整後收益的稅率將為 8%。

Turn to Slide 12. In the quarter, we generated $261 million of cash from operations. That's down $152 million compared with Q1 of 2019. The biggest factor was an increase in working capital primarily due to the COVID related delays and collections from accounts mainly in Asia Pacific. There was also a shift in the timing of cash interest payments due to our refinancing activity. And finally, we made a licensing payment in the quarter for an agreement we executed in Q4 last year.

翻到第 12 張投影片。本季度，我們從營運中產生了 2.61 億美元的現金。與 2019 年第一季相比，下降了 1.52 億美元。最大的因素是營運資本增加，這主要是由於與 COVID 相關的延誤以及主要來自亞太地區帳戶的收款。由於我們的再融資活動，現金利息支付的時間也發生了變化。最後，我們在本季度支付了去年第四季度簽署的協議的許可費用。

Turn to Slide 13. This shows the progression of our debt balance over the last 4 quarters. The settlement of the U.S. Securities litigation funded with unsecured debt raised in December last year set us back on reducing the quantum of our debt and improving our leverage ratio. However, it was the right thing to do, and we will get right back to prioritizing the use of available cash to reduce our debt. I reported back on the February call that the December 31, 2019, net debt balance was inflated by the timing of the December debt raise and the use of those proceeds. In on -- excuse me, our December 31, '19, net debt pro forma for the deployment of those funds was roughly $24.2 billion. On the same basis, our pro forma balance at March 31, the net debt balance is roughly $24 billion, about 20 -- $200 million lower than the pro forma net debt at year-end.

翻到幻燈片 13。這顯示了過去 4 個季度我們的債務餘額的變化。去年 12 月，以無擔保債務資助的美國證券訴訟得到解決，這阻礙了我們減少債務量和改善槓桿率。然而，這是正確的做法，我們將立即優先利用可用現金來減少債務。我在二月的電話會議上報告說，2019 年 12 月 31 日的淨債務餘額因 12 月債務增加的時間和這些收益的使用而膨脹。抱歉，截至 2019 年 12 月 31 日，我們部署這些資金的淨債務預計約為 242 億美元。基於相同基礎，我們 3 月 31 日的預期餘額，淨債務餘額約為 240 億美元，比年末的預期淨債務低約 2,000 萬至 2 億美元。

Turn to Slide 14. Slide 14 is a slide we had relegated to the appendix, but in light of the importance of liquidity in a COVID world, I want to speak to where we are. Sitting here today, we have over $1 billion available under our revolving credit facility and no debt coming due this year or in 2021. Our next debt maturity is in the first quarter of 2022. Importantly, all of our debt coming due in 2022 is of a secured nature. That's an important distinction as the senior secured debt markets are a more predictably available source of capital. The risks associated with refinancing the 2022 maturities with secured debt are lower than if those maturities were unsecured.

翻到幻燈片 14。投影片 14 是我們已放到附錄中的投影片，但鑑於流動性在 COVID 世界中的重要性，我想談談我們目前的情況。今天，我們的循環信貸安排下有超過 10 億美元的可用資金，今年或 2021 年沒有債務到期。我們的下一筆債務將在 2022 年第一季到期。重要的是，我們所有在 2022 年到期的債務都是有擔保的。這是一個重要的區別，因為優先擔保債務市場是更可預測的資本來源。使用有擔保債務為 2022 年到期債務進行再融資的風險低於使用無擔保債務進行再融資的風險。

Let's shift gears and cover guidance for the full year 2020. While COVID-19 had a modest impact on our Q1 results, our expectations of the impact for the full year are meaningful. We have a -- excuse me, we are a diversified health care company. We have different businesses and operate in many geographies around the world. Each of our businesses will be impacted to different degrees as COVID-19 plays out. In addition, the time until the COVID impact bottoms out and the shape of the recovery curves will be different in each and every one of the markets where we do business.

讓我們換個話題，談談 2020 年全年的指引。雖然 COVID-19 對我們的第一季業績影響不大，但我們對其對全年影響的預期是有意義的。我們有—對不起，我們是一家多元化的醫療保健公司。我們擁有不同的業務，業務範圍遍及全球多個地區。隨著新冠肺炎疫情的蔓延，我們的每項業務都會受到不同程度的影響。此外，在我們開展業務的每個市場中，新冠疫情影響觸底所需的時間和復甦曲線的形狀都會有所不同。

On Slide 16, we group our businesses into 4 buckets. From those businesses that we believe will be least impacted to those that we think will be most impacted by COVID-19. Bear in mind that the B&L/International segment that represents roughly 50% of our -- excuse me, 56% of our total revenue in 2019 operates in more than 100 countries and that the mixes of revenue within each of those countries are very different. For example, in Asia Pac, more than 40% of the region's revenues come from vision care. In North America, vision care is only 5% of total revenues. The progression of COVID-19 in each and every country will be different depending on the nature and effectiveness of local steps taken to control the spread of the virus. Within the U.S., the recovery is unlikely to be uniform across all regions. It’s a little long-winded there, but I think it's important when you think about the range of outcomes for us in 2020.

在第 16 張投影片上，我們將業務分為 4 類。從我們認為受影響最小的企業到我們認為受 COVID-19 影響最大的企業。請記住，B&L/國際部門約占我們 2019 年總收入的 50%——對不起，56% 的份額，業務遍及 100 多個國家，而且每個國家的收入結構都非常不同。例如，在亞太地區，該地區超過 40% 的收入來自視力保健。在北美，視力保健僅佔總收入的 5%。每個國家的 COVID-19 疫情發展會有所不同，這取決於當地為控制病毒傳播所採取的措施的性質和有效性。在美國，各個地區的復甦不太可能是均勻的。這話可能有點冗長，但我認為，當你考慮到 2020 年我們的一系列成果時，這一點很重要。

Flip to Slide 17, where we list our major assumptions with respect to COVID-19, to start with broad assumptions. First, we are assuming that health authorities will use the learnings from the initial outbreak and recovery to be far better prepared to deal with a potential resurgence of the virus in the fall. We assume that in the event of a fall resurgence, we will not see significant social restrictions put in place by local authorities. Second, we are assuming that global economies will recover as the COVID-19 situation resolves over the balance of 2020. With respect to our business impact and recovery assumptions, we see the greatest impact on our businesses during Q2 due to the shelf in place directives, closing of retail outlets, health care providers closing offices and postponement of elective surgeries. We expect the recovery to begin in the latter part of Q2 and continue into Q3 and Q4. We expect that all of our businesses have the ability to return to pre COVID levels, some perhaps as early as late 2020, but most certainly in 2021. Several of our business units will recover more slowly, particularly B&L Surgical, our Medical Dermatology business and our Dentistry business.

翻到投影片 17，我們在這裡列出了有關 COVID-19 的主要假設，從廣泛的假設開始。首先，我們假設衛生當局將利用最初疫情爆發和復原過程中的經驗，以更好地準備應對秋季可能出現的病毒復發。我們假設，如果秋季疫情再次爆發，地方當局不會實施重大的社會限制措施。其次，我們假設隨著 COVID-19 疫情在 2020 年餘下時間解決，全球經濟將出現復甦。關於我們的業務影響和復甦假設，我們認為第二季對我們的業務影響最大，原因是停產指令、零售店關閉、醫療保健提供者關閉辦公室以及選擇性手術延遲。我們預計復甦將在第二季後半段開始，並持續到第三季和第四季。我們預計，我們所有的業務都能恢復到新冠疫情之前的水平，有些業務可能最早在 2020 年底恢復，但最肯定是在 2021 年。我們的幾個業務部門的恢復速度會比較慢，尤其是 B&L Surgical、我們的醫學皮膚科業務和我們的牙科業務。

On Slide 18, we show our revised guidance for 2020. The uncertainty around the depth of the COVID impacts and the shape of the recovery curves for each of our businesses presented challenges for us, for sure. We developed multiple scenarios based on varied assumptions regarding the impact of COVID-19 on our businesses. Based on our review, the range of outcomes, and therefore, our guidance ranges are wider than normal. I want to point out that FX rates have been very volatile since we provided guidance back in February and reduced our revenue expectations for 2020 by some $160 million and adjusted EBITDA by $70 million. Four currencies account for the bulk of that change, the euro, the Russian ruble, the Canadian dollar and the Mexican peso.

在投影片 18 上，我們展示了 2020 年的修訂指南。圍繞 COVID 影響深度和我們每項業務復甦曲線形狀的不確定性無疑給我們帶來了挑戰。我們根據對 COVID-19 對我們業務的影響的不同假設制定了多種情境。根據我們的審查，結果範圍以及我們的指導範圍比正常情況要廣。我想指出的是，自從我們在 2 月份提供指引並將 2020 年收入預期下調約 1.6 億美元、調整後 EBITDA 下調 7000 萬美元以來，外匯匯率一直非常不穩定。四種貨幣佔了這項變化的大部分，即歐元、俄羅斯盧布、加幣和墨西哥比索。

Our revised guidance ranges are for revenue of $7.8 billion to $8.2 billion, and adjusted EBITDA of $3.15 billion to $3.35 billion. We are now expecting SG&A to be down roughly $200 million on a reported basis with about $25 million of that decrease due to FX. So in light of the reduced revenue expectations for 2020, we took steps to reduce our full year 2020 SG&A by roughly $175 million on a constant currency basis.

我們修改後的預期範圍為營收 78 億美元至 82 億美元，調整後 EBITDA 31.5 億美元至 33.5 億美元。我們現在預計銷售、一般及行政開支將按報告基礎下降約 2 億美元，其中約 2,500 萬美元的下降是由於外匯影響。因此，鑑於 2020 年收入預期下降，我們採取措施，以固定匯率計算將 2020 年全年銷售、一般和行政費用減少約 1.75 億美元。

Finally, with reduced revenue and profit expectations, we have reduced our guidance for cash generated from operating activities to roughly $1 billion. With liquidity, a topic that is top of mind, I want to state emphatically that we are in excellent shape. Even at the low end of our revised guidance ranges, we are still strongly cash flow positive. We remain in comfortable compliance with the terms of our debt agreements with substantial covenant cushions. We have a $1.225 billion revolving credit facility, under which we have ready access to more than $1 billion, and we have no scheduled debt payments until the first quarter of 2020 -- excuse me, 2022.

最後，由於收入和利潤預期的降低，我們將經營活動產生的現金預期下調至約 10 億美元。關於流動性這個最受關注的議題，我想強調的是，我們的狀況非常好。即使處於我們修訂後的指導範圍的低端，我們的現金流仍然強勁。我們仍然樂意遵守債務協議的條款，並留有大量的契約緩衝。我們擁有 12.25 億美元的循環信貸額度，據此我們可以隨時獲得超過 10 億美元的資金，而且我們在 2020 年第一季（對不起，是 2022 年）之前沒有預定的債務償還計劃。

Before we turn to the 2020 guidance bridge, please note, we are revising our revenue and adjusted EBITDA guidance out to 2022. The way we've expressed this in the past was a little awkward and possibly confusing. What we said was that off of the midpoint of the original 2019 guidance at constant currency, we expect the CAGR on revenue and adjusted EBITDA to be in a range of 4% to 6% for revenue and 5% to 8% for adjusted EBITDA. For clarity, our starting points for that guidance was $8.4 million for revenue and $3.425 billion for adjusted EBITDA. Adjusted to today's FX rates, those amounts would be $8.23 billion and $3.355 billion, respectively.

在我們轉向 2020 年指引之前，請注意，我們正在修改 2022 年的收入和調整後 EBITDA 指引。我們過去表達這一點的方式有點尷尬，可能會令人困惑。我們所說的是，根據以固定匯率計算的 2019 年原始指引的中點，我們預計收入和調整後 EBITDA 的複合年增長率將在 4% 至 6% 之間，調整後 EBITDA 的複合年增長率將在 5% 至 8% 之間。為了清楚起見，我們制定該指引的起點是營收 840 萬美元和調整後 EBITDA 34.25 億美元。根據今天的外匯匯率調整後，這些金額分別為 82.3 億美元和 33.55 億美元。

Slide 19 shows the 2022 ranges defined by the CAGRs in dollars at current FX rates, which I hope will be less confusing. As part of our detailed review of the depth and duration of the impact of COVID-19 for each of our business units, we took steps to protect our near-term profit and cash flow by pairing back, eliminating or deferring some near-term investments. For example, DTC for DUOBRII, the planned expansion of our sales footprint in Europe for both B&L and for Solta and other programs, and that was to ensure that we do our best to protect earnings and remain solidly cash flow positive through the COVID dip and recovery. The deferral of these investments comes at a cost to our longer-term outlook for various of our business units. Today, we're revising our CAGR guidance using the same starting points to 3% to 5% for revenue and 4% to 7% for adjusted EBITDA. Please see Slide 19 for the 2022 dollar ranges at current FX rates. COVID-19 was not the only factor in our revised outlook for 2022. We continually review and update our long range forecast for all of our business units, and it was a combination of both changes in outlook and the impacts of COVID-19 that caused us to revise our CAGR guidance. Absent the longer-term impacts of COVID-19, we would have maintained our prior CAGR ranges.

投影片 19 顯示了以目前外匯匯率計算的美元複合年增長率定義的 2022 年範圍，我希望這不會太令人困惑。在詳細審查新冠疫情對各業務部門影響的深度和持續時間的過程中，我們採取措施，透過削減、取消或推遲一些短期投資來保護我們的短期利潤和現金流。例如，DUOBRII 的 DTC、計劃擴大我們在歐洲的 B&L 以及 Solta 和其他項目的銷售範圍，這是為了確保我們盡最大努力保護收益，並在 COVID 低迷和復甦期間保持穩定的現金流為正。這些投資的延遲將損害我們各個業務部門的長期前景。今天，我們使用相同的起點修改了我們的複合年增長率指引，收入增長率為 3% 至 5%，調整後 EBITDA 增長率為 4% 至 7%。請參閱投影片 19，以了解目前外匯匯率下的 2022 年美元範圍。 COVID-19 並不是我們修改 2022 年展望的唯一因素。我們不斷審查和更新所有業務部門的長期預測，前景變化和 COVID-19 的影響共同導致我們修改了複合年增長率指引。如果沒有 COVID-19 的長期影響，我們將維持先前的複合年增長率範圍。

Turn to Slide 20 for the guidance bridge. At the midpoint of our range, we are reducing our 2020 revenue expectation by $560 million on a constant currency basis, almost entirely due to the impact of COVID-19. You'll also see that we expect to offset some of that lost gross profit for reductions of SG&A and a modest decrease in our expected R&D spend.

前往投影片 20 檢視引導橋。在我們的範圍中間，我們以固定匯率計算將 2020 年收入預期下調 5.6 億美元，幾乎完全是由於 COVID-19 的影響。您還將看到，我們預計透過減少銷售、一般及行政開支以及適度減少預期研發支出來抵銷部分毛利損失。

With that, let me turn it back to you, Joe.

說完這些，讓我把話題轉回你身上，喬。

Thank you, Paul. Well, our revised 2020 guidance largely reflects the impact of COVID-19 on our business. I want to emphasize that it's based on a set of assumptions, there is still uncertainty around COVID-19 and its impact. However, we believe Bausch Health is well positioned to return to growth when we can move beyond the impact of COVID-19.

謝謝你，保羅。我們修訂後的 2020 年指引在很大程度上反映了 COVID-19 對我們業務的影響。我想強調的是，這是基於一系列假設，COVID-19 及其影響仍然存在不確定性。然而，我們相信，當我們能夠擺脫 COVID-19 的影響時，博士倫醫療將有能力恢復成長。

Turning now to Slide 22. We highlight the durable brands in each of our business units. Beginning at Bausch + Lomb, our largest segment represents 56% of total revenue. The brands include products like LUMIFY eye drops, PreserVision vitamin, contact lens items such as Bausch + Lomb's ULTRA, Biotrue ONEday surgical devices like the enVista intraocular lens and the Stellaris Elite System, all great brands. In our Salix segment, which represents 23% of our revenue, XIFAXAN, TRULANCE and RELISTOR are key durable brands. In our Dermatology business, which represents 7% of our sales. We have great brands, including Jublia, DUOBRII and Thermage FLX. So great brands there.

現在翻到第 22 張投影片。我們重點介紹了每個業務部門的耐用品牌。從博士倫開始，我們最大的部門佔總收入的 56%。這些品牌包括 LUMIFY 眼藥水、PreserVision 維生素、博士倫 ULTRA 等隱形眼鏡產品、enVista 人工水晶體和 Stellaris Elite 系統等 Biotrue ONEday 手術設備，均為知名品牌。在我們的 Salix 部門中，XIFAXAN、TRULANCE 和 RELISTOR 是主要的耐用品牌，占我們營收的 23%。在我們的皮膚科業務中，這占我們銷售額的 7%。我們擁有優秀的品牌，包括 Jublia、DUOBRII 和 Thermage FLX。那裡有非常棒的品牌。

Turning to Slide 23. We have outlined a few clinical milestones to watch in 2020. First, we expect approval and U.S. launch of the SiHy daily lenses. We have received 510(k) filing acceptance from the FDA and the expected launch is on track for the second half of 2020. Next is the rifaximin soluble solid dispersion, which we call SSD immediate release formulation. We received positive top line results from a Phase II study at the end of March. According to the results, using rifaximin SSD in combination with standard of care therapy was statistically significantly superior to the placebo plus standard of care therapy in overt hepatic encephalopathy. We are excited about these results, which will help us decide on further results and further research for new potential indications. We expect the first application will be in sickle cell anemia with clinical trials starting to commence later this year or sometime in 2021.

翻到第 23 張投影片。我們概述了 2020 年值得關注的一些臨床里程碑。首先，我們預計 SiHy 日拋隱形眼鏡將獲得批准並在美國上市。我們已收到 FDA 的 510(k) 申請受理，預計將於 2020 年下半年上市。接下來是利福昔明可溶性固體分散體，我們稱之為 SSD 速釋製劑。我們在三月底收到了第二階段研究的正面的頂線結果。結果顯示，在治療明顯的肝性腦病變方面，利福昔明SSD合併標準護理療法明顯優於安慰劑加標準護理療法。我們對這些結果感到非常興奮，這將幫助我們決定進一步的結果並進一步研究新的潛在適應症。我們預計第一個應用將是治療鐮狀細胞性貧血，臨床試驗將於今年稍後或 2021 年某個時候開始。

We have also have a number of additional rifaximin studies evaluating new formulations for treating other GI conditions, including postoperative Crohn's disease, SIBO and the complications of cirrhosis. Finally, positive top line results from Amiselimod QT study demonstrated Amiselimod has no effect on QT interval prolongation, which has been associated with other molecules in this class. No other significant secondary safety signals were identified, and we expect to initiate a Phase II study in the second half of 2020.

我們也進行了一些額外的利福昔明研究，評估治療其他胃腸道疾病的新配方，包括術後克隆氏症、小腸細菌過度生長和肝硬化併發症。最後，阿米塞利莫德 QT 研究的正向頂線結果顯示阿米塞利莫德對 QT 間期延長沒有影響，而這與該類中的其他分子有關。未發現其他重大次要安全訊號，我們預計在 2020 年下半年啟動第二階段研究。

Before I begin my concluding remarks, I want to briefly address the impact of COVID-19 on our R&D organization. The R&D slide in the appendix on Page 26 provides a snapshot of our late-stage pipeline and status of each program. While new patient enrollment in clinical trials have been temporarily paused due to the impact of COVID-19, we continue to work with our investigator sites to follow-up with subjects that were already enrolled in various trials prior to shutdowns as per the study protocols. We plan to resume new patient enrollment clinical trials once restrictions on COVID-19 have been lifted and look forward to getting our clinical trials back on track.

在我開始總結發言之前，我想先簡單談談 COVID-19 對我們研發組織的影響。第 26 頁附錄中的研發投影片提供了我們後期流程和每個專案狀態的快照。儘管由於 COVID-19 的影響，臨床試驗中新患者的招募已暫時停止，但我們仍繼續與研究機構合作，按照研究方案對在停工前已經參加各項試驗的受試者進行跟進。我們計劃在 COVID-19 限制解除後恢復新患者招募臨床試驗，並期待我們的臨床試驗重回正軌。

Finally, on Slide 24. As Paul mentioned, the COVID-19 pandemic and its impacts triggered revisions to our long-term outlook. We now expect a 3-year CAGR from the midpoint of our 2019 guidance of 3% to 5% revenue growth and 4% to 7% adjusted EBITDA growth over the period from 2019 to 2022 on a constant currency basis. While the impacts of COVID-19 are numerous, we believe Bausch Health has a global diversified business model that is durable. We have broad and diverse product portfolio with approximately 1,400 products in a broad array of therapeutic areas. We launched more than 15 of these products in 2019, and we anticipate additional launch over the next several months. These products will help drive durable growth over the long term. We also have a very diverse mix of prescription over-the-counter and device revenue. And we will also benefit from Bausch Health's global footprint. Our products are sold in approximately 100 countries and every day around the world, more than 150 million people use a Bausch Health product. To conclude, when our business faced an unprecedented disruption earlier this year, we took a number of steps to mitigate the impact. Due to these actions and the durability of our business model, we are confident that our business will remain well positioned for growth over the long term.

最後，在第 24 張投影片中，正如保羅所提到的，COVID-19 疫情及其影響引發了我們對長期前景的修正。我們現在預計，從 2019 年指引的中點開始，2019 年至 2022 年期間的 3 年複合年增長率為 3% 至 5%，以固定匯率計算的調整後 EBITDA 成長率為 4% 至 7%。儘管新冠肺炎疫情的影響是多方面的，但我們相信博士倫醫療擁有持久的全球多元化商業模式。我們擁有廣泛且多樣化的產品組合，涵蓋約 1,400 種產品，涉及廣泛的治療領域。我們在 2019 年推出了 15 多種此類產品，並且預計未來幾個月還會推出更多產品。這些產品將有助於推動長期可持續成長。我們的非處方藥和設備收入也非常多樣化。我們也將受益於博士倫醫療的全球影響力。我們的產品銷往約 100 個國家，全球每天有超過 1.5 億人使用 Bausch Health 產品。總而言之，當我們的業務在今年稍早面臨前所未有的中斷時，我們採取了一系列措施來減輕影響。由於這些措施以及我們商業模式的持久性，我們相信我們的業務將在長期內保持良好的成長勢頭。

With that, operator, let's open up the line for questions.

接線員，現在讓我們開始提問吧。

(Operator Instructions) Our first question will come from Ken Cacciatore with Cowen and Company.

（操作員指示）我們的第一個問題來自 Cowen and Company 的 Ken Cacciatore。

I just had a couple. First, thanks for the detail on the 2022 thoughts, Paul. I was wondering, when I look at our model versus your expectations, you're nicely higher than us. So I was wondering, do you include any pipeline in that analysis? And as you look at the consensus models, can you talk about the delta where you all may be different? And why do you think that is?

我剛剛有了一些。首先，感謝保羅 (Paul) 對 2022 年想法的詳細介紹。我想知道，當我將我們的模型與您的期望進行比較時，您會發現您的期望遠高於我們。所以我想知道，您是否在該分析中包含了任何管道？當您查看共識模型時，您能否談談您可能存在差異的差異？您認為這是為什麼呢？

And then also, as an organization, you obviously, as you mentioned, are in over 100 countries. Can you talk about just green shoots you're seeing in some of these areas that help inform your guidance in the U.S.? I know that XIFAXAN seems to be just picking up a little bit. So can you talk about where we were and maybe what we're seeing real-time now in terms of the impact on COVID?

而且，正如你所說，作為一個組織，您們的業務顯然遍布 100 多個國家。您能否談談您在這些領域看到的一些積極跡象，以幫助您在美國提供指導？我知道 XIFAXAN 似乎才剛開始復甦。那麼，您能談談我們當時的情況嗎？以及就 COVID 的影響而言，我們現在實時看到的是什麼？

Paul, why don't you take the first part of that question and talk about the commentary on the pipeline in the 2022. And then as we get to the countries, I'll take over on that on XIFAXAN. So why don't you start first on that guidance question.

保羅，你為什麼不回答這個問題的第一部分，並談談對 2022 年管道的評論。然後，當我們談到這些國家時，我將在 XIFAXAN 上接手這個問題。那為什麼不先從這個指導問題開始呢？

Sure. Thanks, Joe. And Ken, thanks for the question. I mean the -- looking out -- when we do our long range forecast, so we are taking into consideration those new products that we expect to introduce that come out of our development pipeline. As I say, not all of those are going to be of the blockbuster nature, but it's a steady stream of new products that come out of our development pipeline that are included in that 2022 and '23 and '24 as we continue to forecast out our business. We have point out that a good chunk of what you're seeing in, call it, the next 3 years. So '20, '21 -- well, '20 is going to be an interesting year, but '21, '22 is the continued ramps of the products that we've very recently introduced.

當然。謝謝，喬。 Ken，謝謝你的提問。我的意思是——著眼於——當我們進行長期預測時，我們會考慮我們預計將推出的、來自我們開發流程的新產品。正如我所說，並非所有這些產品都會成為轟動一時的產品，但隨著我們繼續預測我們的業務，我們的開發流程中將不斷推出新產品，這些產品將包含在 2022 年、2023 年和 2024 年的產品中。我們已經指出，您所看到的大部分情況是在未來 3 年內發生的。因此，20、21 年——好吧，20 年將是充滿趣味的一年，而 21、22 年是我們最近推出的產品的持續增長期。

And you heard me speak about in my prepared remarks about my excitement around the upcoming launch of the daily SiHy lens in light of the great job that our U.S. team is doing marketing the portfolio that they have now. That's clearly a part of it. And so a lot of the other products that we have within our portfolio today, but there is a steady stream of products being added that helped to contribute to that 2022 number that goes into that CAGR?

在我的準備好的發言中，您聽到了我談到我對即將推出的每日 SiHy 鏡頭的興奮之情，因為我們的美國團隊在營銷他們現在的產品組合方面做得非常出色。這顯然是其中的一部分。那麼，我們今天的產品組合中還有很多其他產品，但有源源不斷的產品被添加，這有助於為 2022 年的複合年增長率做出貢獻嗎？

I'll take that. That second part is the -- I think, Ken, you're asking the questions about what's happening with the rest of the world. And as you walk around the world, what are we seeing. I mean if you think about what's happened here, we clearly -- the United States know that the visits to the dermatologist to the eye care doctors or the gastroenterologists are down somewhere in the 40% to 75%. So clearly, that's what we saw. But as you said, about green shoots, we are starting to see some things happen. So for example, in Europe, our expectation is that we'll see Europe starting to open up in June. We think Germany is already starting opening now in May. China, we're in the field. Activities are back up and running in China. So that gives you some sense of what we are seeing from a global perspective.

我接受。第二部分是──肯，我認為，你問的是世界其他地方正在發生的事。當你走遍世界時，我們看到了什麼。我的意思是，如果你想想這裡發生了什麼，我們清楚地知道——美國知道去皮膚科醫生、眼科醫生或胃腸病學家的就診人數下降了 40% 到 75%。很明顯，這就是我們所看到的。但正如你所說的，關於綠芽，我們開始看到一些事情發生。例如，在歐洲，我們預計歐洲將在六月開始開放。我們認為德國從五月就開始開放。中國，我們在戰場上。中國境內的活動已恢復正常。這可以讓您從全球視角了解我們所看到的情況。

Our expectation on the surgical side is that there is a backlog in the cataract surgery as an example. We're not going to work through all that in 2020, but some portions of that will work through in quarter 3 and quarter 4 as we see that absorb it. In other places like our Dental business, that's a little different. If you didn't go in and get your teeth clean, they -- you will go in the future, but you're going to -- there's going to be some loss in that business. And I think that's how Paul tried to portray that as we thought about what was happening there. And that's the kind of things that we're seeing.

我們對手術方面的預期是，以白內障手術為例，有積壓的情況。我們不會在 2020 年解決所有問題，但隨著我們看到這些問題得到解決，部分問題將在第三季和第四季解決。在我們的牙科業務等其他地方，情況略有不同。如果你不去洗牙，他們——你將來會去，但你會——這項業務會有一些損失。我想，當我們思考那裡發生的事情時，保羅就試圖這樣描述。這就是我們所看到的。

XIFAXAN, we feel really good about XIFAXAN. Yes, there's some short-term issues, but hepatic encephalopathy is holding up very strong. Same comment with our TRULANCE business. Notwithstanding all the noise out there about COVID, the TRULANCE business is up 50 plus percent. Outstanding performance there with TRULANCE. So we're looking at these things and finding the opportunity. The RELISTOR product continue to grow. XIFAXAN is going to continue to grow. We're looking for those kind of things for the future.

XIFAXAN，我們對 XIFAXAN 感覺非常好。是的，存在一些短期問題，但肝性腦病變仍然很嚴重。與我們的 TRULANCE 業務有相同的評論。儘管外界對 COVID 的擔憂不斷，但 TRULANCE 業務仍成長了 50% 以上。 TRULANCE 在那裡表現出色。因此，我們正在研究這些事物並尋找機會。 RELISTOR 產品持續成長。 XIFAXAN 將持續發展。我們正在為未來尋找這樣的事物。

The only other comment I'd add to what Paul said on the SiHy daily because that is our -- one of our key product launches is that we know that the SiHy market is about 15% of the global market. And it's growing at 30-plus percent. So that's why we're excited about what we think the opportunity to launch that silicone hydrogel product here in United States, we've launched in Japan and then take it around the world.

我對保羅在 SiHy 日報上所說內容的唯一補充評論是，因為這是我們推出的關鍵產品之一，我們知道 SiHy 市場約佔全球市場的 15%。而且其成長率超過30％。因此，我們對在美國推出矽水凝膠產品的機會感到非常興奮，我們已經在日本推出了該產品，然後將它推向世界各地。

Our next question will come from David Amsellem with Piper Sandler.

我們的下一個問題來自 Piper Sandler 的 David Amsellem。

So just a couple. So first on the lens business, I know you cited reduced lens wear, but I wanted to get your sense over the long-term regarding whether we could see something of a new normal in terms of reduced lens usage due to more social distancing or just more vigilant behavior, if you will. So is this something that you're planning for over the long term? That's number one.

所以只有一對。因此，首先關於鏡片業務，我知道您提到了減少鏡片佩戴，但我想了解一下您對長期的看法，即由於社交距離的增加或僅僅是更加警惕的行為，我們是否可以看到鏡片使用量減少的新常態。那麼這是您的長期計劃嗎？這是第一點。

And then number two, you had planned to convert some of your derm assets to cash pay with dermatology.com. I was wondering if you could talk about how COVID is impacting your plans there. Do you -- is that something that you're considering broadening over time or incorporating more into telemedicine, if you will, and help us understand your strategic thinking given the realities of the pandemic regarding this cash pay model?

第二，你計劃將部分皮膚科資產透過 dermatology.com 轉換為現金支付。我想知道您是否可以談談 COVID 對您在那裡的計劃有何影響。您是否考慮隨著時間的推移擴大這一領域或將其更多地納入遠距醫療？能否幫助我們了解您在疫情現實情況下對這種現金支付模式的策略思考？

Sure. I'll try to make sure I get all those questions. First, starting on the lens -- contact lens usage. We actually expect this to actually bounce back to what I would say would be what we had seen before continued growth in our lens care business, continued movement towards the daily contact lens, continued movement to SiHy daily. So all those trends that we've seen, I think, will come back. Is there some question about the reduced social interaction? Yes, that is true. However, notwithstanding that, if you think about it for a second, certainly, only thing people can see behind the mask is the eyes. So in fact, I mean, I know that sounds silly, but the reality is we're seeing incredible uptake in what we refer to our cosmetic lens or our colored lenses glass that we have in some of our geographies around the world. So there is some expectation that the contact lens business will continue to return.

當然。我將盡力確保回答所有這些問題。首先從鏡片——隱形眼鏡的使用方法說起。我們實際上預計這實際上會反彈到我們之前看到的水平，我們的鏡片護理業務繼續增長，繼續向日拋隱形眼鏡發展，繼續向 SiHy 日拋發展。因此我認為，我們看到的所有這些趨勢都會回歸。關於社交互動減少是否存在一些疑問？是的，確實如此。然而，儘管如此，如果你稍微想一想，當然，面具後面人們唯一能看到的就是眼睛。事實上，我知道這聽起來很傻，但事實是我們看到，在世界某些地區，我們所謂的美容鏡片或彩色鏡片玻璃的銷量正在驚人地增長。因此人們預計隱形眼鏡業務將繼續復甦。

On the question of derm.com and how we're managing that. Do I think COVID is going to impact our plans to convert more product to cash pay? I do think that there will be some movement in that. If you think about what's happening, the data I looked at is -- in telemedicine, is that in one particular plan, there was less than 1% of the doctor visits prior to 2020 were for telemedicine. The most recent data that's out there is that telemedicine is now accounting for approximately 15%. So you're seeing an absolute transition for telemedicine. We believe our dermatology.com will fit in very well with that because of what we're doing for the dermatologists. So we're looking to continue to see that kind of growth, that kind of opportunity for what we're planning on with our derm.com and telemedicine and how the cash pay fits in with that.

關於 derm.com 的問題以及我們如何管理它。我是否認為 COVID 會影響我們將更多產品轉換為現金支付的計劃？我確實認為這方面會有一些進展。如果你思考一下正在發生的事情，我查看的數據是——在遠距醫療中，在一項特定的計劃中，2020 年之前，只有不到 1% 的醫生就診是進行遠距醫療。最新數據顯示，遠距醫療目前約佔 15%。所以你會看到遠距醫療的絕對轉變。我們相信，鑑於我們為皮膚科醫生所做的工作，我們的 dermatology.com 將非常適合這種情況。因此，我們希望繼續看到這種成長，這種機會，以實現我們在 derm.com 和遠距醫療方面的規劃，以及現金支付如何與之相適應。

Our belief, once again, is that this model will allow physicians to get the formulation they want. They’ll have a predictable price. There won't be any prior authorization and patients won't be upset with them that there was promised the price of action. There's a completely different price than when they went to the pharmacy counter. So for those reasons, we do think there's a good opportunity with our dermatology.com in the telemedicine world.

我們再次相信，這種模式將使醫生獲得他們想要的配方。它們的價格是可預測的。不會有任何事先授權，患者不會因為承諾的治療價格而對他們感到不滿。價格與他們去藥局櫃檯時完全不同。因此，基於這些原因，我們確實認為我們的 dermatology.com 在遠距醫療領域有著良好的機會。

Our next question will come from Annabel Samimy with Stifel.

我們的下一個問題來自 Stifel 的 Annabel Samimy。

I want to talk to you about the guidance assumptions. I guess each of the different regions of the world are different and you’d assume that it runs its course, and you're not going to see social restrictions eased and, say, a second wave of this, but there's very different experiences across the globe versus the U.S. So how have you contemplated that in your guidance? And is that in the low end of your guidance? And what might that end up doing from a liquidity perspective, is there any scenario where you would have to draw on that revolver?

我想和你談談指導假設。我想，世界各地區的情況都不一樣，你會認為它會自然而然地發展，你不會看到社會限制放鬆，也不會出現第二波疫情，但與美國相比，全球各地的經歷非常不同。那麼，你在指導中是如何考慮這一點的呢？這是您指導的低端嗎？從流動性角度來看，這最終會產生什麼影響？是否有需要動用這筆循環信貸的情況？

Well, I'll start on some of this and then, Paul, you should also comment in terms of the guidance assumptions. I think what we tried to do is, as we thought about this, we are fortunate we have a significant business in China and Asia. We utilized the information and the knowledge that we gained from the earlier activities in Asia to help us think about what was going to happen with our business going forward. And as I mentioned before, as we're starting to see China now recovered, they started a little earlier. So we're starting to -- we're learning from that. But to be clear, we developed not just a scenario here, the one that we presented. We developed -- I think it was 4 different scenarios with different time points and different returns and trying to anticipate that there could be multiple things that could happen here.

好吧，我將從這方面開始，然後，保羅，你也應該根據指導假設發表評論。我認為我們嘗試做的是，當我們想到這一點時，我們很幸運在中國和亞洲擁有重要的業務。我們利用早期在亞洲的活動中獲得的資訊和知識來幫助我們思考未來的業務發展。正如我之前提到的，我們開始看到中國開始復甦，他們起步較早一些。所以我們開始—從中學習。但要明確的是，我們在這裡開發的場景不僅僅是我們所展示的場景。我們開發了——我認為它是 4 種不同的場景，具有不同的時間點和不同的回報，並試圖預測這裡可能發生的多種事情。

So we built in the 4 different scenarios, and we came up with what we referred to, as I would say, the most likely scenario and Paul and his team have just done a great job in thinking through the multiple parts of this, the pushes and the pulls relative to when the business would come back, how it would operate going forward in the future. We don't have a crystal ball, but we do clearly want to make sure that we’ve looked at all the contingencies. And I'll just say, before I turn it to Paul, that the work that Paul and the treasury team have done over the last 3 years have put us in a much stronger position to weather the storm here of COVID-19 and clearly be ready regardless of which way it goes. But Paul, why don't you take -- share your thoughts too?

因此，我們建立了 4 種不同的情景，並得出了我們所說的最有可能的情景，而 Paul 和他的團隊在考慮這其中的多個部分、與業務何時恢復相關的推動因素和拉動因素以及未來如何運作方面做得很好。我們沒有水晶球，但我們確實希望確保我們已經考慮過所有的意外情況。在把話題轉給保羅之前，我只想說，保羅和財務團隊在過去 3 年裡所做的工作，使我們處於更有利的地位來抵禦 COVID-19 疫情的風暴，無論情況如何，我們都做好了準備。但是保羅，為什麼不也分享一下你的想法呢？

Yes. Thanks, Joe, and thanks for the question, Annabel. Interesting because we do have so many businesses in so many markets that we are able to take learnings from other markets. The fellow, Tom Appio, who is the -- who runs our B&L business outside United States has been just a wealth of information about how this has played out because it started in Asia, and there were some things, and we were hopeful that some of that data about how this plays out would be directly relevant to how we play out in other markets. But the reality is each market is different. That's why I went through that discussion. And so that's what leads us to having such a wide range of possible scenarios and including taking into effect, a much more protracted period to the end of the dip as well as protracted periods as we work our way out of this environment.

是的。謝謝喬，也謝謝你的提問，安娜貝爾。有趣的是，因為我們在如此多的市場中擁有如此多的業務，因此我們能夠從其他市場中學習經驗。湯姆·阿皮奧 (Tom Appio) 是我們美國境外的 B&L 業務的負責人，他提供了大量關於這一業務如何開展的信息，因為這一業務始於亞洲，而且有一些事情，我們希望這些關於這一業務如何開展的數據能夠與我們在其他市場開展業務的方式直接相關。但實際情況是每個市場都是不同的。這就是我進行那次討論的原因。因此，我們將面臨如此多種多樣的可能情況，包括經濟低迷需要更長的時間才能結束，以及我們走出這種環境需要更長的時間。

Now what I called out, I want to -- I think it's an important point is we looked at how we thought 2020 would play out. In the light of that revenue reduction, we reduced our OpEx mainly selling and advertising and promotion by circa $175 million on a constant currency basis. I can assure you that we have scenarios within our company that if things trend below lines, we would take additional actions in order to protect our profit and to protect our cash flow. It was a very involved process led by my right-hand man, Sam Eldessouky, who develops all these things so that we can prepare and be ready, depending on how the situation plays out because nobody knows. We have a great deal of uncertainty, but we're prepared if it plays out in a less favorable way. We're ready to roll. If we start to recover more rapidly, we've done our level best to ensure that we have our resources as one of my favorite phrases, tanned, rested and ready, to get back to work and to start driving us back towards pre-COVID levels.

現在我要說的是——我認為重要的一點是，我們要思考 2020 年將會如何發展。鑑於收入減少，我們以固定匯率計算減少了約 1.75 億美元的營運支出（主要是銷售、廣告和促銷）。我可以向你們保證，我們公司內部的情況是，如果事情趨勢低於預期，我們會採取額外措施來保護我們的利潤和現金流。這是一個非常複雜的過程，由我的得力助手 Sam Eldessouky 領導，他制定了所有這些事項，以便我們可以做好準備，這取決於情況如何發展，因為沒有人知道。我們面臨很大的不確定性，但如果結果不利，我們也準備好了。我們已準備好出發。如果我們開始更快地恢復，我們已經盡了最大努力確保我們擁有資源，就像我最喜歡的短語之一，曬黑、休息和準備好，以恢復工作並開始推動我們回到 COVID 之前的水平。

Now your second question was around liquidity. And first of all, I said in my remarks, this -- we are in a terrific position. Even in a downside scenario here, we are strongly cash flow positive from operations. And I said this, I think, we tried to articulate this in our 8-K early on in this process. In 2019, our cash from operations was circa $1.5 billion we generated. And you have to remember that after covering a very hefty cash interest load. So after all that cash interest, we generated $1.5 billion. This -- right now, based on our range of guidance, we're saying circa $1 billion of cash generated from operations in 2020 under some scenarios that are down. That are clearly down. We can self-fund. We absolutely can self-fund.

現在您的第二個問題是關於流動性的。首先，我在演講中說過，我們目前處於非常好的地位。即使在不利的情況下，我們的經營活動產生的現金流仍然強勁。我說過，我想，我們在這個過程的早期就試圖在 8-K 中闡明這一點。 2019 年，我們的經營活動產生的現金約為 15 億美元。你必須記住，在支付了非常高昂的現金利息負擔之後。因此，扣除所有現金利息，我們獲利 15 億美元。目前，根據我們的指導範圍，我們預計，在某些下降的情況下，2020 年營運產生的現金約為 10 億美元。這顯然是下降了。我們可以自籌資金。我們絕對可以自籌資金。

Secondarily, we have our revolver available to us. You asked the question, would we borrow on that revolver? Yes, we will borrow on that revolver in the same way as we have borrowed on the revolver in the past, which is to fund short-term requirements. At the end of the quarter, there were no borrowings outstanding under the revolver. Will there be borrowings during the year? Sure, of a short-term nature because our cash flows do not come in on a linear basis across the course of the year. But we are in a very good position liquidity-wise. I can't emphasize enough.

其次，我們有左輪手槍。你問的是，我們會借用那把左輪手槍嗎？是的，我們將以過去借用循環信貸的方式借用該循環信貸，以滿足短期需求。截至本季末，循環信貸項下無未償還借款。年內會有借款嗎？當然，是短期的，因為我們的現金流在一年的時間內並不是線性流入的。但從流動性角度來看，我們處於非常有利的地位。我再怎麼強調也不為過。

I am very pleased that we were able to accomplish everything we were able to accomplish with respect to our debt capital over the last, call it, almost 3 years now such that our first real maturities are of any substance or of any substance around in 2022. Those are secured nature. Those are easier, nothing too easy, but those are easier to finance -- to refinance. And we feel like we're in very good shape to ride this out. You're seeing in our 2020 guidance, what we believe is the range of outcomes in 2020 and we're prepared, whether it's towards the lower end of that range or the upper end of that range, we're prepared either way to manage through it and without blinking.

我很高興我們能夠完成過去近 3 年裡我們在債務資本方面所能完成的一切，以至於我們的第一批實際到期債務將在 2022 年左右到期。這些都是有擔保的。這些比較容易，但也不太容易，但這些比較容易融資──再融資。我們感覺我們已經做好了渡過難關的準備。您可以在我們的 2020 年指引中看到，我們認為 2020 年的結果範圍是這樣的，我們已經做好了準備，無論是朝著這個範圍的下限還是上限，我們都準備好毫不猶豫地度過難關。

Our next question will come from Gregg Gilbert with SunTrust.

我們的下一個問題來自 SunTrust 的 Gregg Gilbert。

I wanted to go back to the second half launches you're expecting. I wanted to make sure I understood whether that was a bet on things returning to normal versus you plan to launch regardless. It's just a function of how you would launch and with what tactics. And then on the biosimilar deal you did, I'm curious, and I'm sorry if you already covered this, I don't think you did. But can you talk about the expense of that program over time? And any associated time lines and whether highly is in your sites as well?

我想回顧一下您所期待的下半年發表會。我想確保我明白這是否是押注事情會恢復正常，還是無論如何都計劃推出。這只是取決於您如何啟動以及使用什麼策略。然後，對於您所做的生物仿製藥交易，我很好奇，如果您已經報道過這個問題，我很抱歉，我想您還沒有報道過。但你能談談該計劃的長期費用嗎？以及任何相關的時間軸以及是否也高度位於您的網站中？

Sure. I'll take the first part of this in the second to start a deal. First of all, on the second half of 2020, are we expecting a return to what I would refer to as the new normal? Yes, we are expecting to that in the second half of 2020. It's not going to be like flipping a light switch. It's going to be a gradual. We're already, as I mentioned before, seeing some activities in China opening up now. We're saying in Germany we expect in May. Europe, we expect in June. United States is going to be variable by state. Some of the states, as you know, are already opening up already. Some of them, we've already had conversations. We're doing a lot of virtual meetings with our docs now, and we expect that some of them are opening up their practices and looking forward to getting back into the surgical suite. So we're going to see it happen over time. It's not going to be like a light switch. It's going to be a gradual, and we're looking at multiple geographies, multiple states as we do that forecast.

當然。我將在第二部分中討論第一部分，以開始達成交易。首先，到2020年下半年，我們是否預期會恢復到我所說的「新常態」？是的，我們預計在 2020 年下半年實現這一目標。這不會像打開電燈開關那麼簡單。這將是一個漸進的過程。正如我之前提到的，我們已經看到中國的一些活動正在開放。我們預計德國會在五月推出。歐洲，我們預計在六月。美國將因州而異。如您所知，一些州已經開始開放。其中一些我們已經進行過對話了。我們現在正在與我們的醫生進行許多虛擬會議，我們預計其中一些正在開放他們的診所並期待重返手術室。因此，隨著時間的推移，我們將會看到它的發生。它不會像電燈開關那樣。這將是一個漸進的過程，我們在進行預測時會關注多個地區、多個州。

On the specific question about the launch, though, for the SiHy daily is our expectation. As I mentioned, we've already had acceptance to file for the 510(k). It is our expectation that we will launch that in the latter half of 2020. We believe that markets will return and will be there will be ability to get that product launched. It's going to -- it's not going to be, once again, an immediate quarterly across all doctors, it's going to be -- as they open up, we're going to have the product available. When we have the product available, we'll give them the fit sets appropriate to launch and make sure that we move forward with those launch activities. So we do think that that's an exciting product, exciting opportunity. And as I mentioned, it's a very fast-growing part of the market and one that we think we can participate in with what we think is a great product. It's already, as you know, launched in Japan. So we've got the experience with the manufacturing side, and we'll continue to move forward. That's clearly the biggest product.

不過，對於此次發布的具體問題，我們對 SiHy 日報抱持著期待。正如我所提到的，我們的 510（k）申請已經獲準。我們預計將在 2020 年下半年推出產品。我們相信市場將會復甦，並且有能力推出該產品。它將 — — 再次，它不會是立即向所有醫生每季度發布一次，它將是 — — 隨著他們開放，我們將提供該產品。當我們有產品可用時，我們會為他們提供適合發布的套裝，並確保我們推進這些發布活動。所以我們確實認為這是一個令人興奮的產品、令人興奮的機會。正如我所提到的，這是一個成長非常快速的市場領域，我們認為我們可以憑藉我們認為的優秀產品參與其中。如您所知，它已經在日本推出。因此，我們在製造方面擁有豐富的經驗，並且會繼續向前發展。這顯然是最大的產品。

On the STADA deal, minimal expense to us over time, STADA has the program already underway. What STADA was looking for, I think, is they had the expertise for the manufacturing side. In the biosimilar side, we had the expertise on calling on these doctors. We do not have access to a product like this. We felt this opportunity would be a perfect opportunity for us to partner with STADA and give them a win, give us a win in getting out to the North American doctors with this product. So we think it's exciting. We're looking forward to partner on this Lucentis biosimilar opportunity, and we’ll work forward towards that. But minimal other than the upfront expense and then some milestone payments as we get closer to launch, there’s very minimal R&D expense for us.

關於 STADA 交易，隨著時間的推移，我們的費用將降到最低，STADA 的計劃已經在進行中。我認為，STADA 尋求的是製造方面的專業知識。在生物相似藥方面，我們擁有諮詢這些醫生的專業知識。我們無法獲得這樣的產品。我們覺得這次機會對於我們與 STADA 合作並為他們帶來勝利的絕佳機會，也讓我們能夠將該產品推廣到北美醫生手中。因此我們認為這很令人興奮。我們期待在 Lucentis 生物相似藥領域展開合作，並將為此不斷努力。但除了前期費用和接近發佈時的一些里程碑付款外，我們的研發費用非常少。

Our next question will come from Umer Raffat with Evercore.

我們的下一個問題來自 Evercore 的 Umer Raffat。

Paul, I'm very confused about something today, which is, I recall we discussed specifically the implied 2022 revenues and implied 2022 EBITDA off of -- which was off of the growth CAGRs you had laid out, but the growth CAGRs were being applied on the midpoint of 2019 guidance. Today, I'm noticing, not only are the growth CAGRs down, they are no longer being applied on the midpoint of 2019 guidance. Instead, they're being applied on an FX-adjusted version of the 2019 guidance. And I'm just trying to understand why that is and why not maybe just give clean growth numbers implied? Is it around 3% on the low end on EBITDA growth CAGR, if we still work off of the original numbers, which was midpoint of 2019 guidance?

保羅，我今天對一些事情感到非常困惑，我記得我們特別討論了隱含的 2022 年收入和隱含的 2022 年 EBITDA——這是基於您所列出的複合年增長率，但複合年增長率是按照 2019 年指引的中點計算的。今天，我注意到，成長複合年增長率不僅下降，而且不再適用於 2019 年指導中點。相反，它們被應用於 2019 年指引的外匯調整版本。我只是想知道為什麼會這樣，為什麼不直接給出隱含的清晰成長數字呢？如果我們仍然以原始數字（即 2019 年指引的中點）為基礎，EBITDA 複合年增長率的低​​端是否在 3% 左右？

Paul, you take that question.

保羅，你回答這個問題。

Yes, sure. I mean it was clearly directed at me. The guidance where we provided it was always meant to be constant currency. It's why we talk about organic. We can't control currency. We operate in many markets around the world. And that's why we talk about organic, that's why we talk about constant currency. When we laid it out, it was meant to be at constant currency. All we did was, indeed, take the midpoint of that 2019 guidance bring it to the FX today, which, by the way, anybody who is trying to follow along at home, you could follow all of our quarters and all -- every time we talk about FX and total up the cumulative impact of FX, and that's what it is. And that's what we can grow off of. That's how we measure ourselves is constant currency. And so I'm only trying to express it now on that Slide 19 in a way that people can at least say, based on currency today, that's what I -- that's the range of outcomes. To hold ourselves to say we'd put a longer-term CAGR range and say, and we'll take currency, I don't think that's reasonable.

是的，當然。我的意思是這顯然是針對我的。我們提供的指導始終是恆定不變的。這就是我們談論有機的原因。我們無法控制貨幣。我們的業務遍及全球許多市場。這就是我們談論有機的原因，這就是我們談論恆定貨幣的原因。當我們佈置它時，它意味著要保持貨幣不變。事實上，我們所做的就是將 2019 年指引的中點帶到今天的外匯市場，順便說一句，任何想在家裡跟進的人都可以關注我們所有的季度和所有——每次我們談論外匯並總結外匯的累積影響，這就是它。這正是我們能夠成長的基礎。這就是我們衡量自己的方式，是恆定的貨幣。所以我現在只是想在第 19 張投影片上以一種人們至少可以說的方式來表達，基於今天的貨幣，這就是我 — — 這就是一系列的結果。如果我們堅持說我們會設定一個長期複合年增長率範圍並且會接受貨幣，我認為這並不合理。

Our last question will come from Akash Tewari with Wolfe Research.

我們的最後一個問題來自 Wolfe Research 的 Akash Tewari。

So there seems to be a disconnect between how much the midpoint of adjusted EBITDA came down versus how much cash flow from operations declined, 300 versus 500, can you explain what's going on there? And I know there's a lot of moving parts, but given the change in long-term guidance and the stock drop payout, we're getting to you getting under 5x leverage, it seems like it's more like a late 2024, 2025 event. Is that a fair take? Or do you have more operating leverage here than we're really appreciating?

因此，調整後的 EBITDA 中點的下降幅度與經營活動現金流的下降幅度之間似乎存在脫節，分別是 300 和 500，您能解釋一下其中發生的情況嗎？我知道有很多因素在起作用，但考慮到長期指導的變化和股票下跌的支出，我們將使您獲得低於 5 倍的槓桿，這似乎更像是 2024 年末或 2025 年的事件。這是一個公平的看法嗎？或者您的經營槓桿比我們實際認識到的要大？

Paul, why don't you take that question, and then I'll comment after you finish.

保羅，你為什麼不回答這個問題，然後你回答完之後我再發表評論。

Yes, sure. I mean I'll start with -- we've got a very broad range of outcomes here for both revenue and for adjusted EBITDA. We've selected a point estimate of roughly $1 billion of operating cash flow to cover the range. The rationale is, I even called it out in, with respect to the expected cash flow generated in the first quarter. COVID impacts are not solely on operating results. COVID impacts are also on classic adjusted working capital type accounts, where I called out in the Asia Pacific region, we've had to extend payment terms to a number of our customers in order to help them work through this crisis. As I say, we're not being foolish about it, but it's absolutely stretching the time that it takes for us to convert revenue to cash.

是的，當然。我的意思是，我首先要說的是——我們對收入和調整後 EBITDA 的結果範圍非常廣泛。我們選擇了大約 10 億美元的營運現金流作為點估計來涵蓋該範圍。其理由是，我甚至針對第一季預計產生的現金流指出了這一點。 COVID 的影響不僅在於經營業績。 COVID 的影響也波及傳統的調整後營運資本型帳戶，我曾在亞太地區指出，我們不得不向一些客戶延長付款期限，以幫助他們度過這場危機。正如我所說，我們並沒有犯傻，但這絕對會延長我們將收入轉化為現金所需的時間。

Secondarily, management of inventories during this time period is also a challenge. If you're hoping for and planning for a more rapid recovery, you maintain inventories on hand to provide a high service level. And that could, across a range of outcomes, end up being a classic use of cash for our growth of adjusted working capital. Flip side of it is that we, like everyone else, are doing our best to ensure that on the payable side, we do what we can do to help offset some of that. But the reality is that we -- while we work our way through this, the normal ratios that you might look at with respect to adjusted working capital and how to think about that as the push/pull of cash generation don't apply until we get back to a more normal state.

其次，這段時間內的庫存管理也是一個挑戰。如果您希望並計劃更快地恢復，您可以保留現有庫存以提供高水準的服務。從一系列結果來看，這最終可能成為我們調整後營運資本成長的典型現金用途。另一方面，我們和其他人一樣，正在竭盡全力確保在應付款項方面，我們盡我們所能來幫助抵消部分損失。但現實情況是，在我們努力解決這個問題的同時，您可能看到的與調整後營運資本有關的正常比率以及如何將其視為現金產生的推拉因素並不適用，直到我們恢復到更正常的狀態。

The range of outcomes is pretty broad. I did not want to put a broad range of forecast for cash generated from operations on the table. We put the circa $1 billion as a good solid spot for you to take a look at for the balance of the year. I'm sorry, not for the balance, but for the full year. I'm sorry, the second part of the question, Akash?

結果的範圍相當廣泛。我不想對營運產生的現金做出廣泛的預測。我們將大約 10 億美元作為一個不錯的穩定金額，供您在全年餘額中查看。抱歉，不是餘額，而是全年的餘額。抱歉，問題是第二部分，Akash？

It was about the question of leverage.

這是關於槓桿率的問題。

Right. So 5x leverage, it seems like late 2024, 2025 event now. Is that a fair take? Or am I missing something?

正確的。因此，5 倍槓桿，現在看來是 2024 年底、2025 年事件。這是一個公平的看法嗎？或者我遺漏了什麼？

Well, I just state basic factoids. One, we certainly pushed that -- the timing of our -- getting to be below 5x out when we settled the U.S. Securities litigation and added $1.1 billion essentially to our debt load. Secondarily, as you take -- if you go with my forecast, as I articulated during guidance today, from $1.5 billion of cash from operations down to $1 billion, that cash is not deployed to reduce debt. So yes, I mean, there is a knock-on effect that we'll push this out. And also, the knock-on effects in the longer-term of the recovery -- long-term recovery from COVID certainly pushed that out. I'm not going to peg a date when we would expected to reduce below 5x.

好吧，我只是陳述基本事實。首先，當我們解決了美國證券訴訟並增加了 11 億美元的債務負擔時，我們確實推遲了這一時間，使其低於 5 倍。其次，如果你按照我的預測，就像我在今天的指導中所闡述的那樣，營運現金將從 15 億美元降至 10 億美元，這些現金不會用於減少債務。是的，我的意思是，我們推行這項措施會產生連鎖反應。此外，長期復甦的連鎖反應——新冠疫情的長期復甦無疑推遲了這一進程。我不會確定我們預計減少至 5 倍以下的日期。

Maybe -- the only thing I'd add to what Paul has said is that we recognize -- when Paul and I got here, 3.5, 4 years ago that we had too much leverage, and we're working very diligently to reduce that. We did make some decisions though to invest in the business, invest behind XIFAXAN and with the primary care. We did make decisions to invest in and acquire a product like TRULANCE. All those business decisions, we think, have been the right decisions, and we do them all the time because we're building this business for the long term.

也許──我對保羅所說的話唯一想補充的是，我們意識到──當保羅和我三、五年、四年前來到這裡時，我們的影響力太大了，我們正在努力減少這種影響力。我們確實做出了一些決定，對業務進行投資、對 XIFAXAN 進行投資以及對初級保健進行投資。我們確實決定投資並收購 TRULANCE 這樣的產品。我們認為，所有這些商業決策都是正確的，而且我們一直都在這麼做，因為我們正在長遠發展這個業務。

Having said that, though, we're absolutely laser-focused on this concept of driving shareholder value. And as you know, we've done before, we've divested approximately $3.8 billion of asset proceeds in the past, and we will continue to look at things that will drive down this leverage and will improve the overall share price performance of our company. That's everything from asset divestitures. That's looking at spinoffs of our business, if we do not believe we're getting the appropriate -- some of the parts for our company. So we're going to look at all the things that will drive long-term shareholder value for our company. And you can expect, as the management team that we are focused on that in terms of driving the shareholder value and urgently looking at the things that we can do to try to help increase shareholder value.

儘管如此，我們仍然全神貫注於推動股東價值這一理念。如你所知，我們以前就這樣做過，我們過去已經剝離了大約 38 億美元的資產收益，我們將繼續尋找能夠降低這種槓桿率並提高公司整體股價表現的因素。這就是資產剝離的全部內容。如果我們認為我們沒有獲得適合我們公司的部分業務，那麼我們就會考慮剝離我們的業務。因此，我們將研究所有能為公司帶來長期股東價值的因素。你可以預料，作為管理團隊，我們專注於提高股東價值，並緊急尋找可以採取的措施來幫助提高股東價值。

Thank you, everyone, for joining us today. I'm going to conclude this Q&A. But appreciate your attention to our company. And please let us know if there are additional questions, happy to try to answer those questions as we go forward. Thank you, everyone, for joining us. Have a great day.

感謝大家今天的參與。我要結束本次問答了。但感謝您對我們公司的關注。如果您還有其他問題，請告知我們，我們很樂意在後續過程中嘗試回答這些問題。感謝大家加入我們。祝你有美好的一天。

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

會議現已結束。感謝您參加今天的演講。您現在可以斷開連線。