禮來公司 (LLY) 2017 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by.

女士們，先生們，謝謝你們的支持。

Welcome to the Q3 2017 earnings conference call.

歡迎參加 2017 年第三季度財報電話會議。

(Operator Instructions) And as a reminder, today's conference call is being recorded.

（操作員說明）作為提醒，今天的電話會議正在錄音中。

I would now like to turn the conference call over to your first speaker, Dave Ricks.

我現在想將電話會議轉交給您的第一位發言人戴夫·里克斯（Dave Ricks）。

Please go ahead.

請繼續。

Good morning.

早上好。

Thank you for joining us for Eli Lilly and Company's Third Quarter 2017 Earnings Call.

感謝您參加禮來公司 2017 年第三季度財報電話會議。

I'm Dave Ricks, Lilly's Chairman and CEO.

我是禮來公司董事長兼首席執行官戴夫·里克斯。

Joining me on the call today are Derica Rice, our Chief Financial Officer; Josh Smiley, currently our Treasurer and the CFO-elect; Dr. Jan Lundberg, President of Lilly Research Laboratories; Enrique Conterno, President of Lilly Diabetes and Lilly U.S.A.; Dr. Sue Mahony, President of Lilly Oncology; Christi Shaw, President of Lilly Biomedicines; and Jeff Simmons, President of Elanco Animal Health.

今天和我一起參加電話會議的是我們的首席財務官 Derica Rice； Josh Smiley，現任我們的財務主管和當選首席財務官；禮來研究實驗室總裁 Jan Lundberg 博士； Enrique Conterno，禮來糖尿病和禮來美國公司總裁；禮來腫瘤學總裁 Sue Mahony 博士；禮來生物醫藥總裁 Christi Shaw；和 Elanco Animal Health 總裁 Jeff Simmons。

We're also joined by Kristina Wright, Chris Ogden and Phil Johnson of the IR team.

IR 團隊的 Kristina Wright、Chris Ogden 和 Phil Johnson 也加入了我們的行列。

This will be the last earnings call for 2 senior executives that have been instrumental in our company's success.

這將是兩位對我們公司的成功發揮重要作用的高級管理人員的最後一次財報電話會議。

At the end of the year, Maria Crowe, President of Manufacturing Operations; and Derica Rice, our CFO, will retire.

年底，製造運營總裁 Maria Crowe；我們的首席財務官 Derica Rice 將退休。

Maria has helped Lilly earn the trust of patients we serve by making medicines with the highest levels of quality and safety.

Maria 通過製造具有最高質量和安全水平的藥物，幫助禮來贏得了我們所服務的患者的信任。

Derica played a key role in leading Lilly for the challenging period of patent expirations we called Years YZ and emerging as a much stronger company.

德里卡在領導禮來公司度過我們稱之為 YZ 年專利到期的充滿挑戰的時期並成為一家更強大的公司方面發揮了關鍵作用。

Both have built strong organizations that will carry on their work.

兩者都建立了強大的組織來繼續他們的工作。

So beginning here, please join me in a round of applause to thank both of them for their contributions to our company.

所以從這裡開始，請和我一起用熱烈的掌聲感謝他們兩位對我們公司的貢獻。

During this conference call, we anticipate making projections and forward-looking statements based on our current expectations.

在這次電話會議期間，我們預計會根據我們目前的預期做出預測和前瞻性陳述。

Our actual results could differ materially due to a number of factors, including those listed on Slide 3 and those outlined in our latest Forms 10-K and 10-Q filed with the SEC.

由於多種因素，我們的實際結果可能存在重大差異，包括幻燈片 3 中列出的因素以及我們向 SEC 提交的最新表格 10-K 和 10-Q 中概述的因素。

The information we provide about our products and pipeline is for the benefit of the investment community.

我們提供的有關我們的產品和管道的信息是為了投資界的利益。

It is not intended to be promotional, and it's not sufficient for prescribing decisions.

它不是為了宣傳，也不足以做出決定。

In Q3, we generated worldwide revenue growth of 9%, driven by volume growth in our human pharmaceutical business, once again, led by our newest products.

在第三季度，我們的全球收入增長了 9%，這得益於我們的人用製藥業務的銷量增長，再次受到我們最新產品的帶動。

I'd also highlight the outstanding performance of our diabetes products, which in total grew 39% this quarter.

我還要強調我們的糖尿病產品的出色表現，本季度該產品總共增長了 39%。

We also continue to expand on our margins.

我們還繼續擴大我們的利潤。

Including the effect of foreign exchange -- excluding the effects of foreign exchange on international inventory sold, gross margin as a percent of revenue increased by over 70 basis points, and total operating expenses as a percent of revenue declined by over 310 basis points to 50.8%.

包括外彙的影響——不包括外匯對銷售的國際庫存的影響，毛利率佔收入的百分比增加了 70 多個基點，總運營費用佔收入的百分比下降了 310 多個基點至 50.8 %。

Our pipeline progress continued.

我們的管道進展仍在繼續。

Highlights include: the FDA approved - and we launched - Verzenio, the U.S. trade name for abemaciclib for advanced breast cancer based on the MONARCH 1 and MONARCH 2 trials.

亮點包括： FDA 批准 - 我們推出了 - Verzenio，這是基於 MONARCH 1 和 MONARCH 2 試驗的晚期乳腺癌 abemaciclib 的美國商品名。

We submitted the BLA for galcanezumab for migraine prevention, and we initiated the Phase III program for our ultra-rapid insulin.

我們提交了用於預防偏頭痛的 galcanezumab 的 BLA，並啟動了超快速胰島素的 III 期計劃。

In terms of capital deployment, we entered into a global immuno-oncology collaboration with CureVac AG, focused on the development and commercialization of up to 5 cancer vaccine products based on CureVac's RNActive technology.

在資本配置方面，我們與 CureVac AG 達成了全球免疫腫瘤學合作，專注於基於 CureVac 的 RNActive 技術的多達 5 種癌症疫苗產品的開發和商業化。

And we returned over $500 million to our shareholders through our dividend.

我們通過股息向股東返還了超過 5 億美元。

In other news, we received an important ruling upholding our Alimta method-of-use patent in the U.S. IPR proceeding.

在其他新聞中，我們收到了一項重要裁決，支持我們在美國知識產權訴訟中的 Alimta 使用方法專利。

If upheld through all remaining challenges, Alimta would maintain U.S. exclusivity until May of 2022.

如果在所有剩餘挑戰中都能堅持下去，Alimta 將在 2022 年 5 月之前保持美國的排他性。

Our performance in 2017 keeps us on track to achieve our midterm goals for each of our strategic objectives.

我們在 2017 年的表現使我們能夠實現每個戰略目標的中期目標。

Slides 5 and 6 contain more details on these events as well as other key events since our July earnings call.

幻燈片 5 和 6 包含有關這些事件以及自 7 月財報電話會議以來其他關鍵事件的更多詳細信息。

I'd highlight that we've submitted abemaciclib for advanced breast cancer in Europe and Japan, and the U.S. FDA granted a priority review designation for the abemaciclib MONARCH 3 NDA.

我要強調的是，我們已經在歐洲和日本提交了用於晚期乳腺癌的 abemaciclib，美國 FDA 授予了 abemaciclib MONARCH 3 NDA 的優先審查指定。

Along with Incyte, we announced that the NDA for baricitinib in RA will be resubmitted before the end of January '18.

與 Incyte 一起，我們宣布將在 18 年 1 月結束之前重新提交用於 RA 的 baricitinib 的 NDA。

After further discussions with the FDA, we've also submitted the sNDA to include the KEYNOTE-021G data in the Alimta label.

在與 FDA 進一步討論後，我們還提交了 sNDA，將 KEYNOTE-021G 數據包含在 Alimta 標籤中。

We announced a series of actions to accelerate our efforts to focus our resources on developing new medicines and improve our cost structure.

我們宣布了一系列行動，以加快我們的努力，將我們的資源集中在開發新藥和改善我們的成本結構上。

And earlier this morning, we announced that we are reviewing strategic alternatives for our Elanco Animal Health business, including an IPO, a merger, sale or retaining the business.

今天早上早些時候，我們宣布我們正在審查 Elanco 動物保健業務的戰略選擇，包括首次公開募股、合併、出售或保留該業務。

Moving to our financial results.

轉向我們的財務業績。

Slide 7 summarizes our presentation of GAAP results and non-GAAP measures, while Slide 8 provides a summary of our GAAP results.

幻燈片 7 總結了我們對 GAAP 結果和非 GAAP 措施的介紹，而幻燈片 8 提供了我們的 GAAP 結果的摘要。

I'll focus my comments on our non-GAAP adjusted measures to provide insight into the underlying trends in our business.

我將把我的評論集中在我們的非公認會計原則調整措施上，以深入了解我們業務的潛在趨勢。

So please refer to today's earnings press release for the detailed description of the year-on-year changes in our third quarter GAAP results.

因此，請參閱今天的收益新聞稿，詳細描述我們第三季度 GAAP 業績的同比變化。

Looking at the non-GAAP measures on Slide 9, you can see the revenue increase of 9% that I mentioned earlier.

查看幻燈片 9 上的非 GAAP 指標，您可以看到我之前提到的 9% 的收入增長。

Gross margin as a percent of revenue decreased to 75.1%.

毛利率佔收入的百分比下降至 75.1%。

This decrease was primarily driven by the effect of foreign exchange rates on international inventories sold and negative product mix, partially offset by manufacturing efficiencies.

這一下降主要是由於外匯匯率對已售國際庫存和負產品組合的影響，部分被製造效率所抵消。

Excluding the effect of FX on international inventories sold, gross margin as a percent of revenue increased by over 70 basis points.

排除外匯對已售國際庫存的影響，毛利率佔收入的百分比增加了 70 多個基點。

Total operating expenses increased 3%, with marketing, selling and administrative expenses decreasing 1% and R&D expenses increasing 7%.

總運營費用增長 3%，其中營銷、銷售和管理費用下降 1%，研發費用增長 7%。

As mentioned earlier, as a percent of revenue, OpEx declined by over 310 basis points.

如前所述，作為收入的百分比，OpEx 下降了 310 多個基點。

The decrease in marketing, selling and administrative expenses was driven by lower spending on late-life cycle products, partially offset by higher spending on our new products.

營銷、銷售和管理費用的減少是由於後期產品支出的減少，部分被我們新產品的支出增加所抵消。

The increase in R&D expenses was driven by a milestone payment related to the BACE inhibitor we're developing in collaboration with AstraZeneca and, to a lesser extent, higher late-stage clinical development costs.

研發費用的增加是由於與我們與阿斯利康合作開發的 BACE 抑製劑相關的里程碑付款，以及在較小程度上較高的後期臨床開發成本。

Other income and expense was an expense of $14 million this quarter compared to income of $27 million in last year's quarter.

本季度的其他收入和支出為 1400 萬美元，而去年同期的收入為 2700 萬美元。

Our tax rate was 18.9%, a decrease of 310 basis points compared to the same quarter last year, primarily driven by a net discrete tax benefit this quarter of approximately $30 million.

我們的稅率為 18.9%，與去年同期相比下降了 310 個基點，主要是由於本季度約 3000 萬美元的淨離散稅收優惠。

At the bottom line, net income and earnings per share both increased 19%.

歸根結底，淨收入和每股收益均增長了 19%。

We achieved this significant earnings growth by delivering high single-digit volume-based revenue growth while significantly reducing our OpEx ratio, creating positive leverage.

我們通過實現基於數量的高個位數收入增長，同時顯著降低我們的運營支出比率，創造了積極的槓桿作用，實現了這一顯著的收益增長。

Slide 10 details the same non-GAAP measures for September year-to-date, while Slide 11 provides a reconciliation between reported and non-GAAP EPS.

幻燈片 10 詳細介紹了今年 9 月至今的相同非公認會計原則措施，而幻燈片 11 提供了報告和非公認會計原則每股收益之間的對賬。

You'll find additional details on these adjustments on Slide 24 and Slide 25.

您將在幻燈片 24 和幻燈片 25 上找到有關這些調整的更多詳細信息。

Moving to Slide 12, let's take a look at the effect of price, rates and volume on revenue growth.

轉到幻燈片 12，讓我們來看看價格、費率和數量對收入增長的影響。

The effect of foreign exchange was minimal this quarter.

本季度外彙的影響微乎其微。

Excluding the slight headwind from FX, our worldwide revenue growth on a performance basis was 9% and was driven by volume, to a much lesser extent, by price.

排除外匯帶來的輕微不利因素，我們的全球收入增長為 9%，主要受銷量驅動，價格驅動的幅度要小得多。

It's worth noting in our human pharma business, each major geography showed volume growth again this quarter.

值得注意的是，在我們的人類製藥業務中，本季度每個主要地區的銷量都再次出現增長。

By geography, you'll notice that U.S. pharma revenue increased 10%, primarily driven by volume.

從地理位置來看，您會注意到美國製藥公司的收入增長了 10%，主要是受銷量的推動。

Trulicity, Basaglar and Taltz were the main drivers of this growth, with recent loss of exclusivity leading to large volume declines for both Strattera and Effient.

Trulicity、Basaglar 和 Taltz 是這種增長的主要驅動力，最近失去了排他性，導致 Strattera 和 Effient 的銷量大幅下降。

It's also worth noting that last year's third quarter included $145 million benefit from a Cymbalta returns reserve reversal.

還值得注意的是，去年第三季度包括來自 Cymbalta 回報準備金逆轉的 1.45 億美元收益。

Excluding this from the base period, our U.S. product growth was 17%.

從基期中排除這一點，我們的美國產品增長率為 17%。

Moving to Europe.

搬到歐洲。

Pharma revenue grew 7%, excluding FX, driven almost entirely by volume despite headwinds on Alimta due to generic erosion in certain countries as well as competitive and pricing pressures.

醫藥收入增長 7%，不包括外匯，儘管由於某些國家的仿製藥侵蝕以及競爭和定價壓力，Alimta 面臨不利因素，但幾乎完全由銷量推動。

Excluding Alimta, the rest of our European pharma revenue grew 13% on a performance basis.

不包括 Alimta，我們其餘的歐洲製藥收入在業績基礎上增長了 13%。

This was led by Trulicity.

這是由 Trulicity 領導的。

In Japan, despite a large negative impact from the entry of generic Zyprexa last June, pharma revenue increased 13%, excluding FX.

在日本，儘管去年 6 月仿製藥 Zyprexa 的進入產生了巨大的負面影響，但不包括外彙在內的製藥收入增長了 13%。

Excluding Zyprexa, the rest of our Japan pharma revenue grew 17% in performance terms this quarter, led by Cyramza, Cymbalta and Trulicity.

除 Zyprexa 外，本季度我們在日本的其他製藥收入增長了 17%，其中 Cyramza 、 Cymbalta 和 Trulicity 領先。

Our pharma revenue in the rest of world increased 9% on a performance basis this quarter, led by Humalog and Trulicity.

本季度，在 Humalog 和 Trulicity 的帶動下，我們在世界其他地區的製藥收入增長了 9%。

Turning to animal health.

轉向動物健康。

Excluding the impact of FX, worldwide revenue increased 4%, driven by volume.

剔除外彙的影響，全球收入在銷量的推動下增長了 4%。

Food animal product revenue declined by 7%, while companion animal product revenue increased 34%.

食用動物產品收入下降了 7%，而伴侶動物產品收入增長了 34%。

On a performance basis, excluding the BI U.S. vaccines acquisition and adjusting for last year's purchasing patterns, our animal health revenue decreased 10%, with food animal product revenue down 7% and companion animal product revenue down 17%.

在業績基礎上，不包括 BI 美國疫苗的收購和對去年採購模式的調整，我們的動物保健收入下降了 10%，食用動物產品收入下降 7%，伴侶動物產品收入下降 17%。

The food animal decline was driven primarily by market access pressure as well as by competitive pressure in U.S. cattle, while the companion animal decline was due to competitive pressures affecting Trifexis, our flea, heartworm and intestinal parasite product.

食用動物下降的主要原因是市場准入壓力以及美國牛的競爭壓力，而伴侶動物的下降是由於競爭壓力影響了我們的跳蚤、心絲蟲和腸道寄生蟲產品 Trifexis。

Slide 13 outlines the same information for our September year-to-date results.

幻燈片 13 概述了我們 9 月份年初至今結果的相同信息。

Now let's look at the drivers of our worldwide volume growth on Slide 14.

現在讓我們在幻燈片 14 上看看我們全球銷量增長的驅動因素。

In total, our new products comprised of Trulicity, Basaglar, Taltz, Jardiance, Lartruvo, Cyramza, Olumiant and Portrazza, were the engine of our worldwide volume growth.

總的來說，我們的新產品包括 Trulicity、Basaglar、Taltz、Jardiance、Lartruvo、Cyramza、Olumiant 和 Portrazza，是我們全球銷量增長的引擎。

You can see that these products drove 13.7 percentage points of volume growth quarter over the last -- the same quarter last year, while the loss of exclusivity for Cymbalta, Strattera, Effient, Axiron, Zyprexa and Evista provided a drag of 610 basis points.

您可以看到，這些產品在上一季度推動了 13.7 個百分點的銷量增長——去年同一季度，而 Cymbalta、Strattera、Effient、Axiron、Zyprexa 和 Evista 的排他性喪失拖累了 610 個基點。

Slide 15 provides a view of our new product uptake.

幻燈片 15 提供了我們新產品吸收的視圖。

In total, these brands generated over $1.2 billion in revenue this quarter and now represent nearly 22% of our total worldwide revenue, up from just 18% last quarter.

這些品牌本季度的總收入超過 12 億美元，目前占我們全球總收入的近 22%，高於上一季度的 18%。

Moving to Slide 16.

轉到幻燈片 16。

As I mentioned earlier, changes in foreign exchange rates had essentially no effect on our Q3 2017 revenue growth.

正如我之前提到的，外匯匯率的變化對我們 2017 年第三季度的收入增長基本上沒有影響。

Similarly, FX had no meaningful impact on our operating expense growth.

同樣，外匯對我們的運營費用增長沒有有意義的影響。

FX did, however, have a large effect on growth in cost of sales and, consequently, in operating income and EPS.

然而，外匯確實對銷售成本的增長產生了重大影響，從而對營業收入和每股收益產生了很大影響。

For example, growth in non-GAAP EPS was 19%, including the effects of foreign exchange, and 30% in constant currency terms.

例如，非 GAAP 每股收益增長 19%，包括外匯影響，按固定匯率計算增長 30%。

This is consistent with the 28% growth we've seen year-to-date.

這與我們今年迄今看到的 28% 的增長是一致的。

Now I'll turn the call over to Derica for a review of our overall corporate pipeline, progress on potential key events and an update on our 2017 financial guidance.

現在，我將把電話轉給 Derica，以審查我們的整體公司管道、潛在關鍵事件的進展以及我們 2017 年財務指導的更新。

Thanks, Dave.

謝謝，戴夫。

Slide 17 shows select NMEs as of October 17.

幻燈片 17 顯示了截至 10 月 17 日的部分 NME。

Movements since our last earning calls include the U.S. approval of abemaciclib for advanced breast cancer, the U.S. submission of galcanezumab for migraine prevention, the initiation of Phase III for our ultrarapid-acting insulin, the addition of a Phase I immunology asset from our recent collaboration with Nektar Therapeutics and termination of development of 2 Phase I assets.

自我們上次收益電話會議以來的變動包括美國批准 abemaciclib 用於晚期乳腺癌、美國提交 galcanezumab 用於預防偏頭痛、啟動我們的超速效胰島素 III 期、從我們最近的合作中增加 I 期免疫學資產與 Nektar Therapeutics 合作並終止 2 期 I 資產的開發。

Our select NILEX pipeline, shown on Slide 18, reflects the 3- and 4.5-milligram dulaglutide study and the negative outcome of the abemaciclib lung cancer study, JUNIPER.

我們選擇的 NILEX 管道，如幻燈片 18 所示，反映了 3 和 4.5 毫克的度拉魯肽研究以及 abemaciclib 肺癌研究 JUNIPER 的負面結果。

Turning to Slide 19, you can see the considerable progress we've made on the key events we projected for 2017.

轉到幻燈片 19，您可以看到我們在預測 2017 年的關鍵事件上取得了相當大的進展。

Dave and I have already mentioned many of the key events that occurred since our last earnings call.

戴夫和我已經提到了自上次財報電話會議以來發生的許多關鍵事件。

So I'll simply comment on just one change.

因此，我將僅對一項更改進行評論。

Following the positive data presented at EADV, we now expect to begin the Phase III program for baricitinib and atopic dermatitis before the end of this year.

在 EADV 公佈的積極數據之後，我們現在預計將在今年年底之前開始針對巴瑞替尼和特應性皮炎的 III 期計劃。

Turning to our 2017 financial guidance on Slide 20.

轉向我們關於幻燈片 20 的 2017 年財務指導。

You'll see that we've raised and narrowed the range for revenue to $22.4 billion to $22.7 billion, primarily due to the uptake trends we're seeing for our new pharmaceutical products and, to a lesser extent, to a stronger euro.

您會看到，我們已將收入範圍提高並縮小至 224 億美元至 227 億美元，這主要是由於我們看到的新醫藥產品的吸收趨勢，以及在較小程度上，歐元走強。

We've also narrowed the range for full year R&D expense to a range of $5.1 billion to $5.2 billion.

我們還將全年研發費用的範圍縮小到 51 億美元到 52 億美元之間。

We've decreased our GAAP and non-GAAP tax rate to reflect the tax effect of this quarter's business development and restructuring charges as well as the discrete tax benefit mentioned earlier.

我們降低了 GAAP 和非 GAAP 稅率，以反映本季度業務發展和重組費用的稅收影響以及前面提到的離散稅收優惠。

For EPS, we've raised our non-GAAP EPS range by $0.05 to $4.15 to $4.25 per share, and we reduced our GAAP EPS range to $1.73 to $1.83 per share.

對於每股收益，我們將非公認會計原則每股收益範圍提高了 0.05 美元至 4.15 美元至 4.25 美元，並將我們的公認會計原則每股收益範圍降低至每股 1.73 美元至 1.83 美元。

Before we go to the Q&A session, let me briefly sum up.

在進入問答環節之前，讓我簡單總結一下。

We've delivered another strong quarter in Q3.

我們在第三季度實現了另一個強勁的季度。

Led by our new products, worldwide revenue grew 9%.

在我們的新產品的帶動下，全球收入增長了 9%。

By making disciplined investments in our business, we leveraged our top line growth into 19% non-GAAP EPS growth or 30% growth when excluding FX.

通過對我們的業務進行嚴格的投資，我們將收入增長轉化為 19% 的非公認會計原則每股收益增長或 30% 的增長（不包括外匯）。

We continue to have strong momentum behind our innovation-based strategy.

我們以創新為基礎的戰略繼續保持強勁勢頭。

Since our last earnings call, we received U.S. approval for and launched Verzenio.

自上次財報電話會議以來，我們獲得了美國的批准並推出了 Verzenio。

We submitted galcanezumab for migraine prevention here in the U.S. We started Phase III for our next-generation mealtime insulin, and we bolstered our pipeline with the CureVac deal.

我們在美國提交了用於預防偏頭痛的 galcanezumab。我們開始了下一代進餐時間胰島素的 III 期研究，並通過 CureVac 交易加強了我們的管道。

We also announced [at ASH] to focus our resources on developing new medicines and to improve the company's cost structure as well as to review our strategic alternatives for our Elanco Animal Health business.

我們還宣布 [在 ASH] 將我們的資源集中在開發新藥和改善公司的成本結構以及審查我們的 Elanco 動物保健業務的戰略替代方案。

Going forward, our management team will remain focused on launching new products with excellence, reloading our late-stage pipeline, driving increased productivity to expand our operating margins and investing in our core drivers for our business: talent, scientific capabilities and technology platforms, to ensure our future growth prospects.

展望未來，我們的管理團隊將繼續專注於推出卓越的新產品，重新加載我們的後期管道，提高生產力以擴大我們的營業利潤，並投資於我們業務的核心驅動力：人才、科學能力和技術平台，以確保我們未來的增長前景。

This concludes our prepared remarks.

我們準備好的評論到此結束。

Now I'll turn the call over to Phil to moderate the Q&A session.

現在我將把電話轉給 Phil 來主持問答環節。

Phil?

菲爾?

Thank you, Derica.

謝謝你，德麗卡。

(Operator Instructions) Now, Alan, if you can go ahead and provide the instructions for the Q&A session, we're ready for the first caller.

（操作員說明）現在，艾倫，如果您可以繼續提供問答環節的說明，我們已經為第一個來電者做好了準備。

(Operator Instructions) First question will come from the line of Tim Anderson with Bernstein.

（操作員說明）第一個問題來自 Tim Anderson 和 Bernstein 的台詞。

On Trulicity, an important growth driver, you guys called it out, a major future growth driver.

關於 Trulicity，一個重要的增長動力，你們稱之為未來的主要增長動力。

I'm wondering if you can just give us your thoughts on the curve of that product as we go into 2018 because you are facing new branded competition from Novo's weekly product.

我想知道您是否可以在我們進入 2018 年時向我們提供您對該產品曲線的看法，因為您正面臨來自 Novo 每週產品的新品牌競爭。

They've had some compelling head-to-head data.

他們有一些令人信服的面對面數據。

I'm wondering how you think that might impact your product.

我想知道您認為這會如何影響您的產品。

And equally importantly, they have their oral GLP-1, they have several Phase III readouts coming in 2018, and I'm wondering if you can give us your opinion of the viability of that program.

同樣重要的是，他們有他們的口服 GLP-1，他們在 2018 年有幾個 III 期讀數，我想知道您是否可以就該計劃的可行性給我們您的意見。

It seems that if they had a good clinical profile, that could be problematic for injectable GLP-1s.

似乎如果它們具有良好的臨床特徵，那麼注射 GLP-1 可能會出現問題。

Or do you think the clinical profile of that product will, in fact, be problematic?

還是您認為該產品的臨床特徵實際上會存在問題？

And then on Humalog, no biosimilar yet approved.

然後在 Humalog 上，還沒有生物仿製藥獲批。

You guys have, I think, a patent that you could potentially assert and leverage into a delay or maybe a settlement with Sanofi.

我認為你們擁有一項專利，您可能會主張並利用該專利來延遲或與賽諾菲達成和解。

Can you give us any update there?

你能告訴我們任何更新嗎？

Great.

偉大的。

Tim, thank you for the questions.

蒂姆，謝謝你的提問。

So Enrique, we'll go to you for the questions on Trulicity heading into '18 with new branded competition coming and thoughts on the oral GLP-1 space.

因此，Enrique，我們將向您詢問有關 Trulicity 進入 18 年的問題，新的品牌競爭即將到來，以及對口服 GLP-1 空間的想法。

And then we do have our General Counsel, Mike Harrington, with us.

然後我們確實有我們的總法律顧問邁克·哈靈頓（Mike Harrington）和我們在一起。

So Mike, if you'd like to give the update on litigation with Sanofi.

邁克，如果您想提供有關賽諾菲訴訟的最新信息。

All right, Enrique?

好吧，恩里克？

Very good.

很好。

Well, thank you for the question.

嗯，謝謝你的問題。

And indeed, Trulicity is having a terrific year.

事實上，Trulicity 的這一年非常棒。

It's a unique time when it comes to innovation in diabetes.

對於糖尿病的創新來說，這是一個獨特的時期。

And let me try to maybe frame some comments and provide some color as we think about Trulicity going forward.

讓我試著在我們考慮 Trulicity 的未來時提出一些評論並提供一些色彩。

I will not provide an outlook for the product but some things to think about.

我不會提供產品的前景，但會考慮一些事情。

The biggest opportunity for Trulicity is -- when we think about this class is that -- and when we look at injectables, GLP-1s as a class still represent less than 30% of the basal insulin prescription.

Trulicity 的最大機會是——當我們考慮這一類時——當我們看注射劑時，GLP-1 作為一類仍然占基礎胰島素處方的不到 30%。

We see significant benefits when it comes to the GLP-1 class, so the opportunity for growth is very significant.

我們看到 GLP-1 類別的顯著優勢，因此增長機會非常重要。

Trulicity has an enviable position in this market by the benefit that it basically offers when it comes to the real-world efficacy of the product, of course, the once-weekly dosing.

Trulicity 在這個市場上具有令人羨慕的地位，因為它在產品的實際功效方面基本上提供了好處，當然，每週一次的劑量。

And we have a single-dose pen that is ready to use and that does not require basically managing or seeing the needle, which is so important for a patient that is transitioning, in many cases, from an oral medicine.

我們有一支可以使用的單劑量筆，基本上不需要管理或看到針頭，這對於在許多情況下從口服藥物過渡的患者來說非常重要。

Now, clearly, we do have competition, yes.

現在，很明顯，我們確實有競爭，是的。

But I think what we have to keep in mind, too, is that the competition is also going to help fuel the overall growth of the class.

但我認為我們也必須牢記的是，競爭也將有助於推動班級的整體發展。

The class has very healthy growth, and we expect that, that's going to be a continued catalyst for Trulicity as we think about the growth of the class and the type of position that we have in the market.

該課程有非常健康的增長，我們預計這將成為 Trulicity 的持續催化劑，因為我們考慮課程的增長和我們在市場中的地位類型。

Our trends continue to be very solid for the product.

我們的趨勢對於產品來說仍然非常穩固。

Clearly, when it comes to sema, we'd like to see all of their data when it comes to SUSTAIN 7, but we feel good about the position that we basically have when we look at the -- both the combination of our efficacy and the safety profile that our product offers.

顯然，當談到 sema 時，我們希望看到他們所有關於 SUSTAIN 7 的數據，但是當我們看到我們基本擁有的位置時，我們感覺很好——我們的功效和我們的產品提供的安全概況。

You asked about oral GLP-1s.

您詢問了口服 GLP-1。

That is an area of interest to us.

這是我們感興趣的一個領域。

We do see the innovation in the space as important, but we need to wait for all of their data to basically come out before we can make more comments.

我們確實認為該領域的創新很重要，但我們需要等待他們所有的數據基本出來，然後才能發表更多評論。

And then I believe that Mike is going to comment on Humalog.

然後我相信邁克將對 Humalog 發表評論。

Thanks, Tim, for your question.

謝謝，蒂姆，你的問題。

The deadline under the Hatch-Waxman Act for Lilly to challenge Sanofi has expired, and we have not filed suit to challenge their follow-on biosimilar.

根據 Hatch-Waxman 法案，禮來公司挑戰賽諾菲的最後期限已過，我們尚未提起訴訟以挑戰他們的後續生物仿製藥。

As you know, Tim, the Hatch-Waxman Act notice process provides an opportunity for a company to carefully assess whether a follow-on product infringes patents listed in the Orange Book for a particular product.

如您所知，蒂姆，Hatch-Waxman 法案通知流程為公司提供了一個機會，可以仔細評估後續產品是否侵犯了橙皮書中針對特定產品列出的專利。

The only remaining Orange Book-listed patent that we have that is relevant to this discussion protects our KwikPen delivery device, and we have thoroughly analyzed both the Sanofi device and our own device.

我們擁有的與本次討論相關的唯一剩餘的橙皮書專利保護了我們的 KwikPen 遞送設備，我們已經徹底分析了賽諾菲設備和我們自己的設備。

Lilly's KwikPen is an innovative device that offers a number of advantages for patients, but for purposes of analyzing the patents, it's a fundamentally different device than the Sanofi pen that they intend to use with their follow-on lispro.

Lilly 的 KwikPen 是一種創新設備，為患者提供了許多優勢，但為了分析專利，它與他們打算與後續 lispro 一起使用的賽諾菲筆是一種根本不同的設備。

We always vigorously defend our intellectual property and will continue to do so aggressively, but we don't engage in litigation to enforce patents unless there is a factual and legal base to do so.

我們始終大力捍衛我們的知識產權，並將繼續積極這樣做，但我們不會通過訴訟來強制執行專利，除非有事實和法律依據。

And here, we didn't have a factual and legal basis to support litigation.

在這裡，我們沒有支持訴訟的事實和法律依據。

Great.

偉大的。

Mike, thank you for the update.

邁克，謝謝你的更新。

Dave Risinger with Morgan Stanley.

摩根士丹利的戴夫·瑞辛格。

My first question is with respect to the animal health business.

我的第一個問題是關於動物保健業務。

So you've announced that you're exploring strategic alternatives.

所以你已經宣布你正在探索戰略選擇。

Could you just provide a little bit more color around the timing, why now?

您能否在時間安排周圍提供更多顏色，為什麼是現在？

I know that this is something you've contemplated for years, but the business' organic growth hasn't been inspiring recently.

我知道這是您多年來一直在考慮的事情，但該業務的有機增長最近並沒有令人鼓舞。

And so it'd be helpful for you to just provide a little bit more color about why now and how you see the business' organic growth prospects going forward.

因此，您只需提供更多關於為什麼現在以及您如何看待企業未來有機增長前景的色彩，對您會有所幫助。

And then second, with respect to Forteo, I believe there may potentially be generic entry in the U.S. and Europe in 2019, but it would be helpful to get your perspective on how investors should think about the generic threat to Forteo in 2019.

其次，關於 Forteo，我相信 2019 年美國和歐洲可能會有仿製藥進入，但了解投資者應如何看待 2019 年對 Forteo 的仿製藥威脅的看法會有所幫助。

Okay.

好的。

Dave, thank you for the questions.

戴夫，謝謝你的提問。

So Dave Ricks, if we can have you answer the question on alternatives that are being explored and timing for the Elanco Animal Health review.

所以 Dave Ricks，如果我們可以讓您回答有關 Elanco 動物健康審查正在探索的替代方案和時間安排的問題。

And then, Christi, if you want to comment on the outlook for Forteo post-generic entry.

然後，克里斯蒂，如果您想評論 Forteo 後通用條目的前景。

Great.

偉大的。

Thanks, Dave.

謝謝，戴夫。

We haven't touched on the short-term operational things, and we may get other calls on that.

我們還沒有觸及短期運營的事情，我們可能會接到其他電話。

I mean, it is true, we've had some challenges in the business this year.

我的意思是，這是真的，我們今年在業務中遇到了一些挑戰。

We don't look at the question of how we should position Elanco in the short term; we think of it as the long term.

我們不考慮短期內應該如何定位 Elanco 的問題；我們認為這是長期的。

And we've been, as you point out, asked this question for a long time.

正如你所指出的，我們長期以來一直在問這個問題。

It's a natural one to ask.

很自然地問。

What -- I think where we think we are now, why now, is over the last many years, we've grown this business rather substantially through acquisition but also through our own organic actions.

什麼 - 我認為我們認為我們現在所處的位置，為什麼是現在，在過去的許多年裡，我們通過收購和我們自己的有機行動大大地發展了這項業務。

And we now have a global business that's highly competitive.

我們現在擁有一個競爭激烈的全球業務。

It's a top-tier animal health business, amongst the top 5 globally, and we participate in all of the relevant segments of animal health, most recently combining BI's vaccine business in North America coupled with Novartis.

這是一家頂級的動物保健業務，在全球排名前五，我們參與了動物保健的所有相關領域，最近將 BI 在北美的疫苗業務與諾華合併。

And it's taken some work to fully operationalize and get those companies pulled together in a way that we think where this company is at least poised to compete effectively and really grow aggressively ahead.

並且需要一些工作才能全面運作並以我們認為這家公司至少準備好有效競爭並真正積極向前發展的方式將這些公司整合在一起。

And so now is a good time, having completed those acquisitions and scaled the business, to reflect on the best posture for Elanco Animal Health.

因此，現在是完成這些收購併擴大業務規模的好時機，以反思 Elanco Animal Health 的最佳姿態。

And as we said today, we're exploring options.

正如我們今天所說，我們正在探索各種選擇。

We expect to be able to get back to investors by mid-'18 with the results of our analysis.

我們希望能夠在 18 年中期之前將我們的分析結果反饋給投資者。

And the full range of options are in scope, keeping the business, IPO or spin or perhaps some other combination that we might determine is the best way to maximize the value to Lilly shareholders.

並且所有選項都在範圍內，保留業務、首次公開募股或旋轉或其他一些我們可能確定的組合是最大化禮來股東價值的最佳方式。

So we'll follow up with you as that process progresses, but we think this is a good time to step back and look at this question.

因此，隨著流程的進展，我們將與您聯繫，但我們認為現在是退後一步，看看這個問題的好時機。

Thanks, Dave.

謝謝，戴夫。

Christi?

克里斯蒂?

Yes.

是的。

On the Forteo question, we continue to be very pleased with the performance of Forteo, and the data continues to support how strong it is in the fracture prevention and treatment.

在 Forteo 的問題上，我們繼續對 Forteo 的表現感到非常滿意，數據繼續支持它在骨折預防和治療方面的實力。

And so as we look at Forteo in the future, we do have the same estimate as you do, which is the expiration of the patent being in 2019, and that's across U.S., major Europe and Japan.

因此，當我們展望未來的 Forteo 時，我們確實有與您相同的估計，即專利將於 2019 年到期，並且遍及美國、主要歐洲和日本。

Obviously, it is difficult to make.

顯然，製作起來很困難。

Forteo is not easy.

Forteo並不容易。

So that will really be the question mark, and -- but our estimates are that 2019 is when we'll lose that intellectual property protection.

所以這確實是一個問號，而且——但我們估計，2019 年我們將失去知識產權保護。

Great.

偉大的。

Thank you, Christi.

謝謝你，克里斯蒂。

Andrew Baum with Citi.

安德魯鮑姆與花旗。

Terrific.

了不起。

So I was saying I'm surprised that I haven't seen Lilly use their balance sheet for any more substantial business development within oncology given the reshaping of the business.

所以我說我很驚訝，鑑於業務的重塑，我沒有看到禮來使用他們的資產負債表在腫瘤學領域進行任何更實質性的業務發展。

Could you just maybe share a little bit of color, is that a question of the bid-ask spread?

你能不能分享一點顏色，這是買賣價差的問題嗎？

Is it available assets?

是可用資產嗎？

Is it a clinical base that needs to be turned over?

是臨床基地需要上交嗎？

What is potentially delaying that?

是什麼潛在地延遲了這一點？

And the second, the relative performance of Taltz versus your competitor, COSENTYX, especially in the last quarter would seem to disfavor Lilly.

第二，Taltz 與您的競爭對手 COSENTYX 的相對錶現，尤其是在最後一個季度，似乎不利於 Lilly。

Could you outline what are the in-market dynamics that are driving this disproportionate marketing and how you're thinking about adjusting going forward?

您能否概述一下推動這種不成比例的營銷的市場動態以及您對未來調整的看法？

Great.

偉大的。

Andrew, thank you for the questions.

安德魯，謝謝你的問題。

Derica, if you'll address the question on using our balance sheet for business development in oncology and then the impediments we're seeing to actioning that.

Derica，如果您要解決有關使用我們的資產負債表進行腫瘤學業務發展的問題，然後是我們看到採取行動的障礙。

And then Christi to comment on dynamics with Taltz and COSENTYX in that market.

然後克里斯蒂評論了 Taltz 和 COSENTYX 在該市場的動態。

Derica?

德麗卡？

Sure.

當然。

We have no apprehension or reservations about using our business -- our balance sheet to pursue our therapeutic goals, whether it's in oncology or across our other therapeutic segments in which we compete.

我們對使用我們的業務——我們的資產負債表來追求我們的治療目標沒有任何擔憂或保留，無論是在腫瘤學領域還是在我們競爭的其他治療領域。

And we do continuously look at the marketplace for external asset opportunities that we'd like to pursue.

我們確實不斷地在市場上尋找我們想要追求的外部資產機會。

Most recently, you've seen just this year, 3 deals in the area of oncology.

最近，您剛剛在今年看到了腫瘤學領域的 3 筆交易。

Now all of those are early-stage deals, and that's by design.

現在所有這些都是早期交易，這是設計使然。

That's the area that we've chosen to focus on.

這就是我們選擇關注的領域。

If we can find late-stage assets like we did with CoLucid at the beginning of this year, we'll pursue that as well.

如果我們能像今年年初對 CoLucid 那樣找到後期資產，我們也會繼續努力。

In regards to market prices, oncology still is very expensive real estate, and one of the things we have to make sure that we do in protecting our shareholders is that we do good diligence on those opportunities we look at.

就市場價格而言，腫瘤學仍然是非常昂貴的房地產，我們必須確保我們在保護股東方面所做的一件事是我們對我們看到的那些機會進行良好的努力。

And sometimes it is tough finding value in some of the assets at the market prices at which they're being touted.

有時很難以被吹捧的市場價格在某些資產中找到價值。

So that's something we've been cognizant of, and that's why we've chosen to go -- look to go earlier rather than later if we can.

所以這是我們已經認識到的事情，這就是我們選擇去的原因——如果可以的話，期待早點而不是晚點。

Great.

偉大的。

Thanks, Derica.

謝謝，德麗卡。

Christi?

克里斯蒂?

Yes.

是的。

Andrew, so on Taltz, we continue to be very pleased with the performance of Taltz, especially as we see patients with clearer skin.

安德魯，等等 Taltz，我們繼續對 Taltz 的表現感到非常滿意，特別是當我們看到皮膚更清晰的患者時。

And as you look at the dermatology office, defining our competitors really is not the IL-17s versus the IL-17s.

當您查看皮膚科辦公室時，定義我們的競爭對手確實不是 IL-17 與 IL-17。

What you see is really the TNFs under -- really not reaching that clear status.

你所看到的實際上是 TNFs - 真的沒有達到那個明確的狀態。

And the more we have new agents like the IL-17s and the newer agents that are coming out, the more that we'll see the expectations of both physicians and patients increase.

我們越有像 IL-17 這樣的新藥物和即將推出的新藥物，我們就越會看到醫生和患者的期望值都在增加。

A couple of those details for you on what you're seeing in the numbers.

為您提供一些關於您在數字中看到的詳細信息。

If you look at the data, there's a couple of things.

如果您查看數據，則有幾件事。

One is COSENTYX has added free goods to their NBRx data.

一是 COSENTYX 在他們的 NBRx 數據中添加了免費商品。

So IMS tells us there's a lot of volatility in that data, and it will take weeks for that to -- or maybe even months for that to actually level out.

因此，IMS 告訴我們，這些數據存在很大的波動性，需要數週時間——甚至可能需要數月才能真正趨於平穩。

So what we're looking at is actually the net sales.

所以我們看到的實際上是淨銷售額。

And if you look at net sales in the U.S. in the dermatology office, we are performing the same as COSENTYX was at the same period of time, which is pretty remarkable for a second entry into the market.

如果你看看美國皮膚科辦公室的淨銷售額，我們的表現與 COSENTYX 在同一時期的表現相同，這對於第二次進入市場來說是相當了不起的。

And usually if you have 80%, that would be great, but for us to be able to do that.

通常如果你有 80%，那就太好了，但我們能夠做到這一點。

So we continue to feel very good about it.

所以我們繼續感覺很好。

The other thing to note is we do see seasonality in the summertime.

另一件需要注意的是，我們確實在夏季看到了季節性。

So as you look at specifically in the dermatology office with psoriasis, that's where you'll see the seasonality.

因此，當您專門在皮膚科辦公室查看牛皮癬時，您會看到季節性變化。

You don't see that with psoriatic arthritis or ankylosing spondylitis.

你看不到銀屑病關節炎或強直性脊柱炎。

So that is another thing that's kind of clouding the numbers as you see the seasonality affect our numbers because we're only in the derm office right now.

因此，當您看到季節性影響我們的數字時，這是另一件使數字蒙上陰影的事情，因為我們現在只在皮膚辦公室。

And then as you look into the future, we're very excited to hear from the FDA by the end of the year, which as we continue to see the breadth and depth of prescribers continue to increase, we see our early adopters increasing their number of prescriptions, we see more physicians trying Taltz with the psoriatic arthritis launch and our entry into the rheumatology office in December and January, given FDA approval, we should see another step-level increase in Taltz.

然後，當您展望未來時，我們很高興在年底前收到 FDA 的消息，隨著我們繼續看到開藥者的廣度和深度不斷增加，我們看到我們的早期採用者人數增加在處方方面，我們看到更多的醫生嘗試 Taltz 與銀屑病關節炎的推出以及我們在 12 月和 1 月進入風濕病學辦公室，在 FDA 批准的情況下，我們應該看到 Taltz 的另一個階段性增長。

So we're very confident and continue to believe in the Taltz performance.

所以我們非常有信心並繼續相信 Taltz 的表現。

Great.

偉大的。

Thank you, Christi.

謝謝你，克里斯蒂。

Jami Rubin with Goldman Sachs.

Jami Rubin 與高盛。

Just a couple of follow-up questions.

只是幾個後續問題。

First, on Dow Elanco, could you remind us, Dave, what the operating margin is on that business?

首先，關於 Dow Elanco，Dave，您能否提醒我們，該業務的營業利潤率是多少？

I seem to recall that's a lower-margin business than your base business, but your overall operating margins at around 22% or so are well below the industry average.

我似乎記得這是一個比您的基礎業務利潤率更低的業務，但您的整體營業利潤率約為 22% 左右，遠低於行業平均水平。

So if you contemplate spinning that business or selling that business, can you talk sort of generally about what impact you would see that having on your overall margins?

因此，如果您考慮拆分該業務或出售該業務，您能否大致談談您認為這對您的整體利潤率有何影響？

And then secondly, just given the opportunity to take advantage of the risk or of the PE overcharge given where Zoetis is trading, what do you think you will do with those proceeds?

其次，考慮到 Zoetis 交易地點的風險或 PE 多收費用的機會，您認為您將如何處理這些收益？

And just if I can ask a question about the cost-cutting announcement that you made a couple of months ago, the 3,500 positions that you are reducing, that has generated some debate among investors regarding your confidence in your ability to hit your sort of mid-single-digit top line growth projection over the intermediate term.

如果我可以問一個關於你幾個月前宣布的削減成本的問題，你正在減少 3,500 個頭寸，這已經在投資者之間引發了一些關於你對達到中等水平的信心的爭論- 中期的個位數收入增長預測。

Can you shed a little bit of light on the reasons for the additional cost-cutting program?

你能解釋一下額外削減成本計劃的原因嗎？

I know that should lead to an improvement in operating margins, but should we think of this as an insurance policy against the top line growth opportunity?

我知道這應該會導致營業利潤率的提高，但我們是否應該將其視為針對頂線增長機會的保險政策？

Or is this -- or should we look at this as above and beyond what the company expects to perform -- how the company expects to perform going forward?

或者這是否——或者我們是否應該將其視為超出公司預期的表現——公司預期未來的表現如何？

Okay.

好的。

Jami, thank you for the questions.

傑米，謝謝你的提問。

If I can, I'm going to reorder our answers just to sort of get the flow going here.

如果可以的話，我將重新排列我們的答案，只是為了讓流程順利進行。

So Dave, if you wouldn't mind handling the headcount reduction question, the last one Jami had, first.

所以戴夫，如果你不介意處理裁員問題，那麼首先是 Jami 的最後一個問題。

If you want to provide any comments on Elanco margins then.

如果您想對 Elanco 利潤提供任何意見。

Jeff, feel free to complement that answer if you'd like.

傑夫，如果您願意，請隨時補充該答案。

And a little bit of Derica for the question around use of proceeds, if we're having the transactions yielding proceeds in the future.

關於收益使用的問題，如果我們將來有交易產生收益的話，還有一點 Derica。

Dave?

戴夫？

Sure, yes.

當然，是的。

Thanks, Jami.

謝謝，傑米。

I mean, you used the Dow Elanco name.

我的意思是，您使用了 Dow Elanco 的名稱。

That's harkening back to the old days.

這讓人想起過去。

So this is just Elanco now, but appreciate the questions.

所以這只是 Elanco 現在，但感謝這些問題。

Let me -- on the cost-cutting, so we announced this in early September.

讓我來談談削減成本，所以我們在 9 月初宣布了這一點。

This has no relation to our belief about the revenue line, just to be clear.

為了清楚起見，這與我們對收入線的信念無關。

What we're looking at is looking beyond our -- what we long held out, this 2018 target of 15% operating expense as a percent of sales.

我們正在關注的是超越我們長期堅持的目標，即 2018 年營業費用佔銷售額的 15% 的目標。

And we've said for some time qualitatively that, that was a stepping stone on the way to a more productive, higher-operating margin company.

一段時間以來，我們已經定性地說，這是通往生產力更高、運營利潤率更高的公司的墊腳石。

These actions put us further down that road.

這些行動使我們在這條道路上走得更遠。

That's how we're thinking of them, both to become more competitive with our operating margins but also to free up cash flow and operating spend capacity to invest in R&D.

這就是我們對它們的看法，既要在我們的營業利潤率上更具競爭力，又要釋放現金流和運營支出能力以投資於研發。

We see a number of late-stage projects that have read out positively more than we expected.

我們看到一些後期項目的積極情況超出了我們的預期。

They're now launching, but we need to invest behind those with important new indications in other uses, like Verzenio in the adjuvant setting, like Olumiant in atopic dermatitis like we spoke about today.

他們現在正在推出，但我們需要投資那些在其他用途中具有重要新適應症的藥物，例如輔助環境中的 Verzenio，例如我們今天談到的特應性皮炎中的 Olumiant。

So that's what it's for.

這就是它的用途。

It's about our quest to become even stronger for the future, nothing to do with our conviction on the 5% revenue growth, which I remind investors we did 9% again this quarter, so -- and we continue to trend above that CAGR we committed to.

這是關於我們對未來變得更加強大的追求，與我們對 5% 收入增長的信念無關，我提醒投資者我們本季度再次實現了 9%，所以 - 我們繼續保持高於我們承諾的複合年增長率至。

And although we know '18 will be facing some more generic events, we're very confident on the 5% by 2020.

雖然我們知道 18 年將面臨一些更普遍的事件，但我們對 2020 年的 5% 非常有信心。

So with that, let me turn it over to Jeff on the Elanco operating margin story.

因此，讓我把關於 Elanco 營業利潤率的故事交給傑夫。

We can compare that to Lilly afterward, and Derica, if you could comment on the balance sheet.

如果您可以對資產負債表發表評論，我們可以將其與禮來（Lilly）和德里卡（Derica）進行比較。

Yes.

是的。

So Jami, just on our margin, as we've come to the integrations of Novartis as well as Lohmann and now BI, we've been hovering around 20% for the past 2 years.

因此，Jami，就在我們的邊緣，當我們來到諾華以及 Lohmann 和現在的 BI 的整合時，過去 2 年我們一直徘徊在 20% 左右。

We feel good about our -- not only this assessment but our strategy going forward on our margin expansion opportunities, as we've been pretty open about.

我們對我們的 - 不僅是這個評估，還有我們在利潤擴張機會方面的戰略感到滿意，因為我們一直很開放。

And we've got a pretty aggressive agenda.

我們有一個非常激進的議程。

We announced 2 events this quarter that are part of that agenda that is well underway.

我們在本季度宣布了 2 項活動，這些活動是正在進行中的議程的一部分。

And the first was our consolidation of our Larchwood, Iowa manufacturing facility into our Fort Dodge, the BI acquisition facility, as well as we're seeking options for rbST.

首先是我們將愛荷華州拉奇伍德的製造工廠整合到我們的道奇堡（BI 採購工廠），以及我們正在尋找 rbST 的選擇。

The 2 big drivers that give us this current state is no question, some of the forces in the lower sales and the other is product mix.

毫無疑問，給我們帶來這種現狀的兩大驅動力是銷量下降的一些力量，另一個是產品組合。

And we are -- we're working aggressively not only to drive these margins closer, as we've said, to 30% over time -- that will not happen here in the short term but over time.

正如我們所說，我們正在積極努力，不僅將這些利潤率拉近，正如我們所說，隨著時間的推移，這不會在短期內發生，而是會隨著時間的推移而發生。

That'll happen by both the margin expansion productivity agenda as well as the innovations that drive our product mix change.

這將通過利潤率擴張生產力議程以及推動我們產品組合變化的創新來實現。

Thanks, Jeff.

謝謝，傑夫。

Derica?

德麗卡？

Jami, in regards to potential proceeds, we haven't gotten that far in our thinking.

Jami，關於潛在收益，我們的想法還沒有那麼遠。

Right now, what we're really focused on is what's the best path forward in terms of maximizing the value of the animal health asset on behalf of the Lilly shareholders.

目前，我們真正關注的是代表禮來公司股東最大化動物保健資產價值的最佳前進道路。

And as Dave highlighted, we'll look at that full array of options before us.

正如戴夫強調的那樣，我們將研究擺在我們面前的全部選項。

That having been said, even back to the earlier question that Andrew asked, we have the balance sheet capacity today to pursue the types of opportunities that we're interested in.

話雖如此，即使回到安德魯之前提出的問題，我們今天擁有資產負債表能力來追求我們感興趣的機會類型。

So while we're contemplating these strategic alternatives for Elanco, it is not inhibiting us or preventing us from moving forward with our current organic and inorganic strategy in terms of assets we want to pursue.

因此，雖然我們正在考慮 Elanco 的這些戰略替代方案，但它並沒有阻止我們或阻止我們在我們想要追求的資產方面推進我們當前的有機和無機戰略。

So we're still moving full speed ahead.

所以我們仍在全速前進。

And as Dave highlighted earlier, back to your 5%, over the last 3 years, recall when we gave the guidance in 2015, we've averaged, in terms of top line growth, somewhere between 9% to -- 7% to 9% in each year.

正如戴夫早些時候強調的那樣，在過去 3 年中，回到你的 5%，回想一下我們在 2015 年給出指導時，我們的平均收入增長在 9% 到 - 7% 到 9 之間每年的百分比。

And this year, as Dave said, we're tracking towards 9% growth.

正如戴夫所說，今年我們正朝著 9% 的增長目標前進。

So we're very confident that we can meet that minimum threshold of 5% for the decade, which takes us out through 2020, and we think we're actually well on track to achieve that.

因此，我們非常有信心可以在十年內達到 5% 的最低門檻，這將使我們在 2020 年之前實現目標，我們認為我們實際上已經步入正軌。

Thanks, Derica.

謝謝，德麗卡。

Jami, thanks for the questions.

傑米，謝謝你的提問。

Umer Raffat with Evercore.

與 Evercore 的 Umer Raffat。

I wanted to focus on a couple of things.

我想專注於幾件事。

One, on baricitinib perhaps, just curious what your confidence is on the 4-milligram dose in particular.

一，也許是巴瑞克替尼，只是好奇你對 4 毫克劑量的信心。

And then secondly, just touching up again on lispro, can you confirm -- and I heard the prior comments, but can you confirm that there's no settlement at present between you and Sanofi on the lispro launch?

其次，關於lispro 的再次接觸，您能否確認——我聽到了之前的評論，但您能否確認目前您和賽諾菲之間沒有就lispro 的推出達成和解？

And then also, how do you think about lispro launch?

然後，您如何看待 lispro 的推出？

And in theory, how should or shouldn't it be different than Basaglar versus Lantus?

從理論上講，它應該或不應該與 Basaglar 與 Lantus 有何不同？

Great.

偉大的。

Umer, thank you for the questions.

烏默爾，謝謝你的提問。

I assume with the 4 milligram, you're referring to the ongoing review at the FDA for our rheumatoid arthritis application, is that correct?

我假設 4 毫克，你指的是 FDA 正在進行的對我們類風濕性關節炎應用的審查，對嗎？

Correct.

正確的。

Okay.

好的。

So Christi, we'll go to you for the question on the baricitinib 4 milligram.

所以克里斯蒂，我們會問你關於巴瑞替尼 4 毫克的問題。

Mike Harrington, if you'd like to comment on whether or not there's any kind of settlement with Sanofi.

邁克哈靈頓，如果你想評論是否與賽諾菲有任何和解。

And then, Enrique, for the dynamics that you could -- might think about for the launch of lispro whenever that occurs here in the future.

然後，Enrique，你可以考慮在未來發生這種情況時推出 lispro。

Christi?

克里斯蒂?

So I think it's important, as we discuss the 4 milligrams of baricitinib, to see, well, how is it doing where we are commercializing the 4 milligrams.

所以我認為重要的是，當我們討論 4 毫克巴瑞替尼時，看看我們將 4 毫克商業化的情況如何。

As we look at Europe, for example, specifically in Germany, the launch in Germany not only exceeds our internal expectations, but as you look at the 5 months in which it's been available, it has exceeded every rheumatoid arthritis launch in history, including Humira.

以歐洲為例，特別是在德國，德國的上市不僅超出了我們的內部預期，而且從上市的 5 個月來看，它已經超過了歷史上所有類風濕性關節炎的上市，包括 Humira .

So as we look at that uptake in the 4 milligrams is the majority of the use, and we see what the patients are seeing and coming back to their offices where they were debilitated, they've tried other agents, and they've gone on baricitinib, and really, things like in Japan, they're now able to drive where they haven't been able to before, it's really life-changing.

因此，當我們看到 4 毫克的攝取量是使用的主要部分時，我們看到患者看到了什麼，回到他們虛弱的辦公室，他們嘗試了其他藥物，他們繼續巴瑞替尼，真的，就像在日本一樣，他們現在能夠開車到他們以前無法開車的地方，這真的改變了生活。

So as we look at the U.S. and our discussions with the FDA and the ongoing conversations we continue to have, the 4 milligrams is imperative for these patients to get the benefit and the efficacy that they need to be able to go about their daily lives.

因此，當我們審視美國以及我們與 FDA 的討論以及我們繼續進行的對話時，4 毫克對於這些患者獲得他們日常生活所需的益處和功效是必不可少的。

So it is still our strategy, that we believe in the 4 milligrams.

因此，我們仍然相信 4 毫克，這仍然是我們的策略。

We're seeing it play out in the real world, and we look forward to having the resubmission.

我們正在看到它在現實世界中上演，我們期待重新提交。

And it is on track to happen before the end of January, as we had mentioned in the past.

正如我們過去提到的，它有望在 1 月底之前發生。

And then after that, we'll have the 6-month clock in which we'll get a read, but we're very optimistic.

然後在那之後，我們將有 6 個月的時鐘，我們將在其中閱讀，但我們非常樂觀。

Thanks, Christi.

謝謝，克里斯蒂。

Mike?

麥克風？

And Umer, I can confirm there is no settlement agreement in place between Lilly and Sanofi related to their follow-on lispro.

和 Umer，我可以確認禮來公司和賽諾菲之間沒有與他們的後續 lispro 相關的和解協議。

Okay.

好的。

Thanks, Mike.

謝謝，邁克。

Enrique?

恩里克?

So, there are a few things to consider when we basically compare and contrast the basal insulin situation vis-à-vis mealtime insulin.

因此，當我們基本比較和對比基礎胰島素情況與進餐時胰島素時，需要考慮一些事項。

And when we enter, of course, with Basaglar and all of the learnings that we got there, and then hopefully, we can apply those learnings in reverse in a certain way.

當然，當我們進入 Basaglar 以及我們在那裡學到的所有知識時，然後希望我們可以以某種方式反向應用這些知識。

So first, the basal insulin class is -- was significantly more open at the time that Basaglar entered.

因此，首先，基礎胰島素類別在 Basaglar 進入時明顯更加開放。

So we've had a number of different basal medicines in formularies, and that's relative to the mealtime insulin space, where most formularies are really under exclusive status, and that leads to lower prices.

因此，我們在處方集中有許多不同的基礎藥物，這與進餐時胰島素空間有關，大多數處方集實際上處於獨家地位，這導致價格降低。

So the situation today and the economics for the payers today are such that it was easier to create viable economics for the payer in the basal insulin space relative to where we are in the mealtime insulin space.

因此，今天的情況和付款人的經濟狀況使得在基礎胰島素領域為付款人創造可行的經濟性比我們在用餐時間胰島素領域的情況更容易。

Two, is that in the case of Humalog, we have a full range of formulations, not just Humalog but Humalog mixtures.

第二，就 Humalog 而言，我們擁有全系列的配方，不僅是 Humalog，還有 Humalog 混合物。

We have a concentrated mealtime insulin, Humalog U-200.

我們有一種濃縮的進餐時間胰島素，Humalog U-200。

And we recently even just launched the Humalog KwikPen Junior, which basically is the first half-unit prefilled pen in the market.

我們最近甚至剛剛推出了 Humalog KwikPen Junior，它基本上是市場上第一款半單元預填充筆。

So we're excited by that offering, and we do believe that our offerings give us some strength when it comes to a follow-on lispro just coming into the market.

因此，我們對該產品感到興奮，並且我們確實相信，當涉及剛剛進入市場的後續 lispro 時，我們的產品會給我們一些力量。

Of course, it's additional competition, and we have to see when will they launch.

當然，這是額外的競爭，我們必須看看他們什麼時候推出。

It is likely that they had to resubmit, of course, to get final approval, and we are -- that's probably a question from a timing perspective for Sanofi.

當然，他們很可能必須重新提交才能獲得最終批准，而我們是——從賽諾菲的時間角度來看，這可能是一個問題。

Great.

偉大的。

Thank you, Enrique.

謝謝你，恩里克。

Tony Butler with Guggenheim Securities.

古根海姆證券公司的托尼·巴特勒。

Enrique, back to Trulicity, if I may.

恩里克，如果可以的話，回到 Trulicity。

To what degree is the growth due to switches from Victoza versus that from orals straight to Trulicity?

從 Victoza 轉換到從口服直接到 Trulicity 的增長在多大程度上？

Part B of this is, does or would diabetic retinopathy actually cloud the class, assuming that's part of the warning of semaglutide in the label?

B 部分是，假設這是標籤中 semaglutide 警告的一部分，糖尿病視網膜病變是否會或是否會真正影響課程？

And then the second question is really around abemaciclib in non-small cell lung cancer.

然後第二個問題實際上是關於非小細胞肺癌中的 abemaciclib。

While one trial did not show OS -- and I'm curious, your confidence on the other trials, specifically in non-small cell lung cancer.

雖然一項試驗沒有顯示 OS——我很好奇，但您對其他試驗的信心，特別是在非小細胞肺癌中。

Great.

偉大的。

Tony, thank you for the questions.

托尼，謝謝你的提問。

Enrique, the first 2 for you on the source of Trulicity's growth as well as if the diabetic retinopathy that was seen in one of the Novo studies might impact the overall class.

Enrique，關於 Trulicity 增長來源的前 2 篇文章，以及在 Novo 研究中發現的糖尿病視網膜病變是否可能會影響整個班級。

And then, Sue, over to you for a discussion on other trials that are ongoing for abemaciclib in non-small cell lung cancer.

然後，Sue，請您討論 abemaciclib 在非小細胞肺癌中正在進行的其他試驗。

Enrique?

恩里克?

Very good.

很好。

When it comes to the source of Trulicity growth, I think it's important to highlight that our strategy from the very beginning was not to focus on current GLP-1 users.

當談到 Trulicity 增長的來源時，我認為重要的是要強調我們的戰略從一開始就不是專注於當前的 GLP-1 用戶。

So most of our strategy has been on additional adoption by specialists and then really the breadth in primary care.

因此，我們的大部分策略都是由專家額外採用，然後是初級保健的廣度。

I believe that strategy has been highly successful, so this is a source of our business by a very significant amount.

我相信該戰略非常成功，因此這是我們業務的一個非常重要的來源。

I don't have the actual figures with me, but it's minimal, whatever we get in terms of switching from other GLP-1s.

我沒有實際的數據，但它是最小的，無論我們從其他 GLP-1 轉換得到什麼。

We'd like for that to continue given the opportunity when it comes to patients on oral medicines that could benefit from better control.

當涉及到可以從更好的控制中受益的口服藥物患者時，我們希望這種情況能夠繼續下去。

When it comes to retinopathy, the data for Trulicity, I think, is very clear, and we do not have a signal when it comes to retinopathy.

當談到視網膜病變時，我認為 Trulicity 的數據非常清楚，我們沒有關於視網膜病變的信號。

We have to see how a potential warning or how the labeling of retinopathy for semaglutide will basically read out.

我們必須看看潛在的警告或索馬魯肽視網膜病變的標籤將如何基本讀出。

But clearly, we see significant advantages of GLP-1s in general, and we are counting on significant growth of this class as we think about Trulicity.

但很明顯，我們總體上看到了 GLP-1 的顯著優勢，並且在考慮 Trulicity 時，我們指望這一類的顯著增長。

I think that is the -- probably the -- one of the most important drivers of overall value for this asset.

我認為這可能是該資產整體價值最重要的驅動因素之一。

Thanks, Enrique.

謝謝，恩里克。

Sue?

起訴？

Yes, sure.

是的，當然。

Tony, with regards to the JUNIPER study, which was abemaciclib in KRAS mutation-positive advanced lung cancer, we did not see an overall survival advantage, I should mention.

托尼，關於 JUNIPER 研究，這是 KRAS 突變陽性晚期肺癌的 abemaciclib，我們沒有看到總體生存優勢，我應該提一下。

We did see, though, interesting single-agent activity in progression-free survival and overall response rates.

不過，我們確實在無進展生存期和總體反應率方面看到了有趣的單藥活性。

And this is the first study that has been prospectively looking at erlotinib in KRAS mutation-positive breast cancer.

這是第一項前瞻性研究厄洛替尼治療 KRAS 突變陽性乳腺癌的研究。

And without giving you full data, we did use historical control and had assumed based on historical in total about a 6.5-month overall survival with erlotinib.

在沒有提供完整數據的情況下，我們確實使用了歷史對照，並根據歷史假設使用厄洛替尼的總生存期約為 6.5 個月。

We saw higher than that.

我們看到的比這更高。

What -- we are continuing to progress, though, other studies in lung cancer, and we continue to be confident in those, particularly around rational combinations.

什麼 - 我們正在繼續推進肺癌的其他研究，我們繼續對這些研究充滿信心，特別是在合理組合方面。

We do believe, particularly with regards to KRAS mutation-positive lung cancer, which is really hard to treat, that rational combinations will be important.

我們確實相信，特別是對於很難治療的 KRAS 突變陽性肺癌，合理的組合將很重要。

And we've got a number of those ongoing, including IO combination with abemaciclib in combination PI3K/mTOR, and also we've got a Phase II squamous lung study ongoing.

我們已經有一些正在進行中，包括 IO 與 abemaciclib 聯合 PI3K/mTOR 的組合，而且我們正在進行一項 II 期鱗狀肺研究。

In addition to that, we're looking at other tumors as well.

除此之外，我們還在研究其他腫瘤。

And so our life cycle plan continues to look at progressing abemaciclib - Verzenio now - in breast cancer, but also in other tumor types.

因此，我們的生命週期計劃繼續著眼於進展 abemaciclib - 現在是 Verzenio - 在乳腺癌以及其他腫瘤類型中的進展。

That will be Marc Goodman with UBS.

那將是瑞銀的馬克古德曼。

If we look in the Phase II pipeline there, there's 8 products.

如果我們看看那裡的第二階段管道，有 8 種產品。

I think, many of us know the BACE, but several of the others are not as well known.

我認為，我們中的許多人都知道 BACE，但其他一些人並不為人所知。

Can you just talk about some of the products and where we should be focused?

你能談談一些產品以及我們應該關注的地方嗎？

And what kind of data we should be expecting?

我們應該期待什麼樣的數據？

And where there's excitement there?

哪裡有興奮？

And then just secondly, on Basaglar, it had a very strong uptick relative to the script trends.

其次，在 Basaglar 上，相對於劇本趨勢，它有一個非常強勁的上升趨勢。

So I was just wondering if there's any stocking or anything unusual in inventory change there.

所以我只是想知道那裡是否有庫存或庫存變化有什麼不尋常的地方。

Marc, thanks for the question.

馬克，謝謝你的問題。

So Jan, if you'd like to take a lead on the Phase II pipeline question.

Jan，如果您想在第二階段管道問題上發揮帶頭作用。

Others feel free to augment that answer if you'd like.

如果您願意，其他人可以隨意增加該答案。

And Enrique, anything unusual in the quarter on the Basaglar numbers, if you can comment on that.

還有恩里克，如果你能對此發表評論，那麼本季度關於 Basaglar 數字的任何不尋常之處。

Jan?

簡?

Okay.

好的。

So let me start in immunology with mirakizumab or IL-23 P19 antibody, which is tested in psoriasis as well as the 2 IBD indications: ulcerative colitis and Crohn's.

因此，讓我從 mirakizumab 或 IL-23 P19 抗體開始免疫學，該抗體在銀屑病以及 2 種 IBD 適應症中進行了測試：潰瘍性結腸炎和克羅恩病。

And we are expecting data late -- well, early next year, the first half for particularly psoriasis would come first.

我們期待數據遲到——嗯，明年初，特別是牛皮癬的上半年將首先出現。

In immunology, we also have the oral BTK inhibitor, the Bruton tyrosine kinase, which we are testing in RA with also data coming next year, and we are interested, clearly, because it's another potential oral agent in the immunology space.

在免疫學方面，我們還有口服 BTK 抑製劑 Bruton 酪氨酸激酶，我們正在 RA 中對其進行測試，明年也有數據，我們很感興趣，顯然，因為它是免疫學領域的另一種潛在口服藥物。

For diabetes, we have 2 agents.

對於糖尿病，我們有 2 種藥物。

The first one is GIP/GLP-1, it's the dual agonist then of 2 different mechanisms to lower body weight and also having potentially a better glucose control.

第一個是 GIP/GLP-1，它是兩種不同機制的雙重激動劑，可降低體重並可能更好地控制血糖。

We are particularly interested in this agent since in preclinical models, it has actually better efficacy than any other GLP-1 agent studie including semaglutide.

我們對這種藥物特別感興趣，因為在臨床前模型中，它實際上比任何其他 GLP-1 藥物研究（包括 semaglutide）具有更好的療效。

The DACRA is another variant and also incretion-like molecules with the Amylin and also the calcitonin stimulating receptor agent.

DACRA 是另一種變體，也是具有胰淀素和降鈣素刺激受體劑的分泌樣分子。

And the reason here is to have not only body weight lowering, but also potentially insulin sensitization activity.

這裡的原因不僅是降低體重，而且還有潛在的胰島素致敏活性。

And clearly, these 2 agents are somewhat in parallel for readouts, and we also have high-dose dulaglutide coming about the same time, and then I think we will make a choice about what is the next potential Phase III then in the insulin space.

很明顯，這兩種藥物的讀數有些平行，而且我們也有大劑量的度拉魯肽大約同時上市，然後我認為我們將就胰島素領域的下一個潛在 III 期做出選擇。

The BACE inhibitor, we also have in Phase II, is a very potent oral agent that has potentially less peripheral issues in relation than to targeting BACE 2. And we are actually running this also as a kind of a backup to lanabecestat, as you know, which is in Phase III.

我們在 II 期也有 BACE 抑製劑，它是一種非常有效的口服藥物，與靶向 BACE 2 相比，它的外圍問題可能更少。而且我們實際上也在運行它作為 lanabecestat 的一種備份，如你所知，處於第三階段。

And we're also considering potential combinations of this BACE inhibitor with N3pG in preclinical models.

我們還在考慮在臨床前模型中將這種 BACE 抑製劑與 N3pG 潛在組合。

That has been shown to have extraordinary clearance on not only plaques but also diffused amyloid.

這已被證明不僅對斑塊而且對彌散的澱粉樣蛋白具有非凡的清除作用。

Perhaps Sue can talk about the oncology space.

也許 Sue 可以談談腫瘤學領域。

Sure.

當然。

Well prexasertib, we have in Phase II in ovarian cancer.

好吧，prexasertib，我們在卵巢癌的 II 期。

We are specifically looking at developing this medicine and looking at biomarkers.

我們正在專門研究開發這種藥物並研究生物標誌物。

So first, you look at ovarian cancer and then we will progress, hopefully with the biomarker driven registration study should the Phase II data warrant that.

所以首先，你看看卵巢癌，然後我們會取得進展，如果 II 期數據證明這一點，希望通過生物標誌物驅動的註冊研究。

Merestinib, we are developing actually this medicine in biliary tract cancer.

Merestinib，我們實際上正在開發這種治療膽道癌的藥物。

We have a study for both Cyramza and merestinib in biliary tract cancer.

我們對 Cyramza 和 Merestinib 治療膽道癌進行了研究。

Depending on the data on the Phase II on that, we would progress one or either, potentially both, but probably one or either of those medicines in that indication.

根據第二階段的數據，我們將開發一種或其中一種，可能同時開發兩種，但可能是該適應症中的一種或兩種藥物。

And PI3K/mTOR inhibitor, we're really developing that as a combination therapy, and we have, as I'd mentioned earlier, a combination of PI3K/mTOR with abemaciclib.

和 PI3K/mTOR 抑製劑，我們確實正在開發它作為一種聯合療法，正如我之前提到的，我們有 PI3K/mTOR 與 abemaciclib 的組合。

Great.

偉大的。

Thank you.

謝謝你。

Enrique, on Basaglar?

恩里克，在巴薩格勒？

Sure.

當然。

We're very pleased with the performance of Basaglar and the continued adoption of Basaglar as a key basal insulin.

我們對 Basaglar 的表現以及 Basaglar 作為關鍵基礎胰島素的持續採用感到非常滿意。

When we look at the quarter, I think there's nothing on the stocking side but there was $12 million worth of a benefit related to changes in rebates and -- of the estimates of rebates and discounts for prior periods.

當我們查看本季度時，我認為庫存方面沒有任何東西，但有價值 1200 萬美元的收益與回扣的變化以及前期回扣和折扣的估計有關。

Great.

偉大的。

Thank you, Enrique.

謝謝你，恩里克。

Seamus Fernandez with Leerink Partners.

Seamus Fernandez 與 Leerink Partners。

So just a couple here.

所以這裡只有一對。

You guys have obviously evaluated the Elanco potential spin for quite some time.

你們顯然已經評估了 Elanco 的潛在旋轉已經有一段時間了。

Did want to talk a little bit and just kind of get your sense of -- in the current market we've seen companies make these types of announcements and then it takes a longer period of time to actually execute on the spin and then results in disappointment.

確實想談一談，只是讓您了解一下-在當前市場上，我們已經看到公司發布了這些類型的公告，然後需要更長的時間才能實際執行，然後導致結果失望。

Just trying to get a sense of your commitments to offering a definitive conclusion as of the middle of 2018, as you stated in your press release.

正如您在新聞稿中所說，只是想了解您在 2018 年年中提供明確結論的承諾。

And if we could, just to get a sense, I think the spin is fairly obvious, but historically, most companies have talked about the synergies between the businesses.

如果可以的話，只是為了了解一下，我認為這種旋轉是相當明顯的，但從歷史上看，大多數公司都在談論業務之間的協同作用。

Dave, I was just hoping you could talk about, if you see those synergies in the business any longer given the evolution of Lilly's business.

戴夫，我只是希望你能談談，如果你在禮來公司的業務發展中看到這些協同效應不再存在的話。

And then my second question, we did see a few additional VTEs announced for a competitor JAK inhibitor in an ACR abstract.

然後是我的第二個問題，我們確實在 ACR 摘要中看到了針對競爭對手 JAK 抑製劑宣布的一些額外 VTE。

I wanted to know if there's been any change in the frequency or rate of VTE that you've seen in any of your clinical data?

我想知道您在任何臨床數據中看到的 VTE 頻率或發生率是否有任何變化？

Or if it's still consistent as part of the resubmission, if it's consistent with the rates that we've seen in the past, which I believe you've stated are consistent with the historical rates of VTE for patients with RA?

或者，如果它作為重新提交的一部分仍然是一致的，如果它與我們過去看到的發生率一致，我相信你所說的與 RA 患者 VTE 的歷史發生率一致？

Seamus, thank you for the question.

Seamus，謝謝你的提問。

So Dave, we'll go to you for the first couple of questions on if we'll be able to provide a definitive answer by mid '18 on the strategy for Elanco going forward.

所以戴夫，我們會問你前幾個問題，關於我們是否能夠在 18 年中期就 Elanco 的未來戰略提供明確的答案。

And your view on synergies with that business.

以及您對與該業務的協同效應的看法。

And then over to Christi to talk about the rates we're seeing of VTE in our program with baricitinib.

然後到克里斯蒂談談我們在巴瑞替尼項目中看到的靜脈血栓栓塞率。

Shamus, thanks for the questions.

沙姆斯，謝謝你的提問。

Of course, we came out today and said mid '18 because that's where we believe we're going to hit.

當然，我們今天出來說 18 年中期，因為我們相信我們會在這方面取得成功。

So that's our best estimate of being able to get back to investors.

因此，這是我們能夠回饋投資者的最佳估計。

And we think that's ample time to evaluate the questions before us, as we look at the options to maximize the value of this asset and over the long-term.

我們認為現在是評估擺在我們面前的問題的充足時間，因為我們正在研究使這項資產的價值最大化和長期最大化的選項。

So that's our focus and I wouldn't wobble from that.

所以這是我們的重點，我不會因此而動搖。

Certainly, today, in day 1, I think this is a business that has been -- it does have some synergies with core Lilly but primarily it's operating outside of the core business of a Lilly.

當然，今天，在第一天，我認為這是一項已經存在的業務——它確實與禮來公司的核心業務有一些協同作用，但主要是在禮來公司的核心業務之外運營。

There's some back office synergies we gained and of course, we've talked through time about the R&D synergies.

我們獲得了一些後台協同效應，當然，我們一直在討論研發協同效應。

Although as we looked into that, I think they are currently rather modest.

儘管我們對此進行了調查，但我認為他們目前相當謙虛。

One reason for that is the platforms used across animal health are different.

原因之一是動物健康使用的平台不同。

We have a large vaccine portfolio that doesn't synergize with pharma R&D today.

我們擁有龐大的疫苗組合，目前無法與製藥研發產生協同效應。

We have a feed additives business that has really no synergy connecting to Lilly.

我們的飼料添加劑業務與禮來公司沒有任何協同作用。

On the companion side, therapeutics, that has some potential, but as we've looked at this, I think there's no reason to believe we couldn't maintain some of the synergies contractually if we had a different structure.

在伴侶方面，治療具有一定的潛力，但正如我們所看到的那樣，我認為沒有理由相信如果我們有不同的結構，我們就不能以合同方式保持一些協同效應。

So we're looking at all this and midyear next year is our deadline.

所以我們正在考慮這一切，明年年中是我們的最後期限。

Thanks, Dave.

謝謝，戴夫。

Christi?

克里斯蒂?

Sure.

當然。

In regards to thromboembolic events with baricitinib, we continue to monitor the real world evidence where we've launched commercially as well as accumulating data for our resubmission.

關於巴瑞克替尼的血栓栓塞事件，我們將繼續監測我們在商業上推出的真實世界證據，並為我們的重新提交積累數據。

As you know, the last time we submitted was January of 2015, so we have much more data to resubmit.

如您所知，我們上次提交是在 2015 年 1 月，因此我們有更多數據需要重新提交。

And everything that we've seen, we've seen nothing in our atopic dermatitis studies.

我們所看到的一切，在我們的特應性皮炎研究中都沒有看到。

And everything is consistent, as we've said before, with normal background rates in the rheumatoid arthritis patient population.

正如我們之前所說，一切都與類風濕性關節炎患者群體的正常背景率一致。

So no new news to report there.

所以那裡沒有新消息要報導。

Great.

偉大的。

Thank you, Christi.

謝謝你，克里斯蒂。

Chris Schott with JP Morgan.

摩根大通的克里斯·肖特。

Just a couple of questions here.

這裡只是幾個問題。

First on Jardiance dynamics, you've obviously seeing fairly healthy share gains.

首先在 Jardiance 動態方面，您顯然已經看到了相當健康的股票收益。

When we're thinking about overall category growth, are you happy with the trends we're seeing there?

當我們考慮整體品類增長時，您對我們在那裡看到的趨勢感到滿意嗎？

And what do you think it is going to take to further expand usage of the class overall?

您認為如何進一步擴大整個班級的使用範圍？

My second question was a broader-diabetes question.

我的第二個問題是一個更廣泛的糖尿病問題。

I know each segment is different, but just as we've gotten maybe further into contracting season, et cetera, just any preliminary comments about 2018?

我知道每個部分都是不同的，但正如我們可能已經進入合同季節等，關於 2018 年的任何初步評論？

Are there pricing or access to the portfolio?

是否有定價或訪問投資組合的權限？

Anything we should just be keeping in mind as we think out to next year?

考慮到明年，我們應該牢記什麼？

And then my follow-up question was on Elanco as we think about strategic options.

當我們考慮戰略選擇時，我的後續問題是關於 Elanco。

Do you believe further consolidation among the large animal health players is possible from an antitrust perspective as we think about the various kind of options that you're considering with this strategic review?

您認為從反壟斷的角度來看，大型動物保健參與者之間的進一步整合是可能的，因為我們考慮了您正在考慮進行此戰略審查的各種選擇？

Chris, thank you for the questions.

克里斯，謝謝你的提問。

Enrique, the first couple for you on Jardiance particular classic growth, potential catalysts for that going forward.

Enrique，Jardiance 特別經典增長的第一對夫婦，是未來發展的潛在催化劑。

And then the diabetes 2018 access picture, to the extent you can comment.

然後是 2018 年糖尿病訪問圖片，您可以發表評論。

And Dave, if you can talk through the question on the Elanco consolidation and the animal health industry question.

還有戴夫，如果你能談談關於 Elanco 整合和動物保健行業問題的問題。

Enrique?

恩里克?

So Jardiance has pretty quickly become the new standard when it comes to initiating patients on an SGLT2 therapy.

因此，在開始患者接受 SGLT2 治療時，Jardiance 很快成為新標準。

Our share now in -- when it comes to new-to-brand prescriptions is now north of 50%.

我們現在的份額——當涉及到新品牌處方時，現在已經超過了 50%。

And the overall trends, when it comes to volume or share, I think are very strong.

總體趨勢，就銷量或份額而言，我認為非常強勁。

Of course, when we look at the class, we do see some dynamics related to the overall leader of the class.

當然，當我們查看班級時，我們確實看到了一些與班級整體領導者有關的動態。

But as we think about the long-term opportunity for this product, we need to focus much more on Jardiance than on the class and the trends that basically Jardiance can continue to have.

但是當我們考慮這個產品的長期機會時，我們需要更多地關注 Jardiance，而不是 Jardiance 可以繼續擁有的類別和趨勢。

Clearly, the opportunity is enormous.

顯然，機會是巨大的。

Let's keep in mind that there are 160 million prescriptions written for oral medicines in the United States and SGLT2s have only 10 million of those.

請記住，美國有 1.6 億張口服藥物處方，而 SGLT2s 只有 1000 萬張。

And we are basically looking at a product that has an indication to reduce the risk of cardiovascular death for people with type 2 diabetes and established cardiovascular disease, which we believe is about 30% or so of the people with diabetes.

我們基本上正在尋找一種產品，該產品具有降低 2 型糖尿病和已確診心血管疾病患者心血管死亡風險的跡象，我們認為該產品約佔糖尿病患者的 30%。

So the opportunity is enormous and we are thinking of that opportunity with Jardiance in mind.

所以機會是巨大的，我們正在考慮 Jardiance 的機會。

When it comes to 2018, and as we think about pricing and access, I think, clearly, the different pharmaceutical benefit managers have already announced their formularies, but we do see a continuation of the trends when it comes to pricing pressures in diabetes.

談到 2018 年，當我們考慮定價和獲取時，我認為，很明顯，不同的醫藥福利管理者已經宣布了他們的處方集，但我們確實看到了糖尿病定價壓力的趨勢延續。

There was one notable exception that we saw that we were surprised and that was the exclusion of Jardiance from the CVS health formulary.

有一個值得注意的例外，我們看到我們感到驚訝，那就是 Jardiance 被排除在 CVS 健康處方集之外。

We, of course, are very disappointed with this decision, and we don't believe this is in the best interest of patients given the profile of Jardiance from a safety perspective and the label when it comes to cardiovascular and the fact that a competitor has a black box related to amputation.

當然，我們對這一決定感到非常失望，鑑於 Jardiance 從安全角度來看的概況和涉及心血管疾病的標籤以及競爭對手擁有的事實，我們認為這不符合患者的最佳利益。與截肢有關的黑匣子。

So we'll make our case with the physicians and with the patients.

因此，我們將向醫生和患者提出我們的意見。

Thanks, Enrique.

謝謝，恩里克。

Dave?

戴夫？

Yes, so Elanco is a combination, still possible in the sector, obviously, and we obviously have a lot of combinations, we've been a part of that.

是的，所以 Elanco 是一個組合，顯然在該領域仍有可能，而且我們顯然有很多組合，我們一直是其中的一部分。

But to answer the question, really have to look at the facts of the combination you might be looking at.

但要回答這個問題，真的必須看看你可能正在看的組合的事實。

So I guess, yes, it's possible, but we need to look at the product mix that would be resulting in any combination and then determine the antitrust risk.

所以我想，是的，這是可能的，但我們需要查看可能導致任何組合的產品組合，然後確定反壟斷風險。

We do think that's an avenue but we'd have to look at the facts in each geography.

我們確實認為這是一條途徑，但我們必須查看每個地區的事實。

Thanks, Dave.

謝謝，戴夫。

That will be John Boris with SunTrust.

那將是 SunTrust 的 John Boris。

First question just has to do with abemaciclib.

第一個問題與 abemaciclib 有關。

Listening to the Novartis call this morning, it certainly seems as though the launch of Kisqali has certainly underwhelmed Novartis.

今天早上聽諾華公司的電話，似乎 Kisqali 的推出肯定讓諾華公司不知所措。

What have you learned from the Pfizer and both the Novartis launches relative to the profile of abemaciclib as we track this product going forward here that gives you confidence that it will have some relatively robust uptake?

您從輝瑞（Pfizer）和諾華（Novartis）的兩次發布中學到了什麼，與 abemaciclib 的概況有關，因為我們在這裡跟踪該產品的發展，讓您相信它將有一些相對強勁的吸收？

And then second question just has to do with pricing in particular.

然後第二個問題尤其與定價有關。

Questions we get all the time are the difference between gross to net and the FDA's approval of so many innovative agents in therapeutic categories that over time is going to lead to an increase in the gross to net differential as discounting and rebating plays a much greater role.

我們一直遇到的問題是總淨額與 FDA 批准治療類別中如此多的創新藥物之間的差異，隨著時間的推移，隨著折扣和回扣發揮更大的作用，總淨額差異將導致增加.

Dave, how do you think about the business especially your most profitable affiliate, the U.S., in managing that going forward, to add some comfort to investors who take a long-term view and invest for the long-term?

戴夫，您如何看待這項業務，尤其是您最賺錢的子公司美國，在管理該業務的過程中，以便為具有長遠眼光並進行長期投資的投資者增添一些安慰？

And then on the patient front, obviously, a lot of discounts and rebates certainly aren't passed onto customers as their deductibles and their co-pays are going up.

然後在患者方面，很明顯，很多折扣和回扣肯定不會傳遞給客戶，因為他們的免賠額和共付額正在增加。

What's the potential solution?

潛在的解決方案是什麼？

Is there one out there to potentially ensure that a greater amount of that discount or rebate gets back into the customer's pocket so they can afford the new innovative medicines that you have here going forward?

有沒有一種方法可以確保更多的折扣或回扣回到客戶的口袋裡，這樣他們就可以買得起你們未來的創新藥物？

Thank you for the questions, John.

謝謝你的問題，約翰。

So Sue, we'll go to you for the things we've learned from the Ibrance and Kisqali launches as we think about launching Verzenio.

所以 Sue，當我們考慮推出 Verzenio 時，我們將向您介紹我們從 Ibrance 和 Kisqali 推出中學到的東西。

And then Dave, the questions on managing the U.S. market, particularly the dynamics that are brought by more branded agents being approved in causing competition as well as what solutions there might be to help with the patient side of the equation where a lot of the cost increases have been occurring.

然後是戴夫，關於管理美國市場的問題，特別是更多品牌代理商被批准在引發競爭方面帶來的動態，以及可能有哪些解決方案可以幫助解決等式的患者方面，其中很多成本增加已經發生。

Sue?

起訴？

Yes, John, thanks for the question.

是的，約翰，謝謝你的問題。

Clearly, it's early days.

顯然，現在還為時過早。

There's only been a few weeks out in the market with Verzenio.

Verzenio 上市僅幾週時間。

But we are very pleased with what we're hearing so far and our progress to-date.

但我們對迄今為止所聽到的內容和迄今為止的進展感到非常滿意。

We can't give you any quantitative data because of timing, but from a qualitative perspective, we are seeing our milestones on access being achieved.

由於時間原因，我們無法為您提供任何定量數據，但從定性的角度來看，我們正在實現訪問方面的里程碑。

We got the channel access ahead of plan just a few days after approval.

我們在批准後幾天就提前獲得了頻道訪問權限。

We've seen hospitals and pharmacists stocking the product and actually patients being started.

我們已經看到醫院和藥劑師儲備了該產品，並且實際上正在開始使用患者。

What we're trying to do is to ensure that access is as easy as possible for patients and also that the first experience that patients and physicians have with Verzenio is good.

我們正在努力做的是確保患者盡可能輕鬆地訪問，並且確保患者和醫生對 Verzenio 的第一次體驗是好的。

What we are hearing is that the differentiating factors for Verzenio are resonating.

我們聽到的是，Verzenio 的差異化因素正在引起共鳴。

The single agent activity is a differentiator for Verzenio.

單一代理活動是 Verzenio 的一個差異化因素。

Also, the fact that we can continuously dose, we've been very proactive from a side effect and safety profile.

此外，我們可以連續給藥這一事實，我們從副作用和安全性方面非常積極主動。

People are very appreciative of that and are telling us that the diarrhea is manageable.

人們對此非常感激，並告訴我們腹瀉是可以控制的。

We're providing loperamide and support around that, and people are very appreciative of that and saying it's manageable.

我們正在為此提供洛哌丁胺和支持，人們對此非常讚賞，並表示它是可控的。

What we're hearing from physicians is that they see Kisqali more like palbo, and that we have some differentiating features that they think are important and clinically relevant.

我們從醫生那裡聽到的是，他們認為 Kisqali 更像是 palbo，並且我們有一些他們認為重要且與臨床相關的差異化特徵。

So I'm very interested in giving you an update as we get further down the launch of Verzenio here in the U.S. Just on that, we've also submitted to Europe and Japan based on the MONARCH 2 and the MONARCH 3 data.

因此，隨著我們在美國進一步推出 Verzenio，我非常有興趣向您提供最新信息。僅此而已，我們還根據 MONARCH 2 和 MONARCH 3 數據向歐洲和日本提交了更新。

The single agent activity data will also be included in that package.

單一代理活動數據也將包含在該包中。

And we have just recently announced that we have gotten priority review for the MONARCH 3 so that's in combination with AI which means that the FDA is looking at an 8-month review versus the 12-month.

我們最近剛剛宣布，我們已經獲得了 MONARCH 3 的優先審查，因此這與 AI 相結合，這意味著 FDA 正在考慮 8 個月的審查而不是 12 個月的審查。

And that's, as a reminder, based on the interim data from the MONARCH 3 so we hope to have final data on that either the end of this year or next year.

提醒一下，這是基於 MONARCH 3 的臨時數據，因此我們希望在今年年底或明年獲得最終數據。

Thank you, Sue.

謝謝你，蘇。

Dave?

戴夫？

Thanks, John for your question.

謝謝，約翰的問題。

If I have it correctly, what you're saying is, as we think about the whole sector through time across all therapeutic areas, how do we -- what underlying trends do we see that would affect the innovative pharma business, and how does that affect our thinking about growth?

如果我的理解正確，您所說的是，當我們考慮整個治療領域的整個行業時，我們如何——我們看到哪些潛在趨勢會影響創新製藥業務，以及如何影響我們對成長的思考？

I don't think we've ever been more bullish about the underlying science in the therapeutic areas we operate in.

我認為我們從未如此看好我們所經營的治療領域的基礎科學。

And that's good news for the pricing dynamics too.

這對定價動態來說也是個好消息。

So just to put that together.

所以只是把它放在一起。

Where we see very competitive pricing dynamics are in relatively older categories with less differentiation and in more primary care versus specialty care.

我們看到極具競爭力的定價動態發生在相對較舊的類別中，差異較小，初級保健與專科保健相比更具競爭力。

And the second one is really because primary care doctors are much more time pressured and working through and building (inaudible) in your office to deal with the various formulary.

第二個確實是因為初級保健醫生的時間壓力更大，並且在您的辦公室工作和建設（聽不清）以處理各種處方集。

For a broader set of products than a specialist, there's a challenge for primary care doctors.

對於比專家更廣泛的產品，初級保健醫生面臨挑戰。

Specialists have set that up and work through it.

專家們已經建立並解決了它。

So the anecdote for this long term, which affects our strategy, -- I can't speak to the broader sector, but we see where the investment's flowing, I think it's consistent -- is to continue to focus on creating more and more differentiated assets at launch, bigger effect sizes, more difference versus standard of care.

因此，影響我們戰略的長期軼事——我無法談論更廣泛的行業，但我們看到投資的流向，我認為這是一致的——繼續專注於創造越來越多的差異化啟動時的資產，更大的影響大小，與護理標準相比有更大的差異。

I think, we see examples in our recent launches with Trulicity, with going to a weekly from a daily or Taltz by getting 40% complete clearance versus what TNFs can do which is similar in the mid-teens.

我認為，我們在最近推出的 Trulicity 中看到了一些例子，通過獲得 40% 的完全清除率從每日或 Taltz 變為每週一次，而 TNF 可以做到這一點，這在青少年中期是相似的。

That's the kind of medicines we need to be working on going forward.

這就是我們需要繼續努力的藥物。

Those that make a profound change versus the standard of care.

那些與護理標準相比發生深刻變化的人。

And then investing through the life cycle so that you don't find yourself less differentiated as competitors continue to launch.

然後在整個生命週期中進行投資，這樣您就不會在競爭對手繼續推出時發現自己的差異化程度降低。

Those are 2 dynamics that affect our thinking about the business.

這是影響我們對業務的思考的兩種動力。

And coupled with specialty care which is the underlying global trend that both the -- there's more innovative opportunities in areas like immunology and oncology relative to others -- areas of scientific inquiry, and that happens to correlate highly with where reimbursement can happen a little more easily because the hurdles that are produced by the payer system -- basically patients and providers are more willing to work through them for a more serious disease.

再加上專業護理，這是潛在的全球趨勢，即在免疫學和腫瘤學等領域相對於其他領域有更多創新機會——科學探究領域，而這恰好與可能發生更多報銷的領域高度相關很容易因為支付系統產生的障礙——基本上患者和提供者更願意通過這些障礙來應對更嚴重的疾病。

And I'm not saying that's a great answer for humanity long term.

我並不是說從長遠來看，這對人類來說是一個很好的答案。

I think we need to find a way to pay for and fund innovation in conditions like diabetes and cardiovascular disease, which are still some of the largest killers in the world.

我認為我們需要找到一種方法來支付和資助糖尿病和心血管疾病等疾病的創新，這些疾病仍然是世界上最大的殺手之一。

But that's just, I think, where both innovation is flowing and where R&D dollars have.

但我認為，這只是創新流動的地方和研發資金的來源。

That affects our strategy and our thinking to continue to stay ahead of what will be a price effect due to competition.

這影響了我們的戰略和我們的想法，以繼續保持領先於競爭導致的價格效應。

The ultimate antidote is differentiation.

最終的解藥是分化。

In terms of patient, you're asking a very important question.

就患者而言，您提出了一個非常重要的問題。

We're seeing in the U.S. this structural problem for many years of the pharmacy benefit having about 20% copay by patients out-of-pocket versus about 4%, 5% for services like hospital services.

我們在美國看到了多年來藥房福利的結構性問題，患者自付費用約 20% 的共付額，而醫院服務等服務的共付額約為 4% 和 5%。

That really hasn't changed.

這真的沒有改變。

What has changed is the number of patients who are exposed to very high deductible.

改變的是暴露於非常高的免賠額的患者數量。

So there's both a cash flow issue during the year as well as just overall out-of-pocket increases particularly for brand name drugs, generic prices remain relatively low and penetration relatively high.

因此，今年既有現金流問題，也有整體自付費用增加，特別是品牌藥，仿製藥價格仍然相對較低，滲透率相對較高。

We think an immediate step that should be taken in all sectors, all segments is to pass through rebates to patients.

我們認為，所有部門、所有環節都應該立即採取的措施是將回扣轉嫁給患者。

This provides an immediate point-of-sale discount.

這提供了即時的銷售點折扣。

I would share with you that, that is something commercial payers are now offering in the 2018 cycle.

我將與您分享，這是商業付款人現在在 2018 年周期中提供的東西。

We, ourselves, as an employer are evaluating that.

作為雇主，我們自己正在評估這一點。

We think that's a great step to ease out-of-pocket burdens.

我們認為這是減輕自付費用負擔的重要一步。

We've advocated aggressively with CMS that, that should be policy at Part D, particularly for a donut hole, that's one solution to help seniors pay for the medications.

我們積極倡導 CMS，這應該是 D 部分的政策，特別是對於甜甜圈洞，這是幫助老年人支付藥物費用的一種解決方案。

And then I think, long term, we need to ask, I think, a broader question, which we can get at through value pricing mechanisms potentially, which is to really ask our medicines a better way to deliver health care than other parts of the health care system.

然後我認為，從長遠來看，我們需要問一個更廣泛的問題，我們可以通過潛在的價值定價機制來解決這個問題，即真正要求我們的藥物提供比其他部分更好的醫療保健方式醫療系統。

And if so, why do we ask patients to pay more for it.

如果是這樣，我們為什麼要要求患者為此支付更多費用。

And I think that is a debate, a national debate, we need to continue to engage in.

我認為這是一場辯論，一場全國性的辯論，我們需要繼續參與。

Again, I think we're making great strides scientifically, but the system isn't well-equipped to help patients have affordable access to these inventions.

同樣，我認為我們在科學上取得了長足的進步，但該系統並沒有很好地幫助患者以負擔得起的方式獲得這些發明。

Thanks, Dave.

謝謝，戴夫。

Greg Gilbert with Deutsche Bank.

德意志銀行的格雷格·吉爾伯特。

With respect to animal health, Jeff, perhaps you can comment with more granularity on some of the revenue pressures you're seeing?

關於動物健康，傑夫，也許您可以更詳細地評論您所看到的一些收入壓力？

And are they Elanco issues or industry issues?

它們是 Elanco 問題還是行業問題？

And where's your atopic dermatitis pipeline given the success of APOQUEL and CYTOPOINT?

鑑於 APOQUEL 和 CYTOPOINT 的成功，您的特應性皮炎管道在哪裡？

Interested to know when you could show up in that market.

有興趣知道你什麼時候可以出現在那個市場上。

And then for Enrique, higher-level question beyond the sort of tit for tat on individual diabetes compounds.

然後對 Enrique 來說，除了針對個別糖尿病化合物的針鋒相對的問題之外，還有更高層次的問題。

In the past when we've met, you've suggested that there could be more of a push to partner with technology companies to enhance your overall diabetes franchise and solutions-based approach.

過去，當我們見面時，您曾建議更多地推動與技術公司合作，以增強您的整體糖尿病專營權和基於解決方案的方法。

So what can you say about that strategy at this point?

那麼，此時您對該策略有何看法？

Greg, thank you for the questions.

格雷格，謝謝你的提問。

So, Jeff, commentary on the revenue pressures, what's Elanco versus industry in terms of dynamics?

那麼，傑夫，關於收入壓力的評論，Elanco 與行業在動態方面的對比是什麼？

And a little bit the pipeline and outlook for getting into the atopic dermatitis, the companion animal space and then, Enrique, question over to you on our strategy for working with devices and device companies going forward.

還有一點進入特應性皮炎的管道和前景，伴侶動物空間，然後，恩里克，向你提問我們與設備和設備公司未來合作的戰略。

Jeff?

傑夫?

Yes, Greg, real quick on animal health.

是的，格雷格，對動物健康非常了解。

I think I would just come back on Elanco.

我想我會回到 Elanco。

Just kind of to anchor back, we again grew 4% excluding FX.

只是有點錨定，我們再次增長了 4%，不包括外匯。

We did see strong growth in global poultry.

我們確實看到了全球家禽的強勁增長。

And I think that overall sector is growing well.

我認為整個行業發展良好。

We grew 17%.

我們增長了 17%。

And then, of course, the U.S. companion animal vaccine.

然後，當然是美國的伴侶動物疫苗。

The pressures really remain and I'll kind of separate them.

壓力確實存在，我將把它們分開。

One is all around market access, which is driven by the clean food movement with antibiotics and productivity products.

一是圍繞市場准入，這是由抗生素和生產力產品的清潔食品運動推動的。

I think this is an industry issue depending on the product mix.

我認為這是一個行業問題，取決於產品組合。

And then any competitive pressures that are coming from a combination again in food animal that's a mix of economics of the industry as well as some generic pressure.

然後是來自食用動物組合的任何競爭壓力，這是行業經濟和一些通用壓力的混合。

So we saw that in U.S. cattle both with beef and dairy.

所以我們在美國牛身上看到了牛肉和奶製品。

The companion animal parasiticide space, let me just highlight, as Dave mentioned, Trifexis was an issue where we lost some share, no question.

伴侶動物殺蟲劑空間，讓我強調一下，正如 Dave 提到的，Trifexis 是我們失去一些份額的問題，毫無疑問。

I think everyone has seen increased spending.

我想每個人都看到了支出的增加。

Innovation is getting rewarded.

創新正在獲得回報。

So the new entrants have gained share.

因此，新進入者獲得了份額。

We still feel very good about companion animals and the parasiticide space in general given the size of our portfolio, existing portfolio and our heartworm platform as well as our pipeline.

考慮到我們的投資組合規模、現有投資組合和我們的心絲蟲平台以及我們的管道，我們仍然對伴侶動物和殺寄生蟲劑空間總體感覺非常好。

The market itself is still growing on the companion animal side and parasiticides, and then, I think lastly, is just the channel opportunities that are coming there.

市場本身在伴侶動物和寄生蟲劑方面仍在增長，然後，我認為最後，只是即將到來的渠道機會。

So again, I think you got some industry dynamics with cattle, beef and dairy.

再說一次，我認為你對牛、牛肉和奶製品有一些行業動態。

You've got some generic pressures a little bit there where there's lacking innovation on the food animal side, but overall, again, we see sectors like poultry, aqua and even companion animals growing in the vaccine space.

在食用動物方面缺乏創新的地方，你會遇到一些普遍的壓力，但總的來說，我們再次看到家禽、水產甚至伴侶動物等領域在疫苗領域的增長。

I think relative to atopic dermatitis, we are actively exploring several mechanisms here related to symptom treatment as well as interruption of disease process for the canine atopic dermatitis area.

我認為相對於特應性皮炎，我們正在積極探索與症狀治療相關的幾種機制以及犬特應性皮炎區域疾病過程的中斷。

We're leveraging Lilly's experience here.

我們在這裡利用了禮來的經驗。

No question, we'll continue to advance novel product concepts.

毫無疑問，我們將繼續推進新穎的產品概念。

Both large molecule and small molecule are being studied here.

這裡正在研究大分子和小分子。

So it's an active platform in our pipeline and we're focused on this.

所以它是我們管道中的一個活躍平台，我們專注於此。

Great, thanks, Jeff.

太好了，謝謝，傑夫。

Enrique?

恩里克?

So we are, in fact, excited about the opportunity brought by the convergence of both pharmaceuticals and technology to be able to create differentiated solutions and to be able to provide outcomes for an area like diabetes.

因此，事實上，我們對藥物和技術的融合所帶來的機會感到興奮，因為我們能夠創造差異化的解決方案，並能夠為糖尿病等領域提供成果。

We think that this could be pretty revolutionary.

我們認為這可能是相當革命性的。

So that's something that we have a high interest on.

所以這是我們非常感興趣的事情。

I'm not prepared to share too much more than that but just to say that we are actively working on it.

我不准備分享太多，只是說我們正在積極努力。

Thanks, Enrique.

謝謝，恩里克。

Steve Scala from Cowen.

來自 Cowen 的史蒂夫·斯卡拉。

On baricitinib, I have a follow-up to Seamus' question.

關於巴瑞替尼，我對 Seamus 的問題進行了跟進。

So you stated that DVTs are in line with the expected background rate.

所以你說 DVT 符合預期的背景率。

Would you confirm that there has been no new imbalances even if they still remain within the expected background rate?

您能否確認沒有新的失衡，即使它們仍保持在預期的背景率之內？

And then on the second quarter call, Dr. Mahony said that KEYNOTE-189 top line release was not expected till late this year or early next.

然後在第二季度電話會議上，Mahony 博士說 KEYNOTE-189 頂線發布預計要到今年年底或明年年初。

That was a surprising statement at the time given the September primary completion, but it has turned out to be correct.

鑑於 9 月份的初選完成，這在當時是一個令人驚訝的聲明，但事實證明它是正確的。

So I'm wondering if Dr. Mahony has any additional updates on the KEYNOTE-189 timing?

所以我想知道 Mahony 博士是否有任何關於 KEYNOTE-189 時間的其他更新？

Great.

偉大的。

Steve, thank you for the questions.

史蒂夫，謝謝你的提問。

Christi, question on DVTs, any new imbalances?

克里斯蒂，關於 DVT 的問題，是否有任何新的不平衡？

And then Sue, any update on the KEYNOTE-189 readout timing?

然後是 Sue，關於 KEYNOTE-189 讀出時間的任何更新？

Christi?

克里斯蒂?

I can confirm there are no new imbalances in regards to DVTs.

我可以確認在 DVT 方面沒有新的不平衡。

Great.

偉大的。

And Sue?

還有蘇？

And Steve, mine will be a quick answer too.

史蒂夫，我的也將是一個快速的答案。

I don't have any update.

我沒有任何更新。

I think you need to go to Merck for any update on 189.

我認為您需要去默克公司了解 189 的任何更新。

Vamil Divan from Crédit Suisse.

瑞士信貸的 Vamil Divan。

One, I just wanted to ask a question about the guidance and more midterm guidance and you mentioned the 5% plus sales CAGR.

一，我只是想問一個關於指導和更多中期指導的問題，你提到了 5% 以上的銷售複合年增長率。

And if you look at the models, I think our numbers, and also consensus in general is a little bit less than that.

如果您查看模型，我認為我們的數字以及總體上的共識比這要少一些。

So as you review the models, are there certain products that you'd highlight where you think the extra sort of $400 million or so in revenues may come by 2020 to get to that 5% number?

因此，當您查看模型時，您是否會強調某些產品，您認為到 2020 年可能會額外增加 4 億美元左右的收入以達到 5% 的數字？

And are there any expectations for business development that's built into that number?

該數字中是否包含對業務發展的任何期望？

And then related to that, when would you think you're maybe comfortable giving us more guidance on 2020 in terms of OpEx or margins or maybe EPS growth or something along those lines?

然後與此相關，您認為您何時可以放心地在 2020 年就運營支出或利潤率或每股收益增長或類似的東西向我們提供更多指導？

Great.

偉大的。

Vamil, thank you for the questions.

瓦米爾，謝謝你的提問。

Josh, we're going to road test you here.

喬希，我們要在這裡對你進行路試。

So if you'd like to comment a little bit, are there any BD transactions or placeholders built into that midterm guidance?

因此，如果您想發表一點評論，該中期指南中是否包含任何 BD 交易或占位符？

And any kind of quantitative comments you can give around where The Street may be missing something and/or confidence in those numbers?

您可以就 The Street 可能遺漏的地方和/或對這些數字的信心給出任何類型的定量評論？

And then we might give more details on 2020 or further out years in terms of midterm guidance.

然後我們可能會在中期指導方面提供更多關於 2020 年或更遠年份的詳細信息。

Sure, thanks.

當然，謝謝。

First, on the business development piece, we don't have future business development sales built into our projections around the 5%.

首先，在業務發展方面，我們沒有將未來業務發展銷售額納入我們對 5% 左右的預測。

As you know, we are very active in looking at external innovation and opportunities.

如您所知，我們非常積極地尋找外部創新和機會。

So if we see those, those would obviously help or add to our projections.

因此，如果我們看到這些，這些顯然會幫助或增加我們的預測。

I think as it relates to the 5% goal itself, as Derica mentioned, we're very confident given the performance, again this period was from 2015 to 2020, and when you look at how we performed since 2015 and where we are today, we think we've got really strong momentum to get us to the 5% CAGR through 2020.

我認為因為它與 5% 目標本身有關，正如 Derica 所提到的，鑑於表現，我們非常有信心，這個時期也是從 2015 年到 2020 年，當你看看我們自 2015 年以來的表現以及我們今天所處的位置時，我們認為我們有非常強大的動力讓我們到 2020 年實現 5% 的複合年增長率。

I think when we look at the models, we don't provide product level guidance, but I think our collective confidence is based on the strength of the new product portfolio.

我認為當我們查看模型時，我們不提供產品級別的指導，但我認為我們的集體信心是基於新產品組合的實力。

As we mentioned, they contribute 14 points of growth this quarter and you look across that portfolio of opportunities, Trulicity, Jardiance, Basaglar, Olumiant, Taltz, abemaciclib, et cetera.

正如我們所提到的，他們在本季度貢獻了 14 個增長點，您可以查看這些機會組合，Trulicity、Jardiance、Basaglar、Olumiant、Taltz、abemaciclib 等等。

We think -- and with the pain portfolio coming, we see that portfolio continuing to grow and continuing to drive growth.

我們認為——隨著痛苦組合的到來，我們看到組合繼續增長並繼續推動增長。

So I think it's probably the collective performance of the new products that give us the confidence that we're well on our way toward that 5% target.

所以我認為可能是新產品的集體表現讓我們相信我們正在朝著 5% 的目標邁進。

I think as it relates to the OpEx guidance, we will provide 2018 guidance in December on our call, and you can expect us to provide some updates on how we see the remainder of the decade performing there.

我認為，由於它與運營支出指南有關，我們將在 12 月的電話會議上提供 2018 年指南，您可以期待我們提供一些關於我們如何看待這十年剩餘時間在那裡表現的更新。

I think as Dave mentioned in an earlier answer, as it relates to our margin guidance, we've used 2018 just as a mile marker along the way toward being a more productive and expanded-margin company, and we'll look to provide some more color on that in our 2018 call this December.

我認為正如戴夫在之前的回答中提到的那樣，因為它與我們的利潤率指導有關，我們將 2018 年用作成為一家更有生產力和擴大利潤率的公司的里程碑，我們將尋求提供一些在今年 12 月的 2018 年電話會議中，我們會對此進行更多的介紹。

Great, Josh.

太好了，喬什。

Thank you very much.

非常感謝。

Geoff Meacham with Barclays.

巴克萊銀行的傑夫·米查姆。

Just a couple of quick ones.

只是幾個快速的。

On baricitinib, on the back of the recent data on atopic dermatitis, maybe just help us with the size and scope of the Phase III program that you're starting later this year and what you guys see as a biggest product differentiator?

關於巴瑞替尼，根據最近關於特應性皮炎的數據，也許只是幫助我們了解你們今年晚些時候開始的 III 期項目的規模和範圍，以及你們認為最大的產品差異化因素是什麼？

And on the RA side for bari, should we expect any formal updates at medical meetings coming up, just on a broader safety question?

在巴里的 RA 方面，我們是否應該期待醫學會議上的任何正式更新，只是關於更廣泛的安全問題？

And then last one on Alimta.

然後是 Alimta 上的最後一個。

I know overall demand trends have, in fact, been negatively impacted by -- but what are you guys seeing with respect to first-line lung trends just of late?

我知道總體需求趨勢實際上受到了負面影響——但是你們最近對一線肺部趨勢有何看法？

Great, Geoff, thanks for the question.

太好了，傑夫，謝謝你的問題。

So Christi, the first 2 to you for the size and scope of the Phase III program and potential areas for differentiation, any updates to the RA safety database coming in medical meetings.

因此，克里斯蒂，前 2 位向您介紹 III 期計劃的規模和範圍以及潛在的差異化領域，醫學會議上對 RA 安全數據庫的任何更新。

And then Sue, over to you for the trends in first-line non-squamous non-small cell lung cancer for Alimta?

然後蘇，請您了解 Alimta 一線非鱗狀非小細胞肺癌的趨勢？

Christi?

克里斯蒂?

So on the atopic dermatitis front, I think, just to clarify, we got a lot of questions on our Phase II data which I think is relevant for the question on what our Phase III study design looks like.

所以在特應性皮炎方面，我想，為了澄清一下，我們有很多關於我們的 II 期數據的問題，我認為這些問題與我們的 III 期研究設計的問題有關。

So in our Phase II data readout, we were very pleased with the results.

所以在我們的第二階段數據讀出中，我們對結果非常滿意。

Unlike our competitors, one of the things that we looked at is what is the depth of efficacy that we could achieve and what I mean by that is we actually took the very resistant patient to corticosteroids.

與我們的競爭對手不同，我們關注的一件事是我們可以達到的療效深度，我的意思是我們實際上讓非常耐藥的患者對皮質類固醇有抵抗力。

So we took patients for 4 weeks, they were on the moderate dose of topical steroids.

所以我們帶了病人 4 週，他們服用中等劑量的局部類固醇。

And those patients that responded were actually taken out of pre-randomization.

那些有反應的患者實際上被排除在預隨機分組之外。

So only those patients that were not responding to topical steroids were actually randomized to Phase III.

因此，只有那些對局部類固醇沒有反應的患者實際上被隨機分配到 III 期。

And so you had, first of all, resistant patients to steroids, but second of all, you had patients that had less severe -- less disease severity.

因此，首先，您有對類固醇有抗藥性的患者，但其次，您的患者病情較輕——疾病嚴重程度較低。

So the EZ scores at baseline were around 20, where you see our competitors who did the opposite used washout period of 4 weeks where patients will have an increased disease activity, their EZ scores actually started at 30 and 32.

因此，基線時的 EZ 分數約為 20，您會看到我們的競爭對手使用了相反的 4 周清除期，患者的疾病活動度會增加，他們的 EZ 分數實際上從 30 和 32 開始。

So that being able to show the results that we did in that patient population really gives us a lot of confidence as we move to the Phase III studies.

因此，當我們進入 III 期研究時，能夠展示我們在該患者群體中所做的結果確實給了我們很大的信心。

And we will study Phase III similar to what our competitors did, now that we know the depth of the efficacies.

既然我們知道功效的深度，我們將像我們的競爭對手所做的那樣研究第三階段。

So as we look at monotherapy, we look at various doses of the 1, 2 and 4 milligrams, we'll be looking at different dosing, the lower and higher.

因此，當我們研究單一療法時，我們會研究 1、2 和 4 毫克的不同劑量，我們將研究不同的劑量，更低的和更高的。

We are very confident that we'll have a robust study with robust results.

我們非常有信心，我們將進行一項穩健的研究，並取得穩健的結果。

And in terms of any updates from the RA program, safety updates coming at medical meetings, are there any -- my understanding was that BACE may have some repeats of things that were done earlier this year, but not necessarily new data.

就 RA 計劃的任何更新、醫學會議上的安全更新而言，是否有任何 - 我的理解是 BACE 可能會重複今年早些時候所做的事情，但不一定是新數據。

Correct.

正確的。

So we have a press release that will be coming out soon.

因此，我們有一份即將發布的新聞稿。

We have 33 different scientific releases on both baricitinib and Taltz at ACR, and baricitinib will be new analysis that we have seen on safety, but no new surprises in a negative way.

我們在 ACR 上發布了 33 個關於巴瑞克替尼和 Taltz 的不同科學版本，巴瑞克替尼將是我們在安全性方面看到的新分析，但沒有負面的新驚喜。

We look forward to showing you those and links to those will be within the press release.

我們期待在新聞稿中向您展示這些內容以及指向這些內容的鏈接。

Great.

偉大的。

Thanks, Christi.

謝謝，克里斯蒂。

Sue?

起訴？

Yes.

是的。

Geoff, with regards to Alimta, as you mentioned, we have been challenged by IO uptake in the front-line setting over the past few months, and we've been seeing a sort of steady decline.

Geoff，關於 Alimta，正如你所提到的，在過去的幾個月裡，我們一直受到一線環境中 IO 吸收的挑戰，而且我們一直在看到一種穩步下降的趨勢。

We are pleased to see that we have seen a flattening in the front-line share.

我們很高興看到一線市場份額趨於平緩。

We now have a 26% share of market in front line.

我們現在在一線擁有 26% 的市場份額。

We've also seen an increase in the second line share, as IO's moved to front line and interestingly, as we're looking at the New to Brand, we're seeing an increase in the uptake of Alimta with Keytruda in the front-line setting.

隨著 IO 轉移到一線，我們還看到二線市場份額有所增加，有趣的是，當我們關注 New to Brand 時，我們看到 Alimta 與 Keytruda 的採用率有所增加——線設置。

Thank you for the update, Sue.

謝謝你的更新，蘇。

Richard Purkiss with Piper Jaffray.

Richard Purkiss 與 Piper Jaffray。

I have 2 questions for Enrique.

我有 2 個問題要問恩里克。

Two quick ones.

兩個快的。

What proportion of patients initiating GLP-1 therapy in the U.S. now have some evidence of diabetic retinopathy?

在美國，有多少開始 GLP-1 治療的患者現在有一些糖尿病視網膜病變的證據？

And then on average, in the U.S., how frequently are type 2 diabetic patients' retinas visualized?

然後平均而言，在美國，2 型糖尿病患者的視網膜多久可視化一次？

Enrique, I won't try to repeat.

恩里克，我不會嘗試重複。

I think you heard those clearly.

我想你聽得很清楚。

So we'll go to you for the answer.

所以我們會去找你的答案。

Not the second part.

不是第二部分。

So the first one was a percent initiating GLP-1 that have evidence of retinopathy.

所以第一個是啟動 GLP-1 的百分比，有視網膜病變的證據。

And then the second one is the percent of patients -- diabetics in the U.S. that are actually being scanned currently to look for evidence of retinopathy.

然後第二個是患者的百分比 - 美國的糖尿病患者目前實際上正在接受掃描以尋找視網膜病變的證據。

So, excellent questions.

所以，很好的問題。

Unfortunately, on the last question, not enough.

不幸的是，在最後一個問題上，還不夠。

There's really a nominal number of patients with diabetes that actually do get screening.

確實有名義上的糖尿病患者確實接受了篩查。

When we look at the patient with diabetes -- I don't have the specific numbers for GLP-1, but when we look generally for patients with diabetes, they're about 30% of patients with diabetes have some degree of retinopathy.

當我們查看糖尿病患者時——我沒有 GLP-1 的具體數字，但是當我們一般地查看糖尿病患者時，大約 30% 的糖尿病患者患有某種程度的視網膜病變。

If you were to look at the more serious retinopathy which is vision threatening, we're looking probably a number of 3% to 5%.

如果您要查看威脅視力的更嚴重的視網膜病變，我們可能會看到 3% 到 5% 的數字。

Great.

偉大的。

Thank you, Enrique.

謝謝你，恩里克。

Jeff Holford with Jefferies.

傑夫霍爾福德與傑富瑞。

Just want to dig a bit more into the JAK and bari safety.

只是想深入了解 JAK 和 bari 安全性。

So can you just help us understand a bit better what the additional data and exposure data that you have will achieve?

那麼您能否幫助我們更好地了解您擁有的額外數據和曝光數據將實現什麼？

Do you think in light of the questions the FDA have around your original submission, because I think, as you referred to before, there was a cluster of events there and just how additional exposure data potentially changes that?

您是否考慮到 FDA 對您最初提交的問題的看法，因為我認為，正如您之前提到的，那裡發生了一系列事件，以及額外的暴露數據可能如何改變這種情況？

Secondly, can you just tell us exactly what is the background rate data that you referred to in terms of what you think should be there in this population?

其次，您能否準確地告訴我們您所指的背景比率數據是什麼，您認為該人群中應該存在什麼？

Obviously, some of these clinical trial populations have different levels of cardiovascular risks.

顯然，其中一些臨床試驗人群具有不同程度的心血管風險。

And I don't know if you've really talked to whether your view was that some of the trials you had are particularly high or relatively low cardiovascular risk.

而且我不知道您是否真的討論過您的觀點是否是您進行的一些試驗是特別高或相對較低的心血管風險。

And then is there anything that you are doing differently in your Phase III atopic dermatitis trial in terms of crossover length of exposure?

那麼就暴露的交叉長度而言，您在 III 期特應性皮炎試驗中做的有什麼不同嗎？

Just other things to help address this question a bit more robustly going forward.

只是其他有助於解決這個問題的事情會更加有力地向前推進。

Right, Christi, all those are for you.

對，克里斯蒂，所有這些都是給你的。

So the additional safety data, what we think it's going to achieve.

因此，額外的安全數據，我們認為它將實現的目標。

What is that background rate that we're referring to in this population?

我們在這個人群中所指的背景率是多少？

What population is that?

那是什麼人口？

And then if there's anything we're doing with atopic dermatitis studies in Phase III that could help to shed light on this particularly safety issue as well?

然後，如果我們在 III 期的特應性皮炎研究中所做的任何事情也有助於闡明這個特別安全的問題？

So in terms of what the additional data will help us with, let me start with the background rates, actually, if that's okay.

因此，就附加數據對我們的幫助而言，讓我從背景費率開始，實際上，如果可以的話。

Background rates in the rheumatoid arthritis patient population already are 0.3 to 0.8 per 100 patient years.

類風濕性關節炎患者群體的背景發生率已經為每 100 患者年 0.3 至 0.8。

So in the general rheumatoid arthritis patients, if they weren't on baricitinib, that would be the incidents that they report.

因此，在一般類風濕性關節炎患者中，如果他們不使用巴瑞替尼，那將是他們報告的事件。

And so when I say that our background rates are similar to that, our specific background rate during the development programs was 0.46 per 100 patient years.

因此，當我說我們的背景率與此相似時，我們在開發計劃期間的特定背景率是每 100 個患者年 0.46 個。

And so when I also say now, since we've submitted in the real-world evidence in atopic dermatitis and all of the data that we've accumulated, that background rate is still within the general rate of the rheumatoid arthritis development program -- or the background rate of the rheumatoid arthritis patient, excuse me.

因此，當我現在還說，由於我們已經提交了特應性皮炎的真實證據以及我們積累的所有數據，該背景率仍然在類風濕性關節炎發展計劃的一般率之內-或者類風濕關節炎患者的背景率，對不起。

So that's what -- hopefully that clarifies it.

所以這就是- 希望可以澄清它。

Our background rate is similar to what you'd see without using baricitinib in this patient population.

我們的背景率與您在該患者群體中未使用巴瑞替尼時所看到的相似。

The additional data, I think, as we discussed with FDA, you have your clinical trial program, we submitted it in January '15.

我認為，正如我們與 FDA 討論的那樣，額外的數據，你有你的臨床試驗計劃，我們在 15 年 1 月提交了它。

Since then, typically when the FDA looks at approving a drug, they say is it safe and is it effective.

從那時起，通常當 FDA 考慮批准一種藥物時，他們會說它安全且有效。

Or is it -- what is that balance.

或者是 - 什麼是平衡。

And now that we have real-world evidence, when they look at that, they're trying to protect patients.

現在我們有了真實世界的證據，當他們看到這一點時，他們正在努力保護患者。

Now that we have patients actually in the real world on baricitinib, why that is important is they can actually see in the real world when you're using baricitinib, how does it really play out?

既然我們有患者在現實世界中使用巴瑞替尼，為什麼重要的是當您使用巴瑞替尼時他們可以在現實世界中看到，它是如何真正發揮作用的？

And now that we've had over 5,000 patients with physicians using it in clinical practice, the way that someone normally would, not in a controlled environment, that we believe that, that gives even more confidence that our background rates matching rheumatoid arthritis in clinical trials as well as now in the new world -- in the real-world evidence is consistent.

現在我們已經有超過 5,000 名患者的醫生在臨床實踐中使用它，這是人們通常在不受控制的環境中使用它的方式，我們相信，這讓我們更有信心相信我們的背景率與臨床中的類風濕性關節炎相匹配試驗以及現在在新世界中——在現實世界中的證據是一致的。

And then as we look at atopic dermatitis, I think the thing that this confirms is if you look at the patient population of patients who actually had a thromboembolic event, each one of those patients had a high risk for those before they had a thromboembolic event.

然後當我們研究特應性皮炎時，我認為這可以證實的是，如果您查看實際發生血栓栓塞事件的患者群體，這些患者中的每一個在發生血栓栓塞事件之前都有很高的風險.

So in the atopic dermatitis trials, we see a much younger patient population which is part of the reason we probably don't see any in the -- through the Phase II trials we've seen so far and why we wouldn't anticipate seeing that many or a difference as we move forward with the Phase III trials.

因此，在特應性皮炎試驗中，我們看到了更年輕的患者群體，這是我們可能在迄今為止看到的 II 期試驗中看不到任何患者的部分原因，以及為什麼我們預計不會看到隨著我們推進 III 期試驗，會有那麼多或不同。

Thank you, Christi.

謝謝你，克里斯蒂。

Alex Arfaei from BMO Capital Markets.

來自 BMO 資本市場的 Alex Arfaei。

Two questions, please, and a clarification.

請提出兩個問題，並澄清一下。

First, why did you discontinue the N3pG antibody in Alzheimer's?

首先，您為什麼停止在阿爾茨海默氏症中使用 N3pG 抗體？

If I recall correctly, at your Alzheimer's R&D day, this was highlighted particularly given that it is similar to aducanumab.

如果我沒記錯的話，在您的阿爾茨海默氏症研發日，考慮到它與 aducanumab 相似，特別強調了這一點。

So what's incremental and new there that led to discontinuation?

那麼導致停產的增量和新功能是什麼？

Second, on Elanco.

第二，關於Elanco。

Unless I'm mistaken, it's not growing organically excluding the BI vaccine acquisitions.

除非我弄錯了，否則它不會有機地增長，不包括 BI 疫苗的收購。

So does it have enough of a pipeline in R&D productivity to sustain growth in line with the market?

那麼它是否有足夠的研發生產力管道來維持與市場同步的增長？

And then finally to clarify Humalog, did I hear you correctly that there are no legal barriers from your side preventing Sanofi from launching their biosimilars?

最後澄清一下 Humalog，我是否正確地聽到你說沒有法律障礙阻止賽諾菲推出他們的生物仿製藥？

Thank you for the questions, Alex.

謝謝你的問題，亞歷克斯。

So Jan, if you'll answer the question on the discontinuation of N3pG in the pipeline.

所以 Jan，如果你能回答關於 N3pG 停止生產的問題。

Maybe Jeff and/or Dave, you want to comment on sort of what are the growth drivers going forward in pipeline prospects for Elanco?

也許 Jeff 和/或 Dave，您想評論一下 Elanco 管道前景的增長動力是什麼？

And then, Mike, if you want to clarify on the Humalog legal situation.

然後，邁克，如果你想澄清一下 Humalog 的法律情況。

Jan?

簡?

If we thought with plaque specific antibody N3PG, as you can see, on the pipeline chart, we actually have 3 molecules there for that target.

如果我們考慮使用斑塊特異性抗體 N3PG，如您所見，在管道圖上，我們實際上有 3 個分子用於該目標。

And the front-runner molecule is still then inside the pipeline as active and the follow-on molecule did not meet the clinical criteria that we wanted.

並且領先的分子仍然在管道中處於活躍狀態，後續分子不符合我們想要的臨床標準。

So, hence, we stopped it.

所以，因此，我們停止了它。

Just to be fair, we took a 2 to get 1 strategy in Phase I here.

公平地說，我們在第一階段採取了 2 獲得 1 的策略。

And then Jeff, on the strength of the animal health pipeline?

然後是傑夫，依靠動物健康管道的力量？

Yes, Alex, good question.

是的，亞歷克斯，好問題。

Yes, we feel very good about our pipeline.

是的，我們對我們的管道感覺非常好。

Also, I think we launched a series of products last year and into this year that we're going to see growth on and then we'll talk more as we get near the end of the year in our guidance call and go into next year about additional launches.

另外，我認為我們去年和今年推出了一系列產品，我們將看到增長，然後我們將在接近年底的指導電話中進行更多討論，並進入明年關於額外的發射。

So it's not just a pipeline, but I think existing launches that are occurring now and ones that are right on top of us.

因此，這不僅僅是一個管道，而且我認為現在正在發生的現有發布以及就在我們之上的發布。

And then I think the last thing is we're shifting our mix into these faster growing markets.

然後我認為最後一件事是我們正在將我們的組合轉移到這些增長更快的市場。

So as I mentioned, the food animal vaccines, nutritional health, companion animals and aqua, as our mix gets higher in those spaces, that'll also drive more additional organic growth.

所以正如我所提到的，食用動物疫苗、營養健康、伴侶動物和水產，隨著我們在這些領域的組合越來越高，這也將推動更多的額外有機增長。

Maybe if I could just add to that, just to be clear, we're not growing organically this year.

也許如果我能補充一點，為了清楚起見，我們今年沒有有機增長。

The growth is the BI addition and companion, and we described food animal pressures.

增長是 BI 的添加和伴侶，我們描述了食用動物的壓力。

I think we're not evaluating this business through the lens of 2017 performance.

我認為我們不會通過 2017 年的表現來評估這項業務。

We're looking at the last 10 years, and we've built a globally competitive animal health company with a nice pipeline, with good opportunities to improve margins and grow at pace and in some segments above industry pace.

我們正在回顧過去 10 年，我們已經建立了一家具有全球競爭力的動物保健公司，擁有良好的管道，有很好的機會提高利潤率，並在某些領域以高於行業的速度增長。

And as we look forward, and do this analysis, we'll be looking again at those long-term trends in animal health, and because we're broadly positioned across many of these segments and we do have innovation coming, we do expect forward trends to reflect those assumptions as we do the analysis.

當我們展望未來並進行分析時，我們將再次審視動物健康的長期趨勢，因為我們在許多這些領域都有廣泛的定位，而且我們確實有創新，我們確實期待未來在我們進行分析時反映這些假設的趨勢。

So this year, we've washed out some challenges.

所以今年，我們已經消除了一些挑戰。

We've had some performance challenges.

我們遇到了一些性能挑戰。

BI has helped us in terms of the stated growth rate, but we're looking at this decision-making through a much broader lens of time.

BI 在規定的增長率方面幫助了我們，但我們正在通過更廣泛的時間視角來看待這一決策。

Alex, you're correct.

亞歷克斯，你是對的。

We have no legal basis to preclude Sanofi from entering the market.

我們沒有法律依據阻止賽諾菲進入市場。

And as Enrique described earlier, we will compete with them in the marketplace.

正如 Enrique 之前所描述的，我們將在市場上與他們競爭。

That concludes the Q&A session.

問答環節到此結束。

So David, if you'd like to wrap up the call please.

所以大衛，如果你想結束通話，請。

Yes, I would.

是的，我會。

Again, I want to recognize and thank both Maria Crowe, who's been with us today and through many years, as well as Derica Rice, at this last earnings call with us as CFO for a great performance through your careers and many contributions to our company.

再次，我要承認並感謝今天和多年來一直與我們在一起的 Maria Crowe 以及 Derica Rice，在最後一次財報電話會議上，我們作為首席財務官在您的職業生涯中表現出色，並為我們公司做出了許多貢獻.

So thank you, again.

所以，再次感謝你。

We appreciate all of your participation on today's earnings call and your interest in our company.

感謝您參加今天的財報電話會議以及您對我們公司的興趣。

Through the first 9 months of 2017, we generated solid revenue growth, driven by volume of our new pharmaceutical products, and we continue to improve margins.

在 2017 年前 9 個月，我們在新醫藥產品數量的推動下實現了穩健的收入增長，並且我們繼續提高利潤率。

We're going to see even faster income growth.

我們將看到更快的收入增長。

We believe Lilly remains a compelling investment given the strength of our product portfolio, and our top and bottom line growth prospects over the balance of the decade.

鑑於我們產品組合的實力以及我們在十年餘下時間的收入和利潤增長前景，我們相信禮來仍然是一項引人注目的投資。

Please follow up with the IR team if we've not answered any questions on the call, or if you have follow-up questions.

如果我們在電話中沒有回答任何問題，或者您有後續問題，請與 IR 團隊聯繫。

That concludes the call today.

今天的通話到此結束。

Have a great day.

祝你有美好的一天。

Ladies and gentlemen, your conference will be available for replay beginning today, October 24, 2017, at 11:30 a.m.

女士們，先生們，你們的會議將於 2017 年 10 月 24 日上午 11:30 開始重播。

and lasting until October 24, 2018, at 11:59 p.m.

並持續到 2018 年 10 月 24 日晚上 11:59。

To access the AT&T executive playback service during that time, please dial 1-800-475-6701.

要在此期間訪問 AT&T 執行播放服務，請撥打 1-800-475-6701。

Internationally, area code 320 365-3844 and enter the access code 430109.

國際區號320 365-3844，輸入接入碼430109。

That will conclude your conference call for today.

這將結束你今天的電話會議。

Thank you for your participation and for using AT&T's Executive Teleconference service.

感謝您的參與和使用 AT&T 的行政電話會議服務。

You may now disconnect.

您現在可以斷開連接。