禮來公司 (LLY) 2018 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Q2 2018 earnings call.

女士們，先生們，感謝您的支持，歡迎參加 2018 年第二季度財報電話會議。

(Operator Instructions) We do remind today's call is being recorded.

（操作員說明）我們提醒您今天的通話正在錄音中。

(Operator Instructions)

（操作員說明）

Your hosting speaker, Dave Ricks.

您的主持人，戴夫·里克斯。

Please go ahead, sir.

請繼續，先生。

Good morning.

早上好。

Thank you for joining us for Eli Lilly and Company's Q2 2018 earnings call.

感謝您參加禮來公司 2018 年第二季度財報電話會議。

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 today's call are Josh Smiley, our Chief Financial Officer; Dr. Dan Skovronsky, President of Lilly Research Labs; Enrique Conterno, President of Lilly Diabetes and Lilly USA; Dr. Sue Mahony, President of Lilly Oncology; Jeff Simmons, President of Elanco Animal Health; and unfortunately, Christi Shaw, our President of Lilly Bio-Medicines is ill and won't be joining us today.

加入我今天的電話會議的是我們的首席財務官 Josh Smiley；禮來研究實驗室總裁 Dan Skovronsky 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； Elanco Animal Health 總裁 Jeff Simmons；不幸的是，我們的禮來生物醫藥總裁 Christi Shaw 病了，今天不會加入我們的行列。

We're also joined by Kristina Wright, Jim Haney, Kevin Hern and Phil Johnson of the IR team.

IR 團隊的 Kristina Wright、Jim Haney、Kevin Hern 和 Phil Johnson 也加入了我們的行列。

This will be the last earnings call for Sue Mahony, President of Lilly Oncology, who retires at the end of August.

這將是禮來腫瘤學總裁 Sue Mahony 的最後一次財報電話會議，他將於 8 月底退休。

Sue led Lilly Oncology through the integration of ImClone, successfully launched several key brands including, most recently, Verzenio, and has now refocused our oncology R&D strategy.

Sue 通過整合 ImClone 領導 Lilly Oncology，成功推出了幾個關鍵品牌，包括最近的 Verzenio，現在重新調整了我們的腫瘤研發戰略。

I want to thank Sue for her leadership over the past 18 years at the company, and for her inspiring passion for helping patients.

我要感謝 Sue 在公司過去 18 年中的領導，以及她對幫助患者的鼓舞人心的熱情。

Please join me on a round of applause for Sue.

請和我一起為 Sue 鼓掌。

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

在這次電話會議中，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 is not sufficient for prescribing decisions.

它不是為了促銷，也不足以做出處方決定。

We continue the strong start to 2018 with a second quarter revenue growth of 9%, non-GAAP operating income growth of 28% and non-GAAP EPS growth of 35%.

我們在 2018 年繼續強勁開局，第二季度收入增長 9%，非公認會計準則營業收入增長 28%，非公認會計準則每股收益增長 35%。

New pharmaceutical products continue to be the driver of our worldwide revenue growth, led by Trulicity, Basaglar, Taltz and Verzenio.

在 Trulicity、Basaglar、Taltz 和 Verzenio 的帶領下，新醫藥產品繼續成為我們全球收入增長的驅動力。

New product growth more than offset revenue declines resulting from the loss of exclusivity on a number of our established products.

新產品的增長遠遠抵消了由於我們一些已建立的產品失去排他性而導致的收入下降。

We continue to expand margins this quarter, excluding the effect of FX on international inventories sold.

本季度我們繼續擴大利潤率，不包括外匯對已售國際庫存的影響。

Non-GAAP gross margin as a percent of revenue increased by 130 basis points over Q2 2017, and non-GAAP operating income as a percent of revenue increased by nearly 600 basis points to 30.6%.

非 GAAP 毛利率佔收入的百分比比 2017 年第二季度增加了 130 個基點，非 GAAP 營業收入佔收入的百分比增加了近 600 個基點，達到 30.6%。

We made significant progress with the pipeline, including the approval and launch of Olumiant in the U.S.; FDA and EMA submissions of nasal glucagon; as well as positive Phase III readouts for galcanezumab in episodic cluster headache, Taltz in ankylosing spondylitis, also known as radiographic AxSpA and tanezumab in OA pain in collaboration with Pfizer.

我們在管道方面取得了重大進展，包括在美國批准和推出 Olumiant； FDA 和 EMA 提交的鼻胰高血糖素；以及與輝瑞合作的 galcanezumab 治療陣發性叢集性頭痛、 Taltz 治療強直性脊柱炎的 III 期陽性讀數，也稱為放射學 AxSpA 和 tanezumab 治療 OA 疼痛。

In terms of capital deployment, we completed the acquisition of ARMO BioSciences, which added pegilodecakin to our Phase III portfolio.

在資本配置方面，我們完成了對 ARMO BioSciences 的收購，將 pegilodecakin 添加到我們的 III 期產品組合中。

We returned nearly $600 million via the dividend, and we repurchased $950 million of stock, which completed our previous $5 billion share repurchase program.

我們通過股息返還了近 6 億美元，我們回購了 9.5 億美元的股票，這完成了我們之前 50 億美元的股票回購計劃。

And we authorized the new $8 billion share repurchase program.

我們批准了新的 80 億美元股票回購計劃。

And as reflected in the press release we released this morning, we concluded the review of our strategic alternatives for our Elanco Animal Health business, and intend to establish Elanco as an independent, publicly traded company via an IPO and subsequent separation.

正如我們今天上午發布的新聞稿所反映的那樣，我們完成了對 Elanco 動物保健業務戰略替代方案的審查，並打算通過 IPO 和隨後的分離將 Elanco 建立為一家獨立的上市公司。

Since announcing the strategic review last October, management and the Board of Directors carefully considered a wide range of options, including the retention, the sale or the initial public offering of the Elanco business.

自去年 10 月宣布戰略審查以來，管理層和董事會仔細考慮了廣泛的選擇，包括 Elanco 業務的保留、出售或首次公開募股。

Based on this review, we concluded that after-tax value for Lilly shareholders would be maximized by pursuing an IPO and subsequent separation of Elanco.

基於這次審查，我們得出結論，通過進行 IPO 和隨後的 Elanco 分離，禮來股東的稅後價值將最大化。

We believe independence will allow Elanco to efficiently deploy its resources to those growth opportunities that best serve its customers.

我們相信，獨立性將使 Elanco 能夠有效地將其資源部署到最能為客戶服務的增長機會上。

This will also allow Lilly even greater focus on the human pharmaceutical business to pursue our purpose of creating life-changing medicines for patients.

這也將使禮來更加專注於人類製藥業務，以實現我們為患者創造改變生活的藥物的目標。

Execution of the IPO is dependent upon, and subject to, a number of factors and uncertainties, including business and market conditions.

首次公開募股的執行取決於並受制於許多因素和不確定性，包括業務和市場狀況。

From a timing perspective, we anticipate a registration statement will be available to the public in the next few weeks, and we are targeting an IPO of less than 20% of Elanco's shares before the end of this year.

從時間的角度來看，我們預計將在接下來的幾週內向公眾發布一份註冊聲明，我們的目標是在今年年底之前 IPO 不到 Elanco 的 20% 的股份。

Given the quiet period imposed by securities laws, on today's call, we will not be able to respond to many, if any, questions on the potential IPO.

鑑於證券法規定的靜默期，在今天的電話會議上，我們將無法回答有關潛在 IPO 的許多問題（如果有的話）。

Moving on to Slides 6 and 7, you'll see more details on key events since our April earnings call.

轉到幻燈片 6 和 7，您將看到自 4 月財報電話會議以來有關關鍵事件的更多詳細信息。

But now let me turn it over to Josh to review our Q2 results, and to provide an update on our financial guidance for 2018.

但現在讓我把它交給喬希審查我們的第二季度業績，並提供我們 2018 年財務指導的最新信息。

Thanks, Dave.

謝謝，戴夫。

Slide 8 summarizes our presentation of GAAP results and non-GAAP measures, while Slide 9 provides a summary of our GAAP results.

幻燈片 8 總結了我們對 GAAP 結果和非 GAAP 措施的介紹，而幻燈片 9 總結了我們的 GAAP 結果。

I'll focus my comments on our non-GAAP adjusted measures to provide insights 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，以提供對我們業務潛在趨勢的洞察。

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

因此，請參閱今天的收益新聞稿，詳細描述我們第二季度 GAAP 業績的同比變化。

Looking at the non-GAAP measures on Slide 10, you'll see the revenue increase of 9% that Dave mentioned earlier.

查看幻燈片 10 上的非 GAAP 指標，您會看到 Dave 之前提到的 9% 的收入增長。

Gross margin as a percent of revenue decreased to 76.1%.

毛利率佔收入的百分比下降至 76.1%。

This decrease was due to the effect of foreign exchange rates on international inventories sold.

這一減少是由於外匯匯率對已售國際存貨的影響。

Excluding this FX effect, gross margin as a percent of revenue actually increased 130 basis points, primarily driven by manufacturing efficiencies, partially offset by the timing of manufacturing production.

排除這種外匯影響，毛利率佔收入的百分比實際上增加了 130 個基點，主要受製造效率的推動，部分被製造生產的時間所抵消。

Total operating expense decreased 1% with marketing, selling and administrative expense decreasing 4%, offset in part by an increased R&D expense of 5%.

總運營費用下降 1%，營銷、銷售和行政費用下降 4%，部分被研發費用增加 5% 抵消。

Total operating expense as a percent of revenue declined 450 basis points compared to Q2 2017, driven by our continued efforts to reduce our cost structure and increase our margins, accelerated by the restructuring actions we took late last year.

與 2017 年第二季度相比，總運營費用佔收入的百分比下降了 450 個基點，這是由於我們繼續努力降低成本結構和提高利潤率，而我們去年底採取的重組行動加速了這一進程。

Total operating income increased 28% compared to Q2 2017, which put our operating margin at 29.1% for the quarter.

與 2017 年第二季度相比，總營業收入增長了 28%，這使我們本季度的營業利潤率為 29.1%。

And as Dave mentioned earlier, excluding the effect of FX on international inventories sold, our operating income was 30.6% of revenue, an improvement of nearly 600 basis points versus last year's quarter.

正如 Dave 之前提到的，不包括外匯對銷售的國際庫存的影響，我們的營業收入佔收入的 30.6%，與去年同期相比提高了近 600 個基點。

Other income and expense was income of $12.2 million this quarter compared to income of $60.4 million in last year's quarter.

其他收入和支出是本季度的收入為 1220 萬美元，而去年同期的收入為 6040 萬美元。

Our tax rate was 17%, a decrease of 470 basis points compared with the same quarter last year, driven primarily by the impact of U.S. tax reform.

我們的稅率為 17%，與去年同期相比下降了 470 個基點，主要受美國稅制改革的影響。

At the bottom line, net income increased 31%, while earnings per share increased slightly faster at 35% due to a reduction in shares outstanding from shares repurchased.

歸根結底，淨收入增長了 31%，而由於回購股票的流通股減少，每股收益增長略快，達到 35%。

We achieved the significant earnings growth by delivering high single-digit revenue growth, while reducing our operating expenses, significantly improving profitability again this quarter.

我們通過實現高個位數的收入增長實現了顯著的盈利增長，同時降低了我們的運營費用，本季度再次顯著提高了盈利能力。

Slide 11 details these same non-GAAP measures for June year-to-date, while Slide 12 provides a reconciliation between reported and non-GAAP EPS.

幻燈片 11 詳細介紹了今年 6 月至今的這些相同的非 GAAP 措施，而幻燈片 12 提供了報告的和非 GAAP 每股收益之間的對賬。

You will find additional details on these adjustments on Slides 24 and 25.

您將在幻燈片 24 和 25 上找到有關這些調整的更多詳細信息。

Moving to Slide 13.

轉到幻燈片 13。

Let's take a look at the effects of price rate and volume on revenue growth.

讓我們來看看價格率和銷量對收入增長的影響。

This quarter, the effective foreign exchange provided a 2% benefit.

本季度，有效外匯提供了 2% 的收益。

Excluding this benefit, our worldwide revenue growth on a performance basis was 7%, driven entirely by volume.

剔除這一優勢，我們的全球收入增長（按業績計算）為 7%，完全由銷量驅動。

For a sixth straight quarter, our human pharma business delivered volume growth in each major geography.

連續第六個季度，我們的人類製藥業務在每個主要地區實現了銷量增長。

U.S. pharma revenue increased 11%, driven almost entirely by volume.

美國製藥業收入增長 11%，幾乎完全受銷量驅動。

Notably, our diabetes portfolio delivered over 30% U.S. volume growth again this quarter.

值得注意的是，我們的糖尿病產品組合本季度在美國的銷量再次增長了 30% 以上。

We also benefited from higher U.S. Adcirca revenue, which totaled $96 million.

我們還受益於美國 Adcirca 收入增加，總計 9600 萬美元。

Moving to Europe.

搬到歐洲。

Pharma revenue grew 5%, excluding FX, driven entirely by volume despite the loss of exclusivity for Cialis.

儘管 Cialis 失去了獨家經營權，但不包括外彙在內的醫藥收入增長了 5%，這完全是由銷量推動的。

Excluding the impact of the Cialis LOE, volume grew over 17%.

排除 Cialis LOE 的影響，銷量增長超過 17%。

This volume growth was led by Olumiant, Trulicity, Taltz, Lartruvo and Jardiance.

這一銷量增長由 Olumiant、Trulicity、Taltz、Lartruvo 和 Jardiance 引領。

In Japan, pharma revenue increased 3%, excluding FX, driven entirely by volume.

在日本，不包括外彙在內的製藥收入增長了 3%，這完全是由銷量推動的。

Volume growth was driven by new products, namely Trulicity, Cyramza, Taltz, Jardiance and Olumiant, with a significant contribution also coming from Cymbalta.

銷量增長是由新產品推動的，即 Trulicity、Cyramza、Taltz、Jardiance 和 Olumiant，Cymbalta 也做出了重大貢獻。

This volume growth was partially offset by price and the impact of the biannual pricing cuts, which took effect in Q1.

這一銷量增長部分被價格和在第一季度生效的半年度降價的影響所抵消。

Our pharma revenue in the rest of the world increased 8% on a performance basis this quarter, led by volume growth of Trulicity, Cyramza, Jardiance, Basaglar, Lartruvo and Taltz.

在 Trulicity、Cyramza、Jardiance、Basaglar、Lartruvo 和 Taltz 的銷量增長的帶動下，本季度我們在世界其他地區的製藥收入增長了 8%。

Turning to animal health.

轉向動物健康。

In total, our Elanco revenue declined 1% this quarter in performance terms.

總體而言，本季度我們的 Elanco 收入在業績方面下降了 1%。

Our core Elanco business, which is the foundation of the business going forward, increased 8% in performance terms.

我們的核心 Elanco 業務是未來業務的基礎，其業績增長了 8%。

Core Elanco excludes strategic exits, which are listed on Slide 41.

Core Elanco 不包括幻燈片 41 中列出的戰略退出。

New products contributed $75 million to our animal health sales in Q2, driven primarily by the companion animal portfolio.

新產品在第二季度為我們的動物保健銷售額貢獻了 7500 萬美元，主要受伴侶動物產品組合的推動。

This was nearly double the amount in Q2 last year.

這幾乎是去年第二季度的兩倍。

The core food animal business increased 10% in Q2, driven by the U.S. -- by U.S. purchasing patterns in 2017 as well as strong growth in poultry and aqua products, partially offset by continued ractopamine competition.

在美國的推動下，核心食用動物業務在第二季度增長了 10%——2017 年美國的採購模式以及家禽和水產品的強勁增長，部分被萊克多巴胺的持續競爭所抵消。

The core companion animal business grew 5%, driven by uptake of Galliprant, Credelio and INTERCEPTOR PLUS, partially offset by continued Trifexis competition.

在 Galliprant、Credelio 和 INTERCEPTOR PLUS 的採用推動下，核心伴侶動物業務增長了 5%，但被持續的 Trifexis 競爭部分抵消。

We continue to take actions to focus Elanco's business in its core areas, and to improve profitability.

我們將繼續採取行動將 Elanco 的業務集中在其核心領域，並提高盈利能力。

Since our last call, we completed the sale of the Sligo, Larchwood and Augusta manufacturing facilities, and we exited a distribution agreement and a product that is not core to Elanco's strategy.

自上次通話以來，我們完成了 Sligo、Larchwood 和 Augusta 製造設施的出售，並且我們退出了分銷協議和並非 Elanco 戰略核心的產品。

We also made the decision to suspend marketing of Imrestor, while we pursue additional indications that could allow Imrestor to provide more value to our customers.

我們還決定暫停 Imrestor 的營銷，同時我們尋求更多跡象表明 Imrestor 可以為我們的客戶提供更多價值。

Slide 14 outlines the same information for our June year-to-date results.

幻燈片 14 概述了我們 6 月份年初至今結果的相同信息。

Now let's take a look at the drivers of our worldwide volume growth on Slide 15.

現在讓我們在幻燈片 15 上看一下我們全球銷量增長的驅動因素。

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

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

You can see that these products drove 12.4 percentage points of volume growth this quarter.

您可以看到，這些產品在本季度推動了 12.4 個百分點的銷量增長。

The loss of exclusivity for Effient, Strattera, Cymbalta, Zyprexa, Evista and Axiron provided a drag of 450 basis points, while Cialis accounted for 170 basis points of volume declines due to the entry of generic erectile dysfunction products.

Effient、Strattera、Cymbalta、Zyprexa、Evista 和 Axiron 的獨家經營權的喪失拖累了 450 個基點，而 Cialis 由於通用勃起功能障礙產品的進入導致銷量下降 170 個基點。

When excluding LOEs in Cialis, the rest of our products had volume growth of approximately 16%.

剔除 Cialis 中的 LOE 時，我們其餘產品的銷量增長約為 16%。

Slide 16 provides a view of our new product updates.

幻燈片 16 提供了我們新產品更新的視圖。

In total, these brands generated over $1.7 billion in revenue this quarter, and represented 28% of our total worldwide revenue.

這些品牌本季度的總收入超過 17 億美元，占我們全球總收入的 28%。

On the performance on Taltz, which grew by 39% in the U.S. and 59% worldwide versus Q2 2017, driven almost entirely by volume.

關於 Taltz 的表現，與 2017 年第二季度相比，在美國增長了 39%，在全球增長了 59%，這幾乎完全是由銷量驅動的。

This growth was due to the continued uptake in psoriasis and, to a lesser extent, the launch of our second indication for Taltz in psoriatic arthritis, both here in the U.S. and in Europe.

這種增長是由於銀屑病的持續吸收，以及在較小程度上，我們在美國和歐洲推出了 Taltz 治療銀屑病關節炎的第二個適應症。

We're also pleased to announce this quarter that Taltz had positive Phase III results for our second study in AxSpA, which Dave mentioned earlier, and was granted a label update in both the U.S. and Europe to include data in difficult-to-treat genital psoriasis.

我們也很高興在本季度宣布，Taltz 對我們在 AxSpA 的第二項研究取得了積極的 III 期結果，Dave 之前提到過，並且在美國和歐洲都獲得了標籤更新，以包括難以治療的生殖器的數據銀屑病。

Later this year, we plan to initiate a head-to-head trial with Tremfya, which will be powered to test superiority on key measures in patients with moderate to severe plaque psoriasis.

今年晚些時候，我們計劃啟動一項與 Tremfya 的頭對頭試驗，這將有助於測試中度至重度斑塊狀銀屑病患者在關鍵措施上的優勢。

This investment underscores our confidence in Taltz as well as Lilly's long-term commitment to immunology.

這項投資強調了我們對 Taltz 的信心以及禮來公司對免疫學的長期承諾。

Moving to Slide 17.

轉到幻燈片 17。

Continuing with our non-GAAP explanations, this quarter, the effect of FX on our income statement was minimal, with a small positive impact on revenue and a small negative impact on earnings.

繼續我們的非公認會計原則解釋，本季度，外匯對我們損益表的影響很小，對收入的正面影響很小，對收益的負面影響很小。

Turning to our 2018 financial guidance on Slide 18.

轉向我們關於幻燈片 18 的 2018 年財務指導。

You will see that we've updated our guidance to reflect an increase of $300 million on the top line, driven by strong performance across our portfolio, particularly in diabetes, and the continued uptake of our new launch brands as well as higher collaboration revenue, partially offset by the impact of weaker foreign currencies; an increase in gross margin percent of 50 basis points on a reported basis, primarily driven by the favorable impact of foreign exchange movements, partially offset by an inventory charge related to the suspension of Imrestor sales; a percentage point increase in the non-GAAP gross margin percent, primarily driven by the favorable impact of foreign exchange movement; and finally, an increase on our tax rate on a reported basis from 17% to 22.5%, which is driven by a nondeductible IPR&D charge of introduction of ARMO BioSciences.

您會看到我們更新了我們的指導，以反映收入增加了 3 億美元，這得益於我們投資組合的強勁表現，特別是在糖尿病領域，以及我們新推出品牌的持續採用以及更高的合作收入，部分被外幣走弱的影響所抵消；在報告的基礎上，毛利率增加了 50 個基點，主要是由於外匯變動的有利影響，部分被與 Imrestor 銷售暫停相關的庫存費用所抵消；非美國通用會計準則毛利率增加一個百分點，主要受外匯變動的有利影響；最後，在報告的基礎上，我們的稅率從 17% 增加到 22.5%，這是由於引入 ARMO BioSciences 的不可扣除的 IPR&D 費用推動的。

On a reported basis, earnings per share for 2018 is now expected to be in the range of $3.19 to $3.29, while our non-GAAP earnings per share is now expected to be between $5.40 and $5.50.

據報導，現在預計 2018 年的每股收益在 3.19 美元至 3.29 美元之間，而我們的非公認會計準則每股收益現在預計在 5.40 美元至 5.50 美元之間。

At the midpoint of the range, this represents an increase of 27% over 2017.

在該範圍的中點，這比 2017 年增長了 27%。

Our updated guidance implies second half non-GAAP EPS of between $2.57 and $2.67, which exceed our consensus, and does not assume U.S. price increases for the remainder of the year.

我們更新後的指引暗示下半年非公認會計原則每股收益在 2.57 美元至 2.67 美元之間，超出了我們的共識，並且不假設今年剩餘時間美國價格上漲。

However, it's lower than our first half EPS due to the expected U.S. generic competition for Cialis in September; higher second half R&D expenses to support additional late-stage investment, including mirikizumab, Olumiant and Taltz NILEX and the IL-10 from the ARMO acquisition, launch investments for galcanezumab and, to a lesser extent, the higher U.S. Adcirca collaboration revenue that we realized in the first half.

然而，由於預計 9 月份 Cialis 在美國的仿製藥競爭，它低於我們上半年的每股收益；下半年研發費用增加，以支持額外的後期投資，包括 mirikizumab、Olumiant 和 Taltz NILEX 以及來自 ARMO 收購的 IL-10，啟動對 galcanezumab 的投資，並且在較小程度上，我們實現了更高的美國 Adcirca 合作收入在上半場。

In total, we expect strong second-half performance led by volume gains in our new products, which allows for targeted investments in our long-term portfolio, and which positions us well to achieve our 2020 financial objectives.

總體而言，我們預計新產品的銷量增長將帶動下半年的強勁表現，這使得我們可以對我們的長期投資組合進行有針對性的投資，並使我們能夠很好地實現我們的 2020 年財務目標。

Now we'll turn the call back over to Dave to review the pipeline and key future events.

現在，我們將把電話轉回給 Dave，以審查管道和未來的關鍵事件。

Thanks, Josh.

謝謝，喬希。

Slide 19 shows select NMEs and NILEX as of July 17.

幻燈片 19 顯示了截至 7 月 17 日的部分 NME 和 NILEX。

In my summary of the quarter, at the beginning of the call, I mentioned the positive movements for nasal glucagon and the Phase III edition of pegylated IL-10 from our acquisition of ARMO BioSciences.

在我對本季度的總結中，在電話會議開始時，我提到了鼻胰高血糖素和聚乙二醇化 IL-10 的 III 期版本從我們收購的 ARMO BioSciences 中的積極變化。

The ARMO acquisition also includes Phase II studies for pegilodecakin, which are now reflected in the pipeline.

收購 ARMO 還包括對 pegilodecakin 的 II 期研究，這些研究現已反映在管道中。

Additional movements since our last earnings call include: the start of Phase III studies for mirikizumab, our IL-23 antibody in both psoriasis and ulcerative colitis; the start of Phase II for our tau antibody for Alzheimer's; the addition of the Aurora A kinase inhibitor into Phase I, with the completion of the AurKa acquisition; attrition of lanabecestat, the BACE inhibitor for Alzheimer's disease we were studying in collaboration with AstraZeneca; and the attrition of 1 Phase I diabetes asset.

自我們上次財報電話會議以來的其他變動包括： mirikizumab 的 III 期研究開始，我們的 IL-23 抗體在銀屑病和潰瘍性結腸炎中均適用；我們針對阿爾茨海默氏症的 tau 抗體的第二階段開始；將 Aurora A 激酶抑製劑添加到 I 期，完成對 AurKa 的收購；我們正在與阿斯利康合作研究的阿爾茨海默病 BACE 抑製劑 lanabecestat 的損耗；以及 1 期 I 期糖尿病資產的流失。

On Slide 20, we provide an update on expected key events for 2018.

在幻燈片 20 上，我們提供了 2018 年預期關鍵事件的最新信息。

In addition to the pipeline movement I've already noted, you'll see that we've added a new line to reflect our expectation that the U.S. Alimta label could be updated before the end of the year for the Phase III KEYNOTE-189 data.

除了我已經註意到的管道移動之外，您會看到我們添加了一條新行以反映我們的預期，即美國 Alimta 標籤可以在今年年底之前更新 III 期 KEYNOTE-189 數據.

Under regulatory submissions, you'll see the submission of nasal glucagon and the new indication for Cyramza as second-line liver cancer as well as Lilly and Boehringer Ingelheim's revised expectation that the U.S. submission for the combination of empagliflozin, linagliptin and metformin XR will occur in 2019.

根據監管提交，您將看到鼻胰高血糖素的提交和 Cyramza 作為二線肝癌的新適應症，以及禮來和勃林格殷格翰修訂後的預期，即美國將提交 empagliflozin、linagliptin 和二甲雙胍 XR 的組合在 2019 年。

In the Phase III data presentations and publications section, we've reflected presentations at ASCO of the REACH-2 study of Cyramza as well as the presentation at the American Headache Society of the Phase III cluster headache trials for galcanezumab.

在 III 期數據介紹和出版物部分，我們反映了在 ASCO 上對 Cyramza 的 REACH-2研究的介紹以及在美國頭痛協會對 galcanezumab 的 III 期叢集性頭痛試驗的介紹。

And in the Phase III top line data disclosures section, you'll see the announcement of positive Phase III data for tanezumab in OA pain and the attrition of lanabecestat.

在 III 期頂線數據披露部分，您將看到 tanezumab 在 OA 疼痛中的積極 III 期數據公佈和 lanabecestat 的損耗。

In terms of Phase III study initiations, you'll see the Phase III starts for mirikizumab that I noted earlier, and now expect to start Phase III before the end of the year for baricitinib in lupus and in adaptive Phase II/III for alopecia.

在 III 期研究啟動方面，您將看到我之前提到的 mirikizumab 的 III 期開始，現在預計將在今年年底前開始用於治療狼瘡的巴瑞替尼和用於脫髮的適應性 II/III 期。

We've also added a line for initiation of Phase III for our novel GIP/GLP agonist in type 2 diabetes.

我們還為我們的新型 GIP/GLP 激動劑在 2 型糖尿病中添加了一條用於啟動 III 期的產品線。

We now have data in-house from the Phase II study of this next-generation incretin.

我們現在擁有來自這種下一代腸促胰島素的 II 期研究的內部數據。

In the past, we've said that we have a high bar for efficacy to move this molecule into Phase III, given the competitive intensity in this category.

過去，我們曾說過，考慮到這一類別的競爭強度，我們將這種分子轉移到 III 期的療效標準很高。

The Phase II results met this high bar.

第二階段的結果達到了這個高標準。

We look forward to presenting this data at EASD this fall.

我們期待在今年秋天的 EASD 上展示這些數據。

And following the data presentation, we will host a call to discuss the data.

在數據展示之後，我們將召開電話會議討論數據。

In addition, we plan to start Phase III in late 2018 or early 2019.

此外，我們計劃在 2018 年底或 2019 年初啟動第三階段。

Finally, we had positive Alimta rulings in both the U.S. and Japan, while the German Federal Patent Court held our Alimta vitamin regimen patent invalid.

最後，我們在美國和日本都做出了積極的 Alimta 裁決，而德國聯邦專利法院裁定我們的 Alimta 維生素方案專利無效。

We strongly disagree with this ruling, and we plan to appeal the decision.

我們強烈反對這一裁決，併計劃對該裁決提出上訴。

This was clearly a busy and productive quarter for the company, and there's still many events to look forward to in 2018.

對於公司來說，這顯然是一個忙碌而富有成效的季度，2018 年仍有許多活動值得期待。

Notably, I'd highlight the expected regulatory actions for galcanezumab in the U.S., Verzenio in Europe and Japan as well as the data readout of the REWIND study for Trulicity.

值得注意的是，我將強調美國對 galcanezumab、歐洲和日本的 Verzenio 的預期監管行動，以及對 Trulicity 的 REWIND 研究的數據讀出。

Before we go to the Q&A section, let me briefly sum up the progress we've made this quarter.

在進入問答部分之前，讓我簡要總結一下我們本季度取得的進展。

In Q2, new products accounted for nearly 28% of our total revenue, and over 13% of our human pharma revenue.

在第二季度，新產品占我們總收入的近 28%，占我們人類製藥收入的 13% 以上。

Volume grew 9% in our human pharma business despite recent patent expirations.

儘管最近專利到期，但我們的人類製藥業務的銷量增長了 9%。

And when excluding strategic exits and FX, our animal health business grew by 8%.

如果不包括戰略退出和外匯，我們的動物保健業務增長了 8%。

We realized significant efficiencies in our cost structure, leading to operating margin expansion of nearly 600 basis points, excluding FX.

我們實現了成本結構的顯著效率，導致營業利潤率增長近 600 個基點，不包括外匯。

We've made excellent progress this quarter in the pipeline with the launch of Olumiant for RA patients in the U.S., the submission of nasal glucagon to the FDA and EMA and positive Phase III data for tanezumab as well as new indication data for Taltz and galcanezumab.

我們在本季度取得了巨大進展，在美國推出了用於 RA 患者的 Olumiant，向 FDA 和 EMA 提交了鼻用胰高血糖素，tanezumab 的 III 期陽性數據以及 Taltz 和 galcanezumab 的新適應症數據.

We also returned over $1.5 billion to shareholders via the dividend and share repurchase.

我們還通過股息和股票回購向股東返還了超過 15 億美元。

We authorized a new $8 billion share repurchase program, and made a significant strategic decision on the future of our Elanco Animal Health business.

我們批准了一項新的 80 億美元股票回購計劃，並對我們 Elanco 動物保健業務的未來做出了重大戰略決策。

Before we move to the Q&A, I would like to share that we will hold a live investor meeting this December to provide our initial 2019 guidance and highlight pipeline progress, including life cycle opportunities for select marketed products.

在進入問答環節之前，我想分享一下，我們將在今年 12 月舉行一次現場投資者會議，以提供我們 2019 年的初步指導並強調管道進展，包括選定上市產品的生命週期機會。

Given the limited space available, our Investor Relations team will be in contact in the coming days to issue invitations and provide more logistical details.

鑑於可用空間有限，我們的投資者關係團隊將在未來幾天與您聯繫，發出邀請並提供更多後勤細節。

This concludes our prepared remarks, and now I'll turn the call over to Phil to moderate the Q&A session

我們準備好的發言到此結束，現在我將把電話轉給 Phil 主持問答環節

Great.

偉大的。

Thank you, Dave.

謝謝你，戴夫。

We would like to take questions from as many callers as possible.

我們希望接受盡可能多的來電者的提問。

(Operator Instructions) Kevin, if you could please provide the instructions for the Q&A session, then we're ready for the first caller.

（操作員說明）Kevin，如果您能提供問答環節的說明，那麼我們已經為第一個來電者做好了準備。

(Operator Instructions) First question is from the line of John Boris, SunTrust.

（操作員說明）第一個問題來自 SunTrust 的 John Boris。

Dave, first question just has to do with the Blueprint, obviously, proposed by HHS secretary and the White House administration.

戴夫，第一個問題顯然與 HHS 秘書和白宮政府提出的藍圖有關。

What do you view as the base case scenario potentially coming out for the industry and to our best case scenario that could come out of that blueprint?

您認為該行業可能出現的基本案例場景以及該藍圖可能出現的最佳案例場景是什麼？

And then just any thoughts on this issue that's rising on copay accumulators that are certainly blunting a manufacturer's ability to use copay assistance against copay accumulators.

然後只是關於這個問題的任何想法都在共付累加器上出現，這肯定會削弱製造商使用共付額援助對抗共付額累加器的能力。

It seems to be very detrimental to patients getting access to medicines.

這似乎對患者獲得藥物非常不利。

So any thoughts that you have around that?

那麼你對此有什麼想法嗎？

Second question just has to do with the emerging pain franchise.

第二個問題與新興的疼痛專營權有關。

Just your optimisms over that franchise, especially galcanezumab, which seemed to have hit some pretty decent data in cluster headache, which is an area where nothing seems to have worked in that area.

只是您對該專營權的樂觀態度，尤其是 galcanezumab，它似乎在叢集性頭痛中獲得了一些相當不錯的數據，而在該領域似乎沒有任何效果。

So just your thoughts on that.

所以只是你的想法。

And lasmiditan, the timing for filing of lasmiditan here in the back half.

和 lasmiditan，在後半區提交 lasmiditan 的時間。

Great.

偉大的。

John, thank you for the questions.

約翰，謝謝你的提問。

Dave, if you want to go ahead and comment.

戴夫，如果你想繼續發表評論。

And then, Dan, if you want to add anything on the pain franchise, that would be great.

然後，丹，如果你想在疼痛專營權上添加任何東西，那就太好了。

Dave?

戴夫？

Okay, great.

好，太棒了。

Thanks, John, and thanks for the questions.

謝謝，約翰，謝謝你的問題。

Just on the policy side.

只是在政策方面。

Of course, the blueprint was rolled out in May.

當然，藍圖是在 5 月推出的。

And recently, and all actors in the industry seemed to have responded to their request for information.

最近，該行業的所有參與者似乎都回應了他們的信息請求。

So I think you're asking me to guess where this will land.

所以我想你是在讓我猜猜這會落在哪裡。

That's a really difficult thing to do at this point because there's dozens of ideas in there.

在這一點上，這是一件非常困難的事情，因為那裡有很多想法。

I think we can comment on actions that have been initiated, though, because I think that indicates where the administration might be going first.

不過，我認為我們可以對已經啟動的行動發表評論，因為我認為這表明政府可能首先採取的行動。

And of course, many of you may have noted last week that the administration sent OMB a proposed rule change for the Anti-Kickback safe harbor, which relates to rebates.

當然，你們中的許多人可能已經註意到上周政府向 OMB 發送了一項關於反回扣安全港的擬議規則變更，該規則與回扣有關。

We don't know the substance of that rule change, but this is heavily commented on through the RFI via questions.

我們不知道該規則更改的實質內容，但通過 RFI 通過問題對此進行了大量評論。

And I think you're right to assume that there would be some changes to the Anti-Kickback Statute as it relates to rebate treatment.

而且我認為你認為反回扣法規會發生一些變化是正確的，因為它與回扣待遇有關。

We don't know what those are, and I think we're preparing for all scenarios there.

我們不知道那些是什麼，我認為我們正在為那裡的所有情況做準備。

But this is consistent with the broad theme of looking at ways to reduce the growth in that spread in the industry, and to allow patients to have a more -- a price point in a high deductible without insurance that's closer to net pricing.

但這與尋找減少行業傳播增長的方法的廣泛主題是一致的，並允許患者擁有更多 - 一個沒有保險的高免賠額的價格點更接近淨定價。

Overall, we support that.

總的來說，我們支持這一點。

I don't think that's a bad thing for innovators.

我不認為這對創新者來說是一件壞事。

And we'll have to watch how that rule develops, so we don't have any specifics as of today.

我們將不得不觀察該規則是如何發展的，所以截至今天我們還沒有任何細節。

You also saw the administration move on putting a task force together related to addressing off-patents, brands, who take super inflationary price increases.

您還看到政府正在組建一個工作組，以解決因超通脹價格上漲而導致的非專利、品牌問題。

In the absence of IT, this is really a regulatory failure.

在沒有 IT 的情況下，這確實是監管失敗。

From our perspective, the administration's talking about importation.

從我們的角度來看，政府正在談論進口。

We think that's the wrong road to go down, but rather to fix the regulatory system to begin with.

我們認為這是錯誤的道路，而是從一開始就修復監管體系。

Nonetheless, clearly, that is a hot-button issue, and we agree it should be solved, the method that we disagree with.

儘管如此，顯然，這是一個熱點問題，我們同意應該解決它，我們不同意這種方法。

But we'll have more to say about that in the future.

但我們將來會對此有更多的發言權。

I think for innovators, over the -- I think I said in the Q4 call in January, we could expect a busy year in regulatory reform.

我認為對於創新者來說，我想我在 1 月份的第四季度電話會議中說過，我們可以預期監管改革會是忙碌的一年。

And I think, thinking back, that's what we're seeing.

我想，回想起來，這就是我們所看到的。

For innovators, at the end of the day, as long as we can embrace a pro-innovation, market-driven set of changes that embraces choice, I think we're going to be fine.

對於創新者來說，歸根結底，只要我們能夠接受支持創新、市場驅動、包含選擇的一系列變革，我認為我們會沒事的。

Getting from A to B, we'll have to see how these changes unfold.

從 A 到 B，我們必須看看這些變化是如何展開的。

And as of today, it's difficult to say more than I did already.

到今天為止，很難說比我已經做過的更多了。

But, of course, we watch it very carefully at various investor updates.

但是，當然，我們會在各種投資者更新中非常仔細地觀察它。

We'll be happy to provide additional commentary as additional actions come forward.

隨著更多行動的出現，我們很樂意提供更多評論。

On the coping accumulators, this is going in the opposite direction of everything I just said.

在應對蓄能器上，這與我剛才所說的一切相反。

This is shifting costs back to consumers by extending the time they spend in the high deductible phase.

這通過延長他們在高免賠額階段花費的時間，將成本轉回給消費者。

We don't think, by itself, that's a good policy.

我們認為，就其本身而言，這不是一個好政策。

Now coupled with many other things, it could blunt the impact of that.

現在再加上許多其他事情，它可能會減弱這種影響。

But frankly, I think this -- although I would say, for Lilly, it's had very limited impact on our performance, it's a concerning thing to watch as we watch the back and forth in commercial markets.

但坦率地說，我認為——雖然我想說，對於禮來，它對我們的表現的影響非常有限，但當我們在商業市場上來回觀察時，這是一件值得關注的事情。

Of course, payers and, ultimately employers, are doing this because they want to control drug spending costs.

當然，付款人和最終的雇主這樣做是因為他們想控製藥物支出成本。

We understand that.

我們明白這一點。

There may be other ways to do that though.

不過，可能還有其他方法可以做到這一點。

Finally, on pain, we're excited about the pain portfolio.

最後，關於疼痛，我們對疼痛組合感到興奮。

You're seeing data emerge now from tanezumab.

你現在看到數據來自 tanezumab。

We have the data, as you mentioned, on galcanezumab, sort of all the Phase IIIs in-house.

正如你所提到的，我們有關於 galcanezumab 的數據，有點像內部的所有 III 期。

And lasmiditan, we do plan to submit before the end of the year as well.

lasmiditan，我們也計劃在今年年底之前提交。

Clearly, pain is a huge unmet need in this country.

顯然，在這個國家，疼痛是一個巨大的未滿足需求。

I think you're seeing good interest in the first CGRP antibody launch.

我認為您對首次推出 CGRP 抗體產生了濃厚的興趣。

We expect that to continue.

我們預計這種情況會繼續下去。

Migraine's an enormous problem in this country, and there are many chronic and episodic sufferers there that we hope to reach with the CGRP antibody as well as products like lasmiditan, which can relieve acute suffering.

偏頭痛在這個國家是一個巨大的問題，我們希望那裡有許多慢性和偶發性患者，我們希望使用 CGRP 抗體以及可以緩解急性疼痛的 lasmiditan 等產品。

So we're bullish on that category.

所以我們看好這個類別。

Of course, we need all the data.

當然，我們需要所有數據。

And the question on tanezumab remains the safety study that there's a large safety study that we'll read out in '19.

關於 tanezumab 的問題仍然是安全性研究，我們將在 19 年宣讀一項大型安全性研究。

And that's really the pivotal question to answer on this part.

這確實是這部分要回答的關鍵問題。

And we know the drug can reduce pain based on prior Phase III studies.

根據之前的 III 期研究，我們知道這種藥物可以減輕疼痛。

Dan, you have any additional comments to make or...

丹，您還有其他意見要提出或...

I'll just reiterate that we're pleased with the data that we're seeing with galcanezumab, of course.

我只是重申，我們對我們看到的 galcanezumab 數據感到滿意，當然。

And I think, probably, I'll highlight 3 opportunities here for Lilly, specifically in the migraine space.

我想，我可能會在這里為禮來（Lilly）強調 3 個機會，特別是在偏頭痛領域。

First, we're really quite pleased with the quality of our data.

首先，我們對數據的質量非常滿意。

Galcanezumab works fast, and has a prolonged maintenance of efficacy in our clinical trials.

Galcanezumab 起效快，在我們的臨床試驗中能長期維持療效。

I think we'll be, right now, as far as we've seen, the only CGRP antibody that has 100% clearance data.

我認為，目前，就我們所見，我們將是唯一擁有 100% 清除數據的 CGRP 抗體。

So 100% reduction in migraines.

所以偏頭痛減少了 100%。

That's statistically significant in our clinical trials.

這在我們的臨床試驗中具有統計學意義。

The second opportunity here is with lasmiditan.

這裡的第二個機會是 lasmiditan。

As you heard from Dave, having both of these products, we think, could be important for patients.

正如您從戴夫那裡聽到的那樣，我們認為擁有這兩種產品對患者來說可能很重要。

And then, of course, the third is what you mentioned, which is cluster headache, which is another important indication.

然後，當然，第三個就是你提到的，即叢集性頭痛，這是另一個重要的跡象。

And we're pleased with the data we have there.

我們對那裡的數據感到滿意。

So differentiated opportunity here for Lilly.

禮來公司的機會如此不同。

Thanks, Dan.

謝謝，丹。

And next question is from the line of Chris Schott, JPMorgan.

下一個問題來自摩根大通的 Chris Schott。

Just 2 here.

這裡只有2個。

Maybe first on tanezumab.

也許首先使用 tanezumab。

Can you just put this initial Phase III data we saw into context that you think about your enthusiasm for the program?

你能把我們看到的這個最初的 III 期數據放在你認為你對這個項目的熱情的背景下嗎？

And specifically, on safety, is there a threshold on rapidly progressing osteoarthritis that the FDA is focused on here?

具體來說，在安全性方面，FDA 重點關注的快速進展的骨關節炎是否存在閾值？

Or how do we -- how should we think about that safety profile going forward?

或者我們如何——我們應該如何考慮未來的安全狀況？

My second question was on price increases.

我的第二個問題是關於價格上漲的。

It seemed like the tone across the industry is a bit more restrained than the past on willingness to take increases.

整個行業的基調似乎比過去在願意加息方面更加克制。

Is this a 2018 dynamic?

這是2018年的動態嗎？

Or do you see this trend continuing out into 2019 and beyond?

還是您認為這種趨勢會持續到 2019 年及以後？

And I guess, given the disconnect we're seeing between gross and net pricing, if there is a slowdown in list price increases going forward, should we think about that impacting that price increases?

而且我想，鑑於我們看到的總定價和淨定價之間的脫節，如果未來標價上漲放緩，我們是否應該考慮影響價格上漲？

Or is that less correlated than it's been in the past?

還是與過去相比，相關性降低了？

Great.

偉大的。

Chris, thank you for the questions.

克里斯，謝謝你的提問。

So Dan, anything you want to comment on tanezumab?

所以丹，你想對 tanezumab 發表評論嗎？

And then, Dave, feel free to compliment that answer, and then we'd take the price increase question.

然後，戴夫，請隨意稱讚這個答案，然後我們會回答價格上漲的問題。

Dan?

擔？

Yes.

是的。

Thanks.

謝謝。

On tanezumab, of course, we've previously said we have a lot of confidence in this mechanism of action based on the wealth of data that's been generated in the past.

當然，關於 tanezumab，我們之前曾說過，基於過去產生的大量數據，我們對這種作用機制充滿信心。

And of course, the challenge here is to discharge the safety risk.

當然，這裡的挑戰是消除安全風險。

Having said that, we also changed some aspects of how we administer the drug in the new Phase III program, on which we're collaborating with Pfizer.

話雖如此，我們還在與輝瑞合作的新 III 期計劃中改變了藥物管理方式的某些方面。

So this first study was primarily focused on that aspect.

因此，第一項研究主要集中在這方面。

And so this is a titration study.

所以這是一項滴定研究。

We're investing a subcutaneous at 2.5 and 2.5 going up to 5-milligram doses.

我們將 2.5 和 2.5 的皮下注射劑量增加到 5 毫克的劑量。

And we're pleased that we hit our efficacy outcomes here.

我們很高興我們在這里達到了我們的療效結果。

With respect to RPOA, rapidly progressive osteoarthritis, your question with thresholds, of course, we and others here have thresholds in our clinical trials that we're watching for.

關於 RPOA，快速進展性骨關節炎，你的問題是閾值，當然，我們和這裡的其他人在我們正在關注的臨床試驗中都有閾值。

We haven't spoken specifically about what those might be.

我們還沒有具體談到那些可能是什麼。

And our trials continue to proceed.

我們的試驗還在繼續進行。

So we're excited about that.

所以我們對此感到興奮。

This study wasn't designed to discharge the safety risk.

這項研究並非旨在消除安全風險。

That study will come with data probably next year or late this year.

這項研究可能會在明年或今年晚些時候提供數據。

And that's a next-year, 3,000-patient, 56-week clinical trial.

這是明年的 3,000 名患者、56 週的臨床試驗。

Great.

偉大的。

Thanks, Dan.

謝謝，丹。

Dave?

戴夫？

Yes, I'd definitely add to that.

是的，我肯定會補充。

I think we -- where the key gating thing is this large safety discharge study.

我認為我們 - 關鍵的門控是這項大型安全排放研究。

We now have, I guess, more than a dozen Phase III trials on tanezumab on efficacy.

我猜，我們現在有十幾個關於 tanezumab 療效的 III 期試驗。

Really, the question is, is it safe for long-term use?

真的，問題是，長期使用是否安全？

On price increases, it's difficult to comment on others' actions or even what happens long term.

關於價格上漲，很難評論其他人的行為，甚至是長期發生的事情。

We've -- as this blueprint's been rolled out, I think our point of view is it's a potentially sweeping set of changes.

我們已經 - 隨著這個藍圖的推出，我認為我們的觀點是它可能是一系列徹底的變化。

Let's see what develops here in 2018 as those changes get implemented or not.

讓我們看看隨著這些變化的實施與否，2018 年會發生什麼。

And then on the back end of this important public conversation about how do we reduce out-of-pocket costs for patients, while preserving innovation and allowing market forces to prevail, how can we reshape a system around those principles?

然後在這場關於我們如何降低患者的自付費用，同時保持創新並讓市場力量佔上風的重要公開對話的後端，我們如何才能圍繞這些原則重塑一個系統？

On the back end of that, of course, we'll reevaluate our strategies.

當然，在這之後，我們會重新評估我們的策略。

Net pricing is subject not just to list price changes.

淨定價不僅受標價變化的影響。

And as you know, Chris, the yield of those is quite different across different categories, but also subject to prior period adjustments on assumptions made in gross to net, on current channel mix and many, many other things.

正如你所知道的，克里斯，不同類別的收益率差異很大，但也受到前期對總淨額假設、當前渠道組合和許多其他因素的調整。

So you'll see.

所以你會看到的。

I think in the U.S., we're reflecting a 1% positive, which reflects prior increases as well as all those other dimensions.

我認為在美國，我們反映了 1% 的積極因素，這反映了之前的增長以及所有其他方面。

As Josh said, we don't have list price changes in our outlook, and it's still very robust.

正如喬希所說，我們的前景沒有定價變化，而且它仍然非常強勁。

And that's kind of where we're focused, just driving volume with new products here in the U.S. and abroad.

這就是我們關注的地方，只是在美國和國外增加新產品的銷量。

Thanks, Dave.

謝謝，戴夫。

And the next question is from the line of Greg Gilbert, Deutsche Bank.

下一個問題來自德意志銀行的 Greg Gilbert。

First for Dave.

首先是戴夫。

I was hoping you could share with us, not a question about the IPO here, but how will the Elanco transaction or transactions in the coming quarters shape your thinking about capital allocation priorities for Lilly?

我希望您能與我們分享，這裡不是關於 IPO 的問題，而是 Elanco 交易或未來幾個季度的交易將如何影響您對禮來資本配置優先事項的思考？

And then shifting gears to diabetes.

然後轉向糖尿病。

You touched on this a bit, but given the strong profile for the current injectable GLP-1s and the emerging oral GLP-1, can you give -- put a little more meat on the bones in terms of that bar you talked about?

您稍微談到了這一點，但鑑於當前可注射 GLP-1 和新興的口服 GLP-1 的強大形象，您能否給出 - 就您談到的那個酒吧而言，在骨頭上多加一點肉？

Is that the primary endpoint or a multitude of endpoints that shape your thinking there?

那是主要的終點還是影響你思考的眾多終點？

And perhaps you can fill in any updates on your own oral GLP-1 work.

也許您可以填寫您自己的口頭 GLP-1 工作的任何更新。

Great.

偉大的。

Greg, thank you for the questions.

格雷格，謝謝你的提問。

So Dave, if you comment on Lilly capital allocation moving forward.

所以戴夫，如果你評論禮來公司的資本配置向前發展。

And then Dan and Enrique, if you'd like to take the question on what we saw with our GIP/GLP in Phase II.

然後是 Dan 和 Enrique，如果您想回答關於我們在第二階段的 GIP/GLP 中看到的內容的問題。

Dave?

戴夫？

Yes.

是的。

Thanks, Greg.

謝謝，格雷格。

Well, as I said, this move is really a result of a deep and thorough analysis of the value maximizing decision for Lilly's shareholders.

好吧，正如我所說，這一舉措實際上是對禮來股東價值最大化決策進行深入徹底分析的結果。

We think an IPO produces that after-tax value.

我們認為 IPO 會產生稅後價值。

And also that it will allow more focus, focus for Elanco on its priorities, allocating its capital to the produce to grow that business, and serve its customers and focus for Lilly, which, for us, assuming this all goes forward as planned, will be a human pharmaceutical business with, I think, many opportunities to invest in creating breakthrough products for patients.

而且這將允許更多的關注，讓 Elanco 專注於其優先事項，將其資金分配給產品以發展該業務，並為客戶提供服務並專注於禮來，對我們來說，假設這一切都按計劃進行，將會成為一家人類製藥企業，我認為有很多機會投資於為患者創造突破性產品。

Our strategy on capital allocation doesn't change as a result of this decision, which is really, first, to invest in our own business, our own organic R&D and the launches and capital needed to manufacture those products, et cetera.

我們的資本配置策略並沒有因為這一決定而改變，這實際上是首先投資於我們自己的業務、我們自己的有機研發以及製造這些產品所需的啟動和資本等等。

Secondly, to look at business development, to build our pipeline, as the commentary there isn't different than before, which is really we're mostly interested in clinical stage assets that can build in our core 5 therapeutic areas.

其次，看看業務發展，建立我們的管道，因為評論與以前沒有什麼不同，這實際上是我們最感興趣的臨床階段資產可以建立在我們的核心 5 個治療領域。

If you saw a number of moves in Q2 in that regard, most notably the ARMO acquisition as an example, it's the kind of thing we're interested in.

如果您在第二季度看到了這方面的一些舉措，最值得注意的是收購 ARMO，這就是我們感興趣的事情。

And then finally, if we run out of those ideas, we'll return capital to shareholders.

最後，如果我們用完了這些想法，我們會將資本返還給股東。

And this quarter, we're announcing a share repurchase program which will allow us to continue to do that.

本季度，我們將宣布一項股票回購計劃，這將使我們能夠繼續這樣做。

And as we said, there was $900 million-or-so in share repurchase activity in Q2, consistent with those priorities.

正如我們所說，第二季度有 9 億美元左右的股票回購活動，與這些優先事項一致。

So I think we've taken a balanced approach on capital allocation.

所以我認為我們在資本配置上採取了平衡的方法。

You can expect us to continue.

你可以期待我們繼續。

And if we have more capital to balance, we'll do just that.

如果我們有更多的資本來平衡，我們就會這樣做。

Thanks, Dave.

謝謝，戴夫。

Dan?

擔？

Yes, sure.

是的，當然。

We've previously said that we see incretin biology as an important platform for Lilly to continue to build on, that there's a lot more opportunities here for patients.

我們之前曾說過，我們將腸促胰島素生物學視為禮來公司繼續發展的重要平台，為患者提供更多機會。

And so over the years, we've invested here and developed and tested now a number of different molecules that could offer differentiated efficacy in this platform.

因此，多年來，我們在這裡投資並開發和測試了許多不同的分子，這些分子可以在這個平台上提供差異化的功效。

So for example, the oxyntomodulin molecules, we're now testing a second one of these in clinical trials, the GIP/GLP and other molecules that are in earlier development.

例如，泌酸調節素分子，我們現在正在臨床試驗中測試其中的第二種，GIP/GLP 和其他早期開發的分子。

In each of these cases, we're really looking for what we consider to be breakthrough efficacy.

在每一種情況下，我們都在尋找我們認為具有突破性功效的東西。

In the case of GIP/GLP, here, we were encouraged that dual-agonism of both of these receptors, which we think is very important in our preclinical studies, showed highly differentiated weight loss and glucose controls.

在 GIP/GLP 的情況下，我們感到鼓舞的是，這兩種受體的雙重激動（我們認為這在我們的臨床前研究中非常重要）顯示出高度分化的體重減輕和血糖控制。

So we're encouraged by that.

所以我們對此感到鼓舞。

We took it check into Phase I clinical trials.

我們將其納入 I 期臨床試驗。

We commented that we're encouraged by what we saw there and, therefore, moved it into Phase II clinical trials.

我們評論說，我們對在那裡看到的情況感到鼓舞，因此，將其移至 II 期臨床試驗。

And I'll hand it to Enrique for the future of this molecule.

我會把它交給 Enrique 來決定這個分子的未來。

Yes.

是的。

No, I think you've framed it well.

不，我認為你的構圖很好。

But we do have a high bar for any type of next-generation incretin.

但對於任何類型的下一代腸促胰島素，我們確實有很高的標準。

And this product clearly met that bar, but we won't be able to comment on the specifics of the efficacy just to say that we do plan to have a full presentation at EASD, and then an investor call following that.

這個產品顯然達到了這個標準，但我們無法評論功效的細節，只是說我們確實計劃在 EASD 上進行全面介紹，然後在此之後進行投資者電話會議。

That'll be early October.

那將是十月初。

That's correct.

這是正確的。

Great.

偉大的。

Greg, thank you.

格雷格，謝謝。

And that will be Andrew Baum, Citi.

那將是花旗銀行的安德魯鮑姆。

A couple of topics, please.

請講幾個話題。

Just to zoom in on the first question around the Blueprint, the big leap, the proposal on rebates.

只是為了放大關於藍圖的第一個問題，即大的飛躍，關於回扣的提議。

Our understanding is this totally relates to federal forms of the plan.

我們的理解是，這完全與聯邦形式的計劃有關。

I just want to make sure that's consistent with your understanding.

我只是想確保這與您的理解一致。

Second, assuming that is the case, how do you envisage the world working if PBMs could meaningfully amend their structure of their rebate or move rebate altogether for federal plan.

其次，假設是這種情況，如果 PBM 可以有意義地修改其回扣結構或將回扣完全轉移到聯邦計劃中，您如何設想世界運轉。

Is it conceivable that the commercial side of this business will remain as is?

是否可以想像這項業務的商業方面將保持原樣？

Or would you anticipate that may change?

還是您預計這可能會改變？

And finally, the timing.

最後，時機。

We're assuming that nothing is going to happen, just given plans are set until 2020 if the earliest again is that system.

我們假設什麼都不會發生，只是考慮到如果最早還是那個系統的話，計劃定在 2020 年。

And then a second topic, just one question on tanezumab.

然後是第二個主題，只有一個關於 tanezumab 的問題。

What are you anticipating in terms of the labeling requirements for radiographic scans, given in the real world of patients maybe premedicating with NSAIDs, which may increase some of the stakes that you saw in the earlier trials?

您對放射線掃描的標籤要求有什麼預期，在現實世界中可能使用非甾體抗炎藥的患者，這可能會增加您在早期試驗中看到的一些風險？

Okay.

好的。

So we've got a series of questions essentially on the blueprint, specifically on the rebate program.

所以我們有一系列關於藍圖的問題，特別是關於回扣計劃的問題。

And is that only applying in our understanding of the federally -- federal programs?

這是否僅適用於我們對聯邦——聯邦計劃的理解？

What will be the impact of PBMs during the commercial business if that change -- kind of change would go into effect.

如果這種變化會生效，那麼 PBM 在商業業務中會產生什麼影響？

Earliest timing that we're thinking is 2020 appropriate.

我們認為最早的時間是 2020 年。

And we also had the question on tanezumab in terms of labeling required for radiographic scan.

我們還對 tanezumab 提出了放射線掃描所需標籤方面的問題。

So maybe, Dave, if you want to take the first question.

所以也許，戴夫，如果你想回答第一個問題。

I don't know if there's much we can say, but whatever we can say on the blueprint speculation.

我不知道我們是否可以說很多，但我們可以在藍圖推測上說什麼。

And then maybe, Dan, if you want to comment on tanezumab.

如果你想對 tanezumab 發表評論，那麼也許丹。

Yes.

是的。

I would just kind of reiterate.

我只是重申一下。

Andrew, it's difficult to speculate on a proposed rule change when all we have is the title of the rule.

安德魯，當我們只有規則的標題時，很難推測提議的規則更改。

I think if you read it like we can, which basically says the change to the rebate rules and the Anti-Kickback Statute and replacing it with a new set of safe harbors.

我認為，如果您像我們一樣閱讀它，它基本上說明了對回扣規則和反回扣法規的更改，並用一套新的安全港取而代之。

Mike Harrington's with us, who's our General Counsel.

Mike Harrington 和我們在一起，他是我們的總法律顧問。

I think if you ask him about what Anti-Kickback Statute refers to, but I believe it is just federal programs.

我想如果你問他反回扣法規指的是什麼，但我相信這只是聯邦計劃。

Mike, do you want to comment on it?

邁克，你想評論一下嗎？

Well, I think we'll have to see.

好吧，我想我們得看看。

The Anti-Kickback Statute addresses payments made to induce prescribing.

反回扣法規解決了為誘導開處方而支付的費用。

So it's -- we'll have to monitor it closely, but there's a potential yet that it could expand more broadly beyond just the federal programs.

所以它 - 我們必須密切監視它，但它有可能擴展到更廣泛的範圍，而不僅僅是聯邦計劃。

Okay, thank you.

好的謝謝你。

And then tanezumab and the radiographic quick labeling?

然後是 tanezumab 和放射線快速標記？

Yes, sure.

是的，當然。

So it's certainly premature to speculate on the labeling on tanezumab, given that we don't have the primary safety data yet.

因此，鑑於我們還沒有主要的安全性數據，現在推測 tanezumab 的標籤肯定為時過早。

But as you know, we made some changes to the Phase III program to try and decrease the risk of RPOA.

但如您所知，我們對第三階段計劃進行了一些更改，以嘗試降低 RPOA 的風險。

I think most significant among those is lowering the dose of tanezumab.

我認為其中最重要的是降低 tanezumab 的劑量。

And so that's, again, why this titration study was the first step in demonstrating that.

這就是為什麼這項滴定研究是證明這一點的第一步。

We still have the efficacy that we need.

我們仍然有我們需要的功效。

Another change was reducing or eliminating the concomitant use of NSAIDs in OA patients as well as changing our screening methods, as you mentioned.

正如您提到的，另一個變化是減少或消除 OA 患者同時使用非甾體抗炎藥，以及改變我們的篩查方法。

Let's see what the data show.

讓我們看看數據顯示了什麼。

And based on that, we'll be able to talk more about where we're headed in the labeling.

基於此，我們將能夠更多地談論我們在標籤中的發展方向。

Thank you, Dan.

謝謝你，丹。

And next we have David Risinger, Morgan Stanley.

接下來是摩根士丹利的 David Risinger。

Yes.

是的。

I have a few questions.

我有幾個問題。

First, with respect to the strategic exits that you mentioned for Elanco, obviously, you can't talk about the IPO, but I just wanted to better understand when those strategic exits were completed that had a negative impact on revenue in the second quarter and, thus, when they will annualize.

首先，關於你提到的 Elanco 的戰略退出，顯然，你不能談論 IPO，但我只是想更好地了解那些對第二季度收入產生負面影響的戰略退出何時完成，以及，因此，它們何時年化。

So that's the first question.

所以這是第一個問題。

Second, with respect to Jardiance and Trajenta, both of those products were flattish sequentially.

其次，就 Jardiance 和 Trajenta 而言，這兩個產品都依次持平。

So they were outliers.

所以他們是異常值。

Obviously, the rest of the portfolio is extremely strong.

顯然，投資組合的其餘部分非常強大。

Could you help us better understand why they were flattish sequentially despite the prescription growth that we saw?

您能否幫助我們更好地理解為什麼儘管我們看到了處方增長，但它們卻依次持平？

And then my final question is with respect to your Alzheimer's candidates.

然後我的最後一個問題是關於您的阿爾茨海默氏症候選人。

You have 2 candidates in Phase II with readouts in coming years.

您在第二階段有 2 名候選人，未來幾年會有讀數。

Can you just provide a framework for those 2 Phase II programs, including the timing?

您能否為這兩個第二階段計劃提供一個框架，包括時間安排？

Great.

偉大的。

Dave, thank you for the questions.

戴夫，謝謝你的提問。

So maybe, Josh, if you want to take the first questions on when we've completed some of the strategic exits and sort of what the time course is for those eventually to annualize.

所以也許，喬什，如果你想問第一個問題，我們什麼時候完成了一些戰略退出，以及最終年度化的時間進程。

And then, Enrique, on the sequential growth patterns for Jardiance and Trajenta, and then over to Dan for the question for our Alzheimer's programs in Phase II.

然後，Enrique，關於 Jardiance 和 Trajenta 的連續增長模式，然後讓 Dan 來回答我們第二階段阿爾茨海默病項目的問題。

Josh?

喬什？

Okay, great.

好，太棒了。

Thanks, David.

謝謝，大衛。

The most significant and the strategic exits would be our Posilac business in the Augusta manufacturing plant in Georgia.

最重要的戰略性退出將是我們在佐治亞州奧古斯塔製造廠的 Posilac 業務。

We really just completed that exit over the course of this month.

我們真的只是在本月完成了退出。

So now, as you know, Posilac has been declining over the course of 2017 and 2018.

所以現在，如你所知，Posilac 在 2017 年和 2018 年期間一直在下降。

So I think you'll start to see the -- this annualizing total revenue beginning in the second half of this year just as we start to work through some of the significant headwinds we saw last year.

所以我認為你會開始看到 - 從今年下半年開始的年化總收入，就像我們開始克服去年看到的一些重大不利因素一樣。

I think it will totally out of the numbers by the time we get into sort of late 2019.

我認為當我們進入 2019 年底時，它會完全超出數字。

But the majority of the effect that we see for Posilac, that's going down every quarter because the product -- before the strategic exit, the product was declining pretty significantly.

但我們看到的對 Posilac 的大部分影響，每個季度都在下降，因為產品——在戰略退出之前，產品的下降幅度相當大。

We also announced that we were, on a smaller basis, exiting a few contracts, including a manufacturing contract that we had around on BI when we acquired the vaccine portfolio.

我們還宣布，我們在較小的基礎上退出了一些合同，包括我們在獲得疫苗組合時在 BI 上擁有的製造合同。

It was a little margin opportunity.

這是一個小小的利潤機會。

But on the top line, that will start to come out in the numbers in the second half of this year as well.

但最重要的是，這也將在今年下半年開始出現。

And if you'll remember, when we gave guidance for Elanco at the beginning of the year, we said you would see a pickup in growth in the second half of this year, as some of these items began to normalize in the numbers.

如果你還記得，當我們在年初為 Elanco 提供指導時，我們說你會在今年下半年看到增長的回升，因為其中一些項目的數字開始正常化。

I think what's -- that's why we have focused on the core Elanco business, which really looks at that portfolio which is not -- we're not exiting from, and is the basis of our growth going forward.

我認為是什麼——這就是我們專注於核心 Elanco 業務的原因，它真正著眼於我們沒有退出的投資組合，並且是我們未來增長的基礎。

Great.

偉大的。

Thanks, Josh.

謝謝，喬希。

Enrique?

恩里克?

Very good.

很好。

So let's start with the easier one.

所以讓我們從更簡單的開始。

Trajenta net sales in the U.S. reflect the trend that we see when it comes to total prescriptions.

Trajenta 在美國的淨銷售額反映了我們在總處方方面看到的趨勢。

Basically, it's a steady number of prescriptions quarter-on-quarter, and that's basically what we see when it comes to net sales.

基本上，季度環比處方數量穩定，這基本上就是我們在淨銷售額方面看到的情況。

When it comes to Jardiance, just maybe to provide a bit more color.

當談到 Jardiance 時，也許只是為了提供更多的顏色。

We show, in the case of Jardiance, a 58% TRx growth versus the previous year quarter-on-quarter.

我們顯示，在 Jardiance 的案例中，TRx 與去年同期相比增長了 58%。

On a sequential basis, that growth is 13%.

按順序計算，增長率為 13%。

So very solid growth when it comes to Jardiance.

Jardiance 的增長非常穩健。

But the net sales, there's a disconnect there because the net sales for the quarter versus the previous year only increased 28%.

但是淨銷售額卻存在脫節，因為本季度的淨銷售額與上一年相比僅增長了 28%。

We did have an adjustment to -- due to changes in estimates for rebates and discounts.

由於回扣和折扣的估計發生變化，我們確實進行了調整。

Normalizing for that, the gross versus the previous year would have been 46%.

正常化，與上一年相比，總額為 46%。

Now when we look on a sequential basis, in the case of Jardiance, some of those changes in the estimates for rebates and discounts really belonged in Q1.

現在，當我們按順序查看 Jardiance 的情況時，回扣和折扣估計的一些變化確實屬於第一季度。

So you basically have a double whammy effect when you look at the sequential quarter-on-quarter comparison.

因此，當您查看連續的季度環比比較時，您基本上會產生雙重打擊。

Thank you, Enrique.

謝謝你，恩里克。

Dan?

擔？

Yes.

是的。

Thanks for the question on the neurodegeneration portfolio.

感謝您提出有關神經退行性變產品組合的問題。

We actually have 3 neurodegeneration-targeted molecules in Phase II trials, starting with D1 PAM.

我們實際上在 II 期試驗中有 3 個神經退行性靶向分子，從 D1 PAM 開始。

This is designed to be a symptomatic molecule for patients suffering with dementia.

這被設計為癡呆症患者的症狀分子。

Initially, we're testing it in Parkinson's disease dementia.

最初，我們正在帕金森病癡呆症中對其進行測試。

We have reason to believe that there's a higher probability of success in that population.

我們有理由相信，在該人群中成功的可能性更高。

But if we get a positive signal there, we would very quickly move that also in parallel to Alzheimer's disease.

但如果我們在那裡得到一個積極的信號，我們會很快將其與阿爾茨海默病並行。

So that's the first.

所以這是第一個。

The other 2 that you've mentioned, the next one behind it is N3pG.

你提到的另外兩個，下一個是 N3pG。

That's an anti-plaque A-beta antibody.

那是一種抗斑塊 A-β 抗體。

Based on what we saw in some pretty extended Phase I trials, this molecule can clear plaques really to a very dramatic depth.

根據我們在一些相當擴展的 I 期試驗中看到的情況，這種分子可以真正將斑塊清除到非常顯著的深度。

So a great degree of clearance.

所以清關程度很大。

And also with a great amount of speed, so faster clearance, I think, than we've seen with other mechanisms.

而且速度也很快，我認為比我們在其他機制上看到的更快。

So we're excited about that.

所以我們對此感到興奮。

We're testing that as monotherapy.

我們正在將其作為單一療法進行測試。

We're also testing it in conjunction in combination therapy.

我們還在聯合治療中對其進行測試。

I believe it's the first combo trial of 2 disease-modifying drugs in Alzheimer's disease with a BACE inhibitor, with a thought there that although BACE monotherapy has been disappointing, if you turn off A-beta production, also clear out the plaque, that could have added benefits.

我相信這是第一次在阿爾茨海默病中使用 BACE 抑製劑對 2 種疾病改善藥物進行聯合試驗，我認為儘管 BACE 單藥療法令人失望，但如果你關閉 A-β 的產生，也可以清除斑塊，這可能有額外的好處。

So that trial's enrolling.

所以該試驗的註冊。

And then we also have the tau monoclonal antibody.

然後我們還有 tau 單克隆抗體。

This is specific for aggregated forms of tau, and we think this is an important therapeutic modality in Alzheimer's.

這是特定於 tau 的聚合形式，我們認為這是阿爾茨海默病的一種重要治療方式。

Both of those Phase II, all really -- all 3 of the Phase II trials are designed to give us efficacy signals, both on biomarkers and on cognitive endpoints.

這兩個 II 期，真的——所有 3 個 II 期試驗都旨在為我們提供關於生物標誌物和認知終點的功效信號。

I think on clinicaltrials.gov, we showed the disease modifying trials ending in 2020 to 18-month treatment period.

我認為在 Clinicaltrials.gov 上，我們展示了到 2020 年結束的疾病修正試驗到 18 個月的治療期。

But depending on enrollment rates and depending on a potential per interim analysis, there's also a potential to have data readouts earlier, even next year.

但根據入學率和潛在的中期分析，也有可能在更早的時候，甚至在明年獲得數據讀數。

But we'll have to wait and see how those trials go.

但我們將不得不等待，看看這些試驗會如何進行。

Great.

偉大的。

Thank you, Dan.

謝謝你，丹。

And the next question is from the line of -- one moment please.

下一個問題來自- 請稍等。

It's going to be Jami Rubin, Goldman Sachs.

它將是高盛的 Jami Rubin。

Dave, I just want to go back to some of the questions around rebate structures.

戴夫，我只想回到有關回扣結構的一些問題。

And I recognize that it's early, and it's hard to predict how this is going to play out.

而且我認識到現在還為時過早，而且很難預測這將如何發展。

But just when you look at your own numbers and think about different scenarios, looking at filing Lilly's gross to net of 48% is the widest in the industry, largely because of your diabetes franchise.

但就在您查看自己的數字並考慮不同的情況時，查看禮來公司 48% 的毛利率是業內最廣泛的，主要是因為您的糖尿病專營權。

If there is a change to those deep rebates, what would you expect to happen to volumes?

如果這些高額回扣發生變化，您預計交易量會發生什麼變化？

You just said that volumes are -- that rebates are used to induce volumes.

您剛才說交易量是- 回扣用於誘導交易量。

So would you expect volumes to go down for that business?

那麼，您是否預計該業務的銷量會下降？

Conversely, if rebates go away, Lilly has about $10 billion in rebates.

相反，如果回扣消失，禮來公司將獲得大約 100 億美元的回扣。

How can this not be a net positive even if you take into consideration lower volumes and potentially lower list price?

即使考慮到較低的銷量和潛在的較低標價，這怎麼可能不是一個淨積極因素呢？

How are you thinking about the different scenarios that can play out here?

您如何看待可以在這裡上演的不同場景？

Great.

偉大的。

Jami, thank you for the questions.

傑米，謝謝你的提問。

Dave?

戴夫？

Yes.

是的。

Thanks, Jami.

謝謝，傑米。

I mean, the huge opening caveat here is we don't know, right?

我的意思是，這裡的巨大開場警告是我們不知道，對吧？

We need -- we don't know what this rule is.

我們需要——我們不知道這條規則是什麼。

We know where the system will go.

我們知道系統將走向何方。

We paused on the list price changes in the U.S. waiting to see what's happening here.

我們暫停了美國的定價變化，等待看看這裡發生了什麼。

But just to get the numbers right, so we reported last year a 51% gross to net spread.

但只是為了得到正確的數字，所以我們去年報告了 51% 的總價差與淨價差。

You're right in that the diabetes segment in particular drives that, primarily because you have a very large Medicaid population, and your very large gross to net spreads in Medicaid are approaching the federal cap at 100%.

你是對的，特別是糖尿病部分推動了這一點，主要是因為你有一個非常大的醫療補助人口，而且你在醫療補助中非常大的總淨利差正在接近聯邦上限 100%。

So we've been pretty open about all of that.

所以我們對所有這些都非常開放。

It depends on how this rule would be enacted, whether it would change the Medicaid system, whether it would treat that commercial, et cetera, to really guess at what would be on the other side of it.

這取決於該規則將如何制定，它是否會改變醫療補助系統，是否會處理該商業廣告等等，以真正猜測它的另一面會是什麼。

As I said in my first response though.

正如我在第一次回復中所說的那樣。

We make innovative products, hopefully, products people want and need.

我們製造創新產品，希望是人們想要和需要的產品。

I think the current system has resulted in basically a structure of the industry where the hospital systems, insurance carriers, distributors and manufacturers seem to be fine with the current system.

我認為目前的系統基本上導致了一個行業結構，醫院系統、保險公司、分銷商和製造商似乎對目前的系統沒有問題。

The problem is we're shifting too much costs via list pricing directly to consumers.

問題是我們通過定價直接將太多成本轉移給了消費者。

I have to believe that if consumer pricing came down, it would improve volume, improve medication adherence, improve outcomes for patients.

我必須相信，如果消費者定價下降，它會提高銷量，提高用藥依從性，改善患者的治療效果。

So we think -- that's why, in general, we think this direction it travels is a good way.

所以我們認為——這就是為什麼，總的來說，我們認為它的這個方向是一個好方法。

Now we have to see all of the specifics because, clearly, there's a lot of room for disruption in a negative way here.

現在我們必須看到所有細節，因為很明顯，這裡有很大的負面影響空間。

And it'd be very difficult for Lilly to predict what would happen to their gross to net line you're talking about or, more specifically, without seeing the totality of the regulatory reforms.

禮來很難預測你所說的他們的總淨額會發生什麼，或者更具體地說，如果沒有看到監管改革的全部內容。

Is there a scenario there where this is a net positive for the industry even if volumes do go down, but your rebates go away as well?

是否存在這樣的情況，即使銷量確實下降，但您的回扣也會消失，這對行業來說是一個淨利好？

I think there's a lot of scenarios, Jami.

我認為有很多場景，Jami。

It's hard to speculate.

很難推測。

Yes, great.

對，很好。

Thanks, Jami.

謝謝，傑米。

And next we have Geoff Meacham, Barclays.

接下來是巴克萊銀行的 Geoff Meacham。

On Olumiant, I would just want to ask you guys a little bit more detail about the strategy going forward for the 4 mg dose in RA.

關於 Olumiant，我只想向你們詳細了解 RA 中 4 mg 劑量的未來策略。

What are the options you're looking at?

您正在查看哪些選項？

And maybe just put this in the context of the priorities compared to your label expanding studies in atopic dermatitis, psoriatic arthritis, et cetera?

與您在特應性皮炎、銀屑病關節炎等方面的標籤擴展研究相比，也許只是把它放在優先事項的背景下？

And then, Dave or Josh, with the Elanco spin-out, you've -- pipeline progress and obviously a few smaller scale deals already done on oncology.

然後，戴夫或喬什，隨著 Elanco 的分拆，你已經 - 管道進展，顯然已經在腫瘤學方面完成了一些小規模的交易。

Maybe just help us with, is it fair to say BD is now a lower priority?

也許只是幫助我們，說 BD 現在是次要優先級是否公平？

Is there a category that you feel like you'll still need to add assets like, for example, in oncology, to be more competitive?

是否有一個類別你覺得你仍然需要添加資產，例如腫瘤學，以提高競爭力？

Great.

偉大的。

Geoff, thank you for the questions.

傑夫，謝謝你的提問。

So Dan, maybe if you can comment on strategies going forward for the 4 mg in RA, and how that may compare with other NILEX opportunities that we're evaluating.

所以，丹，如果你能評論一下 RA 中 4 毫克的未來策略，以及如何與我們正在評估的其他 NILEX 機會進行比較。

And then, Dave, obviously, to comment on business development priorities that we have moving forward.

然後，戴夫顯然要評論我們正在推進的業務發展優先事項。

Dan?

擔？

Yes.

是的。

Thanks.

謝謝。

We're excited about the potential of baricitinib for patients that potentials being realized, of course, to a greater extent, outside of the U.S., in places where both doses are approved.

我們對巴瑞替尼對患者的潛力感到興奮，當然，在美國以外，在兩種劑量都被批准的地方，這種潛力在更大程度上得到了實現。

At the Advisory Committee, I think we were clear in our position about the benefits that each dose could have for patients, and we were clear, to copy the Ad Com, in our disappointment.

在諮詢委員會，我認為我們的立場很明確，即每劑疫苗可能對患者產生的益處，並且我們很清楚，我們很失望地複制了 Ad Com。

And I think in terms of next steps for the 4-milligram dose, we're still considering what different possibilities might be internally at this time.

而且我認為就 4 毫克劑量的後續步驟而言，我們仍在考慮此時內部可能存在哪些不同的可能性。

I think that in terms of the prioritization here, there's great opportunities for baricitinib in RA, but also in some of the other indications.

我認為，就此處的優先級而言，巴瑞克替尼在 RA 中的機會很大，但在其他一些適應症中也有。

So the lupus data, which was recently published in Lancet, I think, represents a really great opportunity for patients, and an opportunity here for us to be first-in-class here in lupus.

因此，我認為，最近發表在《柳葉刀》上的狼瘡數據對患者來說是一個非常好的機會，也是我們在狼瘡領域成為一流的機會。

We're also excited about atopic derm where we now have a phase II trial ongoing.

我們也對特應性皮膚感到興奮，我們現在正在進行 II 期試驗。

So lots of opportunity for patients with bari remaining.

剩下的巴里患者有很多機會。

Yes.

是的。

I would just add, we've launched just now, started promoting in July in the U.S. with the 2-milligram.

我想補充一下，我們剛剛推出，7 月份開始在美國推廣 2 毫克。

Anecdotal feedback's very positive.

軼事反饋非常積極。

And we know from the German launch, French launch, which are ongoing, that patients have rapid pain relief.

我們從正在進行的德國發射、法國發射中得知，患者的疼痛得到了快速緩解。

They -- this is a different modality than they're used in disease modifiers for RA.

它們——這是一種不同於它們用於 RA 疾病調節劑的方式。

And we're far from disappointed with the performance of the molecule at a global basis.

我們對這種分子在全球範圍內的表現並不感到失望。

More to do in the U.S. We'll update investors if probably -- in more detail at the Q3 call on that performance.

在美國還有更多工作要做。如果可能的話，我們將更新投資者——在第三季度電話會議上更詳細地介紹這一表現。

And the life cycle, as Dan pointed out, is potentially quite broad.

正如丹所指出的，生命週期可能相當廣泛。

On the second question of BD priorities, I hate to say this, Geoff, but I think you have it exactly wrong.

關於 BD 優先級的第二個問題，傑夫，我不想這麼說，但我認為你完全錯了。

I wouldn't attribute it all that we're satisfied with BD.

我不會把這一切歸功於我們對 BD 的滿意。

We are in a position now with where we're growing the top line, we're growing income, we're growing cash flows.

我們現在處於收入增長，收入增長，現金流增長的位置。

We are very interested in acquiring assets that add all of our therapeutic areas of interest.

我們對收購能夠增加我們所有感興趣的治療領域的資產非常感興趣。

We're not plugging a hole here.

我們不是在這裡堵住一個洞。

It's really about building value for the long term.

這實際上是關於建立長期價值。

And because we are optimistic about the short and midterm in terms of growth prospects, we're in a position to do just that.

由於我們對短期和中期增長前景持樂觀態度，因此我們能夠做到這一點。

So I would expect to see a continuous flow of pipeline ads from Lilly, hopefully, from our own labs, but if not, from outside labs as well.

因此，我希望看到禮來公司持續不斷地投放管道廣告，希望來自我們自己的實驗室，但如果沒有，也來自外部實驗室。

And we have more than enough resources to execute that strategy.

我們有足夠的資源來執行該戰略。

Great.

偉大的。

Thanks, Dave.

謝謝，戴夫。

The next question is from the line of Jason Gerberry, Bank of America.

下一個問題來自美國銀行的 Jason Gerberry。

I guess, just first question on Humalog.

我想，只是關於 Humalog 的第一個問題。

You've now gotten first half of the year the benefit in terms of the changes and estimates.

您現在已經從變化和估計方面獲得了上半年的收益。

But just on the, I guess, rebates.

但我猜只是在回扣上。

But can you talk about second half, where you are in terms of comps?

但是你能談談下半場，你在比賽方面的表現嗎？

And then kind of moving forward into 2019, how comfortable are you at this stage that the biosimilar competitor won't really represent a meaningful source of competitive pressure to the business?

然後進入 2019 年，在這個階段，您對生物仿製藥競爭對手不會真正代表企業競爭壓力的重要來源感到滿意嗎？

And then my second question, just on galcanezumab.

然後我的第二個問題是關於 galcanezumab。

The feedback from the Amgen launch in the CGRP space seems to be pretty favorable.

Amgen 在 CGRP 領域推出的反饋似乎相當有利。

I'd just be curious to get your evolving thoughts on, do you think payers are going to cover multiple CGRP agents on par or parity?

我只是想知道您不斷發展的想法，您認為付款人會以同等或同等的價格覆蓋多個 CGRP 代理嗎？

Or do you think that they'll opt for exclusive contracts out of the gates?

或者你認為他們會選擇獨家合同嗎？

Great.

偉大的。

Jason, thank you for the questions.

傑森，謝謝你的提問。

So Enrique, we'll go to you for Humalog.

所以恩里克，我們會去找你的 Humalog。

I'm not sure, David, if you may want to handle or what the...

我不確定，大衛，如果你想處理或...

Let me take it, 2 each for galcanezumab.

讓我接受，galcanezumab 各 2 個。

Yes, absolutely.

是的，一點沒錯。

Enrique?

恩里克?

Sure.

當然。

So Humalog had an excellent quarter.

因此，Humalog 有一個出色的季度。

We did have a benefit in Q2 due to changes in the estimates for rebates and discounts.

由於對回扣和折扣的估計發生變化，我們在第二季度確實受益。

That benefit was -- relative to the previous year was about 9 points.

那個好處是 - 相對於前一年大約是 9 個百分點。

So an important benefit.

所以一個重要的好處。

Now as we -- it's difficult to -- for us to be able to project forward.

現在我們——很難——讓我們能夠向前推進。

But we are seeing a bit of a benefit also when it comes to mix.

但在混合方面，我們也看到了一些好處。

So when we look at the different segments, which is a positive for Humalog and for the insulin franchise.

因此，當我們查看不同的細分市場時，這對 Humalog 和胰島素特許經營權都是有利的。

Now as it relates to Admelog, it's very difficult to -- for us to forecast and predict how the competitor would basically play in the market.

現在，由於它與 Admelog 相關，我們很難預測和預測競爭對手在市場上的基本表現。

Clearly, at this point in time, we basically see them as gaining share in particular in the area of managed Medicaid, but it's difficult for us to predict what type of access and uptake will they be able to have in 2019.

顯然，在這個時間點上，我們基本上認為他們正在獲得份額，特別是在託管醫療補助領域，但我們很難預測他們在 2019 年能夠獲得什麼樣的訪問和吸收。

Okay, great.

好，太棒了。

As it relates to access in the migraine category, it's pretty early days here.

由於它與偏頭痛類別的訪問有關，所以現在還處於早期階段。

I understand mostly payers haven't listed the new therapy.

我知道大多數付款人沒有列出新療法。

We're, of course -- heard the guidance from the FDA and early conversations with payers about our data, and seeking that kind of feedback from them.

當然，我們聽到了 FDA 的指導以及與付款人就我們的數據進行的早期對話，並從他們那裡尋求這種反饋。

I could tell you, what our strategy is, which is really broad access to these medications, is appropriate, and particularly given the population.

我可以告訴你，我們的策略是什麼，即真正廣泛地獲得這些藥物，是適當的，特別是考慮到人口。

So these are mostly commercially insured working women, who are having anywhere between 4 and 20 headaches a month.

因此，這些人大多是有商業保險的職業女性，她們每個月頭痛的次數在 4 到 20 次之間。

That's our study population, which causes absenteeism, debilitation, lack of ability to predict and schedule and plan, not to mention just the human suffering cost.

這就是我們的研究人群，這會導致曠工、虛弱、缺乏預測、安排和計劃的能力，更不用說人類的痛苦成本了。

So we think employers will be very interested in covering this class.

所以我們認為雇主會非常有興趣覆蓋這個課程。

We need to get that message through.

我們需要傳達這個信息。

It could be a great category for some value and outcomes-based pricing approaches, and we're optimistic long term that the class will have good coverage.

對於某些基於價值和結果的定價方法來說，這可能是一個很好的類別，我們長期樂觀地認為該類別將有良好的覆蓋範圍。

Enrique, is there anything from your conversations with payers to add?

恩里克，您與付款人的對話中有什麼要補充的嗎？

No.

不。

I think we're very excited about the opportunity that this new product would represent for us, and we're working actively to try to ensure broad access.

我認為我們對這個新產品將為我們帶來的機會感到非常興奮，我們正在積極努力確保廣泛的訪問。

Great.

偉大的。

Thank you.

謝謝你。

Next we have Steve Scala, Cowen.

接下來是Steve Scala，Cowen。

Several questions.

幾個問題。

First, on Taltz.

首先，關於 Taltz。

In Q1, inventory was down 33%.

第一季度，庫存下降了 33%。

How much of the stellar second quarter performance was restocking the trade versus underlying demand?

第二季度的出色表現中有多少是在補充貿易庫存而不是潛在需求？

Second, a filing of galcanezumab in episodic cluster headache is not in the events table.

其次，在發作性叢集性頭痛中的 galcanezumab 不在事件表中。

So why is it 2018 filing's not likely?

那麼為什麼 2018 年的申請不太可能呢？

Is this is a result of the miss in the chronic cluster headache setting?

這是在慢性叢集性頭痛環境中錯過的結果嗎？

And then lastly, do you have any early reading on 2019 formulary discussions?

最後，您對 2019 年處方集討論有任何早期閱讀嗎？

Are they resulting in similar positions as 2018?

他們的排名是否與 2018 年相似？

Or is there a step-change in any way?

或者是否有任何階段性的變化？

Okay, Steve.

好的，史蒂夫。

I'm not sure with Christi being -- look, we've got a strong answer for you on the Q1, but we'll give at least a short answer for you.

我不確定克里斯蒂是否存在——看，我們在第一季度為你提供了一個強有力的答案，但我們至少會給你一個簡短的答案。

We can follow up later, if needed, on the Taltz question for Q1.

如果需要，我們可以稍後跟進 Q1 的 Taltz 問題。

And then maybe, Enrique, if you'd like to also comment on the 2019 formulary question, and I'll be happy to go ahead and provide a comment on the galcanezumab filing for cluster.

然後也許，恩里克，如果你也想對 2019 年的處方問題發表評論，我很樂意繼續對 galcanezumab 集群申請發表評論。

Yes.

是的。

I think the short answer is that Taltz' performance, when we look at Q2, is really demand-driven.

我認為簡短的回答是，當我們查看第二季度時，Taltz 的表現確實是由需求驅動的。

We've seen improvements on -- across our prescription trends in both derm and rheumatology.

我們在皮膚和風濕病學的處方趨勢中看到了改進。

So we are very encouraged with the Taltz performance.

所以我們對 Taltz 的表現感到非常鼓舞。

We typically do not comment on specific formulary forecast for 2019.

我們通常不對 2019 年的具體公式預測發表評論。

Yes.

是的。

And Steve, on your question for galcanezumab and cluster, very, very pleased with the results that we saw in the Phase III studies.

史蒂夫，關於您對 galcanezumab 和集群的問題，對我們在 III 期研究中看到的結果非常非常滿意。

And certainly we'll discuss those with regulators, but are not making any kind of a comment at this point in time on potential financial filing or timing for such filing.

當然，我們會與監管機構討論這些問題，但目前不會就潛在的財務申報或此類申報的時間發表任何評論。

And that will be Umer Raffat at Evercore.

那將是 Evercore 的 Umer Raffat。

I have 3, if I may.

如果可以的話，我有 3 個。

Dave, first, someone brought it up earlier as well, and I wanted to make it a bit more specific on the product level as it relates to the rebates.

戴夫，首先，有人也提早提出了這個問題，我想讓它在產品層面更具體一點，因為它與回扣有關。

And I guess, my question was, when I look at mealtime influence, Lilly and Novo basically split the market, and Sanofi has minimal share.

而且我想，我的問題是，當我查看用餐時間的影響時，禮來和諾和基本上瓜分了市場，而賽諾菲的份額很小。

So do you see -- do you foresee any scenario on rebates where Sanofi becomes a more meaningful player in mealtime insulins?

那麼您是否看到 - 您是否預見到賽諾菲（Sanofi）成為用餐時間胰島素更有意義的參與者的任何回扣情況？

So that's first.

所以這是第一個。

Then second and third are maybe more on R&D.

然後第二和第三可能更多的是研發。

First, on IL-10, my question is, in your ongoing Phase II trials of PD-1 plus IL-10, they're both open label and long.

首先，關於 IL-10，我的問題是，在您正在進行的 PD-1 加 IL-10 的 II 期試驗中，它們都是開放標籤且長期的。

And any observations from that trial to date?

迄今為止，該試驗的任何觀察結果？

And then also on R&D on tanezumab, have you -- do we know what the rate of conversion was from type 1 to type 2 RPOAs in your prior trials?

然後還有關於 tanezumab 的研發，你知道嗎 - 我們知道在你之前的試驗中從 1 型到 2 型 RPOA 的轉化率是多少？

All right.

好的。

Umer, thank you for the questions.

烏默爾，謝謝你的提問。

Enrique, maybe he'd like to comment on the first question about any possibilities we see for Sanofi to become a meaningful player in mealtime insulins?

Enrique，也許他想對第一個問題發表評論，關於我們看到賽諾菲成為餐時胰島素領域有意義的參與者的任何可能性？

Maybe Sue or Dan, if you'd like to comment on data from the IL-10.

如果您想評論來自 IL-10 的數據，可能是 Sue 或 Dan。

And then Umer, I'm sorry, I actually can't read my own chicken scratch for what you asked on tanezumab.

然後是 Umer，我很抱歉，對於你對 tanezumab 的要求，我實際上無法閱讀我自己的雞抓痕。

Oh, it's conversion from RPOA 1 to RPOA 2. And maybe, Dan or Dave, if you want to comment.

哦，這是從 RPOA 1 到 RPOA 2 的轉換。如果您想發表評論，也許是 Dan 或 Dave。

So Enrique, I'll start with you.

所以恩里克，我從你開始。

Yes.

是的。

The premise of the question was under a -- some sort of a different structure when it comes to rebates and so forth, it's -- and I think Dave already mentioned this, but it's very difficult to speculate what the changes would be and what the competitive dynamic would be as a result of that change.

問題的前提是——在回扣等方面採用某種不同的結構，它是——我認為 Dave 已經提到了這一點，但很難推測會發生什麼變化以及會發生什麼變化競爭動態將是這種變化的結果。

Clearly, we do track Sanofi's products in the mealtime insulin space.

顯然，我們確實在用餐時間的胰島素領域跟踪賽諾菲的產品。

But so far, I think uptake is very minimal.

但到目前為止，我認為吸收率非常低。

Great.

偉大的。

Thank you, Enrique.

謝謝你，恩里克。

Sue, you want to start on the IL-10 question?

蘇，你想從 IL-10 的問題開始嗎？

Yes, sure.

是的，當然。

We have 2 phase II studies with IL-10, as you mentioned, one in the front line, and the one in second line.

正如您所提到的，我們有兩項關於 IL-10 的 II 期研究，一項在前線，一項在二線。

Those -- both those dose are currently enrolling.

那些——這兩種劑量目前都在招募中。

The endpoint is response rate data, and we're anticipating seeing that next year.

終點是響應率數據，我們預計明年會看到。

Great.

偉大的。

Thank you, Sue.

謝謝你，蘇。

Dan, do you want to add anything?

丹，你想補充什麼嗎？

Or are you...

還是你...

It's fine.

沒關係。

Okay.

好的。

And then on the tanezumab question?

然後關於 tanezumab 的問題？

Yes.

是的。

So I understand your question about rates of conversion into RPOA 2 from RPOA 1 in previous trials.

因此，我了解您關於在之前的試驗中從 RPOA 1 轉換為 RPOA 2 的比率的問題。

I know there's a lot of interest in comparing what we'll be seeing in this current trial and in future trials of tanezumab with past experiences.

我知道將我們在當前試驗和未來的 tanezumab 試驗中看到的內容與過去的經驗進行比較會引起很大的興趣。

But there's some really important differences, I think, that should lead us to avoid those kinds of comparisons, primarily around the way that we screened and for events and adjudicated events, which is quite different in this trial and, understandably, since we knew what we're looking for, much more thorough.

但我認為，有一些非常重要的差異應該引導我們避免這些比較，主要是圍繞我們篩選的方式以及事件和裁定的事件，這在這次試驗中完全不同，而且可以理解，因為我們知道什麼我們正在尋找，更徹底。

So we don't have relevant data from the past to compare it to.

所以我們沒有過去的相關數據可以與之比較。

With regards to this current trial, we're not disclosing any more details at this point in time.

關於目前的試驗，我們目前沒有透露更多細節。

But that should happen in a future meeting.

但這應該發生在未來的會議上。

Great.

偉大的。

Thank you, Dan.

謝謝你，丹。

Next is Vamil Divan, Crédit Suisse.

接下來是瑞士信貸的 Vamil Divan。

Great.

偉大的。

So maybe just 2 on the oncology side.

所以在腫瘤學方面可能只有 2 個。

One, on Verzenio, the performance is pretty good this quarter.

一，在 Verzenio 上，本季度的表現相當不錯。

Just if you can give a little more color on which patients are getting Verzenio relative to IBRANCE or to Kisqali?

只是如果您可以多一點顏色說明哪些患者相對於 IBRANCE 或 Kisqali 正在獲得 Verzenio？

And then second one, on Alimta, you mentioned you're open to have label update to include the KEYNOTE-189 data later this year.

然後第二個，在 Alimta 上，您提到您願意在今年晚些時候更新標籤以包含 KEYNOTE-189 數據。

Just if you can comment on what you're seeing in terms of adoption of that regimen in practice to date, which Alimta uses now in combination with Keytruda in the frontline setting.

如果您可以評論您在迄今為止在實踐中採用該方案的情況，Alimta 現在在前線環境中將其與 Keytruda 結合使用。

Great.

偉大的。

Vamil, thank you go for the questions.

瓦米爾，謝謝你的問題。

So Sue, for you on both Verzenio and Alimta updates.

所以 Sue，為您提供 Verzenio 和 Alimta 的更新。

So yes, thanks for the question.

所以是的，謝謝你的問題。

Yes, we're really pleased with the update on Verzenio today.

是的，我們對今天 Verzenio 的更新感到非常滿意。

The sales this quarter was $57.7 million.

本季度的銷售額為 5770 萬美元。

So that's a $28 million increase boost last quarter.

因此，上個季度增加了 2800 萬美元。

What we're seeing is, as you know, we're the third-to-market CDK, but we are second now in terms of both NRx, so new to brand, and also in TRx.

如您所知，我們所看到的是，我們是第三個進入市場的 CDK，但我們現在在 NRx（對品牌如此陌生）和 TRx 方面都排名第二。

This quarter, our NBRx share was 18.7%, and we continue to see that increase.

本季度，我們的 NBRx 份額為 18.7%，而且我們繼續看到這種增長。

So we are pleased with the uptake.

因此，我們對吸收率感到滿意。

What we're seeing is when physicians are using the brand, they like it.

我們看到的是，當醫生使用該品牌時，他們會喜歡它。

So our focus is in ensuring that we continue to get trial of Verzenio.

因此，我們的重點是確保我們繼續試用 Verzenio。

And so far, we have about 1,500 physicians who have trialed Verzenio.

到目前為止，我們有大約 1,500 名醫生試用了 Verzenio。

The patients that they're using in is across the spectrum in the frontline and mainly in fulvestrant.

他們使用的患者遍布一線，主要是氟維司群。

And we do have some single-agent activity.

我們確實有一些單一代理活動。

But really, we're starting to see much more now uptake in the frontline.

但實際上，我們現在開始在前線看到更多的吸收。

So with aromatase inhibitors as well as with the second line in fulvestrant.

所以使用芳香酶抑製劑以及氟維司群的二線。

And the things that are resonating is the continuous dozing.

引起共鳴的是持續的打瞌睡。

The single-agent activity is clearly a differentiator.

單一代理活動顯然是一個差異化因素。

People are also interested, and I think the data is resonating in the fact that we see positive data in patients who got concerning clinical characteristics.

人們也很感興趣，我認為這些數據與我們在獲得有關臨床特徵的患者中看到的積極數據這一事實產生了共鳴。

So we feel pretty good so far about the uptake in Verzenio.

因此，到目前為止，我們對 Verzenio 的吸收感到非常滿意。

We see opportunity to continue to grow that brand.

我們看到了繼續發展該品牌的機會。

The market is growing about 22%, and we -- and only about 50% of patients are still getting a CDK4/6 inhibitor.

市場正在增長約 22%，而我們——只有約 50% 的患者仍在使用 CDK4/6 抑製劑。

With regards to Alimta, we've got the data uptake now in -- for the KEYNOTE-021G data is now in the label.

關於 Alimta，我們現在已經獲取了數據——因為 KEYNOTE-021G 數據現在在標籤中。

We have also submitted to the FDA to include the KEYNOTE-189 data.

我們還向 FDA 提交了 KEYNOTE-189 數據。

What we are seeing is, as you heard, we are growing Alimta in the U.S. We have a 2% growth based on volume, 1% price, so 3% overall.

正如你所聽到的，我們所看到的是，我們正在美國發展 Alimta。我們的銷量增長了 2%，價格增長了 1%，因此總體增長了 3%。

And although the data was only presented at ASCO fairly recently, since that time, we are seeing an increase in new patient prescriptions.

儘管這些數據是最近才在 ASCO 上公佈的，但從那時起，我們看到新的患者處方有所增加。

So as a reminder, about 50% of Alimta use is in the -- sort of in promoted areas.

所以提醒一下，大約 50% 的 Alimta 使用是在 - 某種推廣領域。

We do have Alimta -- some of the use for the KEYNOTE-189 regime is sort of in addition to Alimta use that we've got now.

我們確實有 Alimta - KEYNOTE-189 制度的一些用途是我們現在使用的 Alimta 的補充。

But we're clearly also seeing an increase in the typical use, and we continue to believe that we'll see that going forward.

但我們顯然也看到了典型使用的增加，我們仍然相信我們會看到這種情況繼續發展。

Great.

偉大的。

Thank you, Sue.

謝謝你，蘇。

Next is from the line of Louise Chen, Cantor.

接下來是來自 Cantor 的 Louise Chen 的系列。

So first question I had was, what gives you confidence that you will hit stat sig versus just non-inferiority in the REWIND trial for Trulicity?

所以我的第一個問題是，是什麼讓你有信心在 Trulicity 的 REWIND 試驗中達到 stat sig 而不是非劣效性？

And even if it's not stat sig, can Trulicity still continue with robust growth trajectory that you see currently?

即使不是 stat sig，Trulicity 還能繼續保持您目前看到的強勁增長軌跡嗎？

And second question was just back on tanezumab.

第二個問題是關於 tanezumab。

How do you think the FDA will balance the side effect profile of your drug versus the need for alternatives to opioids?

您認為 FDA 將如何平衡您的藥物的副作用與對阿片類藥物替代品的需求？

Great.

偉大的。

Louise, welcome to the call.

路易絲，歡迎來電。

So Enrique, if you'd like to handle the question for REWIND.

恩里克，如果你想處理 REWIND 的問題。

And then, Dan, over to you for the question on tanezumab.

然後，丹，關於 tanezumab 的問題請交給你。

Enrique?

恩里克?

So Trulicity today is having fantastic growth.

因此，今天的 Trulicity 正在實現驚人的增長。

Clearly, the GLP-1 market is growing very fast at 26%, but Trulicity is also having continued share growth over the last few months.

顯然，GLP-1 市場以 26% 的速度增長得非常快，但 Trulicity 在過去幾個月的份額也在持續增長。

We have an excellent access position and, quite frankly, an unmatched patient experience when we look at the real-world efficacy that Trulicity delivers.

當我們看到 Trulicity 提供的實際療效時，我們擁有出色的訪問位置，坦率地說，我們擁有無與倫比的患者體驗。

So we'll look at patient adherence and very simply delivered.

因此，我們將研究患者的依從性並非常簡單地交付。

So very excited about the core performance of the product.

對產品的核心性能感到非常興奮。

Clearly, REWIND, as we said before, is an important trial for us, and we believe that we've designed this trial in the appropriate way.

顯然，正如我們之前所說，REWIND 對我們來說是一個重要的試驗，我們相信我們以適當的方式設計了這個試驗。

We expect that we're going to have a top line sometime by the end of the year.

我們預計我們將在今年年底的某個時候達到頂線。

But we -- one of the differences for REWIND versus other trials is the time the patients are going to be on the product.

但我們——REWIND 與其他試驗的區別之一是患者使用該產品的時間。

This is not a short product.

這不是一個簡短的產品。

It's fairly long, and we expect that the patients would be on average over 5 years on Trulicity.

它相當長，我們預計患者在 Trulicity 上的平均壽命將超過 5 年。

So we look forward to the results of the trial.

所以我們期待試驗的結果。

But at this point in time, we're not going to speculate.

但在這個時間點上，我們不會去推測。

Great.

偉大的。

Thank you, Enrique.

謝謝你，恩里克。

Dan?

擔？

They're strict with tanezumab.

他們對 tanezumab 很嚴格。

But of course, with Pfizer, our priority here in the current slated trials is to demonstrate the benefit, risks of this drug for patients in a variety of settings.

但是，當然，對于輝瑞，我們在當前預定試驗中的首要任務是證明這種藥物對各種環境中的患者的益處和風險。

Having said that, your question was sort of broader about the societal impact here of the opioid crisis and the need for non-opioid alternatives for chronic pain.

話雖如此，你的問題有點更廣泛，關於阿片類藥物危機的社會影響以及慢性疼痛需要非阿片類藥物替代品的需求。

Of course, we also see that.

當然，我們也看到了。

That's one of the reasons we're excited by the potential of the pain portfolio, one of the reasons that several years ago we decided to invest in the future for tanezumab.

這是我們對疼痛產品組合的潛力感到興奮的原因之一，也是幾年前我們決定投資 tanezumab 未來的原因之一。

I think how regulators will see the interplay between new molecules for pain versus the opioid crisis is important, and we think that we have an important role to play there in helping solve that problem.

我認為監管機構將如何看待新的疼痛分子與阿片類藥物危機之間的相互作用很重要，我們認為我們在幫助解決這個問題方面可以發揮重要作用。

Thanks, Dan.

謝謝，丹。

And we do have a question from Steve Scala, Cowen.

我們確實有來自 Cowen 的 Steve Scala 的問題。

Back on REWIND.

回到倒帶。

On the Q1 call, it was stated that the top line press release could be anticipated in early Q4.

在第一季度的電話會議上，據說可以在第四季度初發布頂級新聞稿。

Enrique, you just said year-end.

恩里克，你剛剛說的是年終。

So I'm wondering if there has been a change in timing.

所以我想知道時間是否發生了變化。

Secondly, on Alimta, does the ruling in Germany change anything in the market, such as allowing a generic launch?

其次，關於 Alimta，德國的裁決是否會改變市場上的任何事情，例如允許仿製藥上市？

And then lastly, on Verzenio, a Phase II study in MCL had completed in March, but there's been no update when might we see the data.

最後，在 Verzenio 上，MCL 的 II 期研究已於 3 月完成，但我們何時可以看到數據卻沒有更新。

Great.

偉大的。

Steve, thank you for the questions.

史蒂夫，謝謝你的提問。

So Enrique, back to you for the REWIND follow-up.

所以，恩里克，回到你身邊進行 REWIND 後續行動。

And then, Sue, to you for the Germany ruling for Alimta, and the Verzenio Phase II in MCL.

然後，蘇，請您為德國對 Alimta 的裁決以及 MCL 中的 Verzenio Phase II 作出裁決。

There has been no change in timing.

時間沒有變化。

We expect that the top line would be released in Q4.

我們預計頂線將在第四季度發布。

Okay, great.

好，太棒了。

Thank you, Enrique.

謝謝你，恩里克。

And Sue?

還有蘇？

Yes.

是的。

With regards to the Alimta Germany, we're having junctions in place, so it's really hard to say what the situation is with regards to generics.

關於 Alimta 德國，我們已經建立了交叉點，所以很難說仿製藥的情況如何。

I mean, some may go at risk, but it's really hard to say with regards to that.

我的意思是，有些人可能會面臨風險，但這真的很難說。

And then for Verzenio, we had MCL Phase II wrap-up.

然後對於 Verzenio，我們完成了 MCL 第二階段的總結。

Any thoughts on plans for MCL going forward?

對 MCL 的未來計劃有何想法？

Yes.

是的。

I'm going to have to get back to you on that one.

我將不得不在那個問題上回复你。

I am not sure the plans with regards to the publication on that, but we'll certainly get back to you on that one.

我不確定有關該出版物的計劃，但我們肯定會就此問題與您聯繫。

Great.

偉大的。

And then also just to place in context for our Q2 results.

然後也只是為了說明我們的第二季度結果。

European sales of Alimta were about $145 million.

Alimta 在歐洲的銷售額約為 1.45 億美元。

Less than $30 million of that came from Germany.

其中不到 3000 萬美元來自德國。

That will be Hima Inguva, BofA.

那將是美國銀行的希馬·英古瓦。

Great.

偉大的。

On Slide 5, you're indicating a potential debt offering prior to the IPO.

在幻燈片 5 上，您表示在 IPO 之前可能進行債務發行。

And not asking terms of the transaction details, but do you expect this Elanco to be a levering up event for Lilly?

並且不詢問交易細節的條款，但您是否認為 Elanco 會成為禮來的槓桿事件？

So Josh, if you want to respond to the question in terms of will this cause Lilly to actually lever up?

所以喬希，如果你想回答這個問題，這是否會導緻禮來公司實際槓桿化？

So the debt offering will -- the intent at this point is to do that before we launch the IPO of less than 20%.

因此，債務發行將——此時的意圖是在我們推出不到 20% 的 IPO 之前做到這一點。

Obviously, over time, that sits on Elanco's books.

顯然，隨著時間的推移，這會出現在 Elanco 的書中。

I think if you look at Lilly's capital allocation priorities and cash flow, we do expect to be more levered over time as a function basically of tax reform.

我認為，如果你看看禮來公司的資本配置優先事項和現金流，我們確實預計隨著時間的推移，作為稅收改革的一項基本功能，槓桿率會更高。

You'll recall that prior to tax reform, we were in a position that we had cash that was restricted in how we could use it.

你會記得，在稅制改革之前，我們的現金在使用方式上受到限制。

It was, in effect, trapped overseas.

實際上，它被困在了海外。

As that has freed up, we don't need to keep as much cash.

由於這已經釋放，我們不需要保留盡可能多的現金。

So you should expect to see Lilly on a net basis be more levered.

因此，您應該期望看到禮來（Lilly）在淨額基礎上的槓桿率更高。

And in fact, in Q2, we moved into a net debt position.

事實上，在第二季度，我們進入了淨債務頭寸。

So it's less an issue of what will happen with Elanco because that will normalize over time, and more a function of our capital structure, which is now -- gives us much more flexibility as we're able to manage and use cash around the world.

所以這不是 Elanco 會發生什麼的問題，因為這會隨著時間的推移而正常化，更多的是我們的資本結構的一個功能，現在 - 給我們更多的靈活性，因為我們能夠在世界各地管理和使用現金.

And this is Phil.

這是菲爾。

I guess, as my new role as Treasurer, when we would separate Elanco, should that occur, which is our plan, we would lose a certain amount of EBITDA.

我想，作為我作為財務主管的新角色，當我們分離 Elanco 時，如果發生這種情況，這是我們的計劃，我們將失去一定數量的 EBITDA。

There would not be a significant reduction to our debt.

我們的債務不會大幅減少。

So there would be a modest, maybe 20 basis point increase in the debt-to-EBITDA kind of numbers that we have, a very minimal change in terms of Lilly's leverage moving forward.

因此，我們所擁有的債務與 EBITDA 之比的數字會有適度的增長，可能會增加 20 個基點，這對禮來公司未來的槓桿作用來說變化非常小。

No further questions in queue at this time.

目前沒有其他問題在排隊。

Excellent.

出色的。

Thank you very much.

非常感謝。

Dave, if you'd like to go ahead and conclude the call with some comments.

戴夫，如果您想繼續並以一些評論結束通話。

Thanks, Phil.

謝謝，菲爾。

We appreciate your participation in today's earnings call, and your interest in Eli Lilly and Company.

感謝您參加今天的財報電話會議，以及您對禮來公司的興趣。

Our strong first half growth makes us increasingly confident in our ability to deliver 5% compound revenue growth from 2015 to 2020, and to achieve a 30% operating margin in 2020, while our first half pipeline accomplishments continue to highlight the depth and breadth of our prospects for growth beyond 2020.

我們強勁的上半年增長使我們對我們在 2015 年至 2020 年實現 5% 的複合收入增長以及在 2020 年實現 30% 的營業利潤率的能力越來越有信心，而我們上半年的管道成就繼續突出我們的深度和廣度2020 年以後的增長前景。

As demonstrated most recently by our decision on Elanco, we continue to take concrete actions to focus our resources and allocate capital to best serve our customers and create value for our stakeholders.

正如我們最近對 Elanco 的決定所表明的那樣，我們將繼續採取具體行動來集中我們的資源和分配資本，以最好地為我們的客戶服務並為我們的利益相關者創造價值。

With a diverse set of new product opportunities to drive growth, a strong R&D capability and a clear path to margin expansion, we believe Lilly continues to be a compelling investment.

憑藉多樣化的新產品機會來推動增長、強大的研發能力和清晰的利潤率擴張路徑，我們相信禮來公司將繼續成為一項引人注目的投資。

Thanks, again, for dialing in.

再次感謝您撥入。

Please follow up with our IR team if you have questions we have not addressed on the call.

如果您有我們在電話中未解決的問題，請與我們的 IR 團隊聯繫。

Everyone, have a great day.

大家，有一個美好的一天。

Thank you.

謝謝你。

Ladies and gentlemen, this conference will be available over replay, and that's starting today at 11:30 a.m.

女士們先生們，本次會議將通過重播進行，從今天上午 11:30 開始。

Eastern time, and will run through July 24, 2019.

東部時間，將持續到 2019 年 7 月 24 日。

You may dial the AT&T Executive playback service by dialing 1 (800) 475-6701 with the access code 450818.

您可以撥打 1 (800) 475-6701 並使用訪問代碼 450818 撥打 AT&T Executive 播放服務。

International callers may dial area code (320) 365-3844 with access code 450818.

國際呼叫者可撥打區號 (320) 365-3844，接入代碼為 450818。

Now that does conclude your conference.

現在，您的會議結束了。