葛蘭素史克 (GSK) 2023 Q4 法說會逐字稿

Hello, everyone. It's Nick Stone, Head of Investor Relations. Welcome to today's call and webcast. The presentation was sent to our distribution list by e-mail, and you can also find it on gsk.com.

大家好。我是投資者關係主管尼克·斯通。歡迎參加今天的電話會議和網路廣播。該簡報已透過電子郵件發送到我們的分發列表，您也可以在 gsk.com 上找到它。

Please turn to Slide 2. This is the usual safe harbor statement. We will comment on our performance using constant exchange rates, or CR unless stated otherwise. As a reminder, following the Consumer Healthcare demerger in 2022, we're presenting performance and growth at the continuing operations for GSK.

請翻到投影片 2。這是通常的安全港聲明。除非另有說明，我們將使用固定匯率或 CR 來評估我們的業績。謹此提醒，繼 2022 年消費者保健業務分拆之後，我們將展示葛蘭素史克持續經營業務的業績和成長情況。

Please turn to Slide 3. Today's call will last approximately 1 hour with the presentation taking around 30 minutes and the remaining time for your questions. We request that you ask 1 to 2 questions so that everyone has a chance to participate.

請翻到幻燈片 3。今天的電話會議將持續約 1 小時，其中演示大約需要 30 分鐘，剩下的時間是提問。我們要求您提出 1 到 2 個問題，以便每個人都有機會參與。

Turning to Slide 4. I will now hand the call over to Emma.

轉向投影片 4。我現在將把電話轉給艾瑪。

Hello, and a warm welcome to everybody joining this call. Today, we are updating you on our performance for 2023, giving guidance for 2024, and providing you with new upgraded longer-term outlooks. Please turn to the next slide.

您好，熱烈歡迎大家加入本次電話會議。今天，我們向您通報 2023 年業績的最新情況，為 2024 年提供指導，並為您提供新升級的長期展望。請翻到下一張投影片。

In 2021, we set out a series of commitments to shareholders, including for a step change in performance following the significant transformation in GSK's structure, strategy, capital allocation and culture. Since then, we've delivered 10 quarters of consecutive sales growth ex COVID and our priority to invest in new vaccines and specialty medicines to reshape GSK's portfolio is now strongly evident with around 2/3 of sales now generated from these 2 product areas. At the same time, we continue to strengthen our pipeline. The majority of the late-stage assets that we highlighted in 2021 have moved forward positively. And we've added multiple new opportunities to this portfolio, including through targeted business development, where we've secured more than 16 acquisitions and alliances for innovative assets and new technologies. We have achieved all of this whilst maintaining a continued sharp focus on operating margins, cash flow and capital allocation, mindful of the need to both invest for the future and to deliver attractive returns to shareholders. Next slide, please.

2021年，我們向股東提出了一系列承諾，包括在葛蘭素史克的結構、策略、資本配置和文化發生重大轉變後實現業績的階躍變化。自那時起，除新冠疫情外，我們的銷售額已連續10 個季度增長，而且我們投資新疫苗和特種藥物以重塑葛蘭素史克產品組合的優先事項現已非常明顯，目前約2/ 3 的銷售額來自這兩個產品領域。同時，我們繼續加強我們的管道。我們在 2021 年重點關注的大多數後期資產都取得了積極進展。我們已經為這個投資組合增加了多個新機會，包括透過有針對性的業務開發，我們已經獲得了超過 16 項創新資產和新技術的收購和聯盟。我們在實現所有這些目標的同時，繼續高度關注營業利潤、現金流量和資本配置，同時牢記為未來投資和為股東提供有吸引力的回報的需要。請下一張投影片。

Our performance for 2023 demonstrates all of this. Sales and profits ex COVID solutions grew double-digit levels for the year. Sales were up 14% to over GBP 30 billion, a clear highlight being the exceptional launch of Arexvy. Adjusted operating profit was up 16% and adjusted EPS were up 22%. All 3 of our product areas demonstrated good growth with sales from new products since 2017, contributing more than GBP 11 billion in 2023. This level of performance helped deliver 2 upgrades to guidance in '23 and led to the increased dividend we've announced today of 58p per share. We also sustained good progress with our trust in the ESG goals, not least reflected in our sector leadership of the S&P's Global Corporate Sustainability Assessment. Highlights for the year included moving to Phase III for our low-carbon Ventolin inhaler program, hitting our leadership diversity ambitions 2 years ahead of schedule, and extending rollout of our malaria vaccine to 12 new countries in Africa. Altogether, 2023 provided us with good momentum, which we're now carrying into this year. Next slide, please.

我們 2023 年的業績證明了這一切。今年，除新冠肺炎解決方案外的銷售額和利潤增長了兩位數。銷售額成長 14%，超過 300 億英鎊，其中一個明顯的亮點是 Arexvy 的出色推出。調整後營業利潤成長 16%，調整後每股盈餘成長 22%。自2017 年以來，我們的所有3 個產品領域都表現出了良好的成長，新產品的銷售額在2023 年貢獻了超過110 億英鎊。這種業績水準幫助我們在2023 年對指引進行了2 次升級，並導致我們今天宣布的股息增加每股58便士。我們也憑藉對 ESG 目標的信任而取得了良好進展，這尤其體現在我們在標準普爾全球企業永續發展評估中的產業領導地位。今年的亮點包括我們的低碳萬託林吸入器計畫進入第三階段、提前 2 年實現我們的領導力多元化目標，以及將我們的瘧疾疫苗推廣範圍擴大到非洲 12 個新國家。總而言之，2023 年為我們提供了良好的動力，我們今年將繼續保持這一勢頭。請下一張投影片。

In 2024, we expect another year of meaningful growth. Sales growth of 5% to 7%, adjusted operating profit growth of 7% to 10% and adjusted EPS growth of 6% to 9%. For the period 2021 to 2026, we now expect sales to grow more than 7% on a CAGR basis and adjusted operating profit to increase more than 11% CAGR.

2024 年，我們預計又將實現有意義的成長。銷售額成長5%至7%，調整後營業利潤成長7%至10%，調整後每股盈餘成長6%至9%。 2021年至2026年期間，我們預期銷售額複合年增長率將超過7%，調整後營業利潤複合年增長率將超過11%。

For 2026 to '31, with the progress we've made in our portfolio, we now believe that we can deliver more than GBP 38 billion of sales by 2031. This is an increase of GBP 5 billion versus the estimate we gave in 2021 and continues to exclude any contributions from early-stage pipeline assets and further anticipated business development. We've also not included any potential future sales contribution from Blenrep here either. So this new outlook represents a marked sales acceleration. As in effect, we now expect to reach our original 2031 goal of more than GBP 33 billion by 2026, so 5 years earlier.

2026 年至31 年，隨著我們在投資組合方面取得的進展，我們現在相信，到2031 年，我們可以實現超過380 億英鎊的銷售額。這比我們在2021 年給出的估計增加了50 億英鎊，繼續排除早期管道資產和進一步預期業務發展的任何貢獻。我們在這裡也沒有包括 Blenrep 的任何潛在的未來銷售貢獻。因此，這一新的前景代表著銷售的顯著加速。實際上，我們現在預計到 2026 年（提前 5 年）實現 2031 年最初的目標，超過 330 億英鎊。

Beyond sales, we expect a continued strong focus on margin improvements during this period while retaining flexibility to invest in growth. Recognizing that we'll likely face loss of exclusivity for dolutegravir from '28 to 2030. We're also able to say today that we expect operating margins to be broadly stable through that 3-year period.

除了銷售之外，我們預計在此期間將繼續大力關注利潤率的提高，同時保持投資成長的靈活性。認識到從 28 年到 2030 年，我們可能會失去多替拉韋的獨家經營權。今天我們還可以說，我們預計營運利潤率在這 3 年期間將大致穩定。

Julie and I will cover these outlooks in more detail shortly. But first, we're going to review our 2023 performance and 2024 guidance, starting with comments from Luke.

朱莉和我很快就會更詳細地討論這些觀點。但首先，我們將回顧 2023 年的表現和 2024 年的指導，首先是盧克的評論。

Thanks, Emma, please turn to the next slide. 2023 was a great year for operating performance with strong growth across all our product areas and regions, up 14% for the full year. Please turn to Slide 10.

謝謝，艾瑪，請翻到下一張投影片。 2023 年是經營業績優異的一年，我們所有產品領域和地區均實現強勁成長，全年成長 14%。請翻到投影片 10。

In Vaccines, sales were up 24% for the year, with the outstanding launch performance of Arexvy, contributing more than GBP 1.2 billion together with the strong performances from Shingrix and our meningitis portfolio.

在疫苗領域，由於 Arexvy 的出色上市表現，加上 Shingrix 和我們的腦膜炎產品組合的強勁表現，全年銷售額增長了 24%，貢獻了超過 12 億英鎊。

I'll come to Arexvy in a minute, but first, a few points on the rest of the portfolio and specifically prospects for growth. We continue to expect strong growth for Shingrix this year and to deliver more than GBP 4 billion in peak year sales. In the U.S., our immunization rate is 35% in those people 50 years and older, which means close to 80 million people who are eligible are unvaccinated with more than 4 million people joining this cohort each year. We expect 2024 growth to be driven outside the U.S. where the vaccine is now approved in 39 countries, most of which have less than 4% penetration, and we're really excited about our new partnership with Zhifei in China. Our meningitis portfolio supports a major public health need and continues to be an important contributor to growth. Bexsero and Menveo sales were up 14% and 12% in 2023. We're also excited to be submitting our MenABCWY vaccine for approval in the U.S. this year. Combined, this franchise is expected to deliver around GBP 2 billion in nonrisk-adjusted peak year sales. Beyond the marketed portfolio, we expect to see further progress in 2024 for our mRNA vaccine with Phase II data and flu, the development of our pneumococcal MAPS vaccine candidates and our potential HSV therapeutic vaccine. Next slide, please.

我稍後會談到 Arexvy，但首先，我會介紹一下該投資組合的其餘部分，特別是成長前景。我們繼續預計 Shingrix 今年將強勁成長，並在高峰年實現超過 40 億英鎊的銷售額。在美國，50 歲及以上族群的免疫接種率為 35%，這意味著有近 8,000 萬名符合資格的人未接種疫苗，其中每年有超過 400 萬人加入這群人。我們預計2024 年的成長將由美國以外的地區推動。該疫苗現已在39 個國家/地區獲得批准，其中大多數國家的普及率不到4%，我們對與中國智飛的新合作夥伴關係感到非常興奮。我們的腦膜炎產品組合支持主要的公共衛生需求，並繼續為成長做出重要貢獻。 2023 年，Bexsero 和 Menveo 的銷售額分別增加了 14% 和 12%。我們也很高興今年能在美國提交 MenABCWY 疫苗批准。預計該特許經營權合計將在非風險調整高峰年實現約 20 億英鎊的銷售額。除了已上市的產品組合外，我們預計 2024 年我們的 mRNA 疫苗的 II 期數據和流感、肺炎球菌 MAPS 候選疫苗和潛在的 HSV 治療疫苗的開發將取得進一步進展。請下一張投影片。

As Emma said, the Arexvy launch has been exceptional, and we expect good growth this year, mainly driven by further penetration in the U.S. but also early adoption from the international rollout of the vaccine. We are currently approved in 39 countries. And in the U.S., our choice to emphasize our 94.6% efficacy in the comorbid population continues to resonate well. Script data shows strong brand preference and market data tells us that 2 out of 3 HCPs prefer Arexvy, and we continue to have a strong position with all major pharmacies as we start 2024.

正如艾瑪所說，Arexvy 的推出非常出色，我們預計今年將出現良好增長，這主要是由於該疫苗在美國的進一步滲透以及該疫苗在國際上的推廣而得到早期採用。目前我們已在 39 個國家/地區獲得批准。在美國，我們選擇強調我們對共病族群的 94.6% 療效持續引起良好迴響。腳本數據顯示出強烈的品牌偏好，市場數據告訴我們，三分之二的 HCP 更喜歡 Arexvy，從 2024 年開始，我們將繼續在所有主要藥房中保持強勢地位。

Looking into this year, we have a major opportunity subject to approval and ACIP recommendation with a potential label for at-risk individuals in the 50- to 59-year-old cohort. This is around 15 million people. And on other dynamics for this year, we know we're facing a more competitive environment. And of course, we won't benefit from launch stocking. We'll also start to see how seasonality affects use patents for Arexvy. But we are ready for all of this and are ambitious for 2024. We remain very confident this vaccine can achieve more than GBP 3 billion in peak year sales over time.

展望今年，我們有一個重大機會需要批准和 ACIP 建議，並為 50 至 59 歲人群中的高危險群貼上潛在標籤。這大約是 1500 萬人。關於今年的其他動態，我們知道我們面臨著競爭更加激烈的環境。當然，我們不會從發布庫存中受益。我們也將開始了解季節性如何影響 Arexvy 的使用專利。但我們已經為這一切做好了準備，並對 2024 年充滿雄心壯志。我們仍然非常有信心，隨著時間的推移，這種疫苗的峰值年銷售額將達到 30 億英鎊以上。

Overall, looking across the Vaccines portfolio, we expect sales to increase high single-digit to low double-digit percent in 2024, and we're also upgrading our vaccines outlook from '21 to '26 from high single digits to low double digits. Next slide, please.

總體而言，縱觀整個疫苗產品組合，我們預計2024 年銷售額將增長高個位數百分比至低兩位數百分比，並且我們還將疫苗前景從21 年的高個位數提高到低兩位數。請下一張投影片。

Moving to Specialty Medicines. Here, overall sales were up 15% for the year, driven by strong performance from key products in HIV, which Deborah will cover shortly, respiratory, immunology and oncology. In Respiratory, our market-leading IL-5, Nucala, saw strong growth across all geographies and receive severe asthma approval in China. And as we said at our recent Respiratory, Meet the Management event, we expect pivotal COPD data for Nucala in the second half of this year. Before then, and excitingly for this class of respiratory medicines, we expect first pivotal trial results for depemokimab, our new 6-monthly IL-5, a key new growth opportunity for our respiratory business. Benlysta was also a major contributor for '23, with sales up 19% in oncology. We are very pleased with the strong uptake for Ojjaara, and we're also seeing increasing usage of Jemperli and Zejula in patients with endometrial and ovarian cancers driven by generation of compelling data and launch of new patient valued formulations.

轉向專業藥物。由於愛滋病毒、呼吸、免疫學和腫瘤學領域關鍵產品的強勁表現（Deborah 很快將涉足該領域），今年的整體銷售額增長了 15%。在呼吸系統領域，我們市場領先的 IL-5 Nucala 在所有地區都實現了強勁增長，並在中國獲得了重症氣喘的批准。正如我們在最近的呼吸管理會議上所說，我們預計今年下半年將獲得 Nucala 的關鍵慢性阻塞性肺病數據。在此之前，令人興奮的是，對於此類呼吸系統藥物，我們預計depemokimab（我們新的6 個月一次的IL-5）將獲得第一個關鍵試驗結果，這是我們呼吸系統業務的一個重要的新增長機會。 Benlysta 也是 23 年的主要貢獻者，其腫瘤學銷售額成長了 19%。我們對Ojjaara 的強勁應用感到非常高興，我們也看到，由於令人信服的數據生成和新的患者價值配方的推出，Jemperli 和Zejula 在子宮內膜癌和卵巢癌患者中的使用量不斷增加。

A quick word on Blenrep, sales decreased for the year as expected, but following positive headline results from a planned interim efficacy analysis of the DREAMM-7 trial, we are now waiting for further overall survival data from this study, and we continue to expect DREAMM-8 results later this year. Overall, we can expect another year of strong performance from our Specialty Medicines in 2024, with growth of low double-digit percent and continue to expect double-digit growth between 2021 and 2026. Please turn to Slide 13.

簡單介紹一下 Blenrep，今年的銷售額按預期下降，但在計劃中的 DREAMM-7 試驗中期療效分析取得積極的標題結果之後，我們現在正在等待這項研究的進一步總體生存數據，並且我們繼續期望DREAMM -8 將於今年稍後公佈結果。總體而言，我們預計 2024 年我們的專科藥品將再次表現強勁，成長率將達到兩位數，並預計 2021 年至 2026 年將繼續實現兩位數成長。請參閱投影片 13。

Finally, our General Medicine portfolio. Sales grew 5% in 2023 and led by Trelegy, which is now contributing over GBP 2 million per year and is the world's top-selling brand in asthma and COPD. We are now using our respiratory expertise across both vaccines and medicines with the benefit of Trelegy and Arexvy co-promotion being recognized by HCPs who want to discuss both respiratory, prevention and treatment. Overall, we expect general medicines to decrease mid-single digit percentage in 2024, and this guidance takes into account the AMCAP removal in the U.S., which we previously highlighted as impacting the business by up to USD 700 million. We provided for around 20% of this in 2023 and continue to expect a broadly flat outlook between 2021 and 2026.

最後是我們的一般醫學產品組合。在 Trelegy 的帶動下，2023 年銷售額將成長 5%，該公司目前每年貢獻超過 200 萬英鎊，是全球最暢銷的氣喘和慢性阻塞性肺病品牌。我們現在正在利用我們在疫苗和藥物方面的呼吸系統專業知識，Trelegy 和 Arexvy 的聯合推廣得到了想要討論呼吸系統、預防和治療的 HCP 的認可。總體而言，我們預計普通藥品將在 2024 年下降中個位數百分比，而本指引考慮了美國 AMCAP 的取消，我們先前強調這對業務的影響高達 7 億美元。我們在 2023 年提供了其中約 20% 的資金，並繼續預計 2021 年至 2026 年前景基本持平。

I'll now hand over to Deborah to cover HIV.

我現在將把愛滋病毒的工作交給黛博拉。

Thank you, Luke. HIV sales grew 13% to GBP 6.4 billion in 2023, driven by a notable acceleration in our Oral 2 Drug and long-acting injectable regimens. Sales from these 2 areas represent 55% of our portfolio compared to an exit of 46% in 2022. For the year, Dovato sales grew 33% to GBP 1.8 billion. Cabenuva grew more than 100% with sales over GBP 700 million, and Apretude contributed sales of GBP 149 million. The growth of these products reflect strong patient demand and our deep commitment to innovation. For long-acting regimens, specifically, more than 80% of U.S. health care prescribers now tell us they are convinced that these regimens will become a key part of HIV care. Based on this demand and our growth and momentum, we're projecting a growth rate of high single to low double digits in 2024.

謝謝你，盧克。在我們的口服 2 號藥物和長效注射療法顯著加速的推動下，愛滋病毒銷售額到 2023 年增長 13%，達到 64 億英鎊。這兩個領域的銷售額占我們產品組合的 55%，而 2022 年的退出比例為 46%。這一年，Dovato 銷售額成長了 33%，達到 18 億英鎊。 Cabenuva 成長超過 100%，銷售額超過 7 億英鎊，Apretude 貢獻銷售額 1.49 億英鎊。這些產品的成長反映了患者的強勁需求和我們對創新的堅定承諾。特別是對於長效治療方案，超過 80% 的美國醫療保健處方者現在告訴我們，他們相信這些治療方案將成為愛滋病毒護理的關鍵部分。根據這項需求以及我們的成長和勢頭，我們預計 2024 年成長率將達到高個位數到低兩位數。

We're excited by the potential of our early-stage pipeline to deliver more innovative longer-acting injectable regimens. And as I said at last year's investor event, 2024 will be an important year for us as we select regimens for 4 monthly treatment and self-administered treatment as well as starting the registrational studies for our 4 monthly prep. We will be presenting data on our early pipeline and our current portfolio at CROI in March.

我們對我們的早期產品線提供更具創新性的長效注射方案的潛力感到興奮。正如我在去年的投資者活動中所說，2024 年對我們來說將是重要的一年，因為我們選擇了4 個月治療和自我管理的治療方案，並開始了4 個月準備的註冊研究。我們將於 3 月在 CROI 上展示我們早期產品線和目前產品組合的數據。

To conclude, 2023 was another positive year of performance and portfolio development. As such, we're looking forward to 2024 and are confident that we are well on track to deliver our 2021 to 2026 sales ambition of 6% to 8%.

總而言之，2023 年是績效和投資組合發展又一個積極的一年。因此，我們期待 2024 年，並相信我們將順利實現 2021 年至 2026 年 6% 至 8% 的銷售目標。

With that, I shall hand to Julie.

接下來，我將交給朱莉。

Thank you, Deborah, and good morning, everyone. Next slide, please.

謝謝黛博拉，大家早安。請下一張投影片。

Starting with the income statement, with growth rates stated at CER. Sales increased 14%, excluding COVID solutions and were up 5% overall, reflecting continued strong business performance. Adjusted operating profit grew 16%, excluding COVID and 12% overall. The margin increased to 29%, driven largely by favorable product mix and operational efficiencies as well as increased royalties. COGS and SG&A grew broadly in line with sales, excluding COVID. R&D costs increased due to the investment in late-stage programs in vaccines, respiratory, immunology and infectious diseases with the step-up in Q4 due to reorganization costs and the acceleration of late-stage projects. Adjusted earnings per share grew 22%, excluding COVID solutions and 16% overall. And this benefited also from lower net finance expense down 15% following debt restructuring. The effective tax rate was 15.5%, in line with our guidance.

從損益表開始，成長率以固定匯率表示。銷售額成長 14%（不含新冠肺炎解決方案），整體銷售額成長 5%，反映出持續強勁的業務表現。調整後營業利潤成長 16%（不含新冠疫情），整體成長 12%。利潤率增至 29%，主要得益於有利的產品組合和營運效率以及特許權使用費的增加。銷貨成本和銷售管理費用的成長與銷售額大致一致，不包括新冠疫情。由於重組成本和後期項目的加速，疫苗、呼吸系統、免疫學和傳染病等後期項目的投資在第四季度有所增加，導致研發成本增加。調整後每股收益成長 22%（不包括新冠疫情解決方案），整體收益成長 16%。這也得益於債務重組後淨財務費用下降了 15%。有效稅率為 15.5%，與我們的指導一致。

Turning to the reported results. Total operating profit increased 10% to GBP 6.7 billion, driven by overall performance and favorable CCL movements. The reconciliation of total to adjusted results is included in the appendix.

轉向報告的結果。受整體業績和 CCL 有利走勢的推動，總營業利潤成長 10%，達到 67 億英鎊。總結果與調整結果的調節結果包含在附錄中。

On currency, there was an adverse 200 basis point impact on sales and 400 basis points on adjusted operating profit versus the prior year, primarily due to the strengthening of sterling against emerging market currencies. Next slide, please.

在貨幣方面，與前一年相比，銷售額受到了 200 個基點的不利影響，調整後營業利潤受到了 400 個基點的不利影響，這主要是由於英鎊兌新興市場貨幣走強。請下一張投影片。

Moving on to the adjusted operating margin dynamics for the year. On this slide, we have shared, including and excluding COVID to provide an underlying review of margin dynamics. Excluding COVID solutions, the margin improved 60 basis points CER to 29.1% due to improved product mix, productivity improvements and increased royalty income. Including COVID, there was a 180 basis point improvement, primarily reflecting reduced sales of lower margins Xevudy. Regarding SG&A, growth was focused on investment in vaccines, including disease awareness and the launch of Arexvy, together with Shingrix, long-acting HIV, Jemperli and Ojjaara. Royalty income also contributed to margin improvement. Next slide, please.

接下來討論今年調整後的營業利益率動態。在這張投影片中，我們分享了包括和排除新冠病毒在內的情況，以提供對利潤動態的基本審查。不包括新冠肺炎解決方案，由於產品組合的改善、生產力的提高和特許權使用費收入的增加，利潤率提高了 60 個基點 CER 至 29.1%。包括新冠疫情在內，成長了 180 個基點，主要反映了利潤率較低的 Xevudy 的銷售額減少。關於SG&A，成長的重點是對疫苗的投資，包括疾病意識和Arexvy以及Shingrix、長效HIV、Jemperli和Ojjaara的推出。特許權使用費收入也有助於提高利潤率。請下一張投影片。

Free cash flow increased to GBP 3.4 billion. And this, despite annualizing the receipt of GBP 0.9 billion from Gilead in 2022. This increase was primarily driven by higher operating profit, together with favorable timing of Xevudy cash flows and a lower U.K. pension contribution. This was partly offset by higher trade receivables from sales of Arexvy in the last quarter.

自由現金流增至 34 億英鎊。儘管按年計算，2022 年從吉利德獲得的收入為 9 億英鎊。這一增長主要是由於營業利潤增加、Xevudy 現金流的有利時機和英國養老金繳款減少所致。這在一定程度上被上季度 Arexvy 銷售的應收帳款增加所抵消。

Q4 CGFO performance was particularly strong, delivering GBP 3.7 billion versus GBP 2.1 billion last year. And this increase was primarily driven by higher collections following the strong launch of Arexvy in Q3. We expect cash generated from operations to remain strong, and we're fully committed to delivering more than GBP 10 billion by 2026. Next slide, please.

第四季 CGFO 表現尤為強勁，實現了 37 億英鎊的收入，而去年為 21 億英鎊。這一成長主要是由於在第三季強勢推出 Arexvy 後產品系列增加所致。我們預計營運產生的現金將保持強勁，並且我們完全致力於在 2026 年交付超過 100 億英鎊。請看下一張幻燈片。

Slide 19 shares our net debt position and how we've deployed capital in the business in line with the capital allocation framework. We look to deploy funds to enhance growth and deliver attractive shareholder returns. We started the year with net debt of GBP 17 billion and strong free cash generation in addition to the monetization of our stake in Haleon supported GBP 3.8 billion of investment in targeted business development and capital expenditure and GBP 2.2 billion in returns to shareholders via the dividend. Overall, this led to a further reduction in net debt to GBP 15 billion by the end of 2023 and a net debt to adjusted EBITDA ratio of 1.5x.

投影片 19 分享了我們的淨債務狀況以及我們如何根據資本分配框架在業務中部署資本。我們希望部署資金來促進成長並提供有吸引力的股東回報。年初，我們的淨債務為170 億英鎊，自由現金流強勁，此外，我們在Haleon 股份的貨幣化支持了38 億英鎊的目標業務發展和資本支出投資，並透過股息為股東帶來了22 億英鎊的回報。總體而言，這導致到 2023 年底淨債務進一步減少至 150 億英鎊，淨債務與調整後 EBITDA 的比率達到 1.5 倍。

Post the year-end, we conducted a further sale of 300 million Haleon shares, yielding proceeds of GBP 978 million and leaving our equity holding at just over 4%. Further, we reached a successful agreement to acquire Aiolos Bio, subject to customary regulatory clearances and to further strengthen our respiratory portfolio.

年底後，我們進一步出售了 3 億股 Haleon 股票，收益達 9.78 億英鎊，持股比例略高於 4%。此外，我們成功達成收購 Aiolos Bio 的協議，但須遵守慣例監管許可，並進一步加強我們的呼吸產品組合。

I'll now turn to our expectations for the coming year. Next slide, please.

我現在談談我們對來年的期望。請下一張投影片。

In 2024, we expect another year of meaningful growth for GSK. We expect sales to increase between 5% and 7%, adjusted operating profit to increase between 7% and 10% and adjusted earnings per share to increase between 6% and 9%. Important to note that the cessation of Gardasil royalties negatively impacts profit growth by 6 percentage points within our 2024 guidance. As a reminder, our guidance is provided at CER and excludes the impact of COVID-19 solutions.

2024 年，我們預期葛蘭素史克又將實現有意義的成長。我們預計銷售額將成長 5% 至 7%，調整後營業利潤將成長 7% 至 10%，調整後每股盈餘將成長 6% 至 9%。值得注意的是，停止收取 Gardasil 特許權使用費會對我們 2024 年指導範圍內的利潤增長產生 6 個百分點的負面影響。請注意，我們的指南是在 CER 中提供的，不包括 COVID-19 解決方案的影響。

Some points to note for modeling purposes. Firstly, our sales composition. As Luke and Deborah have said, for vaccines, we expect high single-digit to low double-digit percent growth. For Specialty Medicines, we expect a low double-digit percent growth. For HIV, sales to grow high single-digit to low double-digit percent. And within General Medicines, we expect sales will decrease by a mid-single-digit percent largely as a result of the [AMP cap] removal in the U.S. We also do not anticipate any further revenue from COVID solutions, and this will reduce sales growth by 1% and operating profit growth by 2% in 2024.

出於建模目的需要注意的一些要點。首先，我們的銷售構成。正如盧克和黛博拉所說，對於疫苗而言，我們預計將出現高個位數到低兩位數的增長。對於特殊藥物，我們預計將出現兩位數的低成長。對於愛滋病毒，銷售額將從高個位數成長到低兩位數百分比。在普通藥品領域，我們預計銷售額將下降中個位數百分比，這主要是由於美國取消了 [AMP 上限]。我們也預計新冠解決方案不會帶來任何進一步收入，這將降低銷售額增長2024年成長1%，營業利潤成長2%。

Secondly, turning to operating margin dynamics. We have been in an investment cycle, supporting our newly launched vaccines and medicines, and we now expect to move to a period of delivering increasing returns on our investment. In this new cycle, we expect a step down in SG&A growth to a low single-digit percentage, improving productivity and providing margin leverage whilst remaining competitive. We will continue to invest for growth as established in our capital allocation framework, and we will continue to build a strong R&D pipeline for the longer term. And finally, we expect an increased tax rate of 17% to 2024.

其次，轉向營業利潤率動態。我們一直處於投資週期，支持我們新推出的疫苗和藥物，現在我們預計將進入一個投資回報不斷增加的時期。在這個新周期中，我們預計 SG&A 成長將下降至較低的個位數百分比，從而提高生產力並提供利潤槓桿，同時保持競爭力。我們將繼續依照資本配置架構的規定，為成長進行投資，並持續建立強大的長期研發管道。最後，我們預計到 2024 年稅率將提高 17%。

And I'll now hand back to Emma.

現在我將把事情交還給艾瑪。

Thanks, Julie. So in this final section, we'd like to provide you with a bit more detail on the key elements that we see as underpinning our performance in '26 to 2031. We know this period is a key area of focus for investors with growth and profitability being two clear dynamics for us to manage. Next slide, please.

謝謝，朱莉。因此，在最後一節中，我們希望向您提供有關我們認為支撐 26 至 2031 年業績的關鍵要素的更多詳細資訊。我們知道這段期間是投資者關注的關鍵領域，其成長和獲利能力是我們需要管理的兩個明確的動力。請下一張投影片。

First, growth and its most important driver portfolio development. We start from a very healthy position with a core set of marketed vaccines and specialty medicines driving significant growth. With the progress we're making, particularly in vaccines and HIV, these marketed assets now support an outlook of more than 7% sales growth on a 5-year CAGR basis in 2026. These growth drivers will be supplemented by a planned set of near-term new product launches, each with peak year sales potential of GBP 2 billion or more. Here, we have new potential vaccines for meningitis, influenza, pneumococcal disease and HSV and new potential medicines for long-acting HIV treatment and prevention, a functional cure for hepatitis B, bepirovirsen, a new portfolio of anti-infective treatments, including gepotidacin, new medicines for respiratory diseases with high burden and unmet need, depemokimab and camlipixant.

首先，成長及其最重要的驅動力組合開發。我們的起步非常健康，擁有一系列核心的已上市疫苗和特殊藥物，推動了顯著成長。隨著我們取得的進展，特別是在疫苗和愛滋病毒方面，這些上市資產現在支持2026 年5 年複合年增長率超過7% 的銷售增長前景。這些增長動力將得到一系列計劃中的近期項目的補充。定期推出新產品，每款產品的峰值年銷售潛力可達 20 億英鎊或以上。在這裡，我們有針對腦膜炎、流感、肺炎球菌疾病和單純皰疹病毒的新的潛在疫苗，以及用於長效愛滋病毒治療和預防的新的潛在藥物、乙型肝炎的功能性治療藥物貝匹羅韋森、新的抗感染治療組合，包括gepotidacin、用於治療高負擔和未滿足需求的呼吸系統疾病的新藥，depemokimab 和 camlipixant。

And in oncology, further indications for Jemperli and potentially CD226 targeting a variety of cancer types. Altogether, we are currently planning for at least 12 major product launches in the period 2025 to 2031. With these planned launches and our current marketed growth drivers, we expect to deliver more than GBP 38 billion in risk-adjusted sales for GSK by 2031. And beyond this, so not included in that GBP 38 billion, we continue to develop a promising early-stage pipeline, and we will continue to pursue targeted business development. Next slide, please.

在腫瘤學方面，Jemperli 和潛在的 CD226 的進一步適應症針對多種癌症類型。總而言之，我們目前計劃在2025 年至2031 年期間推出至少12 個主要產品。憑藉這些計劃的推出和我們目前的市場成長動力，我們預計到2031 年將為葛蘭素史克帶來超過380 億英鎊的風險調整銷售額。除此之外，不包括在 380 億英鎊中，我們將繼續開發有前景的早期產品線，並將繼續追求有針對性的業務發展。請下一張投影片。

Of course, we recognize that there is development risk and that refreshing and progressing our pipeline is a continual process. By definition, not everything will come through. Continued strong execution is needed, and we're committed to it. We forecast our sales on an RA, risk-adjusted and NRA, nonrisk-adjusted basis. As you can see here, there is significant potential for upside with successful development outcomes. Our highest adjustments are in specialty oncology, reflecting the development risk and the upside returns the assets we have in this space offer. Overall, our portfolio offers scale growth opportunity and has an attractive risk profile, more than 90% of those future sales come from products already approved or from planned launches of GBP 2 billion or more, most of which we plan to launch in the next 4 years. Next slide, please.

當然，我們認識到存在開發風險，並且更新和推進我們的產品線是一個持續的過程。根據定義，並非所有事情都會成功。需要持續強而有力的執行力，我們也致力於此。我們根據 RA（風險調整後）和 NRA（非風險調整後）預測銷售額。正如您在這裡所看到的，成功的開發成果具有巨大的上升潛力。我們最高的調整是在專業腫瘤學領域，反映了我們在這個領域提供的資產的開發風險和上行回報。總體而言，我們的產品組合提供了規模成長機會並具有有吸引力的風險狀況，未來銷售額的90% 以上來自已批准的產品或計劃推出的20 億英鎊或更多產品，其中大部分我們計劃在未來4 年推出年。請下一張投影片。

You'll be increasingly familiar with many of these assets following our meet the management events last year. We will, of course, continue to provide updates as we expect significant amounts of pipeline value to unlock this year in '25 and in 2026, as this growing late-stage portfolio matures. As shown here, you can see we have multibillion pound scale opportunities in all of our core product areas. These peak year sales estimates are given on a non-risk-adjusted basis, and all of them are at least GBP 2 billion with many significantly higher.

在我們去年的管理會議之後，您將越來越熟悉其中的許多資產。當然，我們將繼續提供最新信息，因為我們預計，隨著這一不斷增長的後期投資組合的成熟，今年 25 年和 2026 年將釋放大量管道價值。如圖所示，您可以看到我們在所有核心產品領域都擁有數十億英鎊規模的機會。這些高峰年的銷售預估是在未經過風險調整的基礎上給出的，所有預估均至少為 20 億英鎊，其中許多預估值要高得多。

So let's now turn to the second dynamic for us to manage in '26 to '31, a continued focus on profitability and disciplined capital allocation. So over to Julie to comment on this.

因此，現在讓我們轉向我們在 26 年至 31 年期間管理的第二個動力，即繼續關注盈利能力和嚴格的資本配置。現在請朱莉對此發表評論。

Thanks, Emma. And first, I will cover operating margins. Since 2021, we've delivered an increase in margin of 290 basis points and we remain focused on delivering further margin improvements in the next 3 years to achieve an operating margin in excess of 31% by the end of 2026. This represents more than a 530 basis point improvement over the 5 years. Our margin is benefiting from the strategic shift we've made to invest in Vaccines and Specialty Medicines together with the significant productivity improvements across supply chain, commercial operations and global functions. This margin progression is after absorbing various headwinds, including several already highlighted, such as Gardasil royalties and the impact from [AMP cap]. These are all factored into our outlook.

謝謝，艾瑪。首先，我將介紹營業利益率。自 2021 年以來，我們的利潤率已增長 290 個基點，並且我們仍致力於在未來 3 年內進一步提高利潤率，以在 2026 年底前實現營業利潤率超過 31%。5 年來提高了 530 個基點。我們的利潤得益於我們投資疫苗和特種藥物的策略轉變，以及供應鏈、商業營運和全球職能部門生產力的顯著提高。這項利潤率成長是在吸收了各種不利因素之後產生的，其中包括一些已經強調的因素，例如 Gardasil 特許權使用費和 [AMP 上限] 的影響。這些都被納入我們的展望中。

Moving to the period 2026 to '31. Whilst we do not plan to guide on operating margin beyond 2026, we do understand that investors are concerned about the period when dolutegravir loses exclusivity. We would, therefore, like to set out our expectations for this 3-year period, starting in 2028 with the majority impact in 2029, '30.

移至 2026 年至 31 年。雖然我們不打算對 2026 年之後的營業利潤率進行指導，但我們確實理解投資者對多魯特韋失去獨佔權的時期感到擔憂。因此，我們希望列出我們對這 3 年期間的預期，從 2028 年開始，到 2029 年 30 年產生主要影響。

Offsetting this are a number of positive factors. Firstly, and very importantly, the development of new long-acting and ultra long-acting HIV treatment and prevention therapies, such that by the time the loss of exclusivity starts, we would expect around 40% of our HIV business to be in long-acting therapies.

有許多正面因素可以抵消這一影響。首先，非常重要的是，開發新的長效和超長效 HIV 治療和預防療法，這樣，當開始失去排他性時，我們預計大約 40% 的 HIV 業務將處於長期治療中。行動療法。

Second, the mix benefit to the operating margin from growth in Vaccines and Specialty Care products, which we anticipate to be around 3/4 of revenues by 2026.

其次，該組合受益於疫苗和特殊護理產品的成長，我們預計到 2026 年，這些產品將佔收入的 3/4 左右。

Thirdly, accelerating productivity gains, notably in supply chain and in SG&A, with increased use of AI and analytics to underpin and further support GSK's profitability in this period.

第三，加快生產力的提高，特別是在供應鏈和銷售管理費用方面，增加人工智慧和分析的使用，以鞏固和進一步支持葛蘭素史克在此期間的盈利能力。

Taking all of this together, our expectation is for operating margins to be broadly stable through the 3 years where dolutegravir loses exclusivity. Known headwinds, including the impact of the IRA on certain products are also incorporated into this expectation.

綜合考慮所有這些因素，我們的預期是，在多替拉韋失去獨家經營權的三年內，營業利潤率將大致保持穩定。已知的不利因素，包括 IRA 對某些產品的影響，也納入了這項預期。

And finally, we will continue to have a strong focus on margin improvement and ensure our P&L is both competitive and invested for growth. We remain ambitious and we'll seek further upside through progression of the early-stage pipeline, targeted business development and a continued drive for efficiency. Next slide, please.

最後，我們將繼續專注於利潤率的提高，並確保我們的損益表既具有競爭力，又能夠投資於成長。我們仍然雄心勃勃，並將透過早期管道的進展、有針對性的業務發展和持續提高效率來尋求進一步的發展。請下一張投影片。

Turning to capital allocation. Our first priority remains to invest in the business with capital allocated towards development of the pipeline, both organic and targeted business development. We also remain committed to delivering attractive returns to shareholders and pursuing a progressive dividend policy. We are, therefore, pleased to announce an uplift in the fourth quarter dividend to bring the total for 2023 to 58p allowing shareholders to benefit from the upgraded performance last year and our increased confidence in the future. In addition, we are announcing today that we expect to pay a dividend of 60p for the year 2024, in line with our progressive policy and to be paid in equal quarterly installments. Next slide, please.

轉向資本配置。我們的首要任務仍然是投資業務，並將資金分配給管道開發，包括有機和有針對性的業務開發。我們也持續致力於為股東提供有吸引力的回報並奉行漸進的股利政策。因此，我們很高興地宣布提高第四季度股息，使 2023 年股息總額達到 58 便士，使股東受益於去年業績的提升以及我們對未來信心的增強。此外，我們今天宣布，根據我們的累進政策，我們預計將在 2024 年支付 60 便士的股息，並按季度等額分期支付。請下一張投影片。

It is important that we share our progress with you and that you're able to track our major milestones and value unlocks, Emma referred to earlier. Last year, we set out an IR road map for investors covering the next 18 months, inclusive of 4 major areas: execution, pipeline, capital allocation and investor engagement. Our progress on this has been very positive and is available in our appendix. Today, we are providing you with a new and updated road map for 2024 and extending this into 2025. Outlining the milestones and potential inflection points, we expect to deliver in the next 24 months. The Phase III and regulatory decisions are highlighted and aligned to the planned major launches, Emma referenced and include expected progress from MenABCWY vaccines, depemokimab, Nucala, COPD and camlipixant in respiratory, gepotidacin in infectious disease, together with Blenrep, and Jemperli in oncology. We hope you'll find this useful, and we also look forward to providing you with updates at several scientific conferences this year. And we were also planning to hold 2 additional Meet The Management events, covering oncology in the summer and selected early-stage pipeline assets towards the end of the year.

艾瑪之前提到，重要的是，我們與您分享我們的進展，並且您能夠追蹤我們的主要里程碑和價值釋放。去年，我們為投資者制定了涵蓋未來18個月的IR路線圖，包括4個主要領域：執行、管道、資本配置和投資者參與。我們在這方面的進展非常積極，可以在我們的附錄中找到。今天，我們為您提供了 2024 年新的更新路線圖，並將其延伸到 2025 年。概述了我們預計在未來 24 個月內實現的里程碑和潛在轉折點。 Emma 提到，第三階段和監管決定得到了強調，並與計劃的主要上市保持一致，包括MenABCWY 疫苗、depemokimab、Nucala、COPD 和camlipixant 治療呼吸道疾病、gepotidacin 治療傳染病、以及Blenrep 和Jemperli 治療腫瘤學的預期進展。我們希望您會發現這很有用，我們也期待在今年的幾場科學會議上為您提供最新資訊。我們也計劃再舉辦 2 場與管理層會面的活動，內容涵蓋夏季的腫瘤學以及年底選定的早期管道資產。

I will now hand back to Emma to conclude.

現在我將把結論交給艾瑪。

Thanks, Julie. So to summarize, GSK is delivering on its commitments and performing to a new standard. The excellent performance that we delivered in 2023 provides us with clear momentum, and we expect to deliver another year of meaningful growth in 2024 as we continue to focus on prevention and changing the course of disease for millions of people. Our progress means we're also upgrading our outlooks for 2026 and 2031. All of this bodes well. But equally, we also know there is much to be done. We remain very focused on delivering this potential and more at continued pace for patients, for shareholders and for our people, combining science, technology and talent to get ahead of disease together.

謝謝，朱莉。總而言之，葛蘭素史克正在兌現其承諾並按照新標準行事。我們在 2023 年取得的出色業績為我們提供了明顯的動力，隨著我們繼續專注於預防和改變數百萬人的病程，我們預計將在 2024 年實現另一個有意義的成長。我們的進步意味著我們也在升級對 2026 年和 2031 年的展望。所有這些都是好兆頭。但同樣，我們也知道還有很多工作要做。我們仍然非常專注於為患者、股東和我們的員工持續不斷地發揮這種潛力以及更多潛力，將科學、技術和人才結合起來，共同克服疾病。

With that, I will now open up the call for the Q&A with the team.

現在，我將開始與團隊進行問答。

Thanks, Emma. We're going to take our first question from Peter Welford.

謝謝，艾瑪。我們將回答彼得·韋爾福德的第一個問題。

You said 1 or 2. So I'll stick to 2, if I may. Firstly, on Arexvy, I wonder if Luke can just talk a little bit about the contracting discussions that you've got in place for 2024, given comments from Pfizer about trying to become more competitive this year? And if you could give us any insights into the sort of levels of stocks that you have at the moment and whether that is now at sort of sustainable level that you think going forward, given the apparent lack of seasonality, at least relative to flu that we're seeing?

你說的是 1 或 2。如果可以的話，我會堅持選擇 2。首先，關於 Arexvy，考慮到輝瑞今年試圖變得更具競爭力的評論，我想知道盧克是否可以談談你們在 2024 年進行的合約討論？如果您能給我們任何關於目前庫存水平的見解，以及您認為未來是否處於可持續水平，考慮到明顯缺乏季節性，至少相對於流感而言，我們看到了？

And then the second, just a quick one, just on oncology. Looks though you've got 2 -- over GBP 2 billion peak year sales potential in oncology that you're including in the 2031 now. Just we're curious when could we get some visibility, I guess, to increase the confidence in the oncology part of that GBP 38 billion. And to be clear, that presumably doesn't include a return of Blenrep.

然後是第二個，只是一個快速的，關於腫瘤學的。看來您現在已將腫瘤學領域的 2031 年高峰銷售潛力納入了 2 至 20 億英鎊以上。我想，我們只是好奇什麼時候才能獲得一些知名度，以增強對這 380 億英鎊腫瘤學部分的信心。需要明確的是，這可能不包括布倫雷普的回歸。

Right. Thanks, Peter. We'll come to Luke. First on Arexvy, we're obviously delighted with doing the (inaudible) to blockbuster in 4 months that the company has ever done in '23 and ambitious for the path forward. And then I'm going to ask Tony to comment on oncology. Just to confirm, though, Blenrep isn't included in any of the outlook, although we do have some more data to come. And as a reminder, in one of the slides that I presented, this is the more heavily risk-adjusted portfolio in our outlook to 2031 and particularly with the 226 portfolio, not starting right towards the end of that period. But Tony can give you more visibility on when we'll know what for Jemperli. But Luke, first to you.

正確的。謝謝，彼得。我們會去找盧克。首先是 Arexvy，我們顯然很高興能在 4 個月內（聽不清楚）取得該公司在 23 年所取得的轟動效應，並對未來的道路充滿雄心壯志。然後我將請托尼對腫瘤學發表評論。不過，只是為了確認一下，儘管我們確實有更多數據即將發布，但 Blenrep 並未包含在任何展望中。提醒一下，在我展示的一張投影片中，這是我們對 2031 年前景進行更嚴格風險調整的投資組合，特別是 226 投資組合，而不是在該時期結束時開始。但托尼可以讓您更清楚地了解我們何時知道 Jemperli 的情況。但是盧克，首先對你來說。

Yes, sure. Thanks. Thanks, Emma. Thanks, Peter. Look, stocking levels are about 20% of what we've sold in. And if you remember, we had that initial loading with the launch, as you'd expect, you need to fill the shelves. But yes, now we're at steady state. I think I agree with you in terms of shifting away from -- I think we're increasingly confident this is not going to be a seasonal vaccine, and we're working very hard to do that. I think the [certainties] in data that we'll get in the middle of the year will also help to cement that.

是的，當然。謝謝。謝謝，艾瑪。謝謝，彼得。你看，庫存量大約是我們銷量的 20%。如果你還記得的話，我們在發佈時就進行了初始裝載，正如你所期望的那樣，你需要填滿貨架。但是，是的，現在我們處於穩定狀態。我想我同意你的觀點——我認為我們越來越有信心這不會成為季節性疫苗，我們正在非常努力地做到這一點。我認為我們將在今年年中獲得的數據的[確定性]也將有助於鞏固這一點。

In terms of contract, as you can imagine, I'm going to be a little bit coy there because as we've said on the past call, people get up early to listen to these calls. So -- but I would say we're very pleased with the launch so far in the 2023 performance. But our mindset is this is the first round of a multi-round fight. And in 2024, of course, we've got a third boxer jumping into the ring to make things interesting. So we're very focused on it. We're very confident, and I think we've shown that we can compete with the best. And our aim is to have another good year in 2024.

在合約方面，正如你可以想像的那樣，我會有點害羞，因為正如我們在過去的電話中所說，人們很早就起床收聽這些電話。所以，但我想說，我們對 2023 年迄今為止的發布表現感到非常滿意。但我們的心態是，這是多輪戰鬥的第一輪。當然，到 2024 年，我們將迎來第三位拳擊手，讓事情變得有趣。所以我們非常關注它。我們非常有信心，我認為我們已經證明我們可以與最好的球隊競爭。我們的目標是在 2024 年再創美好的一年。

Thanks, Luke. Tony, for oncology?

謝謝，盧克。托尼，腫瘤學？

Yes. So just to reiterate, first of all, Blenrep is not in the projections. For Jemperli, as you've called out, there are 2 areas. And the way to think about this is the continued development of [value] from Jemperli in areas where the underpinning genetics of the cancer support its activity, for example, building on the results that we have with RUBY and looking at other areas, which dMMR or MSI-High status are likely to generate transformative results. In addition, we've taken a careful look back on what we might call opportunities for which the PD-1 class is showing some effect, but adjustments in the approach would deliver potential differentiated -- long-term differentiated efficacy for Jemperli, that would be in the third line head and neck. And then broadly speaking, which -- and you'll hear more about this towards the end of the year is the data that we have in the CD226 access begin to mature and we hold Meet the Management session is going to be associated with exploring our combinations with TIGIT in particular, and that's a question of how those data play out in [lungs] and other opportunities like head and neck.

是的。所以重申一下，首先，Blenrep 不在預測之內。對於 Jemperli，正如您所說，有 2 個區域。思考這個問題的方法是，Jemperli 在癌症基礎遺傳學支持其活性的領域中持續開發 [價值]，例如，以我們在 RUBY 上獲得的結果為基礎，並著眼於其他領域，這些領域 dMMR或MSI 高狀態可能會產生變革性的結果。此外，我們仔細回顧了 PD-1 類藥物顯示出一些效果的所謂機會，但方法的調整將為 Jemperli 帶來潛在的差異化——長期差異化功效，這將位於第三線的頭頸處。然後從廣義上講，您將在今年年底聽到更多關於這一點的信息，即我們在 CD226 訪問中擁有的數據開始成熟，我們舉行的與管理層會面會議將與探索我們的特別是與TIGIT的組合，問題是這些數據如何在[肺部]和其他機會（如頭部和頸部）中發揮作用。

Thanks, Tony. Next question, please.

謝謝，托尼。請下一個問題。

Okay. So we're going to take our next question from Jo Walton at UBS.

好的。我們將回答瑞銀集團喬沃爾頓的下一個問題。

Jo?

喬？

I'll come back to you, Jo. Bear with me. We'll take our next question from James Gordon at JPMorgan.

我會回到你身邊，喬。耐心聽我說。我們將回答摩根大通的詹姆斯戈登的下一個問題。

James Gordon, JPMorgan. First question was just about Arexvy and about the revaccination data that I think we're going to get in the first half. So I remember 1 year, there wasn't a revaccination benefit, even though the protection had fallen quite a long way. So my question is confidence that we are going to see a strong benefit and how strong a benefit do you need to see? What would be a clinically meaningful benefit that would justify vaccinating people at 2 years? And is it right that the '26 assumption is that there is a strong benefit from revaccinating people? So that's the first question, please.

詹姆斯‧戈登，摩根大通。第一個問題是關於 Arexvy 以及我認為我們將在上半年獲得的重新接種數據。所以我記得一年後，儘管保護作用大幅下降，但重新接種疫苗並沒有帶來任何好處。所以我的問題是，我們是否有信心看到強大的效益，以及您需要看到多強的效益？哪些具有臨床意義的益處可以證明人們在 2 歲時接種疫苗是合理的？ 26 年的假設是重新接種疫苗會為人們帶來很大的好處，這對嗎？這是第一個問題。

Second question was just on the longer-term margin. So I saw the comment about broadly stable operating margin and as dolutegravir goes away, and I understand it's partly about productivity gains. But can you just remind us -- what is the headwind, how much are you losing? So I think when you did break out (inaudible) before in dolutegravir when it was really just dolutegravir, it was a margin north of 70%. And presumably, the margin will be even higher as that business has grown and you've got more operating leverage. So is that right that you'll be losing a business that's more than 70% EBIT margin when it goes away? And is part of it that you think there's going to be a new pipeline that's going to come in at a similarly high margin? Or am I overestimating the profitability you lose?

第二個問題是關於長期利潤的。因此，我看到了有關營運利潤率基本上穩定以及多替拉韋消失的評論，我知道這在一定程度上與生產力的提高有關。但你能否提醒我們──逆風是什麼，你損失了多少？所以我認為，當你之前在多魯特韋（dolutegravir）中確實爆發（聽不清楚）時，當時它實際上只是多魯特韋（dolutegravir），其利潤率超過了 70%。據推測，隨著業務的成長並且您擁有更多的營運槓桿，利潤率會更高。那麼，當息稅前利潤率超過 70% 的業務消失時，您會失去它嗎？您是否認為會有一條新的管道以同樣高的利潤進入？還是我高估了您損失的獲利能力？

Thanks, James. So we'll come to Julie to give you a response on the building blocks to the margin. But first, Tony, to comment on revaccination. And just to be clear, the '26 outlooks, we haven't given the specific '26 outlook but RSV, given the peak year sales for RSV and overall vaccines growth, upgraded outlook to '26 as well. But this is obviously a key asset and very excited with the efficacy of more data to come. So Tony?

謝謝，詹姆斯。因此，我們將請朱莉為您提供有關邊緣構建塊的答案。但首先，托尼，對重新接種疫苗發表評論。需要明確的是，對於“26 年”前景，我們沒有給出具體的“26 年前景”，但考慮到 RSV 銷售高峰年和整體疫苗增長，RSV 也將前景升級為“26 年”。但這顯然是一項關鍵資產，並且對即將到來的更多數據的功效感到非常興奮。那麼東尼?

Yes, sure. Look -- so James, just, of course, a reminder that the existing 2-year data is what is supporting the deseasonalization of the product. I'll talk about the plan to get to the decision point for determining the seasonality of the product. We're on track with regards to the third season data. That is -- will be presented at ACIP, it's worthwhile reminding everybody that the season is called by CDC and the determination of attack rates. So on track for that as far as we stand at the moment, and that will include boost comparison. If you ask me to make the best guess based on what we see from immunogenicity data in the 006 study and other smaller studies than I think we're heading for a 2-season vaccine again though that and the data supporting it will be on the basis of the ACIP decision and our conversations with ACIP. So I'll just give you a plan on this.

是的，當然。聽著—詹姆斯當然只是提醒我們，現有的兩年數據是支持產品淡季化的。我將討論到達確定產品季節性的決策點的計劃。我們正在按計劃完成第三季的數據。也就是說，將在 ACIP 上展示，值得提醒大家的是，該季節是由 CDC 命名並確定發病率的。因此，就我們目前的情況而言，這將包括增強比較。如果你讓我根據我們從 006 研究和其他小型研究中看到的免疫原性數據做出最佳猜測，我認為我們將再次開發兩季疫苗，儘管如此，支持它的數據將在ACIP 決定以及我們與ACIP 對話的基礎。所以我會給你一個計劃。

Yes. And I think the other thing to say on deseasonalization. As Luke presented, obviously, RSV vaccination is holding up better than flu and pneumococcal, but it still came down between October and December. And we don't -- we've got work to do, and we will soon discover more over the coming quarter on how those efforts play forward.

是的。我認為關於淡季化還有另一件事要說。正如盧克所言，RSV 疫苗接種的效果明顯優於流感和肺炎球菌疫苗，但 10 月至 12 月期間疫苗接種率仍下降。我們沒有——我們還有工作要做，我們很快就會在下個季度發現更多關於這些努力如何發揮作用的資訊。

Julie, the margin (inaudible).

朱莉，邊緣（聽不清楚）。

Thanks, Emma, and thank you for the question. In terms of the -- obviously, we are conscious that people are concerned about the loss of margin from dolutegravir, it's not at the level of the HIV business of the 70% that you mentioned. We've continued to invest heavily in this franchise and build in particular, the long-acting portfolio. And the reason for the confidence that we can hold it stable during that period. First of all, I'd draw attention to the 12 launches that Emma called out in her review. We've got some of them near term. I mean the majority of these will be launching within the next 4 years. So the inflections are coming quite quickly, but we've got meningitis, ABCWY, we've got the mRNA influenza. We've also very importantly, got HIV. We're confident of the 4 months, and we've got work going on, on that already.

謝謝艾瑪，也謝謝你的提問。顯然，我們意識到人們擔心多替拉韋的利潤損失，這並不達到您提到的 70% 的 HIV 業務水平。我們繼續對此系列產品進行大量投資，特別是建立長效產品組合。以及我們有信心在此期間保持穩定的原因。首先，我想提請大家注意艾瑪在她的評論中提到的 12 項發布。我們近期已經得到了其中一些。我的意思是其中大部分將在未來 4 年內推出。所以變化來得很快，但我們有腦膜炎，ABCWY，我們有 mRNA 流感。非常重要的是，我們感染了愛滋病毒。我們對這 4 個月充滿信心，我們已經在這方面開展了工作。

So the long-acting portfolio, very importantly, at the time the dolutegravir patent expiry starts we expect to have 40% of the business already in long-acting. So that's an important mechanism. In addition to that, as you know, we've got camlipixant launching, depemokimab, important readout coming out in the first half of this year, together with the anti-infective portfolio and others that Emma mentioned. So 12 major product launches just coming out now the majority in the next 4 years.

因此，長效產品組合非常重要，在多替拉韋專利到期開始時，我們預期 40% 的業務已經處於長效狀態。所以這是一個重要的機制。除此之外，如您所知，我們還推出了 camlipixant、depemokimab、今年上半年發布的重要消息，以及艾瑪提到的抗感染產品組合和其他產品。因此，目前剛推出的 12 個主要產品將在未來 4 年內推出。

The other factors are the productivity gains. We're very confident you see we've stepped down SG&A growth into 2024. Luke and I have worked very closely together. We are very confident that we can leverage the great base that we've built. And very importantly, some of those assets that are launching, particularly in respiratory, we've got very capable field forces in the areas where we're launching these assets. So the leverage capability is there. And you've seen us leverage the margin. We're committing to more than 500 basis points already by 2026. You'll see is we're never going to be satisfied. We are going to grow the top line.

其他因素是生產力的提高。我們非常有信心您會看到我們已將 SG&A 成長降低到 2024 年。盧克和我合作非常密切。我們非常有信心能夠利用我們已經建立的良好基礎。非常重要的是，在正在啟動的一些資產中，特別是在呼吸系統領域，我們在啟動這些資產的地區擁有非常有能力的現場部隊。所以槓桿能力是有的。您已經看到我們利用了利潤。我們承諾在 2026 年實現超過 500 個基點。您會發現我們永遠不會滿足。我們將增加營收。

The GBP 38 billion, we're saying above the GBP 38 billion, that's a risk-adjusted number, very importantly. Secondly, we continue to do business development. We've got the balance sheet to do it. It's part and parcel of building the R&D pipeline further. And also finally, that more than GBP 38 billion does not include those early-stage projects that Emma alluded to in her conversation. So we're very confident of withstanding the DTG patent expiry.

380 億英鎊，我們所說的高於 380 億英鎊，這是一個經過風險調整的數字，非常重要。其次，我們繼續做好業務發展。我們有資產負債表來做到這一點。這是進一步建置研發管道的重要組成部分。最後，超過 380 億英鎊的資金不包括艾瑪在談話中提到的那些早期項目。因此，我們非常有信心能夠承受 DTG 專利到期的考驗。

I mean in the end, the outlook that we're updating today, we have added GBP 5 billion top line versus where we were in the summer of '21, and we know there's still more to do. So we're confident on making further progress with a lot of ambition. Next question, please.

我的意思是，最後，我們今天更新的前景，與 21 年夏天相比，我們增加了 50 億英鎊的收入，而且我們知道還有更多工作要做。因此，我們有信心以雄心壯志取得進一步進展。請下一個問題。

So I'm going to come back to you, Jo. So hopefully, you can speak now.

所以我會回到你身邊，喬。希望您現在可以發言。

Could I ask about U.S.? Patients are already beginning to see lower co-pays as we go into 2024. Is there any benefit that you have in terms of less charitable giving to support people on Medicare who might need your assistance or any view that you have for some of your more expensive medications that there would be an increase in volume coming through?

可以問一下美國的情況嗎？進入 2024 年，患者的共付額已經開始降低。在減少慈善捐贈來支持 Medicare 可能需要您幫助的人方面，您有什麼好處嗎？或者您對某些更多的需求有什麼看法嗎？昂貴的藥物會增加治療量嗎？

And my second question would be to look a bit more about Shingrix in China. If we look at how Merck has dealt with their relationship with Zhifei and Gardasil, which has obviously been extremely successful, Merck is promoting as well as Zhifei is promoting. So given your relatively small base in China, can you tell us what you are doing to ensure that there is a strong uptake of Shingrix in China, so that over time, it will be more than the minimum amount of sales Zhifei is taking from you?

我的第二個問題是更多地了解 Shingrix 在中國的情況。如果我們看看默克如何處理與智飛和加衛苗的關係，這顯然非常成功，默克在推動，智飛也在推動。鑑於您在中國的基礎相對較小，您能否告訴我們您正在採取哪些措施來確保 Shingrix 在中國的廣泛應用，以便隨著時間的推移，它將超過智飛從您那裡獲得的最低銷售額？

Thanks, Jo. Both of those questions will come to Luke. We're after a record quarter on Shingrix, again, we really do see Zhifei as a very important building block for the ongoing growth of this great vaccine. So Luke, to you on that? Any other thoughts?

謝謝，喬。這兩個問題都會向盧克提出。我們在 Shingrix 創下了創紀錄的季度業績之後，再次，我們確實將智飛視為這種偉大疫苗持續增長的非常重要的組成部分。盧克，你對此有何看法？還有其他想法嗎？

Thanks, Jo. I'll cover to the China question first. So -- we -- the way the deal is structured, we still maintain the license in China, and we preserve 600 head count. We are promoting the product in addition to Zhifei's structure, which is several orders of magnitude larger. We also partner with them in terms of profile, positioning and life cycle work with Shingrix. So we're very engaged. And I think the partnership has started very well. there's high levels of trust. And you mentioned the Merck structure, which has been in place, I think, 11 years, nearly 12 years now, and that's been very successful. So our aim is to replicate or even exceed that. One thing to keep in mind with revenue recognition in China next year, it's driven by shipments. So there will be a bolus, which is between 60% and 80%, depending on how much we shift which will be recognized in quarter 2. So that's just one watch out. But yes, we're very excited about the long-term potential for Shingrix in China and the partnership and also the capacity to expand that to include RSV.

謝謝，喬。我首先談談中國問題。因此，我們——按照交易的結構方式，我們仍然保留在中國的許可，並且保留 600 名員工。我們正在推廣的產品除了智飛的結構之外，還要大幾個數量級。我們也在Shingrix 的概況、定位和生命週期工作方面與他們合作。所以我們非常投入。我認為這種夥伴關係已經開始得很好。信任度很高。你提到了默克的結構，我認為它已經存在了 11 年，現在已經接近 12 年了，而且非常成功。所以我們的目標是複製甚至超越它。明年在中國的收入確認需要記住的一件事是，它是由出貨量驅動的。因此，將會有一個推注，介於 60% 和 80% 之間，具體取決於我們將在第二季度確認的轉變程度。因此，這只是一個需要注意的地方。但是，是的，我們對 Shingrix 在中國的長期潛力、合作夥伴關係以及將其擴展到包括 RSV 的能力感到非常興奮。

In terms of co-pay assistance, indigent programs, et cetera, we do have extensive programs across the business in HIV, of course, oncology and other areas. We're not seeing an increase in those, Jo, but we do have extensive progress that people can take advantage of. And of course, the co-pay has now been removed from Shingrix and RSV, which is a big advantage for seniors citizens.

在共同支付援助、貧窮計畫等方面，我們確實在愛滋病毒、腫瘤學和其他領域的整個業務領域制定了廣泛的計畫。喬，我們沒有看到這些增加，但我們確實取得了人們可以利用的廣泛進展。當然，Shingrix 和 RSV 現在已經取消了共付額，這對老年人來說是一個很大的優勢。

So our next question is going to come from Simon Baker.

所以我們的下一個問題將來自西蒙·貝克。

Two if I may, please. Firstly, on Arexvy. Arexvy ex U.S., you've said in the past that you expect a Shingrix-like broadly flat global pricing for Arexvy. Given that that's now beginning to roll out, I just wonder if you could confirm if that's still the case and give us any updates on how things are going outside in terms of those negotiations?

如果可以的話，請給我兩個。首先，關於 Arexvy。 Arexvy ex 美國，您過去曾說過，您預計 Arexvy 的全球定價將與 Shingrix 類似，基本上持平。鑑於現在已經開始推出，我只是想知道您是否可以確認情況是否仍然如此，並向我們提供有關談判進展的任何最新資訊？

And then secondly, and forgive my pronunciation, I probably get this wrong. On the Aiolos acquisition, it's slightly earlier than we've seen from your acquisitions in the past where you've prepared -- been prepared to pay more for later-stage products. So I just wonder if you could give us an idea of whether this marks a shift in your business development approach or whether there was something particular about that [T-slip], which -- to go earlier than perhaps we've done in the past?

其次，請原諒我的發音，我可能會弄錯。關於 Aiolos 的收購，比我們在過去的收購中看到的要早一些，你們已經準備好為後期產品支付更多費用。因此，我只是想知道您能否告訴我們，這是否標誌著您的業務發展方法的轉變，或者該 [T 字條] 是否有什麼特別之處，這可能比我們在過去的？

Thanks very much. Well, let's come to Luke for some globalization of Arexvy though the U.S. will still be, by far, the biggest part of the business. But obviously, that's going to be a key contributor for the future. And then Tony to comment on the Aiolos deal, and our consistent approach strategically to BD, which starts with getting a very good return on the investment of that because of the sizable assets and their differentiation, which is definitely what we're excited about here. But first to you, Luke.

非常感謝。好吧，讓我們來了解一下 Arexvy 的全球化，儘管到目前為止，美國仍將是該業務的最大部分。但顯然，這將成為未來的關鍵貢獻者。然後托尼評論了 Aiolos 交易，以及我們對 BD 的一貫戰略方針，首先是因為規模龐大的資產及其差異化而獲得了非常好的投資回報，這絕對是我們在這裡感到興奮的地方。但首先是你，路克。

Thanks, Simon. Yes, I mean, as I said, we're approved in 39 countries. If you look below that, and it's very similar to what we've seen with Shingrix. It just takes time to assemble the arguments for the infrastructure in those countries to review the data. We know that some governments are waiting for that third season, which we'll have shortly. But if you look within that, of those 89 countries, we've got 9 that have issued recommendations and 4 that have voluntary reimbursement. So for example, I was in Germany yesterday, if you look at the 60-plus population, we've already got reimbursement through the 6 funds on about 24% of that population.

謝謝，西蒙。是的，我的意思是，正如我所說，我們在 39 個國家獲得了批准。如果你看下面，你會發現它與我們在 Shingrix 中看到的非常相似。只是需要時間來收集這些國家基礎設施的論點來審查數據。我們知道一些政府正在等待第三季，我們很快就會迎來第三季。但如果你仔細觀察一下，在這 89 個國家中，我們有 9 個國家提出了建議，有 4 個國家提出了自願報銷。例如，我昨天在德國，如果你看看 60 歲以上的人口，我們已經透過 6 個基金為大約 24% 的人口提供了報銷。

So it's early days. But in terms of pricing, our aim in the private market is to preserve that pricing level. Of course, always, we open if we can secure a contract because the structural nature of those contracts is such that we don't have to do the DTC, et cetera, that we need to do in the U.S., there's smaller sales forces because the system itself will pull through those scripts, the U.K. being a typical example. So early days, it's been exciting. And I mentioned China before. there, we're working actively to get Arexvy to China as quickly as possible.

所以現在還為時過早。但在定價方面，我們在私人市場的目標是維持定價水準。當然，如果我們能獲得合同，我們總是會開放，因為這些合同的結構性質使得我們不必做 DTC 等，而我們需要在美國做，銷售人員規模較小，因為系統本身將執行這些腳本，英國就是一個典型的例子。這麼早，這真是令人興奮。我之前提到過中國。在那裡，我們正在積極努力，盡快將 Arexvy 引入中國。

Thanks, Luke. Tony, comment on Aiolos and BD (inaudible).

謝謝，盧克。東尼，對艾俄洛斯和 BD 的評論（聽不清楚）。

Yes, Simon. So first of all, the way to think about Aiolos deal. Let me just reemphasize something to begin with. This is in the low [T2] population. So it gives us access to an additional 40% of the severe asthma population for which Nucala and depemokimab aren't addressed. Now similarly to Nucala and depemokimab. The reason we were confident to go early with the Aiolos asset is we have a very clear understanding of the PK/PD proposition there. So you can learn an awful lot with regards to projected dosing and efficacy through Phase Ib data, which is the case of Aiolos, and we look upon that as being a best-in-class opportunity, which will appear in the market, potentially first-in-class with a Q6M profile and well matched in depemokimab. Those features, I would say, emphasize a continuing focus that we'll have on BD with deals (inaudible) that scale to match our overall therapeutic area focus on in an appropriate strategic way of the factors that Emma just mentioned. For earlier deals, then what you should be expecting there is a focus more on the underpinning technologies that are transforming R&D for us.

是的，西蒙。所以首先，思考艾俄洛斯交易的方式。首先讓我再次強調一些事情。這是在低 [T2] 人群中。因此，它使我們能夠接觸到另外 40% 的 Nucala 和 depemokimab 未針對的嚴重氣喘族群。現在類似於 Nucala 和 depemokimab。我們之所以有信心儘早使用 Aiolos 資產，是因為我們對那裡的 PK/PD 主張有非常清晰的了解。因此，您可以通過 Ib 期數據（Aiolos 的情況）了解有關預計劑量和功效的大量信息，我們認為這是一個一流的機會，它將出現在市場上，可能是第一個- 具有Q6M 特性，與depemokimab 完美匹配。我想說，這些功能強調了我們對 BD 的持續關注，其交易規模（聽不清楚）與我們的整體治療領域重點相匹配，以適當的戰略方式關注艾瑪剛才提到的因素。對於早期的交易，您應該期望更多地關注正在為我們改變研發的基礎技術。

Thank you. And obviously, extremely clear as our top priority in the capital allocation framework and as Julie laid out in her slides around allocation of capital. That's a consistent approach we're taking and was all part of the demerger strategy to create that balance sheet capacity for us to put a BD as the way we do R&D at GSK now as it is across the industry. Next question please.

謝謝。顯然，這非常明確，這是我們在資本配置框架中的首要任務，正如朱莉在她的幻燈片中圍繞資本配置所闡述的那樣。這是我們一貫採取的方法，也是分拆策略的一部分，旨在為我們創造資產負債表能力，將 BD 作為我們現在在葛蘭素史克（GSK）和整個行業進行研發的方式。請下一個問題。

Okay? So we've got about 7 people with their hands raise with about 10 minutes left. So if I can ask people to keep the questions short and equally, we'll try and keep answers concise. But our next question is going to come from Tim Anderson at Wolfe Research.

好的？距離還剩 10 分鐘左右，大約有 7 個人舉手了。因此，如果我可以要求人們保持問題簡短且平等，我們將盡力保持答案簡潔。但我們的下一個問題將來自沃爾夫研究中心的蒂姆·安德森。

If I could go back to Shingrix in China and just drawing the analogy to Merck's Gardasil or even your server. The question I have is the disease awareness among the general population about shingles versus cervical cancer vaccine because with Gardasil, there's been a high consumer awareness that's really kind of created this classic poll demand at the consumer level, but I don't have a feel for is what is it like with shingles among consumers in China. Is the awareness -- disease awareness high? Or do you have to build that?

如果我能回到中國的 Shingrix 並與默克的 Gardasil 甚至你們的伺服器進行類比。我的問題是一般人群對帶狀皰疹和子宮頸癌疫苗的疾病認識，因為有了加衛苗，消費者的認識就很高，這確實在消費者層面創造了這種經典的民意調查需求，但我不覺得這就是中國消費者對帶狀皰疹的看法。對疾病的認識是否高？或者你必須建造它嗎？

Yes. Thanks, Tim. It's relatively low. But I was in China at the stage when Gardasil did launch and awareness around HPV vaccination, it was also very low. What we found through our market research is that people are receptive to it. The main challenge we had was just navigating the 30,000 points of vaccination in China because all vaccines need to be administered in those centers. So I think we can build that awareness. And whether we can get to the level of Gardasil did. I think before COVID, it was actually the #1 selling product in China, so a remarkable achievement. The key thing I took away from that is, one, you've got a company that partners well with multinational over many years with extensions to that relationship. And two, they can build a market in partnership very successfully. So yes, I'm very optimistic about the long-term outlook there with China.

是的。謝謝，蒂姆。這是相對較低的。但我當時在中國，正值加德西 (Gardasil) 推出的階段，人們對 HPV 疫苗的認識也很低。我們透過市場調查發現人們對此很容易接受。我們面臨的主要挑戰是在中國 30,000 個疫苗接種點進行導航，因為所有疫苗都需要在這些中心進行接種。所以我認為我們可以建立這種意識。以及我們能否達到加德西的水準。我認為在新冠疫情之前，它實際上是中國銷量第一的產品，這是一個了不起的成就。我從中得到的關鍵一點是，第一，你擁有一家與跨國公司多年來保持良好合作關係的公司，而這種關係得到了擴展。第二，他們可以非常成功地合作建立市場。所以，是的，我對中國的長期前景非常樂觀。

Thanks, Luke. Next question, please.

謝謝，盧克。請下一個問題。

We take our next question from Richard Parkes of BNP Paribas.

我們接受法國巴黎銀行的理查德·帕克斯 (Richard Parkes) 提出的下一個問題。

I can stick to one. I just wondered if you could just discuss the challenges to specifically growing RSV in the U.S. market next year? It looks like about 10% of the eligible population has been vaccinated with an RSV vaccine now. And obviously, clearly, that leaves a lot of room for growth given the 35% penetration you've achieved with Shingrix, but it's taking you 6 years to get to that level. And clearly, the RSV market competition is going to intensify over the next 12 months. So given that the very strong start you've had, I'm just wondering how challenging it will be to grow RSV specifically in the U.S. market and to what extent we should expect growth to be more driven by ex U.S.?

我可以堅持一個。我只是想知道您是否可以討論一下明年在美國市場專門種植 RSV 所面臨的挑戰？目前看來，大約 10% 的符合條件的人群已經接種了 RSV 疫苗。顯然，鑑於您透過 Shingrix 實現了 35% 的滲透率，這留下了很大的成長空間，但您需要 6 年才能達到這一水平。顯然，RSV 市場競爭將在未來 12 個月內加劇。因此，鑑於你們已經有了非常強勁的開局，我只是想知道在美國市場上成長 RSV 會有多大的挑戰性，以及我們應該在多大程度上預期成長將更多地由美國以外的市場推動？

Sure, Richard. Great question. So I think the pie is going to grow. You've got 3 companies in there. The level of awareness is remarkable already. I think it's 86% awareness for individuals in the U.S. around RSV, the willingness to prescribe and recommend on part of doctors and pharmacists is very, very positive. And your numbers are right. I mean, if you look at Shingrix, we're 4%, 11%, 17%, 23% in those first years. So hitting 11% immediately is encouraging, but we just don't know what the other 2 competitors, how they're going to behave going into the year, so that's an unknown. But again, if we look at the long term, if you look at 65-plus individuals to a 65% and above about 72%, 73% and typically every year, get a flu vaccine. So that's the potential here, and that's why we're very confident about our long-term GBP 3 billion peak revenue outlook. But it will -- let's see how we go in 2024. It's probably all I should say at this point.

當然，理查德。很好的問題。所以我認為蛋糕會越來越大。你那裡有3家公司。人們的意識水平已經非常了不起。我認為美國人對 RSV 的認知度為 86%，部分醫生和藥劑師開處方和建議的意願非常非常積極。你的數字是正確的。我的意思是，如果你看看 Shingrix，我們在最初幾年的比例分別是 4%、11%、17%、23%。因此，立即達到 11% 是令人鼓舞的，但我們只是不知道其他 2 個競爭對手是什麼，他們在今年的表現如何，所以這是一個未知數。但同樣，如果我們著眼於長期，如果你觀察 65 歲以上的人，有 65% 及以上的人接種流感疫苗，比例約為 72%、73%，通常每年都會接種。這就是這裡的潛力，這就是為什麼我們對 30 億英鎊的長期高峰收入前景非常有信心。但它會——讓我們看看 2024 年會如何。這可能是我現在應該說的。

Worthwhile adding the cost of the 50-plus label (inaudible) the 15 million at risk eligible individuals.

值得加上 50 多個標籤（聽不清楚）的 1500 萬處於危險中的合格個人的成本。

Okay. Next question is from Andrew Baum, Citi.

好的。下一個問題來自花旗銀行的安德魯·鮑姆 (Andrew Baum)。

Andrew, we can't hear you.

安德魯，我們聽不到你的聲音。

There we go. Sorry about that. I apologize. So 2 questions for Deborah on HIV. First, given how important the switch is to long-acting for both the margin and the revenues, could you talk to what are the current barriers to adoption? Is it any evidence for step editing given you've got 50% falling under PBMs. Is it clinical inertia? Is it access? I'm curious to understand that in terms of the risks and opportunities there?

我們開始吧。對於那個很抱歉。我道歉。黛博拉有兩個關於愛滋病毒的問題。首先，考慮到轉向長效對於利潤和收入的重要性，您能否談談目前採用的障礙是什麼？鑑於您有 50% 屬於 PBM，這是否有任何步驟編輯的證據？是臨床惰性嗎？是訪問嗎？我很想了解其中的風險和機會？

And then second, I note that there's been a pause placed on your litigation with Exavir for their cabo pro drug. Given the patent expiration on cabo and I'm thinking particularly about Apretude, is there any interest in licensing this compound in order to secure the future of a once-yearly long-acting prep formulation?

其次，我注意到你們與 Exavir 就 Cabo Pro 藥物提起的訴訟已暫停。鑑於 cabo 的專利即將到期，而且我特別考慮的是 Apretude，是否有興趣獲得該化合物的許可，以確保每年一次的長效製劑製劑的未來？

Thanks, Andrew. So in terms of barriers to switch in the long-acting market, actually, they're pretty typical to the barriers that you see across many long-acting injectables that are in the Medicare Part B, and part is about clinic capacity. So for us, that is a barrier, but we're seeing the belief in physicians increase that long-acting is going to be favorably a bigger part of the way that they treat their HIV patient population. So we are seeing them expanding capacity to bit as a slow journey.

謝謝，安德魯。因此，就長效市場轉換的障礙而言，實際上，它們與您在 Medicare B 部分中看到的許多長效注射劑中看到的障礙非常典型，其中一部分與診所的能力有關。所以對我們來說，這是一個障礙，但我們看到醫生越來越相信長效藥物將在他們治療愛滋病患者群體的方法中佔據更大的比例。因此，我們看到他們擴大產能是一個緩慢的過程。

The second thing is the ability to get physicians' offices ready and able to manage their way through the benefit verification, the element of specialty pharmacy versus buy-and-build. Again, we are seeing more and more uptake and more and more process flows within the clinician offices that are making this faster and slicker but still is a learning journey as we are building a brand-new market for HIV physicians. So I would say complexity around payer and pharmacy buy-and-build and the capacity to inject in the clinics, the 2 biggest barriers, and we're seeing significant progress on all of those areas, which is why we're seeing the continued significant growth amongst long-acting injectables in both preps and in treatment mainly because there is enormous patient demand, and that just keeps on growing as awareness grows.

第二件事是能夠讓醫生辦公室做好準備並能夠透過利益驗證來管理他們的方式，這是專業藥房與購買和建造的要素。我們再次看到臨床醫生辦公室內越來越多的採用和越來越多的流程，這使得這一過程變得更快、更順暢，但仍然是一個學習之旅，因為我們正在為愛滋病毒醫生建立一個全新的市場。因此，我想說，付款人和藥房購買和建設的複雜性以及診所注射的能力是兩個最大的障礙，我們在所有這些領域都看到了重大進展，這就是為什麼我們看到持續不斷的進展長效注射劑在準備和治療中的顯著增長主要是因為患者的需求龐大，而且隨著意識的增強，這種需求也不斷增長。

In terms of Exivir, I'm not going to comment on any of the litigation, but we have our own in-house long-acting injectable that we were formulating cabotegravir to get to every 4 and hopefully, we'll be able to get throughput where we can get to every 6 months, either with VH184 or other options. And we've also got in-house options that can take us to every 12 months but we keep an eye on the whole landscape from a BD perspective of HIV. And if there is something to do a deal on, we will actually do that.

就 Exivir 而言，我不會對任何訴訟發表評論，但我們有自己的內部長效注射劑，我們正在配製 cabotegravir，以達到每 4 個，希望我們能夠獲得通過VH184 或其他選項，我們可以達到每6個月一次的吞吐量。我們還提供了每 12 個月一次的內部選項，但我們從愛滋病毒的 BD 角度密切關注整個情況。如果有什麼事情需要達成協議，我們實際上就會這麼做。

Next question please.

請下一個問題。

Okay. Our next question is from Graham Parry at Bank of America.

好的。我們的下一個問題來自美國銀行的格雷厄姆·帕里。

It's -- going back to Arexvy in the third season data, can you just confirm that there's no vaccine efficacy measurement to compare one and done vaccination with and every other year vaccination in either the RSV 006 or 004 trials? And if it is just immunogenicity data that you're going to be using there, how do you go to ACIP and convince them that a boost in immunogenicity in the third season would correlate with vaccine efficacy when we didn't see that in the first season in data?

回到 Arexvy 第三季的數據，您能否確認，在 RSV 006 或 004 試驗中，沒有疫苗功效測量可以將一次接種和已完成的疫苗接種與每隔一年的疫苗接種進行比較？如果你要在那裡使用的只是免疫原性數據，你如何去 ACIP 並說服他們第三季免疫原性的增強將與疫苗功效相關，而我們在第一季沒有看到這一點數據季節？

And then second question, just any sense of what percentage of the high-risk or comorbid population, so let's say, over 80s or the comorbid population has been vaccinating with the Arexvy now? Or has it been across a fairly broad age range?

然後是第二個問題，高風險或合併症族群（例如 80 歲以上或合併症族群）現在接種了 Arexvy 疫苗的比例是多少？或者它已經跨越了相當廣泛的年齡範圍？

So very briefly, Luke, any comment on the penetration (inaudible).

盧克，非常簡單地說，關於滲透的任何評論（聽不清楚）。

Yes, it's about 13% in the older individuals, so 65-plus. It's about 4% in the 60 to 64. That's the only data we have at this point, Graham, but we will get more in Q2.

是的，老年人（65 歲以上）的比例約為 13%。 60 到 64 歲之間的比例約為 4%。格雷厄姆，這是我們目前擁有的唯一數據，但我們將在第二季度獲得更多數據。

And on the third season, the comparison will be exactly the same as the one we took in second season, Graham. So that is vaccine efficacy based on a 3-year duration versus a 3-year (inaudible). Sorry, 2-year.

在第三季中，比較將與我們在第二季中進行的完全一樣，格雷厄姆。這就是基於 3 年持續時間與 3 年持續時間（聽不清楚）的疫苗功效。對不起，2年了。

Yes. Okay. So I'm going to try and push us a little bit over a [mindful] of the call starting, but we can take the next question from Mark Purcell at Morgan Stanley.

是的。好的。因此，我將嘗試讓我們稍微關註一下電話會議的開始，但我們可以回答摩根士丹利的馬克·珀塞爾的下一個問題。

Just a quick one, sticking on HIV. Ahead of the CROI data, historically, Phase II data has translated very nicely into Phase III profile. So when it comes to assessing your combination options and the 4-month formulations, how confidently should we be extrapolating Phase II data into Phase III and effectively the derisking of the portfolio strategy?

只是一個快速的，堅持愛滋病毒。從歷史上看，在 CROI 數據之前，第二階段的數據已經很好地轉化為第三階段的概況。因此，在評估您的組合選項和 4 個月配方時，我們應該如何自信地將第二階段的數據外推到第三階段並有效地降低投資組合策略的風險？

So just to answer that very quickly. So we're incredibly confident in our ability to replace a significant proportion of the revenue that will be lost through the dolutegravir patents expiry. This is a big year for us. So we'll be presenting data at CROI, we'll be starting the Phase III study for every 4-month prep. We'll be regimen selecting every 4 month for treatment and we'll also be regimens selecting for (inaudible). So I would say we're extremely confident in the progression of our HIV pipeline. And very confident in the statement that we've been making for some time that we will be able to potentially replace a significant proportion of the revenue that you'll lose when dolutegravir goes.

所以我只想快速回答這個問題。因此，我們對彌補因多替拉韋專利到期而損失的大部分收入的能力充滿信心。今年對我們來說是重要的一年。因此，我們將在 CROI 上展示數據，我們將在每 4 個月的準備階段開始 III 期研究。我們將每 4 個月選擇一次治療方案，我們也將選擇（聽不清楚）治療方案。所以我想說，我們對愛滋病毒管道的進展非常有信心。我們對一段時間以來一直發表的聲明非常有信心，即我們將有可能彌補多替拉韋失效後您將損失的很大一部分收入。

We've got 2 more questions. I'm going to take the next question from Kerry Holford of Berenberg.

我們還有 2 個問題。我將回答貝倫貝格 (Berenberg) 的克里·霍爾福德 (Kerry Holford) 提出的下一個問題。

Thanks, Nick. Just one final pipeline question, well, recently launched product question, Ojjaara, I know it's early days but how is the U.S. launch progressing relative to expectations? And in which line of therapy are patients predominantly using this drug?

謝謝，尼克。最後一個管道問題，嗯，最近推出的產品問題，Ojjaara，我知道現在還處於早期階段，但相對於預期，美國的推出進展如何？患者主要在哪一種治療中使用這種藥物？

Very well, Luke?

很好，盧克？

I'll go quickly. So 750 patients since launch, 43% of them are in academic centers, 57% are in community centers. Market research is very, very encouraging. Unaided awareness is well above benchmarks, aided awareness is 99%. I'm not sure about that 1%. We've got around 15% patient share in patients with anemia and about 25% share in the second line. If you look at the intent to prescribe 1/4 of doctors have already prescribed it, and over 64% who have not prescribed intent to prescribe over the next few months. So very encouraging, very exciting launch.

我快點走吧。自推出以來已有 750 名患者，其中 43% 在學術中心，57% 在社區中心。市場研究非常非常令人鼓舞。獨立意識遠高於基準，輔助意識為 99%。我不確定那1%。我們大約有 15% 的患者患有貧血，大約 25% 的患者接受二線治療。如果你看看開處方的意願，1/4 的醫生已經開過處方，超過 64% 的未開處方的醫生打算在未來幾個月內開處方。這是非常令人鼓舞、非常令人興奮的發射。

Great. And so last question, Nick.

偉大的。最後一個問題，尼克。

Last question. So Steve Scala, TD Cowen.

最後一個問題。史蒂夫·斯卡拉（Steve Scala），TD·考恩（TD Cowen）。

On Cabenuva, emerging resistance in 1% to 2% of people is viewed by clinicians as a real risk seems to occur in the obese population, but could tarnish prospects overall. So I'm just wondering what is GSK's position on this? And secondly, pneumococcal vaccine, do you plan an efficacy study? And if not, is that because you think that is not important?

在 Cabenuva 上，臨床醫生認為 1% 至 2% 的人出現的抗藥性似乎在肥胖族群中存在真正的風險，但可能會損害整體前景。所以我想知道葛蘭素史克對此有何立場？其次，對於肺炎鏈球菌疫苗，您是否計劃進行功效研究？如果不是，那是因為您認為這不重要嗎？

Well, we do think the pneumococcal vaccine is very important, but -- so Tony can comment on that. But Deborah, I'm not sure we characterize it quite as Steve has though.

嗯，我們確實認為肺炎球菌疫苗非常重要，但是——所以托尼可以對此發表評論。但是黛博拉，我不確定我們對它的描述是否像史蒂夫那樣。

So you've got less than 1% failure on Cabenuva. There are some risk factors that all physicians are aware of, obesity is one of them. Being resistant to rilpivirine is the other. And then there is a sort of [pet] relatively rare subtype, so we are clearly characterizing where people should not use the drug. It's a very limited population. And the real-world evidence is actually showing less than 1%, in fact, significantly less than 1% failure because physicians have taken on board the multivariate analysis that guides where to use it. And when they use it in that population, you see very low levels of failure and very, very high satisfaction with the drug and continuity on the drug over time. So that's why we're seeing significant growth with Cabenuva that we are.

所以 Cabenuva 的失敗率不到 1%。所有醫生都知道一些危險因素，肥胖就是其中之一。對利匹韋林抗藥性是另一回事。還有一種相對罕見的[寵物]亞型，因此我們明確描述了人們不應該使用該藥物的地方。這是一個非常有限的人口。現實世界的證據實際上顯示失敗率不到 1%，事實上，顯著低於 1%，因為醫生已經採用了多變量分析來指導在哪裡使用它。當他們在該族群中使用它時，您會發現失敗率非常低，並且對藥物的滿意度非常非常高，隨著時間的推移，藥物的連續性也非常高。這就是為什麼我們看到 Cabenuva 的顯著增長。

Thanks. Tony?

謝謝。托尼？

Just quickly then on pneumococcal. Obviously, we're focused on using immunogenicity data and in particular, restarting the infant [24mg/ml] this year alongside the data that we have in adult and starting in adults 30+. In terms of our strategies with regards to vaccine efficacy and broader competitive content of that, I'll keep that to future discussions.

很快就肺炎球菌。顯然，我們專注於使用免疫原性數據，特別是今年重新啟動嬰兒 [24mg/ml] 以及我們在成人和 30 歲以上成年人中開始的數據。就我們在疫苗功效和更廣泛的競爭內容方面的策略而言，我將保留到未來的討論中。

Great. So thank you very much, everyone, for the call. I'm very pleased to have been able to share with the team today, how GSK is delivering on its commitments, strengthening our outlook for growth, we are making great progress. We know there's always more to do, and we're looking forward to keeping you updated. Thanks to everybody for joining the call.

偉大的。非常感謝大家的來電。我很高興今天能夠與團隊分享葛蘭素史克如何履行其承諾，加強我們的成長前景，我們正在取得巨大進展。我們知道總有更多事情要做，我們期待為您提供最新資訊。感謝大家加入通話。