Bausch Health Companies Inc (BHC) 2019 Q4 法說會逐字稿

Good day, and welcome to the Bausch Health Fourth Quarter and Full Year 2019 Financial Results Conference Call. (Operator Instructions) Please note this event is being recorded.

大家好，歡迎參加博士倫健康 2019 年第四季及全年財務業績電話會議。（操作員指示）請注意，此事件正在被記錄。

I would now like to turn the conference over to Arthur Shannon, Senior Vice President of Investor Relations and Global Communications. Please go ahead.

現在，我想將會議交給投資者關係和全球傳播高級副總裁 Arthur Shannon。請繼續。

Thank you, Alicia. Good morning, everyone, and welcome to our Fourth Quarter and Full Year 2019 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. 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.

謝謝你，艾莉西亞。大家早安，歡迎參加我們的2019年第四季和全年財務業績電話會議。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。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。

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.

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。

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.

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 Papa.

現在，我很高興將電話轉給喬·帕帕 (Joe Papa)。

Thank you, Art, and thanks, everyone, on the phone for joining us today. Let's quickly review the topics we will cover today. I'll begin with a brief summary of our 2019 company highlights before turning the call over to Paul Herendeen, our CFO. Paul will take us through the fourth quarter and full year financial results and provide our 2020 guidance. I'll then review the segment highlights and catalysts before opening the line for questions.

謝謝你，阿特，也感謝今天透過電話與我們交談的所有人。讓我們快速回顧一下今天要討論的主題。我將首先簡要介紹我們 2019 年公司的亮點，然後將電話轉給我們的財務長 Paul Herendeen。保羅將帶我們回顧第四季和全年的財務業績，並提供 2020 年的指導。然後，我將回顧該部分的亮點和催化劑，然後再開始回答問題。

Beginning on Slide 4. In 2019, our theme was pivot to offense or focus on driving organic growth in our core businesses. We have now delivered 8 consecutive quarters of organic growth, and 2019 was our first full year of reported revenue growth since 2015. Bausch Health grew organically by 4% in 2019 and reported revenues were up 3%.

從投影片 4 開始。 2019 年，我們的主題是轉向進攻或專注於推動核心業務的有機成長。我們現已連續 8 個季度實現有機成長，2019 年是我們自 2015 年以來首次實現全年營收成長。博士倫健康公司 (Bausch Health) 2019 年有機成長 4%，報告營收成長 3%。

Our largest segment, B + L/International, delivered its third consecutive year of mid-single-digit organic revenue growth. Salix reported full year revenue of more than $2 billion for the first time ever. We generated $1.5 billion of cash from operations. We increased R&D investment by 14% compared to 2018. And we used approximately $1.1 billion of cash to pay down roughly $900 million of debt and fund approximately $250 million of bolt-on acquisitions or license in products. Pivoting to offense also included launching new products and driving their growth, and our new products continue to grow.

我們最大的部門，B + L /國際，連續第三年實現中等個位數的有機收入成長。Salix 報告稱，全年營收首次超過 20 億美元。我們的營運產生了 15 億美元的現金。與2018年相比，我們的研發投入增加了14%。我們使用了約 11 億美元現金償還約 9 億美元的債務，並資助約 2.5 億美元的附加收購或產品許可。轉向進攻還包括推出新產品並推動其成長，我們的新產品持續成長。

First, following the launch of Thermage FLX in Asia Pacific, the Thermage franchise saw a 73% organic revenue growth compared to 2018. This exceptional growth rate made the Thermage one of the Bausch Health's top 10 franchises in 2019. LUMIFY achieved a weekly market share of approximately 43% in 2019, is the #1 physician recommended product in the redness reliever category.

首先，隨著 Thermage FLX 在亞太地區推出，Thermage 特許經營權與 2018 年相比實現了 73% 的有機收入成長。這一卓越的成長率使 Thermage 成為 Bausch Health 2019 年十大特許經營店之一。LUMIFY 在 2019 年的每週市佔率約為 43%，是紅腫緩解類中醫師推薦的第一產品。

TRULANCE TRxs grew by 31% (sic) [30%] year-over-year, and we have improved the market access position for approximately 35 million lives since we acquired the product in the first quarter of 2019.

TRULANCE TRxs 年成長 31% (原文如此) [30%]，自 2019 年第一季收購該產品以來，我們已改善了約 3500 萬人的市場准入地位。

DUOBRII has been another standout. Weekly TRxs grew by 25% from the third to the fourth quarter of 2019, and we have now achieved 63% commercial access.

DUOBRII 是另一個引人注目的產品。2019年第三季至第四季度，每週的傳輸量成長了25%，目前我們已實現63%的商業訪問量。

Overall, the entire Bausch Health team of 22,000 employees delivered on our promise to pivot to offense in 2019 and demonstrated the durability of our business, which we grew both organically and through strategic bolt-on acquisitions. Great effort by the entire Bausch Health team.

總體而言，整個博士倫醫療團隊由 22,000 名員工組成，兌現了我們在 2019 年轉向進攻的承諾，並展示了我們業務的持久性，我們透過有機成長和策略性附加收購實現了業務成長。整個 Bausch Health 團隊都付出了巨大的努力。

Paul is going to walk you through the fourth quarter and full year results in more detail. So with that, I'll turn it over to Paul.

保羅將向您更詳細地介紹第四季和全年的業績。因此，我將把話題交給保羅。

Thanks, Joe. A lot to cover. I'll try to go fast. Good quarter and a good year. A little different approach this quarter. I'm going to start with Slide 5, a summary of the changes in revenue by segment and major business unit for both Q4 and the full year 2019. I'll then walk down the top-level P&L for the quarter and provide some observations about the full year before turning to our guidance for 2020.

謝謝，喬。要講的內容很多。我會盡量跑快一點。這是一個好的季度，也是一個好的年度。本季度的方法略有不同。我將從投影片 5 開始，投影片總結了 2019 年第四季和全年各部門和主要業務部門的收入變化。然後，我將介紹本季的頂層損益表，並對全年提供一些觀察，然後再介紹我們對 2020 年的指導。

A quick reminder, when we talk about organic growth, that means excluding the impact of changes in FX rates, the impact of divested and discontinued businesses in the prior year periods and the impact of acquired businesses.

快速提醒一下，當我們談論有機成長時，這意味著排除外匯匯率變化的影響、上一年期間剝離和停止的業務的影響以及收購業務的影響。

Okay. Slide 5. In the quarter, we posted 4% organic revenue growth versus Q4 2018. Recall, that last year, we took steps to reduce our channel inventories held at wholesalers and that that had the effect of reducing Q4 '18 revenue by an estimated $76 million. So that's a tailwind for us this quarter. Excluding the impact of the inventory contraction, we still posted top level organic revenue growth of plus 1%. There were a lot of moving parts, but a lot of good stuff within each of our segments.

好的。投影片 5. 本季度，與 2018 年第四季相比，我們的有機收入成長了 4%。回想一下，去年我們採取措施減少批發商持有的通路庫存，這導致 2018 年第四季的收入減少了約 7,600 萬美元。所以這對我們本季來說是一個順風。除去庫存收縮的影響，我們仍然實現了 1% 的最高水準有機收入成長。有很多活動部件，但每個部分都有很多好東西。

Let's start with Salix as it was the largest contributor to organic revenue growth in the quarter, up 17% organically on continued strong performance from XIFAXAN, up 29%. RELISTOR, up 29%, and PLENVU also contributed growth. We lost exclusivity for APRISO in the quarter, and that, combined with the continued generic erosion of UCERIS offset some of the growth. While not a factor in organic growth, TRULANCE sales totaled $18 million in the quarter and filled TRxs were up 69% versus Q4 of '18. A strong quarter from Salix to wrap up a great year, posting 13% organic revenue growth for the full year versus 2018 despite LOEs.

讓我們從 Salix 開始，因為它是本季有機收入成長的最大貢獻者，有機收入成長了 17%，得益於 XIFAXAN 繼續強勁的表現，成長了 29%。RELISTOR 上漲 29%，PLENVU 也貢獻了成長。我們在本季失去了 APRISO 的獨家經營權，再加上 UCERIS 仿製藥的持續侵蝕，抵消了部分成長。雖然 TRULANCE 不是有機成長的因素，但本季的銷售額總計 1,800 萬美元，且已填充的 TRxs 與 2018 年第四季相比成長了 69%。Salix 本季表現強勁，為這一年畫上了圓滿的句號，儘管出現 LOE，但與 2018 年相比，全年有機收入增長了 13%。

B + L/International segment revenue was up 3% organically in the quarter, led by Global Consumer, plus 7% organically on strength in LUMIFY in the U.S. and our global contact lens solution brands, renu and Biotrue multipurpose. Global Surgical was plus 5% organically in the quarter on strength in consumables for the back of the eye and enVista IOLs. Global Vision Care was plus 4% organically in the quarter on strength in ULTRA monthly silicone hydrogel lenses, our AQUALOX Daily SiHy lenses in Japan and Biotrue ONEday lenses. Our international pharma business was essentially flat versus Q4 of '18, while Global Ophtho Rx declined 2% organically as growth of VYZULTA and PROLENSA were more than offset by the decline of the LOTEMAX brand family due to generic erosion.

本季度，B + L/國際部門營收有機成長 3%，主要得益於全球消費者業務的推動，同時由於美國 LUMIFY 和我們的全球隱形眼鏡護理液品牌 renu 和 Biotrue 多用途的強勁增長，有機增長 7%。由於眼後部耗材和 enVista IOL 的強勁增長，Global Surgical 本季有機增長 5%。由於 ULTRA 月拋矽水凝膠鏡片、日本的 AQUALOX Daily SiHy 鏡片和 Biotrue ONEday 鏡片的強勁銷售，Global Vision Care 本季有機成長了 4%。我們的國際製藥業務與 2018 年第四季相比基本持平，而全球眼科處方業務有機下降 2%，因為 VYZULTA 和 PROLENSA 的成長被 LOTEMAX 品牌家族因仿製藥侵蝕而導致的下滑所抵消。

For the full year, B + L/International grew 5% organically, consistent with our belief that this diverse and durable segment can deliver mid-single-digit growth over time. All 5 of the B + L/International business units posted organic revenue growth for the year, led by Global Consumer, up 6% organically on strength in LUMIFY in the U.S. and our eye vitamins globally; followed by Global Vision Care, up 7% organically, with contributions from our Biotrue ONEday lenses, our monthly ULTRA lenses and our AQUALOX Daily SiHy lenses in Japan.

全年來看，B+L/國際業務有機成長了 5%，這與我們的信念一致，即這個多元化且持久的細分市場能夠隨著時間的推移實現中等個位數的成長。所有 5 個 B + L/國際業務部門都公佈了全年有機收入成長，其中全球消費者業務領先，得益於美國 LUMIFY 和全球眼部維生素的強勁增長，有機收入增長 6%；其次是 Global Vision Care，有機增長 7%，這得益於我們在日本的 Biotrue ONEday 鏡片、每月 ULTRA 鏡片和 AQUAL Daily。

Our international pharma business was up 5% organically on strength in Russia, Egypt and Canada. Global Ophtho Rx was up 2% organically. Unlike in the quarter, for the full year, growth of VYZULTA, PROLENSA and a portfolio of our international ophthalmic brands overcame the LOE drag from LOTEMAX. The Ortho Dermatologics segment declined 1% organically in Q4 of '19 versus '18, as spectacular growth in our global aesthetics business, Solta, which was up 42%, nearly overcame the 18% decline in medical dermatology.

由於俄羅斯、埃及和加拿大的強勁成長，我們的國際製藥業務有機成長了 5%。全球眼科藥物銷售額有機成長 2%。與本季不同的是，全年來看，VYZULTA、PROLENSA 和我們的國際眼科品牌組合的成長克服了 LOTEMAX 帶來的 LOE 拖累。與 2018 年相比，2019 年第四季度矯形皮膚科部門有機下降了 1%，因為我們的全球美容業務 Solta 實現了 42% 的驚人增長，幾乎抵消了醫學皮膚科 18% 的降幅。

In the Solta business, the Thermage platform is now solidly in the top 10 products for the entire company and was a significant contributor to company-wide growth. LOEs played a big role in the quarterly decline in medical derm, mainly Elidel and Zovirax cream. The balance of promoted products in medical derm, including DUOBRII, JUBLIA, SILIQ and BRYHALI, all grew versus Q4 of 2018. It's pretty much the same story for the Ortho Derm segment for the full year, strong growth from Global Solta, plus 45% organically for the year, more than offset by the decline in medical dermatology.

在 Solta 業務中，Thermage 平台現在穩居整個公司十大產品之列，並為整個公司的成長做出了重要貢獻。LOE 在醫療皮膚科季度下滑中扮演了重要角色，主要是 Elidel 和 Zovirax 乳膏。DUOBRII、JUBLIA、SILIQ 和 BRYHALI 等醫學皮膚科促銷產品的餘額與 2018 年第四季相比均有所增長。全年 Ortho Derm 部門的情況基本上相同，Global Solta 業務強勁增長，全年有機增長率達 45%，但被醫學皮膚病學業務的下滑所抵消。

For the full year, medical derm was our business most impacted by LOEs, a minus $121 million growth drag versus 2018. On the plus side, JUBLIA was 1 of the top 15 contributors to company-wide revenue growth in 2019 versus '18. As the impact of LOEs moderates in this segment, JUBLIA, together with our brands in growth phase, that's DUOBRII, SILIQ and BRYHALI, form the core of our medical derm portfolio and the basis for an expected return to growth in this business in 2020.

就全年而言，醫療皮膚科是我們受 LOE 影響最大的業務，與 2018 年相比，成長拖累為 1.21 億美元。從積極的一面來看，與 2018 年相比，JUBLIA 是 2019 年全公司收入成長的前 15 名貢獻者之一。隨著 LOE 對該領域的影響逐漸減弱，JUBLIA 與我們處於成長階段的品牌 DUOBRII、SILIQ 和 BRYHALI 一起構成了我們醫學皮膚科產品組合的核心，也是該業務預計在 2020 年恢復成長的基礎。

Finally, the Diversified segment, which declined 5% organically in the quarter as LOEs were a $29 million drag on the neuro business. Our generics business grew 3% organically in the quarter with authorized generic versions of our branded products that lost exclusivity, mainly UCERIS, APRISO, LOTEMAX and Elidel, providing the bulk of that growth. For the full year, Diversified declined 5% organically, as 11% growth of our generics business offset some of the $116 million LOE growth drag in our neuro business. Total company revenue for the year grew 4% organically with 2% coming from improved realized net selling prices and 2% from increased volume.

最後，多元化部門本季有機下滑 5%，因為 LOE 對神經業務造成了 2,900 萬美元的拖累。我們的仿製藥業務在本季度實現了 3% 的有機成長，其中大部分成長來自失去獨佔權的品牌產品的授權仿製藥，主要是 UCERIS、APRISO、LOTEMAX 和 Elidel。全年來看，多元化藥物業務有機下滑 5%，因為仿製藥業務成長 11%，抵消了神經藥物業務 1.16 億美元的 LOE 成長拖累。公司全年總收入有機成長 4%，其中 2% 來自實現淨銷售價格的提高，2% 來自銷售量的增加。

Flip to Slide 6, the P&L summary for the quarter. Our gross margin in the quarter was 71.4%, down about 20 basis points versus Q4 of 2018, mainly due to higher inventory write-offs in Q4 '19 relative to the prior year quarter. Note that for the full year, our gross margin was 72.7%, favorable by 80 basis points versus 2018, with mix a big driver, particularly impacted by the growth of XIFAXAN but also from improvements associated with our Project CORE activities. Our final guidance for the full year for gross margin was roughly 73%.

翻到投影片 6，這是本季的損益摘要。本季的毛利率為 71.4%，較 2018 年第四季下降約 20 個基點，主要原因是 2019 年第四季的庫存註銷額較去年同期增加。請注意，全年而言，我們的毛利率為 72.7%，較 2018 年高出 80 個基點，其中產品組合是主要推動力，尤其受到 XIFAXAN 成長的影響，同時也受到我們專案 CORE 活動相關改進的影響。我們對全年毛利率的最終預期約為 73%。

Selling and advertising expenses in the quarter were up -- or unfavorable on a constant currency basis by 6% versus Q4 2018 due to the addition of TRULANCE to the Salix portfolio and higher A&P costs in Vision Care to support new launches and in international pharma for product launches, particularly in Canada and Russia. Adjusted G&A expenses on a constant currency basis were 8% unfavorable in the quarter compared to Q4 of '18, due to increased cost of business development initiatives and higher ongoing IT costs as we continue to work to improve our global operating systems.

本季的銷售和廣告費用與 2018 年第四季相比有所上升（以固定匯率計算為不利的），原因是 TRULANCE 被添加到 Salix 產品組合中，以及 Vision Care 為支持新產品的發布和國際製藥公司（特別是在加拿大和俄羅斯）的產品發布而增加的廣告和宣傳成本。以固定匯率計算的調整後 G&A 費用與 2018 年第四季相比下降了 8%，因為我們繼續致力於改善全球作業系統，導致業務發展計畫的成本增加和持續 IT 成本增加。

I want to point out that in Q4 of 2019, adjusted G&A run rate is -- it's above what I would expect on average the quarterly run rate to be in 2020. The go-forward adjusted G&A run rate is likely between the $163 million we saw in Q4 and the $140 million average over the first 3 quarters of 2019. R&D was down in the quarter, favorable by 5% on a constant currency basis. I would not read much into that as it's just how the timing of expenses fell in both periods. For the full year, R&D was up 15% on a constant currency basis to $471 million, slightly below our final 2019 guidance for R&D of $480 million. Again, just the timing of how expenses fell. As you'll see when I get to 2020 guidance, we intend to commit more capital to R&D activities.

我想指出的是，2019 年第四季調整後的 G&A 運行率高於我預期的 2020 年平均季度運行率。未來調整後的 G&A 運行率可能介於第四季度的 1.63 億美元和 2019 年前三個季度的 1.4 億美元平均值之間。本季研發支出下降，以固定匯率計算下降了 5%。我不會對此進行過多的解讀，因為這只是兩個時期內費用發生的時間安排而已。全年研發支出以固定匯率計算成長 15% 至 4.71 億美元，略低於我們 2019 年最終研發指引金額 4.8 億美元。再次強調，這只是費用下降的時間問題。當我發布 2020 年指引時您就會看到，我們打算在研發活動上投入更多資金。

Adjusted EBITDA in the quarter was $898 million, up 5% from the year-ago quarter on a constant currency basis. A solid quarter that enabled us to post adjusted EBITDA of $3.571 billion for the full year, which was plus 4% on a constant currency basis from 2018 and just below the top end of our final guidance range for 2019.

本季調整後 EBITDA 為 8.98 億美元，以固定匯率計算較去年同期成長 5%。本季業績表現穩健，讓我們全年調整後的 EBITDA 達到 35.71 億美元，以固定匯率計算較 2018 年成長 4%，略低於我們對 2019 年的最終指引範圍的最高限。

Turn to Slide 7. I think it's worth taking a look back at how we did in 2019 relative to the midpoint of our original 2019 guidance, which was $8.4 billion of revenue and $3.425 billion of adjusted EBITDA. Our actual 2019 revenue was $201 million above the midpoint of original guidance with a favorable result a function of 4 things: the acquisition of TRULANCE added $55 million; revenue from LOE assets was plus $53 million; our base business was favorable by $115 million; and offsetting the good guys changes in FX rates reduced revenue by some $22 million.

翻到第 7 張投影片。我認為值得回顧一下我們在 2019 年的表現，相對於我們最初 2019 年指引的中點，即 84 億美元的收入和 34.25 億美元的調整後 EBITDA。我們 2019 年的實際收入比原始指引的中點高出 2.01 億美元，這是一個有利的結果，得益於以下四個因素：收購 TRULANCE 增加了 5500 萬美元； LOE資產收入增加5300萬美元；我們的基礎業務盈利1.15億美元；而抵消收入的匯率收益將導致好人收入減少約 200 萬美元。

Adjusted EBITDA was $146 million above the midpoint of our original guidance. FX had no impact. TRULANCE had no impact. The better LOE revenues added $36 million of profit. The better base performance added $71 million of profit, while investment in R&D and SG&A spending were both a bit above our original view. The biggest single factor in the improved adjusted EBITDA was our gross margin coming in 120 basis points better than initially forecast, which accounted for roughly $100 million of lift.

調整後的 EBITDA 比我們最初預期的中位數高出 1.46 億美元。FX 沒有影響。TRULANCE 沒有產生任何影響。LOE收入增加，利潤增加3,600萬美元。更好的基礎績效增加了 7,100 萬美元的利潤，而研發投資和銷售、一般及行政開支均略高於我們最初的預期。調整後 EBITDA 改善的最大單一因素是我們的毛利率比最初預測高出 120 個基點，這帶來了約 1 億美元的成長。

Point of the story is that as the year played out, we had some good fortune with the LOE assets. But the lion's share of the better results came from our commercial units driving improved performance in our base businesses, from our Project CORE activities to improve gross-to-nets, and from our relentless efforts to improve efficiency in our supply chain. A good year.

故事的重點是，隨著時間的推移，我們在 LOE 資產方面獲得了一些好運。但是，取得的更好業績大部分來自於我們的商業部門推動基礎業務績效的提高、來自於我們為提高毛利與淨利潤而開展的 Project CORE 活動，以及來自於我們為提高供應鏈效率而做出的不懈努力。美好的一年。

Turn to Slide 8, the cash flow summary. Our net cash provided by operating activities in 2019 came in at $1.501 billion, the low end of our expected range as we increased inventories of certain key products and API to ensure uninterrupted supply. Note that at year-end, we had $3.244 billion of cash on hand, as we completed an offering of $2.5 billion of unsecured notes in late December and had not yet applied those proceeds to the payment of the U.S. Securities Litigation, that's $1.21 billion, and the prepayment of other debt totaling $1.24 billion. Net of those amounts and related fees, our working cash at year-end was roughly $750 million.

翻到幻燈片 8，現金流量摘要。2019 年，我們的經營活動產生的淨現金為 15.01 億美元，處於預期範圍的低端，因為我們增加了某些關鍵產品和 API 的庫存以確保不間斷供應。請注意，截至年底，我們手頭上有 32.44 億美元現金，因為我們在 12 月底完成了 25 億美元無擔保票據的發行，並且尚未將這些收益用於支付美國證券訴訟的款項（即 12.1 億美元）和預付總計 12.4 億美元的其他債務。扣除這些金額和相關費用後，我們年底的營運現金約為 7.5 億美元。

Similarly, on Slide 9, the cash and debt on our balance sheet at year-end are inflated due to the timing of the $2.5 billion debt raise and the use of those net proceeds. I think of it like this. Pro forma for the deployment of those funds, our net debt at year-end would have been roughly $24.2 billion. Settling the U.S. Securities case set us back in our progress reducing the quantum of our debt and improving our leverage ratios, but it was absolutely the right thing to do to quantify and settle a significant overhanging uncertainty.

類似地，在投影片 9 中，由於 25 億美元債務增加的時間和這些淨收益的使用，我們年末資產負債表上的現金和債務被誇大了。我是這樣想的。根據這些資金的部署預測，我們年底的淨債務約為 242 億美元。解決美國證券案阻礙了我們減少債務量和改善槓桿率的進程，但這絕對是量化和解決重大不確定性的正確做法。

A quick aside, just last week, we began the process of calling another $100 million principal amount of bonds. We intend to continue to systematically grind our debt down.

順便說一下，就在上週，我們開始了另外 1 億美元本金債券的贖回流程。我們打算繼續有系統地減少債務。

One last thing on the balance sheet. During the quarter, we accrued for the settlement of the U.S. stock drop case, other related cases and ongoing legacy litigation and investigations. The total accrual was for $1.39 billion and is included in GAAP Other Income and Expenses in our P&L. For the avoidance of doubt, we exclude this expense from the computation of adjusted EBITDA and adjusted net income.

資產負債表上還有最後一件事。本季度，我們為美國股市下跌案、其他相關案件以及正在進行的遺留訴訟和調查的和解提列了準備金。總應計費用為 13.9 億美元，包含在我們的損益表的 GAAP 其他收入和支出中。為避免疑義，我們將該費用排除在調整後的 EBITDA 和調整後的淨收入的計算之外。

Finally, and on to the money slides for me, starting with Slide 10, showing our guidance for 2020. Our revenue guidance for 2020 is a range of $8.65 billion to $8.85 billion, and that represents a range of growth of plus 1% to plus 3% at current FX rates. Our adjusted EBITDA guidance is a range of $3.5 billion to $3.65 billion, representing a range of growth of minus 2% to plus 2% at current FX rates.

最後，我來談談資金幻燈片，從第 10 張幻燈片開始，展示我們對 2020 年的指導。我們對 2020 年的營收預期在 86.5 億美元至 88.5 億美元之間，以當前匯率計算，這意味著成長範圍為 +1% 至 +3%。我們調整後的 EBITDA 預期範圍為 35 億美元至 36.5 億美元，以目前外匯匯率計算，成長範圍為 -2% 至 +2%。

I want to cover the other elements of our guidance on this slide before talking about how to think about those revenue and profit growth rates for 2020. Adjusted SG&A expenses were $2.5 billion in 2019, and we're guiding to approximately $2.6 billion for 2020. The roughly $100 million or 4% increase is higher than it may be as we look ahead to 2021 and 2022.

在討論如何看待 2020 年的營收和利潤成長率之前，我想先在這張投影片上介紹我們指引的其他要素。2019 年調整後的銷售、一般及行政費用為 25 億美元，我們預計 2020 年將該數字約為 26 億美元。展望 2021 年和 2022 年，約 1 億美元或 4% 的增幅高於實際水準。

In our 2020 plan, we rationalized OpEx across several business units. But we also allocated incremental selling, advertising and promotional resources to some units to support launch products and products in launch phases, including Daily SiHy lenses, LUMIFY, DUOBRII and Thermage. In G&A, we're continuing to build out our global IT organization and infrastructure, and that comes at a cost, increasing our adjusted G&A in 2020 versus 2019. As we move forward into 2021 and 2022, we should be able to hold the growth of SG&A below that of revenue growth.

在我們的 2020 年計畫中，我們合理化了多個業務部門的營運支出。但我們也向一些部門分配了增量銷售、廣告和促銷資源，以支援推出產品和處於推出階段的產品，包括 Daily SiHy 鏡片、LUMIFY、DUOBRII 和 Thermage。在一般及行政開支 (G&A) 方面，我們將繼續建立我們的全球 IT 組織和基礎設施，但這需要付出代價，導致 2020 年調整後的一般及行政開支 (G&A) 較 2019 年有所增加。隨著我們進入 2021 年和 2022 年，我們應該能夠將銷售、一般及行政費用的成長控制在收入成長以下。

We're guiding to roughly $500 million in R&D for 2020, up roughly $30 million from 2019. If you go back to 2017, our investment in R&D totaled $361 million. Over the last few years, we've built up the R&D organization and infrastructure to support an increased volume of products to sustain each of our core businesses. That includes reducing the investment intensity in some areas, while increasing commitments to other areas where we had been underinvested over a number of years, and that's specifically GI, B + L Surgical and Ophtho Rx.

我們預計 2020 年的研發投入約為 5 億美元，比 2019 年增加約 3,000 萬美元。如果回顧 2017 年，我們在研發方面的投資總計 3.61 億美元。在過去的幾年中，我們建立了研發組織和基礎設施來支援不斷增加的產品數量，從而維持我們的每項核心業務。這包括減少某些領域的投資強度，同時增加對我們多年來投資不足的其他領域的投入，具體是胃腸道、B + L 外科和眼科處方。

While a 6% increase in R&D reduces our near-term earnings and earnings growth, it's the right thing to do to enhance our prospects to deliver long-term organic growth. For interest expense, we're guiding to $1.55 billion, down from $1.6 billion despite the addition of $1.21 billion of debt to fund the settlement of the U.S. Securities class action.

雖然研發費用增加 6% 會降低我們的短期收益和獲利成長，但這對於增強我們實現長期有機成長的前景是正確的做法。對於利息支出，我們預計從 16 億美元降至 15.5 億美元，儘管增加了 12.1 億美元的債務來資助美國證券集體訴訟的和解。

Our tax rate on adjusted earnings was 7.8% in 2019. We expect that rate to be about the same, roughly 8%, in 2020. Towards the bottom of the page, note that we're guiding to capital expenditures in 2020 of roughly $300 million. In the past, I've said that our steady-state CapEx might be roughly $160 million to $175 million per year, and that the uptick in 2019 was mainly due to investments in connection with the daily silicone hydrogel lens initiative and our build-out of our global IT systems.

2019 年我們的調整後收益稅率為 7.8%。我們預計 2020 年將大致相同，約為 8%。在頁面底部，請注意​​我們預計 2020 年的資本支出約為 3 億美元。過去我曾說過，我們的穩定狀態資本支出可能約為每年 1.6 億至 1.75 億美元，而 2019 年的增長主要歸因於與每日矽水凝膠鏡片計劃相關的投資以及我們全球 IT 系統的建設。

Over time, we've determined that underinvestment, particularly in our supply chain, over the last number of years necessitates increased investment in 2020 and beyond. It's our current view that after roughly $300 million of investment in 2020, we will likely see CapEx requirements decrease in 2021 and again in 2022. Our steady-state a few years out may be closer to $225 million of CapEx per year.

隨著時間的推移，我們發現過去幾年的投資不足，特別是在我們的供應鏈方面，需要在 2020 年及以後增加投資。我們目前認為，在 2020 年投資約 3 億美元之後，我們可能會看到資本支出需求在 2021 年和 2022 年再次減少。幾年後我們的穩定狀態可能接近每年 2.25 億美元的資本支出。

Contingent consideration, milestones and license agreements totaled $58 million in 2019, and we're guiding to roughly $100 million in 2020. The increase is related to a forecast sales milestone on RELISTOR and payments related to the recently acquired rights to XIPERE and NOV03.

2019 年的或有對價、里程碑和授權協議總額為 5,800 萬美元，我們預計 2020 年將達到約 1 億美元。該增長與 RELISTOR 的預測銷售里程碑以及與最近獲得的 XIPERE 和 NOV03 權利相關的付款有關。

Finally, Restructuring and Other. In 2019, these items totaled $52 million. In 2020, we're guiding to $75 million. Point out that this item represents our estimate of restructuring costs, some systems integration and settlement of legal cases and investigations.

最後，重組及其他。2019年，這些物品總額達5,200萬美元。到 2020 年，我們預計收入將達到 7,500 萬美元。指出此項費用是我們對重組成本、部分系統整合以及法律案件和調查解決的估計。

Turning to Slide 11, the bridge from 2019 actual results to our 2020 guidance. First, focus on the LOE impact. We are forecasting a $275 million of growth drag from the basket of LOE assets in 2020. The good news here is that we are finally close to putting the impact of the large bucket of LOEs behind us. In 27 (sic) [2017] versus '16, the growth drag was $486 million; in '18 versus '17, it was $289 million; in '19 versus '18, it was $360 million. Over the last 3 years, our revenue growth was trammeled by more than $1.1 billion of LOE drag.

轉到幻燈片 11，這是從 2019 年的實際結果到 2020 年指導的橋樑。首先，關注 LOE 影響。我們預測，2020 年 LOE 資產籃子將對成長造成 2.75 億美元的拖累。好消息是，我們終於可以擺脫大量 LOE 的影響了。2017 年與 2016 年相比，成長拖累為 4.86 億美元；而2018年，這一數字為2.89億美元；而19年與18年相比，這一數字為3.6億美元。在過去 3 年裡，我們的營收成長受到超過 11 億美元的 LOE 拖累。

In 2020, we expect the drag to moderate to $275 million. And here's the good part. That's based on us realizing revenues on the LOE basket of $237 million in 2020. And while that amount will decline into 2021 versus 2020, the drag will be substantially reduced. We did not add any new LOEs to the LOE basket in 2020. And looking out over the period from '21 to '23, we expect the impact of future LOE assets to be quite manageable.

到 2020 年，我們預計拖累金額將降至 2.75 億美元。接下來是精彩的部分。這是基於我們在 2020 年實現 LOE 籃子收入 2.37 億美元。雖然到 2021 年，這一數量將比 2020 年下降，但阻力將大幅減少。2020 年，我們沒有在 LOE 籃子中增加任何新的 LOE。展望21年至23年期間，我們預期未來 LOE 資產的影響將相當可控。

The base performance of plus 100 -- excuse me $415 million is impacted in negative ways by a few things that I called out on our last call and a few others worth noting. First, there is the nonrecurring portion of the improvements in gross-to-nets that we saw in 2019, and especially in Q3, that are a headwind to 2020 growth. Next, the trajectory -- is the trajectory of Glumetza. Glumetza had been a strong performer through the first 3 quarters of 2019 before, as we forewarned, it dropped almost in half in Q4 and is now expected to trend downward from there in future quarters.

基本業績加上 100 美元（對不起，4.15 億美元）受到了我上次電話會議中提到的幾件事以及其他一些值得注意的事情的負面影響。首先，我們在 2019 年（尤其是第三季）看到的毛利與淨利之比的改善中存在非經常性部分，這對 2020 年的成長來說是一個阻力。接下來是軌跡──是格盧梅札的軌跡。Glumetza 在 2019 年前三個季度表現強勁，但正如我們之前警告的那樣，其股價在第四季度下跌了近一半，預計未來幾季將呈下降趨勢。

Next, and one I had not previously called out for you, we had terrific performance in our generics business in 2019 with major contributions from the authorized generic versions of UCERIS and Elidel. As more generic versions of these products have launched, we will see significant declines in revenue for our AGs in 2020. Think of the AGs as us stretching the tail of brands that lose exclusivity. It's good, but it's fleeting.

接下來，我之前沒有提到過，2019 年我們的仿製藥業務表現出色，其中 UCERIS 和 Elidel 的授權仿製藥做出了重大貢獻。隨著更多此類產品的通用版本的推出，我們將看到 2020 年 AG 的收入大幅下降。想像一下，AG 就像我們拉長了那些失去獨家經營權的品牌的尾巴一樣。這很好，但是它很短暫。

One other bit of color. The base performance could have been better, but our guidance includes an estimate of a meaningful headwind for -- on our Asia Pac region, especially China, associated with the coronavirus situation. Our revenue guidance includes a roughly $50 million coronavirus impact. That's an estimate, and we'll see how this plays out over 2020. Obviously, this impacted our adjusted EBITDA guidance as well. So these items are part of the reason why the revenue growth in 2020 implied by guidance is only in the range of 1% to 3% at current FX rates.

另一點顏色。基本表現本來可以更好，但我們的指引包括對亞太地區（尤其是中國）與冠狀病毒疫情相關的重大阻力的估計。我們的收入預期包括約 5000 萬美元的冠狀病毒影響。這是一個估計值，我們將看看 2020 年的情況如何。顯然，這也影響了我們調整後的 EBITDA 指引。因此，這些因素是導致預期 2020 年營收成長僅在當前匯率下 1% 至 3% 範圍內的原因之一。

Turning to the EBITDA bridge at the bottom of the page, the currency, LOE and R&D impacts are self-explanatory. Within the base performance, we're absorbing the roughly $100 million or 4% increase in SG&A. And the coronavirus impact on our revenue expectations impacts our adjusted EBITDA as well. All these items together are drivers of the adjusted EBITDA growth rates implied by our guidance ranges being below that of our revenue growth rate.

翻到頁面底部的 EBITDA 橋，貨幣、LOE 和研發的影響是不言而喻的。在基本業績中，我們吸收了約 1 億美元或 4% 的銷售、一般和行政費用成長。冠狀病毒對我們的收入預期的影響也會影響我們的調整後 EBITDA。所有這些項目共同推動了調整後的 EBITDA 成長率，這意味著我們的指導範圍低於我們的收入成長率。

That's it for me. Back to you, Joe.

對我來說就是這樣了。回到你身邊，喬。

Thank you, Paul. On Slide 12, there's a lot of information, but the important message to highlight is we have now delivered 3 consecutive years of mid-single-digit organic revenue growth for B + L/International. B + L/International was up 6% in 2017, up 4% in 2018 and up 5% in 2019.

謝謝你，保羅。投影片 12 上有很多訊息，但需要強調的重要訊息是，我們現在已經連續 3 年為 B + L/International 實現了中等個位數的有機收入成長。2017 年 B+L/國際成長率為 6%，2018 年成長率為 4%，2019 年成長率為 5%。

Turning to Slide 13. Global Vision Care has been a strong performer, and I want to highlight 2 products that have been key drivers of the growth in this business: Biotrue ONEday and ULTRA contact lenses. We've shown 5-year reported revenue for each in the chart on the bottom of Slide 13. On the left, from 2015 through 2019, Biotrue ONEday lenses had a 22% compound annual growth rate and organic revenue grew by 23% in 2019. On the right, ULTRA lenses had a 32% CAGR over the past 5 years and grew organically by 24% in 2019. We've called out the significant milestones that drove incremental growth, including the launches of lenses for astigmatism, Presbyopia and extended wear.

翻到第 13 張投影片。Global Vision Care 的表現十分出色，我想重點介紹兩款作為該業務成長關鍵推動力的產品：Biotrue ONEday 和 ULTRA 隱形眼鏡。我們在第 13 頁投影片底部的圖表中展示了每家公司的 5 年報告收入。左側，從 2015 年到 2019 年，Biotrue ONEday 鏡片的複合年增長率為 22%，2019 年有機收入增長了 23%。右側，ULTRA 鏡片在過去 5 年中的複合年增長率為 32%，並在 2019 年實現了 24% 的有機增長率。我們列舉了推動逐步成長的重要里程碑，包括推出散光鏡片、老花鏡片和長戴鏡片。

This strong performance underscores the durability of these products and the strength of the Bausch + Lomb brand. We are seeing increased market share in U.S. Vision Care. This business gained 1.6 share points to 11% unit share for the month of December 2019 versus a 9.4% share in December 2018. Finally, we plan to launch our daily silicone hydrogel lenses in the U.S. later this year. Silicone hydrogel lenses are one of the fastest-growing segments of the contact lens market.

強勁的表現凸顯了這些產品的耐用性和博士倫品牌的實力。我們看到美國視力保健市場份額正在增加。2019 年 12 月，該業務的份額增加了 1.6 個百分點，達到 11%，而 2018 年 12 月的份額為 9.4%。最後，我們計劃今年稍後在美國推出我們的日拋型矽水凝膠鏡片。矽水凝膠鏡片是隱形眼鏡市場成長最快的部分之一。

Turning to Slide 14 for an update on Global Consumer. I want to highlight 2 franchises. First, our top-selling eye vitamin portfolio in the U.S., Ocuvite and PreserVision, grew organically by 4% in 2019 and had a CAGR of about 7% from 2015 to 2019. And second, LUMIFY, the #1 physician recommended product in the redness reliever category, had sales of $63 million in 2019 and achieved a weekly market share of approximately 43%.

請翻到第 14 張投影片來了解全球消費者的最新動態。我想重點介紹兩個特許經營權。首先，我們在美國最暢銷的眼部維生素產品組合 Ocuvite 和 PreserVision 在 2019 年實現了 4% 的有機成長，2015 年至 2019 年的複合年增長率約為 7%。其次，LUMIFY 是紅腫緩解類中醫師推薦的第一大產品，2019 年的銷售額為 6,300 萬美元，每週的市佔率約為 43%。

On Slide 15, we highlighted enVista's performance in our Global Surgical business. The enVista family of intraocular lenses, or IOL, are clear, artificial lenses that eye surgeons use to replace a person's natural lenses when it becomes too cloudy due to a cataract. enVista grew organically by 36% in 2019. The chart below provides enVista's reported revenue for the past 5 years, which grew at a 22% CAGR.

在投影片 15 上，我們重點介紹了 enVista 在我們的全球外科業務中的表現。enVista 系列人工水晶體（IOL）是透明的人工水晶體，當患者的自然水晶體因白內障而變得過於渾濁時，眼科醫生會使用它來取代它。enVista 在 2019 年實現了 36% 的有機成長。下圖顯示了 enVista 過去 5 年的報告收入，複合年增長率為 22%。

We also launched an enVista toric in 2019, which we've shown on the bottom right. Looking ahead to the 2020 catalyst, we expect to launch an extended depth of focus intraocular lens platform in 2020. With the introduction of this platform, we will be entering the premium IOL segment outside the U.S. And finally, we expect to launch a preloaded IOL injector platform for enVista IOLs in the second quarter of 2020.

我們也在 2019 年推出了 enVista toric，如右下角所示。展望 2020 年的催化劑，我們預計在 2020 年推出擴展景深的人工水晶體平台。隨著該平台的推出，我們將進入美國以外的高端 IOL 領域。最後，我們預計將在 2020 年第二季推出 enVista IOL 的預裝 IOL 注射器平台。

Moving now to Slide 16. Before we go through the key highlights for Salix, I want to address 2 updates.

現在轉到投影片 16。在我們介紹 Salix 的主要亮點之前，我想先介紹 2 個更新。

First, after reviewing our GI portfolio in light of market opportunities, we decided to increase promotional focus on XIFAXAN and TRULANCE and have discontinued promoting DOPTELET and LUCEMYRA. Also, we recently received notice that Norwich Pharmaceuticals have filed an ANDA for rifaximin 550-milligram tablets. Alfasigma and Bausch Health will file suit against Norwich, alleging patent infringement and will trigger a 30-month stay of approval. We remain confident in the strength of the 23 patents covering XIFAXAN, and we will continue to vigorously defend our intellectual property.

首先，在根據市場機會審查了我們的 GI 產品組合後，我們決定增加對 XIFAXAN 和 TRULANCE 的宣傳重點，並停止宣傳 DOPTELET 和 LUCEMYRA。此外，我們最近收到通知，諾維奇製藥公司已為利福昔明550毫克片劑提交了ANDA。Alfasigma 和 Bausch Health 將對 Norwich 提起訴訟，指控其侵犯專利，並將引發 30 個月的批准暫停期。我們對涵蓋XIFAXAN的23項專利的實力仍然充滿信心，我們將繼續大力捍衛我們的智慧財產權。

The chart on the right shows XIFAXAN's TRx growth over the past 9 quarters. As you can see, TRxs grew by 7% from 2017 to 2018 and by 8% from 2018 to 2019. For IBS-D specifically, TRxs grew by 15% in 2019 compared to '18.

右側的圖表顯示了 XIFAXAN 過去 9 個季度的 TRx 成長情況。如您所見，TRxs 從 2017 年到 2018 年增長了 7%，從 2018 年到 2019 年增長了 8%。具體來說，對於 IBS-D，2019 年的 TRxs 與 2018 年相比成長了 15%。

Moving now to RELISTOR, TRxs grew by 6% in 2019. And beginning in 2020, we recently improved RELISTOR's oral market access position for more than 50 million lives.

現在轉向 RELISTOR，TRxs 在 2019 年成長了 6%。從 2020 年開始，我們最近改善了 RELISTOR 的口服市場准入地位，惠及超過 5,000 萬人。

Finally, TRULANCE. TRxs grew by greater than 30% in 2019. And since the acquisition, we have improved the market access position for approximately 35 million lives. We are seeing progress in the IBS-C branded market, where TRULANCE new Rx market share grew by -- from 3.9% to 6.4% in 2019.

最後，TRULANCE。2019年TRxs成長了30%以上。自收購以來，我們已改善了約 3500 萬人的市場准入地位。我們看到 IBS-C 品牌市場取得了進展，其中 TRULANCE 新 Rx 的市佔率在 2019 年從 3.9% 成長到 6.4%。

On to Slide 17, Ortho Dermatologics. First, DUOBRII TRxs were up 25% in the fourth quarter compared to the third quarter, and we're very pleased with this launch. As we show in the chart on the bottom left, within 2 quarters of launch, DUOBRII is capturing approximately 40% of new patients who are started on a first-line branded topical or oral psoriasis product. When you look at DUOBRII against these 3 competitors listed, we believe it gives a perspective on the opportunity for DUOBRII and the potential savings that could result from delaying the need to start patients on a biologic.

轉到第 17 張投影片，Ortho Dermatologics。首先，DUOBRII TRxs 在第四季度較第三季度增長了 25%，我們對此發布非常滿意。正如我們在左下角的圖表中顯示的那樣，在推出後的兩個季度內，DUOBRII 吸引了大約 40% 開始使用一線品牌外用或口服牛皮癬產品的新患者。當您將 DUOBRII 與列出的這 3 個競爭對手進行比較時，我們相信它可以讓您了解 DUOBRII 的機會以及推遲患者開始使用生物製劑的需求可能帶來的潛在節省。

Also, I'm delighted to say that DUOBRII is now at 63% commercial access for the United States. And we gain -- as we gain incremental coverage, we expect to reduce couponing support and expect gross-to-nets will improve over time. Importantly, average selling price increased from the third quarter, and we ended the year with a higher ASP. We are clearly moving in the right direction. We are very enthusiastic about the opportunity for DUOBRII, primarily because, for the first time, we can offer psoriasis patients a topical product with a high-potency corticosteroid that they can treat to clearance rather than being limited to a certain duration of time.

此外，我很高興地說，DUOBRII 現在在美國的商業普及率已達到 63%。而且，隨著我們獲得增量覆蓋，我們預計會減少優惠券支持，並且預計總淨利率將隨著時間的推移而改善。重要的是，平均銷售價格從第三季開始上漲，而我們以更高的平均銷售價格結束了這一年度。我們顯然正朝著正確的方向前進。我們對 DUOBRII 的機會非常熱衷，主要是因為我們首次可以為牛皮癬患者提供一種含有高效皮質類固醇的外用產品，他們可以通過治療直至痊癒，而不受一定時間的限制。

Moving now to SILIQ. TRxs grew by 100% in 2019 compared to the prior year, and we achieved 67% commercial access. BRYHALI TRxs were up 60% in the second half of 2019 compared to the first half, and BRYHALI now has 71% commercial access. We believe access rates of 60% to 70% demonstrate that managed care recognizes the value and the efficacy of our psoriasis products in helping to improve patients' lives.

現在轉到 SILIQ。2019年，TRxs比前一年成長了100%，我們實現了67%的商業准入。2019年下半年，BRYHALI TRxs 較上半年成長了 60%，目前 BRYHALI 的商業化覆蓋率已達 71%。我們相信，60% 至 70% 的可及率表明管理式醫療承認我們的牛皮癬產品在幫助改善患者生活方面的價值和功效。

On the right, we highlight a new cash pay model for our prescription dermatology products in the United States that's now available online at Dermatology.com. Telemedicine and e-commerce are available on the platform as of yesterday. Iconic products such as Retin-A will be available on Dermatology.com as well as new products like ALTRENO. The platform was launched with a portfolio of 15 products, and we plan to expand the number of cash pay products over time. We believe that Dermatology.com has the potential to meet patient needs and help grow our dermatology business.

右側我們重點介紹了美國處方皮膚病學產品的新現金支付模式，該產品目前可在 Dermatology.com 上在線購買。從昨天起，遠距醫療和電子商務已在該平台上線。標誌性產品（例如 Retin-A）以及新產品（例如 ALTRENO）將在 Dermatology.com 上發售。該平台推出時擁有 15 種產品，我們計劃隨著時間的推移擴大現金支付產品的數量。我們相信 Dermatology.com 有潛力滿足患者的需求並幫助我們發展皮膚病學業務。

Turning to Slide 18. Our aesthetics business, Global Solta, grew organically by 42% in the fourth quarter of 2019 versus the fourth quarter of 2018 and 45% in the full year, driven by the global expansion of Thermage FLX. Thermage is a noninvasive radio frequency therapy that can address the science of aging skin. You can see the trend in the chart on the left with a 46% CAGR from 2017. Looking ahead to 2020 and beyond, we expect to see continued global expansion for Thermage FLX, including geographic expansion in the EU.

翻到第 18 張投影片。在 Thermage FLX 全球擴張的推動下，我們的美學業務 Global Solta 在 2019 年第四季較 2018 年第四季有機成長 42%，全年有機成長 45%。Thermage 是一種非侵入性射頻療法，可以解決皮膚老化的科學問題。您可以在左側的圖表中看到趨勢，自 2017 年起的複合年增長率為 46%。展望 2020 年及以後，我們預計 Thermage FLX 將繼續在全球擴張，包括在歐盟的地理擴張。

On Slide 19, you can see we have a good number of late-stage development programs in each of our 4 business segments. We increased R&D investment in 2019 versus 2018 and allocated a greater percentage of our R&D budget to Bausch + Lomb and Salix on a full year basis. Launching new products will drive our future growth, and we are pleased to have active late-stage pipeline of innovative new programs with the potential to expand our eye health, GI and dermatology portfolio.

在投影片 19 上，您可以看到我們的 4 個業務部門中都有大量後期開發專案。與 2018 年相比，我們在 2019 年增加了研發投入，並將全年研發預算的更大比例分配給了博士倫和 Salix。推出新產品將推動我們未來的成長，我們很高興擁有活躍的創新新項目後期管線，有可能擴大我們的眼部健康、胃腸道和皮膚病學產品組合。

I've talked about some of the programs along the way, but I want to highlight a couple of them in more detail. Before we turn to Slide 20, at the beginning of 2018, we identified the Significant Seven as key drivers of future growth. These 7 products grew collectively by 68% in 2019.

我已經討論過其中的一些計劃，但我想更詳細地強調其中的幾個。在我們翻到第 20 張投影片之前，在 2018 年初，我們確定了七大重要因素作為未來成長的關鍵驅動力。這7款產品在2019年總共成長了68%。

While we are pleased with that growth, limiting ourselves to 7 products and excluding growth products like Biotrue, ULTRA, PreserVision, enVista IOL, Thermage, Aplenzin, TRULANCE and XIFAXAN doesn't give a complete picture of the expected drivers of our future revenue growth. Accordingly, we will continue to report revenue for our top 10 products for each business and overall for Bausch Health, but would no longer report combined revenue for the Significant Seven.

雖然我們對這種成長感到滿意，但將我們限制在 7 種產品範圍內，並排除 Biotrue、ULTRA、PreserVision、enVista IOL、Thermage、Aplenzin、TRULANCE 和 XIFAXAN 等成長產品，並不能全面反映我們未來營收成長的預期驅動力。因此，我們將繼續報告每項業務的前 10 種產品的收入以及 Bausch Health 的整體收入，但不再報告七大重要產品的綜合收入。

Let's turn to Slide 20 for additional detail on our promising late-stage programs in GI and eye health. Amiselimod is a late-stage oral compound that targets the S1P receptor, which plays an important role in autoimmune diseases such as inflammatory bowel disease. Approximately 1.6 million Americans currently suffer from IBD and as many as 70,000 new patients are diagnosed in the U.S. annually. We entered into an exclusive licensing agreement with Mitsubishi to develop and commercialize amiselimod in April 2019.

讓我們翻到幻燈片 20，以了解有關我們在胃腸道和眼部健康領域有前景的後期項目的更多詳細資訊。阿米塞莫德是一種針對 S1P 受體的後期口服化合物，在發炎性腸道疾病等自體免疫疾病中發揮重要作用。目前約有 160 萬美國人患有 IBD，美國每年有多達 7 萬名新患者被診斷出來。我們於 2019 年 4 月與三菱簽訂了獨家授權協議，以開發和商業化阿米塞莫德。

In January '20, we completed an FDA-approved cardiovascular clinical trial protocol that compared amiselimod to placebo and moxifloxacin. The primary endpoint demonstrated that amiselimod had no effect on QT interval prolongation and no other secondary safety signals were identified. We expect to initiate a multi-arm, randomized, placebo-controlled Phase II study in 2020 in ulcerative colitis for amiselimod.

20年1月，我們完成了FDA核准的心血管臨床試驗方案，將阿米塞利莫德與安慰劑和莫西沙星進行了比較。主要終點顯示阿米塞莫德對 QT 間期延長沒有影響，且未發現其他次要安全訊號。我們預計將於 2020 年啟動一項針對阿米塞莫德治療潰瘍性結腸炎的多組、隨機、安慰劑對照的 II 期研究。

On Slide 21, we highlight NOV03, which we recently licensed in for the U.S. and Canada. NOV03 is a nonaqueous eye drop for the treatment of Dry Eye. The prescription Dry Eye market represents a great opportunity with 6.8% of the U.S. adult population projected to have diagnosed Dry Eye disease, and prevalence will increase with age.

在投影片 21 上，我們重點介紹了 NOV03，這是我們最近在美國和加拿大獲得許可的。NOV03 是一種用於治療乾眼症的非水性眼藥水。處方乾眼症市場代表著一個巨大的機遇，預計美國成年人口中將有 6.8% 被診斷出患有乾眼症，並且患病率將隨著年齡的增長而增加。

If approved, NOV03 will be the first new prescription treatment for Dry Eye disease with a mechanism of action that is different from currently available products. A Phase II study has already been completed, which showed significant and clinically meaningful improvements in both signs and symptoms of Dry Eye disease. There's a Phase III study underway, and we expect to initiate a second Phase III study later this year.

如果獲得批准，NOV03 將成為首個治療乾眼症的新型處方藥，其作用機制與現有產品不同。第二階段研究已經完成，結果顯示乾眼症的徵兆和症狀均有顯著且具有臨床意義的改善。目前第三階段研究正在進行中，我們預計將在今年稍後啟動第二階段第三階段研究。

To wrap up, on Slide 22, we have provided an overview of the 2020 vision for our 3 core businesses which includes both a look back on what has driven performance and a look ahead to what is coming into focus for 2020.

總而言之，在第 22 張投影片中，我們概述了三大核心業務的 2020 年願景，其中包括回顧推動績效發展的因素以及展望 2020 年的重點。

First, Bausch + Lomb. We expect mid-single-digit growth to continue for 2020 based on 5 years of organic revenue growth for ULTRA, Biotrue and Ocuvite and PreserVision and new products like LUMIFY and VYZULTA. Looking ahead, we see significant opportunities in the SiHy launch in the U.S., in EU and the rest of the world, the ramp of our enVista IOL platform and the expected launch of an extended depth of focus for the IOL platform.

第一，博士倫。基於 ULTRA、Biotrue、Ocuvite、PreserVision 以及 LUMIFY 和 VYZULTA 等新產品 5 年的有機收入成長，我們預計 2020 年將繼續保持中等個位數成長。展望未來，我們看到了 SiHy 在美國、歐盟和世界其他地區的推出、enVista IOL 平台的普及以及 IOL 平台擴展景深功能的預期推出等重大機遇。

Next, in Salix, while absorbing the headwinds from APRISO and Glumetza in 2020, our GI business will be based on 2 years of high single TRx growth for XIFAXAN, increased market share for TRULANCE and double-digit growth driven by market access for our RELISTOR oral business. In 2020, we are planning to look forward to also PLENVU ramp-up, continued development of new formulations and indications for rifaximin and pipeline expansions, including dolcanatide and amiselimod.

接下來，在 Salix，在吸收 2020 年來自 APRISO 和 Glumetza 的阻力的同時，我們的 GI 業務將基於 XIFAXAN 兩年的單 TRx 高增長、TRULANCE 的市場份額增加以及 RELISTOR 口服業務的市場准入推動的兩位數增長。2020 年，我們還計劃期待 PLENVU 的加速發展、利福昔明新配方和適應症的繼續開發以及包括多卡那肽和阿米塞莫德在內的產品線的擴展。

Third, in Ortho Dermatologics, we expect this business to return to growth in 2020 based on a 73% organic revenue growth for the Thermage franchise, weekly DUOBRII TRx growth and increased commercial access, driving improved gross-to-nets and the continued ramp of launch products, including SILIQ, BRYHALI and ALTRENO.

第三，在 Ortho Dermatologics 方面，我們預計該業務將在 2020 年恢復成長，這得益於 Thermage 特許經營權 73% 的有機收入增長、每週 DUOBRII TRx 的增長和商業渠道的增加，從而推動毛利與淨利的提高和 SILIQ、BRYHALI 和ALTRENO 等上市產品的持續增長。

Looking ahead, we see opportunity in building out the cash pay model with more products, telemedicine and e-commerce and the launch of ARAZLO. Finally, we continue to expect to deliver on our 3-year CAGRs on a constant currency basis. And for the midpoint of 2019 guidance, we expect revenue to grow at 4% to 6% CAGR and adjusted EBITDA to grow at 5% to 8% CAGR.

展望未來，我們看到透過更多產品、遠距醫療和電子商務以及 Arazlo 的推出來建立現金支付模式的機會。最後，我們繼續期望以固定匯率計算實現 3 年複合年增長率。對於 2019 年指引中期，我們預計營收將以 4% 至 6% 的複合年增長率成長，調整後 EBITDA 將以 5% 至 8% 的複合年增長率成長。

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) The first question today comes from Terence Flynn of Goldman Sachs.

（操作員指示）今天的第一個問題來自高盛的特倫斯·弗林（Terence Flynn）。

Maybe 2 for me. Just wondering, at a high level, what's embedded in your 2020 guidance for net pricing across the portfolio. How that compares to 2019?

對我來說也許應該是 2。只是想知道，從總體上看，您在 2020 年的指導中對整個投資組合的淨定價包含了什麼內容。與 2019 年相比如何？

And then on SiHy, the launch in Japan. I was wondering any details you can share on market share. And then how we should think about pricing and positioning as you approach the U.S. launch?

然後是 SiHy 在日本的發表會。我想知道您能否分享有關市場份額的詳細資訊。那麼，當您準備在美國推出產品時，我們應該如何考慮定價和定位？

Okay. Let me start on our pricing -- net pricing. Our expectation is that we'll have somewhere in that 2% range, approximately. That's very consistent with what we saw in our 2019 information. Net pricing was approximately 2%. We expect it to be something comparable to that. Now there will be some variation between the product A and product B, but on balance there.

好的。讓我開始介紹我們的定價—淨價。我們的預期是，這個數字大約在 2% 左右。這與我們在 2019 年的訊息中看到的情況非常一致。淨定價約2%。我們期望它能與之相媲美。現在，產品 A 和產品 B 之間會存在一些差異，但總體上是一致的。

In terms of the SiHy market share gain in Japan, we're pleased with our initial launch in Japan. There were some issues that we had to deal with as we launched a new product, but on balance, we're pleased with what we've seen in terms of that launch. And as Paul said in previous quarters, importantly, as we looked at the Japan market, we believe the SiHy market as a percentage of Japan is about 15% and is growing by about 31%, so -- the SiHy market that is. So we think it's an important contributor to growth and will be an important contributor for a long time and also as we launch here in the U.S. later this year. The U.S. is a little smaller percentage of total market. In the U.S. it's less than, I think, 13%, but we also see it growing quickly. So we're excited about what that means for us.

就SiHy在日本市場的佔有率成長而言，我們對在日本的首次推出感到滿意。我們在推出新產品時必須處理一些問題，但總的來說，我們對此次發布的結果感到滿意。正如保羅在前幾個季度所說的那樣，重要的是，當我們觀察日本市場時，我們認為 SiHy 市場佔日本的份額約為 15%，並且增長率約為 31%，所以 — — 這就是 SiHy 市場。因此，我們認為它是成長的重要貢獻者，並且將在很長一段時間內保持重要貢獻者的地位，而且當我們今年晚些時候在美國推出該產品時也是如此。美國在整個市場中所佔的比例略小。在美國，我認為這一比例不到 13%，但我們也看到它正在快速成長。所以我們對這對我們意味著什麼感到非常興奮。

We probably aren't going to say anything about pricing yet on the SiHy Daily, but I think you can take it that we'll be competitive with the other products out in the marketplace in the U.S. SiHy Daily business.

我們可能還不會透露有關 SiHy Daily 定價的任何信息，但我想您可以認為我們將與美國 SiHy Daily 業務市場上的其他產品具有競爭力。

(Operator Instructions) The next question comes from David Amsellem of Piper Sandler.

（操作員指示）下一個問題來自 Piper Sandler 的 David Amsellem。

I wanted to focus on XIFAXAN. And looking at the IQVIA retail data is in January, it looks like the growth trajectory of prescriptions is a little more muted compared to 2019. So I'm wondering if there's any indication that the franchise is maturing in any way. And how should we think about the trajectory of volumes for both IBS and AG as we move more into 2020?

我想專注於 XIFAXAN。從 IQVIA 1 月的零售數據來看，處方藥的成長軌跡與 2019 年相比略顯平緩。所以我想知道是否有跡象表明該特許經營權正在逐漸成熟。隨著我們進入 2020 年，我們應該如何看待 IBS 和 AG 的銷售走勢？

Sure. I'll start with that one. We always see some normal variation in the early year, especially as patients have the donut hole questions and different reimbursement challenges as we start the year. So we don't see anything specifically happening there that is unusual relative to what we've seen in the past.

當然。我先從那一個開始。我們總是會在年初看到一些正常的變化，特別是當患者在年初遇到甜甜圈洞問題和不同的報銷挑戰時。因此，我們沒有發現那裡發生任何與過去相比不尋常的事情。

I think as you think about trajectory, I mean if you -- one of the comments I made was talking about XIFAXAN specifically relative to IBS-D. I remind you that within IBS-D, we were growing, I think, it was mid-double digits. Somewhere around 15%. And importantly, we believe the opportunity there is still very significant for us with XIFAXAN.

我認為當您考慮軌跡時，我的意思是如果您 - 我所做的評論之一是談論 XIFAXAN 與 IBS-D 的具體關係。我提醒你，在 IBS-D 中，我們正在成長，我認為，是兩位數的中段成長。大約 15%。重要的是，我們相信 XIFAXAN 對我們來說仍然具有非常重要的機會。

Remember that the IBS-D category, for example, has about 9 -- I'm sorry, has about 12 million antispasmodic prescriptions. And as we've looked at that, we're less than, let's call it, 10% of that business. Therefore, we believe we've got a great product for IBS-D patients, where, with an episodic treatment, you can potentially get these patients to just move off of these products like the antispasmodics like a BENTYL dicyclomine and actually get relief from -- long-term relief for use of XIFAXAN. So we're going to continue to promote that area, and we continue to expect to see that growth going on into the future to be clear.

請記住，例如，IBS-D 類別有大約 9 — — 抱歉，大約有 1200 萬張解痙藥處方。正如我們所看到的，我們的業務量還不到 10％。因此，我們相信我們為 IBS-D 患者帶來了一款出色的產品，透過定期治療，這些患者可以擺脫對 BENTYL 雙環胺等解痙藥的依賴，並真正從長期使用 XIFAXAN 中獲得緩解。因此，我們將繼續推動這一領域的發展，並繼續期望看到未來這一領域的成長能夠更加清晰。

The next question comes from Ken Cacciatore of Cowen and Company.

下一個問題來自 Cowen and Company 的 Ken Cacciatore。

Congratulations on all the progress. I know from time to time, you're asked about splitting or selling some of the businesses. But I was wondering, as you get more credit for your performance and the underlying value of all the entity and everything that you're doing, your equity is clearly responding. So I just wanted to know, strategically, how do you view your equity? Is this something that you would think about using to deleverage? Is it something you're thinking about in terms of maybe larger acquisitions? Just wanted to get your thoughts on that.

祝賀您取得的所有進展。我知道，有時你會被問到拆分或出售某些業務的問題。但我想知道，隨著你的表現和所有實體的潛在價值以及你所做的一切獲得更多的讚譽，你的股權顯然會做出反應。所以我只是想知道，從策略上講，您如何看待您的股權？您會考慮用它來去槓桿嗎？您是否正在考慮進行更大規模的收購？只是想聽聽你對此的想法。

Yes. Thanks for the question, Ken. It's Paul. Yes. As our equity has responded, it kind of opens the door to potentially using that equity in some way. I'd say that, for now, I mean, we have a great deal of runway to continue to run our businesses and using equity to reduce our leverage and just be -- based on the quantum of our debt and what it would take in order to make a meaningful change, probably not the path we go down.

是的。謝謝你的提問，肯。是保羅。是的。隨著我們的股權做出反應，這為以某種方式利用這些股權打開了大門。我想說，就目前而言，我們有很大的發展空間來繼續經營我們的業務，並使用股權來降低我們的槓桿率，並且——基於我們的債務量以及需要做些什麼才能做出有意義的改變，這可能不是我們要走的道路。

Now using equity in the context of a value generative transaction, obviously, would have to be the right transaction and something we were incredibly excited about, but we would indeed consider that. I want to touch on because it's interesting. We haven't heard the question as often about splitting the company up over the last, I'd say, several months as the stock has performed better. But I think when you look longer term, the trend -- the overall trend in financial markets is for a preference on the part of investors for pure plays. And we own a bunch of great businesses that are today together, and I think that they are stronger -- we are stronger with those businesses together today in light of our capital structure.

現在，在價值生成交易的背景下使用股權顯然必須是正確的交易，也是我們感到非常興奮的事情，但我們確實會考慮這一點。我想談一下，因為它很有趣。我想說，在過去的幾個月裡，由於股票表現較好，我們很少聽到關於分拆公司的問題。但我認為，從長遠來看，金融市場的整體趨勢是投資者傾向於純粹的投資。我們擁有許多優秀的企業，這些企業如今都合併在一起，我認為，考慮到我們的資本結構，如果將這些企業合併在一起，我們的企業就會變得更加強大。

But as we look down the road, someday down the road, there may be opportunities to pursue more pure plays with respect to one or more of our businesses. But that's just something that's down the road.

但當我們展望未來時，有一天，我們可能有機會在一項或多項業務上追求更純粹的經營。但那隻是未來的事。

The next question comes from Umer Raffat of Evercore.

下一個問題來自 Evercore 的 Umer Raffat。

I have 2, if I may. One for you, Joe -- maybe both for you, Joe. Okay. So you clearly characterize the pivot to be offense and the EBITDA growth of 5% to 8%. But in light of the guidance for this year and in light of our raising investor debate on whether the base business is truly a growth business in the first place, I'm curious, do you feel strongly that the 5% to 8% CAGR is achievable? Especially this year, tracks at the midpoint of the guidance?

如果可以的話，我有 2 個。一個給你，喬——也許兩個都給你，喬。好的。因此，您明確地將重點放在進攻上，並將 EBITDA 成長率定為 5% 至 8%。但鑑於今年的指導方針，也鑑於投資者對基礎業務是否真正是成長型業務的爭論日益激烈，我很好奇，您是否強烈認為 5% 至 8% 的複合年增長率是可以實現的？尤其是今年，軌道處於指導的中間點嗎？

And secondly, I was very curious about the S1P1 press release you guys put out in January, not only because I could still never find the trial online anywhere. So I was curious where it was actually done. And -- but also, it seemed to me that the issue with the drug was cardiovascular adverse events and not exactly a QT signal. So I was curious if FDA asked you to do a QT study as a clearing event for larger trials.

其次，我對你們在一月份發布的 S1P1 新聞稿非常好奇，不僅因為我仍然無法在網路上任何地方找到該試驗。所以我很好奇它實際上是在哪裡完成的。而且——但在我看來，該藥物的問題在於心血管不良事件，而不完全是 QT 訊號。因此，我很好奇 FDA 是否要求您進行 QT 研究作為更大規模試驗的清算事件。

Okay. So I'll start on the first part of the question of what we're thinking about pivot to offense and guidance, but I'm going to also turn it over to Paul who's worked his way through that. And then I'll comment on the S1P modulator.

好的。因此，我將從問題的第一部分開始，即我們對轉向進攻和指導的看法，但我也將把它交給保羅，他已經解決了這個問題。然後我將對 S1P 調製器進行評論。

So the simple answer to your question on the CAGRs, are we confident? The answer is yes. We continue to look at that revenue guidance of 4% to 6% growth and then the 5% to 8% on the EBITDA as something that is achievable, and I'm going to let Paul comment more about that specifically. But the simple answer is yes. And Paul, do you want to make some specific comments, and then I'll come back on the amiselimod?

因此，對於您關於複合年增長率的問題，簡單的答案是，我們有信心嗎？答案是肯定的。我們繼續將 4% 至 6% 的營收成長預期和 5% 至 8% 的 EBITDA 成長預期視為可實現的目標，我將讓保羅對此進行更多具體評論。但簡單的答案是肯定的。保羅，你想發表一些具體的評論，然後我再來談談阿米塞莫德嗎？

Yes, sure. I mean -- and thanks for the question because we -- Umer, because we do get this question a fair amount. Joe said in his remarks, so let's refresh what we meant when we said 4% to 6% and 5% to 8%. It was off the midpoint of our original 2019 guidance at constant currency. If you adjust that, you could come up with a range of targets for 2022 in order to meet that CAGR in the range of, say, circa $9.4 billion to $9.95 billion in revenue, $3.9 billion to $4.29 billion for adjusted EBITDA.

是的，當然。我的意思是——感謝你提出這個問題，因為我們——烏梅爾，因為我們確實經常被問到這個問題。喬在演講中說，那麼讓我們重新審視我們所說的 4% 到 6% 和 5% 到 8% 的含義。以固定匯率計算，數字低於我們最初 2019 年指引的中位數。如果您對此進行調整，則可以製定 2022 年的一系列目標，以實現複合年增長率，例如收入約為 94 億美元至 99.5 億美元，調整後 EBITDA 為 39 億美元至 42.9 億美元。

Yes, we continue to believe that we can and will produce revenue and adjusted EBITDAs in that range. I mean that's our current belief. Obviously, not a forecast or a bit of guidance that we take lightly. It is fully supported by our bottoms-up long-term view of what we think we can do with each of our businesses.

是的，我們仍然相信我們能夠並且將會創造該範圍內的收入和調整後 EBITDA。我的意思是這是我們當前的信念。顯然，這不是我們可以輕易接受的預測或指導。它完全得到了我們自下而上的長期眼光的支持，我們認為我們可以對每項業務做些什麼。

I want to point out because people lose sight of this, and say it was off the midpoint of 2019 guidance. I spent some time in my prepared remarks talking about how we did in 2019 relative to that original midpoint. We did better so that helps us along the road. I think people are going to look at our revenue -- forecast revenue off of our guidance range of plus 1% to plus 3% and adjusted EBITDA minus 2% to plus 2%, say, gee, you're not on track. And say, first of all, we've said this a million times, it's not linear. And we are focused on where we do need to be in 2022 in order to be able to achieve those targets that we set for ourselves, and we remain confident that we can achieve those targets.

我想指出的是，因為人們忽略了這一點，並說它偏離了 2019 年指導方針的中點。我在準備好的發言中花了一些時間談論我們 2019 年相對於最初中點的表現。我們做得更好，這對我們前進有幫助。我認為人們會看我們的收入——預測收入超出我們的指導範圍（+1% 到 +3%），調整後的 EBITDA 低於 2% 到 +2%，他們會說，哎呀，你沒有走上正軌。首先，我們已經說過一百萬次了，它不是線性的。我們專注於 2022 年我們需要達到的目標，以便能夠實現我們為自己設定的目標，我們仍然有信心實現這些目標。

The good news is we had a great 2019. The bad news is part of that was through LOEs that continued on. We're delighted to have earned the profit and have generated the cash from those LOEs, but that goes away. And so that's a bit of a growth track for us in 2020. Net-net, we are on track.

好消息是，我們度過了美好的 2019 年。壞消息是，部分原因在於 LOE 仍在持續發生。我們很高興能夠從這些 LOE 中賺取利潤並產生現金，但這些都消失了。所以這對我們 2020 年來說是一個成長軌跡。整體來說，我們進展順利。

On the second part of your question, Umer, on the S1P modulator, amiselimod, the trial that we did was an FDA-approved protocol that we had gone and had the FDA approve the protocol. So we had that in place. We wanted to solve that question or answer that question so that we were assured that there was no QT elongation issue. As you know, other products in this category have had that problem. And we wanted to make sure that that was not going to happen with this product.

關於你問題的第二部分，Umer，關於 S1P 調節劑阿米塞利莫德，我們進行的試驗是 FDA 批准的方案，我們已經獲得了 FDA 批准。所以我們已經實現了這一點。我們希望解決或回答這個問題，以便確保不存在 QT 延長問題。如您所知，該類別的其他產品也存在該問題。我們希望確保該產品不會發生這樣的情況。

We had belief that it wasn't, but we finished -- we wanted to finish the definitive trial for amiselimod to get to that answer. So that is the reason we did it. There was no request or anything. It was just -- we had asked and had that as part of the information that we acquired when we received the product from Mitsubishi on amiselimod. So I think that answers that part of the question.

我們堅信事實並非如此，但我們完成了——我們希望完成對阿米塞莫德的最終試驗以獲得答案。這就是我們這樣做的原因。沒有任何請求或任何事情。只是——我們曾經詢問過，這是我們在收到三菱的阿米塞利莫德產品時獲得的資訊的一部分。所以我認為這回答了問題的這一部分。

On the rest of it, we will publish this trial. It has not been published yet, but it will be published and presented in a poster session in the not-too-distant future. And I think that was the other part of the question.

關於其餘內容，我們將發布本次試驗。它還沒有出版，但在不久的將來將會出版並在海報展示會上展示。我認為這是問題的另一部分。

The next question comes from Gregg Gilbert of SunTrust.

下一個問題來自 SunTrust 的 Gregg Gilbert。

It's Greg Fraser on for Gregg Gilbert. On XIFAXAN, can you comment on payer coverage for the IBS indication and whether there's any room for improvement there? And can you also please comment on your initiatives to drive higher growth for the HE indication?

格雷格·弗雷澤 (Greg Fraser) 代替格雷格·吉爾伯特 (Gregg Gilbert)。關於 XIFAXAN，您能否評論一下 IBS 適應症的付款人覆蓋範圍以及是否有改進空間？您能否評論一下推動高等教育指示更高成長的舉措？

Sure. We have very strong coverage for XIFAXAN. Overall, it's 98.7%. HE is a little bit stronger, but at that level, it's essentially universal coverage. I mean, we've got very strong coverage on XIFAXAN. There is some variation from plan A to plan B, but we're very pleased with that.

當然。我們對 XIFAXAN 的報導非常廣泛。整體是98.7%。HE 稍微強大一些，但在這個級別上，它基本上是全民覆蓋。我的意思是，我們對 XIFAXAN 的報導非常深入。計劃 A 和計劃 B 之間存在一些差異，但我們對此非常滿意。

On the question of HE, our view is that we are going to continue to try to improve the compliance and adherence to the product. We have great data that says that if a patient stays compliant with XIFAXAN, you can reduce rehospitalization for hepatic encephalopathy. And if we're able to do that, obviously, we could save the healthcare system a tremendous amount of dollars. So that's our plan and our focus, and we continue to go out and share that data with plans so that they can help lower the cost.

關於 HE 的問題，我們的觀點是，我們將繼續努力提高產品的合規性和依從性。我們有大量數據表明，如果患者堅持服用 XIFAXAN，就可以減少因肝性腦病變而再次入院的幾率。如果我們能夠做到這一點，顯然我們可以為醫療保健系統節省大量的資金。這就是我們的計劃和重點，我們會繼續與各計劃機構分享這些數據，以便他們可以幫助降低成本。

Our fundamental belief, though, is that as healthcare plans, and there's mergers where the medical and the pharmaceutical comes together, we believe we're going to have even more traction on that as we look at the opportunity to not only lower the total cost of the patient from the point of view of both the drug cost and the cost of rehospitalization, et cetera.

然而，我們的基本信念是，隨著醫療保健計劃以及醫療和製藥行業的合併，我們相信我們將在這方面取得更大的進展，因為我們不僅有機會從藥品成本和再住院成本的角度降低患者的總成本，等等。

So that's our plan, and that's how we've been working on it. We think it's going to be important for patients going into the future with hepatic encephalopathy. And you may recall from our previous comments, we're even looking at trying to get to some of these patients before the actual hepatic encephalopathy by going after some clinical trial evidence that we see in patients who have cirrhosis. So a lot more work. Stay tuned to that for the future.

這就是我們的計劃，我們也一直在努力實現這項計劃。我們認為這對於未來患有肝性腦病變的患者來說非常重要。您可能還記得我們先前的評論，我們甚至試圖透過在患有肝硬化的患者身上看到的一些臨床試驗證據來在實際出現肝性腦病之前找到這些患者。所以還有很多工作要做。請繼續關注未來。

The next question comes from Jason Gerberry of Bank of America.

下一個問題來自美國銀行的 Jason Gerberry。

So a quick question on XIFAXAN. I think previously, in September, you communicated around a 10% to 12% range of growth with minimal contribution from Project CORE. I just wanted to confirm if that's still the fundamental outlook.

關於 XIFAXAN 有一個快速問題。我記得之前在 9 月份，你們曾傳達過一個大約 10% 到 12% 的成長範圍，而 CORE 專案貢獻很小。我只是想確認這是否仍然是基本觀點。

And then just on the Significant Seven, is the change in disclosure more or less, hey, this isn't indicative of our broader pipeline value? Or is there a diminished outlook as it pertains to the $1 billion target end of 2022?

然後僅就「七大重要因素」而言，披露的變化是否或多或少，嘿，這不能表明我們更廣泛的管道價值嗎？或者，對於 2022 年底 10 億美元的目標而言，前景是否有所黯淡？

Paul, why don't you take the first part of that?

保羅，你為什麼不先講第一部分呢？

Yes. Yes. On the first part of that, I think what we said was we kind of continue to believe that XIFAXAN would -- in 2020 versus 2019 that the way -- best way to forecast that would be to think about TRxs in growth and use as a proxy for unit growth. And I think we continue to believe that that can be in the high single digits. And to that, you need to add a couple hundred basis points of net price increase.

是的。是的。關於第一部分，我想我們所說的是，我們繼續相信 XIFAXAN 會在 2020 年與 2019 年相比有所增長，預測這一點的最佳方式是考慮 TRxs 的增長並將其用作單位增長的代理。我認為我們仍然相信這個數字可以達到較高的個位數。在此基礎上，你還需要增加幾百個基點的淨價格漲幅。

And the reason it's only a couple hundred basis points is that nonrecurring part of the revenue that we saw in 2019 related to the nondurable part of the improvements in gross-to-nets. Some of it is reflected in the absolutely improved net selling price increases that we've realized in '19, but some of it is -- it just goes away and becomes kind of a growth headwind.

而之所以只有幾百個基點，是因為我們在 2019 年看到的非經常性收入部分與毛利與淨利比率改善中的非耐用品部分有關。其中一部分反映在我們19年實現的淨銷售價格絕對改善的成長中，但其中一部分則消失了，成為一種成長逆風。

So net-net, I think we pretty much said high single-digits units and a couple hundred basis points of growth, so circa 10%.

所以淨值方面，我認為我們基本上說的是高個位數單位和幾百個基點的成長，大約是 10%。

On the second part of your question on the Significant Seven, the way we looked at it is if you go back historically, in 2018 -- early 2018, we identified 7 products that we felt were the key growth drivers for us. And as we thought about that, we had great success. This year, it was up 68%, achieved $269 million and expect to see it continue to grow to be clear going forward.

關於你提到的「七大重要產品」問題的第二部分，如果回顧歷史，我們是這樣看待它的，在 2018 年——2018 年初，我們確定了 7 種我們認為是我們關鍵成長動力的產品。當我們想到這一點時，我們獲得了巨大的成功。今年，該數字成長了 68%，達到 2.69 億美元，預計未來將繼續成長。

But what we felt is that that's going to leave out some really important growth drivers like XIFAXAN, like TRULANCE, like Thermage, like Biotrue, ULTRA, PreserVision, enVista, Aplenzin. And we really came up with a group of not 7, but actually, I could be fair to say, so closer to 15 products that are clear drivers for our future. Now we're not going to comment specifically about those. But my point was that there are some big opportunities there for the future relative to where we saw the future of this business.

但我們認為，這將會忽略一些真正重要的成長動力，如 XIFAXAN、TRULANCE、Thermage、Biotrue、ULTRA、PreserVision、enVista 和 Aplenzin。我們真正提出的產品組合不只 7 種，實際上，我可以公平地說，接近 15 種，它們將明確地推動我們的未來發展。現在我們不會特別評論這些。但我的觀點是，相對於我們對該業務未來的展望，未來仍存在一些巨大的機會。

And specifically, you get a product like XIFAXAN, our largest product growing double digits, it really is a meaningful contributor. And you can't leave that out of the equation as you're thinking about the future for our business. So that was really the issue. It was -- no concerns about our expectations for the future on that one.

具體來說，你會得到像 XIFAXAN 這樣的產品，這是我們最大的產品，成長了兩位數，它確實是一個有意義的貢獻者。當你考慮我們業務的未來時，你不能忽略這一點。所以這確實是個問題。我們對於未來的期望沒有任何擔憂。

The next question comes from Chris Schott of JPMorgan.

下一個問題來自摩根大通的 Chris Schott。

Maybe -- first question was maybe one for Paul and just following up with the potential for a split and some of those comments you made on investor appetite for pure plays. I know you mentioned that's a trend to think about down the road. But just maybe a little more color on what you'd need to see to enable a split. Is this simply just a matter of getting leverage to a lower level? Or is there something fundamentally we need to think about in the businesses before you would consider maybe separating out into individual kind of units as compared to the portfolio you have today?

也許——第一個問題可能是給保羅的，只是跟進拆分的可能性，以及您對投資者對純粹遊戲的興趣的一些評論。我知道您提到這是未來值得思考的趨勢。但也許您只需要看到更多顏色即可進行拆分。這只是將槓桿率降至較低水準的問題嗎？或者，在您考慮將業務分成與目前投資組合不同的單一單位之前，我們需要從根本上考慮哪些業務？

My second question was just a quick one on the second XIFAXAN filer. Just any color about this filer relative to Sandoz as you think about the defense of that franchise over time?

我的第二個問題只是關於第二個 XIFAXAN 檔案的一個快速問題。當您考慮長期對該特許經營權的辯護時，與 Sandoz 相比，該文件有什麼特點嗎？

Yes. Chris, thanks for the question. I'll obviously take the first one. Leverage, I would say our level of leverage today is a -- makes -- it would make it challenging to pursue something where we spin out one of our entities or whatever. It's not impossible, but it would make it a fairly significant challenge. That is the primary thing that we'd sit there and say, it becomes more clear for us with the passage of time. And yes, I don't think I'm saying anything here that's groundbreaking.

是的。克里斯，謝謝你的提問。我當然會選第一個。槓桿，我想說我們今天的槓桿水平是——使得——我們很難剝離我們的一個實體或其他什麼。這並非不可能，但這將是一個相當大的挑戰。這是我們坐下來說的主要事情，隨著時間的推移，我們會對此更加清晰。是的，我不認為我在這裡所說的話有什麼開創性的東西。

Pure play is a thing. I mean people love pure play. We get it. We own businesses that are very attractive and very attractive in their own right. As we're sitting here today and for the near term, we continue to believe that we are, based on our cap structure, stronger together. And we'll continue to evaluate opportunities for providing that pure play as we go forward.

純粹的遊戲是一回事。我的意思是人們喜歡純粹的遊戲。我們明白了。我們的企業本身就非常有吸引力，而且非常有吸引力。今天，以及在短期內，我們仍然相信，基於我們的上限結構，我們將更加強大。我們將在未來繼續評估提供純粹遊戲的機會。

On the second part of your question, the new XIFAXAN filer, as I mentioned in my comments, that company is Norwich. My understanding, although we don't have all the information yet, is they filed specifically on both the IBS-D and HE. Our belief is that we have 23 patents. So when we initially settled with the largest generic company, Teva, we had 22 patents. We have now supplemented that with another patent. So we have 23 patents. So we feel very strong about our intellectual property position relative to this filing. And we don't see anything specifically different from this -- from what they filed versus what Teva filed.

關於你問題的第二部分，新的 XIFAXAN 文件提交者，正如我在評論中提到的，該公司是諾維奇 (Norwich)。據我了解，雖然我們還沒有掌握全部信息，但他們已經專門針對 IBS-D 和 HE 進行了歸檔。我們相信我們擁有 23 項專利。因此，當我們最初與最大的仿製藥公司 Teva 達成和解時，我們擁有 22 項專利。現在我們又補充了另一項專利。所以我們有23項專利。因此，我們對此項申請的智慧財產權地位感到非常自信。我們沒有發現他們提交的文件與 Teva 提交的文件有任何特別的不同。

So we continue to believe we've got a strong intellectual property position. So no other specifics -- any differences that we've observed.

因此我們仍然相信我們擁有強大的智慧財產權地位。因此，沒有其他具體細節——我們沒有觀察到任何差異。

The last question comes from Akash Tewari of Wolfe Research.

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

So look, if we take into account the $275 million LOE impact, the roughly $160 million kind of inventory true-up accrual benefit you had in 2019 that we might not necessarily carry over, it looks like you need over $500 million in new product sales year-over-year to kind of hit the midpoint of your guidance on reps. Can you walk us through where that growth is coming from?

因此，如果我們考慮到 2.75 億美元的 LOE 影響，以及您在 2019 年可能不一定會結轉的約 1.6 億美元的庫存真實應計收益，看起來您需要同比增長超過 5 億美元的新產品銷售額才能達到您對銷售代表的指導中點。您能向我們介紹一下這種成長源自何處嗎？

I'm assuming maybe like $150 million is on XIFAXAN, but what's the contribution on the Significant Seven? What's the contribution on Thermage, et cetera, et cetera? Any color would be really appreciated.

我估計 XIFAXAN 上的投入可能有 1.5 億美元，但是 Significant Seven 上的投入有多少呢？對 Thermage 等等的貢獻是什麼？任何顏色都會很受歡迎。

And then just a bit on the cash flow. There was a bit of dip in Q4. I'd love a bit more color on what happened. And then how we should think about it in 2020. It looks like your 2020 cash flow from operations is $1.5 billion, which is a bit lower than what I had expected. So if there's any color on that, we'd really appreciate it.

接下來我們來談談現金流。第四季略有下滑。我很想更詳細地了解一下發生的事情。然後我們在 2020 年應該如何思考這個問題。看起來您 2020 年的營運現金流為 15 億美元，比我的預期低一點。因此，如果您對此有任何了解，我們將非常感激。

Okay. I'm going to start, but Paul -- we're going to -- there were quite a few questions there. We're going to have to take pieces here.

好的。我要開始了，但是保羅──我們要──那裡有不少問題。我們必須在這裡採取行動。

I think the fundamental first question is, where can we grow and how can we grow in 2020 and beyond? And what I would simply go back to is that as we look at our business, we think the overall B + L/International business is going to grow at that mid-single-digit rate. I think your characterization of XIFAXAN growing ballpark 10%, I think that's a fair characterization. Solta, I think you saw the growth that we experienced with Solta in 2019. We clearly think that that's a great opportunity.

我認為第一個根本問題是，2020 年及以後我們可以在哪裡發展以及如何發展？我想簡單回顧一下，當我們審視我們的業務時，我們認為整體 B + L /國際業務將以中等個位數的速度成長。我認為您對 XIFAXAN 成長大概 10% 的描述是公平的。Solta，我想你看到了我們 Solta 在 2019 年經歷的成長。我們顯然認為這是一個絕佳的機會。

And then the final area I'd say is the derm returning to growth is a really important message. If you think about our business, the B + L business, the Salix business have been important to us, but we've had a headwind with dermatology.

最後我想說的是，皮膚恢復生長是一個非常重要的訊息。如果你考慮我們的業務，B + L 業務、Salix 業務對我們來說都很重要，但我們在皮膚病學方面遇到了阻力。

As that dermatology grows, especially with some of the new programs, new products like DUOBRII plus the Derm.com -- Dermatology.com contribution to our business, we think are all going to be important parts of that growth for the future. And obviously, we got less LOEs versus we had in the past. But Paul, anything you want to add to that portion or talk a little bit about cash flow with them?

隨著皮膚病學的發展，特別是一些新項目、新產品（如 DUOBRII 以及 Derm.com - Dermatology.com 對我們業務的貢獻），我們認為這些都將成為未來成長的重要組成部分。顯然，與過去相比，我們收到的 LOE 更少了。但是保羅，您想補充一些關於這部分的內容或和他們談談現金流問題嗎？

Well, sure. I mean I actually -- I do want to talk about the kind of the growth, where is it going to come from. First is, I think you stated a number on the kind of an inventory issue that was well above what it really was. In 2019, the '18, the aggregate amount that it was kind of a onetimer, if you will, of us taking those wholesale inventories down was $76 million. A big number in the quarter, a couple hundred basis points of volume growth that was based on that relative -- basically what was a relative expansion, although it was not an expansion at all. And for the year, yes, it was also baked into our year versus 2018, but not as big a factor on a total revenue base of $8.6-odd billion.

嗯，當然了。我的意思是，我確實想談談這種增長的類型以及它將從何而來。首先，我認為您所說的庫存問題的數字遠高於實際情況。2019 年，也就是 2018 年，我們一次減少批發庫存的總額為 7,600 萬美元。本季的數字很大，基於相對的幾百個基點的銷售成長——基本上是相對擴張，儘管它根本不是擴張。就今年而言，是的，它也計入了我們 2018 年的收入中，但對 86 億美元的總收入來說，影響並不大。

If you look at the bridge on Slide 11 of our presentation, that $415 million of increase in coming from what we call base performance is obviously net of any pipeline things that would have come up. So that bridge shows you, I think, how we will get to in the aggregate at a company-wide basis, how we'll get to within our revenue guidance.

如果您看一下我們簡報第 11 張投影片上的橋樑，您會發現來自我們所謂的基本績效的 4.15 億美元的增長顯然是扣除任何可能出現的管道項目後的淨額。所以我認為，這座橋樑向你展示了我們如何在公司整體範圍內實現目標，如何達到我們的收入預期。

With respect to cash flow, I mean, I don't want to start with 2019 because, as I said in my prepared remarks, we were at $1.501 billion. So just at the low end of our guidance range. And to be super clear, that is for cash generated from operations, and that's on a GAAP basis.

關於現金流，我的意思是，我不想從 2019 年開始，因為正如我在準備好的演講中所說，我們的現金流為 15.01 億美元。因此，這只是處於我們指導範圍的低端。需要特別明確的是，這是經營活動產生的現金，並且是基於 GAAP 計算的。

The primary difference between us at being $1.5 billion and being $1.55 billion or $1.6 billion was that we did at the end of the year have more inventory than we had perhaps been thinking about when we started the year. And that was based on specific decisions that we took to increase inventories of both finished goods and of API for key products to ensure that we had consistency of supply. You'll get our balance sheet later this year. You'll see the increase in our inventory at the end of the year, and that was a primary driver.

15 億美元和 15.5 億美元或 16 億美元之間的主要區別在於，我們年底的庫存確實比年初時想像的要多。這是基於我們所做的具體決定，即增加主要產品的成品和 API 庫存，以確保供應的一致性。您將在今年稍後收到我們的資產負債表。你會看到我們的庫存在年底增加，這是主要驅動因素。

Looking ahead to 2020, we have all the factoids that you essentially need to make -- come up with a forecast for cash flow from ops. You've got our adjusted EBITDA from the guidance range. You've got our interest expense. You've got restructuring and other. You've got recent milestones and license agreements. You have a pretty good idea what our taxes will be based on our guidance there. And the 1 wildcard is working capital. We will grow in 2020 versus 2019. And accordingly, that growth, if you assume we're currently at the right level of adjusted working capital, which I would comment on in a minute, that you would add some working capital.

展望 2020 年，我們已經掌握了您需要做出的所有事實——對營運現金流做出預測。您已經從指導範圍內獲得了我們調整後的 EBITDA。您已經了解了我們的利息支出。您進行了重組和其他工作。您已獲得最近的里程碑和許可協議。根據我們的指導，您很清楚我們的稅收是多少。第一個通配符是營運資金。與 2019 年相比，2020 年我們將成長。因此，如果您假設我們目前處於調整後營運資本的正確水平，那麼我將在稍後評論，您將增加一些營運資本。

So you'll do that math and you're going to come out somewhere near $1.5 billion. That's the way the math works out. I mean, the pieces that you can't see or can't forecast as well as we can is the interaction or the impact of accruals and other things that are very difficult to forecast. But I think the length -- the $1.5 billion will be consistent. I mean, interesting if you look at the history, in 2018, it was $1.501 billion. In 2019, it was $1.501 billion. And we're guiding to $1.5 billion in 2020. It's what we expect today. It could be more than that, but we'll just have to wait and see how that year plays out.

所以你算一下就會發現這個數字接近 15 億美元。這就是數學的運算方式。我的意思是，您無法看到或無法預測的部分是應計項目與其他很難預測的因素之間的相互作用或影響。但我認為 15 億美元的長度是一致的。我的意思是，如果你看看歷史，你會發現很有趣的是，2018 年，這個數字是 15.01 億美元。2019年為15.01億美元。我們預計 2020 年將達到 15 億美元。這正是我們今天所期望的。事實可能不止於此，但我們只需拭目以待，看看那一年的情況如何。

On my last comment, I said about inventory and working capital. I want to provide additional texture. Over time, we are going to drive our inventory balance down. We made some progress, and we've now taken some strategic steps that have moved us in the opposite direction. Longer term, we will be able to unlock cash from our balance sheet by better managing our inventory balances. It's -- we're not seeing it in 2019. And I'm essentially telling you we're not going to see it in a significant way in 2020. Stop there.

在我的上一條評論中，我談到了庫存和營運資金。我想提供額外的紋理。隨著時間的推移，我們將減少庫存餘額。我們取得了一些進展，現在我們又採取了一些策略步驟，讓我們朝著相反的方向前進。從長遠來看，透過更好地管理庫存餘額，我們將能夠從資產負債表中釋放現金。我們在 2019 年沒有看到過這種情況。我基本上是想告訴你，我們不會在 2020 年看到這種顯著的情況。停在那兒。

Okay. Let me just thank everyone for joining us, and we'll see you soon as we will be on the road for the next few months at the various healthcare conferences. Thank you, everyone, for joining. Have a great day, everyone.

好的。我只想感謝大家的加入我們，我們很快就會在接下來幾個月參加各種醫療保健會議的。感謝大家的加入。祝大家有個愉快的一天。

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。