禮來公司 (LLY) 2019 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by.

女士們，先生們，謝謝你們的支持。

Welcome to the Eli Lilly Q3 2019 Earnings Call.

歡迎參加禮來公司 2019 年第三季度財報電話會議。

(Operator Instructions) As a reminder, this conference call is being recorded.

（操作員說明）作為提醒，此電話會議正在錄音中。

I'd now like to turn the conference over to the Vice President of Investor Relations, Kevin Hern.

我現在想把會議交給投資者關係副總裁凱文赫恩。

Please go ahead.

請繼續。

Thank you.

謝謝你。

Good morning.

早上好。

Thanks for joining us for Eli Lilly and Company's Q3 2019 Earnings Call.

感謝您參加禮來公司 2019 年第三季度財報電話會議。

I'm Kevin Hern, Vice President of Investor Relations.

我是投資者關係副總裁 Kevin Hern。

Joining me on today's call are Dave Ricks, Lilly's Chairman and CEO; Josh Smiley, our Chief Financial Officer; Dr. Dan Skovronsky, President of Lilly Research Laboratories; Anne White, President of Lilly Oncology; Enrique Conterno, President of Lilly Diabetes and Lilly USA; Patrik Jonsson, President of Lilly Bio-Medicines; and Mike Mason, incoming President of Lilly Diabetes.

與我一起參加今天電話會議的還有禮來公司董事長兼首席執行官戴夫·里克斯（Dave Ricks）；我們的首席財務官 Josh Smiley；禮來研究實驗室總裁 Dan Skovronsky 博士；禮來腫瘤學總裁 Anne White； Enrique Conterno，禮來糖尿病和禮來美國公司總裁； Patrik Jonsson，禮來生物醫藥總裁；和即將上任的禮來糖尿病公司總裁 Mike Mason。

We are also joined by Kim Macko and Mike Czapar of the Investor Relations team.

投資者關係團隊的 Kim Macko 和 Mike Czapar 也加入了我們的行列。

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

在這次電話會議期間，我們預計會根據我們目前的預期做出預測和前瞻性陳述。

Our actual results could differ materially due to a number of factors, including those listed on Slide 3 and those outlined in our latest Forms 10-K, 10-Q and any 8-Ks filed with the Securities and Exchange Commission.

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證券交易委員會提交的最新表格 10-K、10-Q 和任何 8-K 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 is not sufficient for prescribing decisions.

它不是為了促銷，也不足以做出處方決定。

As we transition to our prepared remarks, a reminder that our commentary will focus on non-GAAP financial measures, which exclude the financial contribution from Elanco during 2018 and 2019, and present earnings per share as though the full disposition via the exchange offer was complete on January 1, 2018.

當我們過渡到我們準備好的評論時，提醒我們的評論將集中在非公認會計原則財務指標上，其中不包括 Elanco 在 2018 年和 2019 年的財務貢獻，並呈現每股收益，就好像通過交換要約完成的全部處置一樣2018 年 1 月 1 日。

Now I'll turn the call over to Dave for a summary of our Q3 results.

現在，我將把電話轉給 Dave，以總結我們的第三季度業績。

Thanks, Kevin.

謝謝，凱文。

Q3 was another strong quarter for Lilly as we continue to deliver robust results and execute on our strategy, which is launching new medicines, advancing our pipeline and driving productivity.

第三季度對禮來來說是另一個強勁的季度，因為我們繼續提供強勁的業績並執行我們的戰略，即推出新藥、推進我們的管道和提高生產力。

Revenue grew 3% this quarter or 4% in constant currency driven entirely by robust volume growth from our new products and international operations.

本季度收入增長 3% 或按固定匯率計算增長 4%，這完全得益於我們新產品和國際業務的強勁銷量增長。

Volume contributed 8% -- 8 percentage points of growth despite sizable headwinds from the loss of exclusivity for Cialis in the U.S. and the withdrawal of Lartruvo.

儘管 Cialis 在美國的獨家經營權喪失和 Lartruvo 的退出帶來了巨大的阻力，但銷量貢獻了 8% - 8 個百分點的增長。

Excluding Cialis and Lartruvo, volume growth was an impressive 16%.

不包括 Cialis 和 Lartruvo，銷量增長了 16%，令人印象深刻。

Our newest medicines continue to be the engine of revenue growth and account for 44% of revenue this quarter.

我們最新的藥物繼續成為收入增長的引擎，佔本季度收入的 44%。

We made good progress on productivity in Q3 as our non-GAAP operating margin was 28.6%, keeping us on track to meet our 2019 and 2020 operating margin goals.

我們在第三季度的生產力方面取得了良好進展，因為我們的非公認會計原則營業利潤率為 28.6%，使我們能夠實現 2019 年和 2020 年的營業利潤率目標。

Compared to last year's quarter, operating margin was essentially flat, reflecting lower gross margin, offset by prudent management of our operating expenses.

與去年同期相比，營業利潤率基本持平，反映了較低的毛利率，但被我們對運營費用的審慎管理所抵消。

We achieved milestones on several pipeline assets since our last earnings call, including the FDA approval of REYVOW for the acute treatment of migraine with or without aura in adults, the European Commission approval to expand Trulicity's label to include results from the REWIND cardiovascular outcome study, the presentation of registration Phase II data for selpercatinib in non-small cell lung cancer and thyroid cancers and the presentation of overall survival data of Verzenio in metastatic breast cancer.

自上次財報電話會議以來，我們在幾項管道資產上實現了里程碑，包括 FDA 批准 REYVOW 用於成人有或無先兆偏頭痛的急性治療，歐盟委員會批准擴大 Trulicity 的標籤以包括 REWIND 心血管結果研究的結果，介紹 selpercatinib 在非小細胞肺癌和甲狀腺癌中的註冊 II 期數據以及 Verzenio 在轉移性乳腺癌中的總體生存數據的介紹。

Taltz also made impressive progress with its development program this quarter with the FDA approval of radiographic axial spondyloarthritis, r-axSpA, along with its submission in Europe; submission of our non-radiographic axial spondyloarthritis in the U.S. and Europe, which represents a first-in-class opportunity in this indication; and positive results from a head-to-head study in psoriasis versus guselkumab in IL-23 antibody.

Taltz 本季度的開發計劃也取得了令人矚目的進展，FDA 批准了放射學軸向脊柱關節炎 r-axSpA，並在歐洲提交了申請；在美國和歐洲提交我們的非放射軸性脊柱關節炎，這代表了該適應症的一流機會；銀屑病與 guselkumab 在 IL-23 抗體中的頭對頭研究的陽性結果。

We remain focused on creating long-term value for shareholders as we allocate capital, seeking external innovation that will enhance future growth prospects while at the same time, we returned nearly $1.2 billion to shareholders this quarter via share repurchase and the dividend.

在分配資本、尋求外部創新以增強未來增長前景的同時，我們仍然專注於為股東創造長期價值，同時，我們本季度通過股票回購和股息向股東返還了近 12 億美元。

Moving on to Slide 5, you'll see more detail on key events since our last earnings call in July.

轉到幻燈片 5，您將看到自 7 月上次財報電話會議以來關鍵事件的更多詳細信息。

I would like to highlight today's announcements regarding leadership changes.

我想強調今天關於領導層變動的公告。

And I want to congratulate and thank my longtime colleague, Enrique Conterno, for his significant contributions to Lilly.

我要祝賀並感謝我的長期同事 Enrique Conterno 對禮來公司的重大貢獻。

Enrique has done an outstanding job leading Lilly Diabetes over the past decade, really reestablishing our company as a leader in diabetes care with the broadest and fastest-growing portfolio of medicines in the industry.

在過去十年中，恩里克在領導禮來糖尿病業務方面做得非常出色，憑藉業內最廣泛和增長最快的藥物組合，真正將我們公司重新確立為糖尿病護理領域的領導者。

Enrique, Lilly would not be in the strong position it is today without your leadership.

恩里克，如果沒有你的領導，禮來公司不會有今天這樣的強勢地位。

Your energy, optimism and thirst for excellence will be missed.

你的精力、樂觀和對卓越的渴望將被錯過。

I would also like to welcome Mike Mason as he assumes leadership for our diabetes business unit.

我還要歡迎 Mike Mason 擔任我們糖尿病業務部門的領導。

Mike is a 30-year veteran with deep expertise and significant experience in our diabetes business.

Mike 是一位擁有 30 年經驗的資深人士，在我們的糖尿病業務領域擁有深厚的專業知識和豐富的經驗。

Mike is a patient-focused leader with a track record of delivering results for Lilly and for patients in the U.S. and Canada.

Mike 是一位以患者為中心的領導者，在為禮來公司以及美國和加拿大的患者提供成果方面有著良好的記錄。

Under Mike's leadership, Lilly successfully launched both Jardiance and Trulicity in the U.S., becoming the diabetes market volume leader during his tenure.

在 Mike 的領導下，禮來在美國成功推出了 Jardiance 和 Trulicity，在他任職期間成為糖尿病市場銷量的領導者。

Since July 2018, Mike has led our Connected Care and Insulin commercial and development organizations, working to leverage technology to enhance insulin delivery and improve the user experience.

自 2018 年 7 月以來，Mike 一直領導我們的 Connected Care 和胰島素商業和開發組織，致力於利用技術來增強胰島素輸送並改善用戶體驗。

Importantly, he has also led Lilly's efforts in building the most comprehensive suite of insulin affordability solutions in the U.S., including the Lilly Diabetes solutions center to support people in need of less expensive alternatives for their medicines.

重要的是，他還領導了禮來公司在美國建立最全面的胰島素可負擔性解決方案套件，包括禮來公司糖尿病解決方案中心，以支持需要更便宜的藥物替代品的人們。

Mike, it's great to have you join our senior leadership team.

邁克，很高興你加入我們的高級領導團隊。

And now I'll turn the call over to Josh to review our Q3 results and provide an update on financial guidance for 2019.

現在我將把電話轉給喬希，以審查我們的第三季度業績並提供 2019 年財務指導的最新信息。

Thanks, Dave, and good morning, everyone.

謝謝，戴夫，大家早上好。

Slide 6 summarizes our presentation of GAAP results and non-GAAP measures, and Slide 7 provides a summary of our GAAP results.

幻燈片 6 總結了我們對 GAAP 結果和非 GAAP 措施的介紹，幻燈片 7 總結了我們的 GAAP 結果。

Looking at the non-GAAP measures on Slide 8, you'll see revenue increased 3% or 4% in constant currency.

查看幻燈片 8 上的非 GAAP 指標，您會看到按固定匯率計算的收入增長了 3% 或 4%。

Gross margin as a percent of revenue declined 60 basis points to 79.6%.

毛利率佔收入的百分比下降 60 個基點至 79.6%。

Excluding the impact of FX on international inventory sold, gross margin as a percent of revenue was 78.9%.

排除外匯對國際銷售庫存的影響，毛利率佔收入的百分比為 78.9%。

On this same basis, our gross margin percent declined approximately 140 basis points compared to Q3 2018 driven by the unfavorable impact of product mix due to Cialis and the negative impact of price on revenue, partially offset by manufacturing efficiencies.

在同樣的基礎上，與 2018 年第三季度相比，我們的毛利率下降了約 140 個基點，這是由於 Cialis 對產品組合的不利影響以及價格對收入的負面影響，部分被製造效率所抵消。

Total operating expense grew 2% this quarter.

本季度總運營費用增長 2%。

Marketing, selling and administrative expenses declined 3% as our ongoing cost-containment measures and lower litigation charges versus last year were partially offset by increased investment behind recent launches, consistent with our long-term strategy.

營銷、銷售和行政費用下降了 3%，因為我們持續的成本控制措施和與去年相比較低的訴訟費用被最近推出的投資增加所部分抵消，這與我們的長期戰略一致。

R&D expense increased 8%, reflecting higher development expenses for late-stage assets, including selpercatinib and tirzepatide.

研發費用增長 8%，反映後期資產的開發費用增加，包括 selpercatinib 和 tirzepatide。

Total operating income increased 3% compared to Q3 2018 as sales growth outpaced expense growth, driving operating income as a percent of revenue to 28.6% for the quarter.

與 2018 年第三季度相比，總營業收入增長了 3%，原因是銷售額增長超過了費用增長，將本季度營業收入佔收入的百分比推高至 28.6%。

As our recent launches continue to drive revenue growth and headwinds from Cialis and Lartruvo sunset in 2020, we expect additional operating margin expansion and bottom line growth.

隨著我們最近推出的產品繼續推動收入增長以及 Cialis 和 Lartruvo 在 2020 年日落時的逆風，我們預計營業利潤率將進一步擴大和底線增長。

We are on track and committed to achieving our full year operating margin guidance of approximately 28% as well as our 2020 target of 31%.

我們正在步入正軌，並致力於實現全年約 28% 的營業利潤率指導以及 2020 年 31% 的目標。

Other income and expense was expense of $25 million this quarter compared to expense of $2 million in Q3 2018 driven by higher net interest expense primarily due to the Loxo acquisition, partially offset by investment gains.

本季度的其他收入和支出為 2500 萬美元，而 2018 年第三季度的支出為 200 萬美元，主要是由於收購 Loxo 導致的淨利息支出增加，部分被投資收益抵消。

Our tax rate for the quarter was 11.7%, which is a decrease of 320 basis points compared with the same quarter last year driven primarily by a net discrete tax benefit related to the settlement of certain tax matters.

我們本季度的稅率為 11.7%，與去年同期相比下降了 320 個基點，主要是由於與解決某些稅務事項相關的淨離散稅收優惠。

At the bottom line, net income increased 5% while earnings per share increased 10% due to reduction in shares outstanding from share repurchases.

歸根結底，淨收入增長了 5%，而每股收益增長了 10%，原因是股票回購導致的流通股減少。

In summary, in Q3, we again grew volume-based revenue growth and made progress on our productivity goals.

總之，在第三季度，我們再次實現了基於銷量的收入增長，並在我們的生產力目標方面取得了進展。

In addition to continued solid execution, third quarter also featured impressive performance outside the U.S. as revenue grew 10% in constant currency driven by 12% volume growth.

除了持續穩健的執行之外，第三季度在美國以外的表現也令人印象深刻，因為在銷量增長 12% 的推動下，按固定匯率計算的收入增長了 10%。

Examples of our ability to launch with excellence.

我們卓越啟動能力的例子。

As Emgality and Baqsimi are off to strong starts, the approval of the first medicine in a new class to treat acute migraine, submissions of new indications for our key growth brands in multiple geographies and important clinical data at major medical meetings from our late-stage portfolio.

隨著 Emgality 和 Baqsimi 的強勢開局，第一個治療急性偏頭痛的新類別藥物獲批，我們在多個地區的關鍵增長品牌提交了新的適應症，以及我們後期在主要醫學會議上的重要臨床數據文件夾。

Moving to Slide 9. It outlines these non-GAAP measures for September year-to-date while Slide 10 provides a reconciliation between reported and non-GAAP EPS.

轉到幻燈片 9。它概述了今年 9 月至今的這些非 GAAP 措施，而幻燈片 10 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 11.

轉到幻燈片 11。

Let's review the effect of price rate and volume on revenue growth.

讓我們回顧一下價格率和銷量對收入增長的影響。

As mentioned earlier, worldwide revenue grew 4% in constant currency driven by volume growth of 8%, partially offset by price.

如前所述，在銷量增長 8% 的推動下，全球收入按固定匯率計算增長了 4%，部分被價格抵消。

Foreign exchange reduced revenue growth by 1 percentage point this quarter.

外匯使本季度的收入增長減少了 1 個百分點。

For the 16th straight quarter, we delivered worldwide revenue growth despite major headwinds from patent expirations.

儘管專利到期帶來了重大阻力，但我們連續第 16 個季度實現了全球收入增長。

U.S. revenue was flat compared to the third quarter of 2018.

與 2018 年第三季度相比，美國收入持平。

Volume growth of 5% was led by our newer products: Trulicity, Taltz, Emgality, Jardiance, Verzenio and Basaglar.

我們的新產品帶動了 5% 的銷量增長：Trulicity、Taltz、Emgality、Jardiance、Verzenio 和 Basaglar。

Excluding Cialis and Lartruvo, volume grew nearly 17%.

不包括 Cialis 和 Lartruvo，銷量增長了近 17%。

Consistent with our 2019 financial guidance and in line with Q1 and Q2 results, U.S. price declined 5%.

與我們 2019 年的財務指導一致，並與第一季度和第二季度的結果一致，美國價格下跌了 5%。

This quarter's decline was impacted by approximately 3 percentage points driven by the net of higher rebates across the segments, offset by modest list price increases and over 2 percentage points from increased funding obligations during the donut hole phase of Medicare plans.

本季度的下降受到約 3 個百分點的影響，這主要是由於各細分市場的較高回扣的淨額，但被適度的標價上漲和醫療保險計劃的甜甜圈洞階段增加的資金義務超過 2 個百分點所抵消。

We anticipated approximately $200 million of impact for the year, and our actual results are consistent with this projection.

我們預計這一年的影響約為 2 億美元，我們的實際結果與這一預測一致。

However, we are seeing the donut hole impact more concentrated in Q2 and Q3 than prior years and expect a smaller impact in Q4 as our largest product, Trulicity, of course, had a significant impact on the U.S. portfolio's price decline.

然而，我們看到甜甜圈洞的影響比往年更集中在第二季度和第三季度，並預計第四季度的影響較小，因為我們最大的產品 Trulicity 當然對美國投資組合的價格下跌產生了重大影響。

Trulicity's robust U.S. volume growth of 42% was consistent with first half trends and was partially offset by unfavorable pricing dynamics in the quarter, including disproportionate growth in lower net price segments driven by the access wins we had in 2018 and the increased volume associated with these wins throughout this year, increased funding obligations during the coverage gap in Medicare, late harmonization due to payer consolidation and adjustments to our overall estimates for rebates and discount liabilities across various segments.

Trulicity 在美國的強勁銷量增長 42% 與上半年趨勢一致，但被本季度不利的定價動態部分抵消，包括我們在 2018 年獲得的訪問權以及與這些相關的銷量增加推動的較低淨價格細分市場的不成比例增長今年全年獲勝，在醫療保險覆蓋缺口期間增加了資金義務，由於付款人合併而導致的後期協調以及我們對各個部門的回扣和貼現負債的總體估計進行了調整。

Combined, these factors had a negative impact on price in the quarter of approximately 20 percentage points.

綜合起來，這些因素對本季度的價格產生了大約 20 個百分點的負面影響。

If we exclude these items, Trulicity price declined roughly 5% versus Q3 2018.

如果我們排除這些項目，Trulicity 價格與 2018 年第三季度相比下降了約 5%。

While we don't typically give forward-looking product level guidance and don't intend to change that practice, I do want to provide some perspective on Trulicity over the coming quarters.

雖然我們通常不提供前瞻性的產品級別指導，也不打算改變這種做法，但我確實想就未來幾個季度的 Trulicity 提供一些觀點。

We expect the Q3 negative factors to moderate substantially going forward as impacts from the donut hole diminish in Q4 and then will be in the base for next year's comparisons.

隨著甜甜圈洞的影響在第四季度減弱，我們預計第三季度的負面因素將大幅緩和，然後將成為明年比較的基礎。

Similarly, as we have driven rapid volume growth in government segments, including the VA and DOD, between Q4 of last year and this quarter, we expect these segments to -- going forward grow more in line with overall sales.

同樣，由於我們在去年第四季度和本季度之間推動了包括弗吉尼亞州和國防部在內的政府部門的快速銷量增長，我們預計這些部門未來的增長將與整體銷售更加一致。

Finally, rate harmonization due to payer consolidation is now fully reflected in the base going forward.

最後，由於付款人合併導致的費率協調現在完全反映在未來的基數中。

Given the absolute size of the Trulicity rebate and discount liability, we'll continue to see quarterly adjustments to that liability.

鑑於 Trulicity 回扣和折扣負債的絕對規模，我們將繼續看到該負債的季度調整。

But as we have seen historically, these are difficult to predict and can be both positive and negative.

但正如我們從歷史上看到的那樣，這些很難預測，既可以是正面的，也可以是負面的。

So taking these factors into account, we think Trulicity's underlying U.S. net price decline of roughly 5% in Q3 is more representative of what we expect to see in subsequent quarters.

因此，考慮到這些因素，我們認為 Trulicity 第三季度美國潛在淨價格下跌約 5% 更能代表我們對隨後幾個季度的預期。

We have excellent access for Trulicity across all payer segments and anticipate that continuing in 2020.

我們在所有付款人領域都可以輕鬆訪問 Trulicity，並預計這種情況在 2020 年將繼續。

Moving to Europe.

搬到歐洲。

Revenue grew 8%, excluding FX, driven by 9% volume growth, partially offset by the negative effect of price.

收入增長 8%，不包括外匯，受銷量增長 9% 的推動，部分被價格的負面影響所抵消。

Volume growth was led by Trulicity, Olumiant and Taltz.

銷量增長由 Trulicity、Oluminant 和 Taltz 引領。

In Japan, revenue growth of 6%, excluding FX, was driven by volume with Verzenio, Cyramza, Trulicity, Alimta and Olumiant as key contributors to the growth.

在日本，不包括外彙在內的收入增長了 6%，這是由 Verzenio、Cyramza、Trulicity、Alimta 和 Olumiant 作為增長的主要貢獻者推動的。

We were negatively impacted by purchasing patterns in Q3 in Japan by approximately 4 percentage points, which we expect to largely recover in Q4.

我們受到日本第三季度採購模式的負面影響約 4 個百分點，我們預計第四季度將大幅恢復。

Revenue in the rest of the world increased 15%, excluding FX, led by 33% growth in China.

不包括外彙在內，世界其他地區的收入增長了 15%，其中中國增長了 33%。

The same information for our September year-to-date results is at the bottom of the slide.

幻燈片底部顯示了我們 9 月份年初至今結果的相同信息。

As shown on Slide 12, our key growth products were once again the engine of our worldwide volume growth.

如幻燈片 12 所示，我們的主要增長產品再次成為我們全球銷量增長的引擎。

These products drove 15.4 percentage points of volume growth this quarter, reinforcing our confidence in achieving our 2020 revenue goals.

這些產品在本季度推動了 15.4 個百分點的銷量增長，增強了我們實現 2020 年收入目標的信心。

Brands that have experienced loss of exclusivity provided a drag of 700 basis points driven primarily by Cialis.

經歷了排他性喪失的品牌拖累了 700 個基點，主要由 Cialis 推動。

As expected, we have seen a rapid erosion of Cialis sales following the entry of generics in the U.S. market at the end of September last year.

正如預期的那樣，在去年 9 月底仿製藥進入美國市場後，我們看到 Cialis 的銷售額迅速下降。

So we expect this impact to begin to normalize in Q4 this year.

因此，我們預計這種影響將在今年第四季度開始正常化。

Slide 13 highlights the contributions of our key growth products.

幻燈片 13 突出了我們主要增長產品的貢獻。

In total, these brands generated over $2.4 billion in revenue this quarter, making up 44% of total revenue.

這些品牌本季度的總收入超過 24 億美元，佔總收入的 44%。

Q3 sales of growth products were impacted by inventory burn in the quarter of approximately 17 -- $70 million with U.S. Trulicity comprising approximately $40 million of that total.

增長產品的第三季度銷售受到大約 17-7000 萬美元的庫存消耗的影響，其中美國 Trulicity 約佔 4000 萬美元。

Our diverse commercial portfolio of new medicines continue to drive growth and is well positioned in large and growing therapeutic areas.

我們多元化的新藥商業組合繼續推動增長，並在龐大且不斷增長的治療領域處於有利地位。

Within diabetes, Trulicity and Jardiance continue market leadership in the GLP-1 and SGLT2 classes, respectively.

在糖尿病領域，Trulicity 和 Jardiance 分別在 GLP-1 和 SGLT2 類別中繼續保持市場領先地位。

In immunology, Taltz continues to perform well in psoriasis, and new indications in rheumatology present opportunities for additional growth.

在免疫學方面，Taltz 在銀屑病方面繼續表現良好，風濕病學的新適應症為進一步增長提供了機會。

In pain, Emgality continues its impressive uptake, exiting Q3 with a market-leading 46% share of market from new-to-brand prescriptions in the U.S. Within oncology, Cyramza growth has accelerated over the past year, and we are excited for the newly released overall survival data to drive additional use of Verzenio.

在痛苦中， Emgality 繼續其令人印象深刻的吸收，退出第三季度，市場領先的市場份額來自美國新品牌處方的 46%。在腫瘤學領域， Cyramza 的增長在過去一年中加速，我們對新的發布了總體生存數據，以推動 Verzenio 的更多使用。

Finally, I would like to highlight our newest launched product, nasally administered glucagon, which is sold under the trade name Baqsimi.

最後，我想強調一下我們最新推出的產品，經鼻給藥的胰高血糖素，它以商品名 Baqsimi 出售。

Baqsimi is an important new option for the treatment of severe hypoglycemia and, unlike existing rescue therapies, does not require reconstitution to administer.

Baqsimi 是治療嚴重低血糖的重要新選擇，與現有的搶救療法不同，它不需要重組即可給藥。

This is a significant improvement in user experience and exemplifies the type of innovation we strive to deliver to patients.

這是用戶體驗的顯著改善，體現了我們努力為患者提供的創新類型。

The commercial uptake in the U.S. has been strong as Baqsimi already has 33% of new-to-brand prescriptions, and we believe this product has the potential to grow the overall glucagon market.

由於 Baqsimi 已經擁有 33% 的新品牌處方，美國的商業吸收一直很強勁，我們相信該產品具有增長整個胰高血糖素市場的潛力。

Slide 14 shows the year-over-year change in select lines of our income statement.

幻燈片 14 顯示了我們損益表中特定行的同比變化。

Focusing on our non-GAAP results, foreign exchange rate had a net modest negative impact on revenue and a modest positive impact on gross margin, operating expenses, operating income and EPS.

著眼於我們的非公認會計原則結果，匯率對收入產生了適度的負面影響，對毛利率、運營費用、營業收入和每股收益產生了適度的積極影響。

On Slide 15, we provide an update on capital allocation.

在幻燈片 15 上，我們提供了資本配置的最新信息。

In line with our strategic priorities between our business development activities, capital expenditures and internal investment in R&D, we invested over $11 billion in the first 9 months of the year to drive our future growth.

根據我們的業務發展活動、資本支出和內部研發投資之間的戰略重點，我們在今年前 9 個月投資了超過 110 億美元，以推動我們未來的增長。

Additionally, we have returned nearly $6 billion to shareholders via dividends and share repurchases.

此外，我們通過股息和股票回購向股東返還了近 60 億美元。

We continue to prioritize investment in the pipeline through both internal and external sources.

我們繼續通過內部和外部資源優先考慮對管道的投資。

Turning to our 2019 financial guidance on Slide 16.

轉向我們關於幻燈片 16 的 2019 年財務指導。

You will see that we've updated our non-GAAP guidance to reflect an increase in our bottom line results for the year.

您會看到我們更新了我們的非公認會計準則指導，以反映我們今年底線業績的增長。

Specifically, we are updating the range for other income and deductions to $50 million of income to an expense of $100 million, reflecting year-to-date gains in our equity portfolio.

具體來說，我們正在將其他收入和扣除額的範圍從 5000 萬美元的收入更新為 1 億美元的支出，以反映我們股票投資組合的年初至今收益。

We are decreasing our tax rate from a range of 13% to 14% to 12% to 13% to reflect the net discrete tax benefit in the third quarter, and we are raising our non-GAAP earnings per share range to $5.75 per share to $5.85 per share reflecting those 2 items as our operating performance expectations remain on track with our prior full year guidance.

我們將稅率從 13% 至 14% 降至 12% 至 13%，以反映第三季度的淨離散稅收優惠，我們將非公認會計準則每股收益範圍提高至每股 5.75 美元至每股 5.85 美元反映了這兩項，因為我們的經營業績預期與我們之前的全年指導保持一致。

On a reported basis, the tax rate is expected to be in the range of 13% to 14% and earnings per share for 2019 is now expected to be in the range of $8.59 to $8.69 per share.

據報導，稅率預計在 13% 至 14% 之間，2019 年的每股收益現在預計在每股 8.59 美元至 8.69 美元之間。

We continue to progress towards our 2019 guidance and remain committed to delivering on our 2020 goals.

我們將繼續朝著我們的 2019 年指導方針前進，並繼續致力於實現我們的 2020 年目標。

Now I'll turn the call over to Dan to highlight our progress on R&D.

現在我將把電話轉給丹，以強調我們在研發方面的進展。

Thanks, Josh.

謝謝，喬希。

Slide 17 shows select pipeline opportunities as of October 22.

幻燈片 17 顯示了截至 10 月 22 日的選定管道機會。

The positive movement since our last earnings call includes the previously mentioned FDA approvals for REYVOW and the FDA approval for a new indication for Taltz; the European Commission approval for Trulicity REWIND and the submission of Taltz for non-radiographic axial spondyloarthritis; the U.S. submission of Ultra Rapid Lispro for type 1 and type 2 diabetes; the U.S. submission of flortaucipir for uses of tau PET imaging agent in Alzheimer's; initiation of Phase III testing for mirikizumab in Crohn's disease; and the initiation of Phase I for 2 assets.

自我們上次財報電話會議以來的積極進展包括前面提到的 FDA 批准 REYVOW 和 FDA 批准 Taltz 的新適應症；歐盟委員會批准 Trulicity REWIND 和提交 Taltz 治療非放射軸性脊柱關節炎；美國提交的用於 1 型和 2 型糖尿病的 Ultra Rapid Lispro；美國提交的 flortaucipir 用於 tau PET 顯像劑在阿爾茨海默氏症中的應用；啟動克羅恩病中 mirikizumab 的 III 期試驗；並啟動 2 項資產的第一階段。

In addition to the positive milestones we delivered this quarter, we also announced disappointing results from the Phase III SEQUOIA trial of pegilodecakin in patients with metastatic pancreatic cancer.

除了我們本季度實現的積極里程碑外，我們還宣布了 SEQUOIA 對轉移性胰腺癌患者進行的三期 SEQUOIA 試驗的令人失望的結果。

Pegilodecakin plus FOLFOX failed to show benefit in overall survival compared to FOLFOX alone in this difficult-to-treat and deadly cancer.

在這種難以治療的致命癌症中，與單獨使用 FOLFOX 相比，Pegilodecakin 加 FOLFOX 未能顯示出總生存期益處。

While this is a disappointing outcome for patients, we continue to move forward with pegilodecakin in lung and renal cancer, which we've always viewed as the key indications.

雖然這對患者來說是一個令人失望的結果，但我們繼續在肺癌和腎癌中使用 pegilodecakin，我們一直將其視為關鍵適應症。

Moving to Slide 18.

轉到幻燈片 18。

Since the last earnings call, we made progress on a number of key events.

自上次財報電話會議以來，我們在一些關鍵事件上取得了進展。

In addition to the previously highlighted approvals and submissions, Cyramza has been submitted for first-line, EGFR-positive non-small cell lung cancer in the U.S.

除了之前強調的批准和提交，Cyramza 已在美國提交用於一線 EGFR 陽性非小細胞肺癌。

As Dave mentioned in his opening remarks, the third quarter was an exciting one for our oncology portfolio as we shared promising registrational data for selpercatinib at World Lung and ESMO, which showed impressive, objective response rates and durability of response data along with low-treatment-related discontinuation rates across RET fusion-positive non-small cell lung cancer, RET-mutant medullary thyroid cancer and RET fusion-positive thyroid cancer.

正如 Dave 在開幕詞中提到的那樣，第三季度對我們的腫瘤產品組合來說是一個令人興奮的季度，因為我們在 World Lung 和 ESMO 分享了 selpercatinib 的有希望的註冊數據，這些數據顯示了令人印象深刻的客觀反應率和反應數據的持久性以及低治療RET融合陽性非小細胞肺癌、RET突變甲狀腺髓樣癌和RET融合陽性甲狀腺癌的相關停藥率。

We're excited about the opportunity for this first-in-class and potentially best-in-class RET inhibitor to help patients with cancer.

我們對這種一流且可能是一流的 RET 抑製劑有機會幫助癌症患者感到興奮。

These are the kind of results we were hoping for when we planned the Loxo acquisition, and we are extremely pleased with the progress at Loxo since then.

這些是我們在計劃收購 Loxo 時所希望的結果，我們對 Loxo 自那時以來取得的進展感到非常滿意。

We were also pleased to share the results of the MONARCH 2 study at ESMO, showing that Verzenio plus fulvestrant delivered the largest median survival benefit to date in this setting, extending survival by 9.4 months.

我們還很高興地分享了 ESMO 的 MONARCH 2 研究結果，表明 Verzenio 加氟維司群在這種情況下提供了迄今為止最大的中位生存期益處，將生存期延長了 9.4 個月。

We also announced that Taltz demonstrated superiority versus TREMFYA in total skin clearance at 12 weeks for people living with moderate to severe plaque psoriasis and met all major secondary end points.

我們還宣布，對於中度至重度斑塊型銀屑病患者，Taltz 在 12 週的總皮膚清除率方面表現出優於 TREMFYA 的優勢，並滿足了所有主要的次要終點。

And Olumiant had a positive readout in atopic dermatitis in the third of 5 studies which will support its global submissions.

在支持其全球提交的 5 項研究中的第三項中，Olumiant 在特應性皮炎方面的讀數呈陽性。

It continues to be a busy and productive year for our pipeline.

對於我們的管道來說，這仍然是忙碌而富有成效的一年。

Moving to Slide 19.

轉到幻燈片 19。

Last quarter, we highlighted select Phase II opportunities.

上個季度，我們強調了選擇的第二階段機會。

This quarter, we'd like to highlight select Phase I molecules from our portfolio.

本季度，我們將重點介紹我們產品組合中的部分 I 期分子。

As we continue to accelerate our internal discovery and development engine, by year-end, we expect to have delivered more Phase I initiations in a single year than we have in any other year this decade.

隨著我們繼續加速我們的內部發現和開發引擎，到年底，我們預計在一年內交付的第一階段啟動數量將超過本十年中的任何其他年份。

Importantly, these new Phase I entries represent a mix of internal discoveries from our own labs as well as external innovation that we have brought in through business development.

重要的是，這些新的第一階段條目代表了我們自己實驗室的內部發現以及我們通過業務發展帶來的外部創新。

We selected several Phase I molecules to highlight today.

我們今天選擇了幾個 I 期分子來強調。

Let me start with another molecule from the Loxo Oncology acquisition, the BTK inhibitor, LOXO-305, which is a next-generation noncovalent reversible BTK inhibitor that does not depend on interacting with the cysteine 481 residue.

讓我從 Loxo Oncology 收購的另一個分子開始，即 BTK 抑製劑 LOXO-305，它是下一代非共價可逆 BTK 抑製劑，不依賴於與半胱氨酸 481 殘基的相互作用。

We started dosing patients in a Phase I/II study earlier this year in patients with previously treated chronic lymphocytic leukemia, small lymphocytic lymphoma or non-Hodgkin's lymphomas.

今年早些時候，我們開始在 I/II 期研究中對先前治療過的慢性淋巴細胞白血病、小淋巴細胞淋巴瘤或非霍奇金淋巴瘤患者進行給藥。

The unmet need in this space continues to grow.

該領域未滿足的需求繼續增長。

Since as more patients are treated with chronic -- with current BTK inhibitors, more and more patients become resistant or intolerant to therapy.

由於隨著越來越多的患者接受慢性 - 使用當前的 BTK 抑製劑治療，越來越多的患者對治療產生抗藥性或不耐受性。

LOXO-305 was built to be potent, selective and have well-behaved human pharmacology.

LOXO-305 具有強效、選擇性和良好的人體藥理學特性。

Should these attributes present in the clinic as hope, LOXO-305 could be an important new therapy for these patients.

如果這些屬性作為希望出現在臨床上，LOXO-305可能是這些患者的重要新療法。

As we announced in September, we plan to present data from the trial later this year.

正如我們在 9 月宣布的那樣，我們計劃在今年晚些時候公佈試驗數據。

It will be a typical early clinical presentation from a dose escalation trial, including safety, PK and any efficacy assessments that have been conducted.

這將是劑量遞增試驗的典型早期臨床表現，包括安全性、PK 和已進行的任何療效評估。

In neurodegeneration, last quarter, we initiated with our collaborator, AC Immune, a Phase I study in healthy volunteers for small molecule tau aggregation inhibitor.

在神經退行性變方面，上個季度，我們與合作者 AC Immune 啟動了一項針對健康志願者的小分子 tau 聚集抑製劑的 I 期研究。

While still early in development, we're excited about this program and also about the target, aggregated tau.

雖然仍處於開發初期，但我們對這個程序以及目標聚合 tau 感到興奮。

Of course, aggregated tau, along with amyloid plaque, comprised the 2 pathological hallmarks of Alzheimer's disease.

當然，聚集的 tau 與澱粉樣蛋白斑一起構成了阿爾茨海默病的 2 個病理特徵。

Accordingly, we remain excited about our 2 Phase II programs aimed at disease modification in Alzheimer's disease, zagotenemab, which is our anti-aggregated tau antibody; and now, especially, donanemab, our N3pG antibody, which is also in a Phase II trial designed to test efficacy in a carefully selected population.

因此，我們仍然對我們的 2 個旨在改善阿爾茨海默病疾病的 II 期項目感到興奮，zagotenemab 是我們的抗聚集 tau 抗體；現在，尤其是我們的 N3pG 抗體 donanemab，它也處於 II 期試驗中，旨在在精心挑選的人群中測試療效。

Both of these programs are now fully enrolled with donanemab clearing an important interim futility analysis, and we look forward to the final readouts for these trials in 2021.

這兩個項目現在都完全註冊了 donanemab，通過了一項重要的臨時無效分析，我們期待 2021 年這些試驗的最終結果。

Moving to pain.

移動到痛苦。

Earlier this year, we acquired the rights to a novel small molecule somatostatin receptor type 4 agonist that's currently in Phase I as a potential non-opioid treatment for chronic pain.

今年早些時候，我們獲得了一種新型小分子生長抑素受體 4 型激動劑的權利，該激動劑目前處於 I 期，作為一種潛在的非阿片類藥物治療慢性疼痛。

The clinical hypothesis here is that the known analgesic effects of somatostatin are mostly mediated by SSTR4, which is found in the dorsal root ganglia.

這裡的臨床假設是，已知的生長抑素鎮痛作用主要由在背根神經節中發現的 SSTR4 介導。

A selective agonist for SSTR4 could therefore have an analgesic effect without purple somatostatin adverse effects.

因此，SSTR4 的選擇性激動劑可能具有鎮痛作用，而沒有紫色生長抑素的副作用。

We look forward to the internal readout next year to inform the potential progression to Phase II.

我們期待明年的內部讀數，以告知第二階段的潛在進展。

Pain is the #1 reason people go to physicians.

疼痛是人們去看醫生的第一大原因。

If you look at the opioid crisis, there's still significant unmet medical need.

如果你看看阿片類藥物危機，仍然有大量未滿足的醫療需求。

There's more work to do here.

這裡還有更多工作要做。

And I'm excited we're a leader in this space with a number of interesting mechanisms now being tested in patients by Lilly.

我很高興我們是這個領域的領導者，禮來公司現在正在對患者進行一些有趣的機制測試。

Turning now to immunology.

現在轉向免疫學。

We have 3 novel checkpoint agonists in Phase I with first-in-class potential: BTLA agonist antibody, CD200R agonist antibody and our PD 1 agonist antibody.

我們在 I 期擁有 3 種具有一流潛力的新型檢查點激動劑：BTLA 激動劑抗體、CD200R 激動劑抗體和我們的 PD 1 激動劑抗體。

These are all immune resolution agents where instead of dampening down immune system with chronic immunosuppression, we're trying to potentially reset the immune system.

這些都是免疫解決劑，我們不是通過慢性免疫抑制來抑制免疫系統，而是試圖潛在地重置免疫系統。

These checkpoints exploit insights from immuno-oncology, but they work in a different direction.

這些檢查點利用了免疫腫瘤學的見解，但它們的工作方向不同。

These are checkpoint agonists that put the brakes on the immune system.

這些是抑制免疫系統的檢查點激動劑。

BTLA is a novel checkpoint receptor that negatively regulates activation of P -- of B, pDC and T cells.

BTLA 是一種新型的檢查點受體，它負向調節 B、pDC 和 T 細胞的 P 的激活。

Agonism of this pathway has the potential to provide a first-in-class treatment, and our BTLA agonist antibody is currently being studied in Phase Ib in lupus.

該途徑的激動劑有可能提供一流的治療，我們的 BTLA 激動劑抗體目前正在狼瘡的 Ib 期研究。

CD200 is a key immune checkpoint that functions on both innate and adaptive immune system on many cell types involved in autoimmune skin disorders.

CD200 是一個關鍵的免疫檢查點，對涉及自身免疫性皮膚病的許多細胞類型的先天性和適應性免疫系統都起作用。

Our CD200R agonist antibody is in a Phase I trial in both healthy volunteers as well as in atopic dermatitis patients.

我們的 CD200R 激動劑抗體正在健康志願者和特應性皮炎患者中進行 I 期試驗。

Finally, we know that treatment of cancers with PD-1 inhibitors leads to a variety of autoimmune conditions.

最後，我們知道用 PD-1 抑製劑治療癌症會導致多種自身免疫性疾病。

It's hypothesized that a PD-1 agonist will suppress activation expansion lymphocytes leading to treatment of autoimmune diseases.

據推測，PD-1 激動劑將抑制活化擴增淋巴細胞，從而治療自身免疫性疾病。

Our PD-1 agonist antibody is currently in Phase I. Each of these 3 opportunities represents novel biology, which we are among the first to explore, with the potential for each to move into Phase II next year.

我們的 PD-1 激動劑抗體目前處於 I 期。這 3 個機會中的每一個都代表了新的生物學，我們是最先探索的，每個都有可能在明年進入 II 期。

We also have an IL-2 conjugate licensed from Nektar Therapeutics, which preferentially stimulates expansion of regulatory T-cells.

我們還有一種從 Nektar Therapeutics 獲得許可的 IL-2 偶聯物，它優先刺激調節性 T 細胞的擴增。

This potentially first-in-class opportunity is currently being studied in Phase Ib in lupus patients with Phase I data in healthy volunteers presented at EULAR earlier this year, which show the IL-2 conjugate could achieve robust expansion of T-regs.

這一潛在的一流機會目前正在 Ib 期狼瘡患者中進行研究，今年早些時候在 EULAR 上展示了健康志願者的 I 期數據，這表明 IL-2 偶聯物可以實現 T-regs 的穩健擴展。

Additional Phase I studies in psoriasis and atopic dermatitis have been posted to clinicaltrials.gov and are expected to start up before the end of the year.

銀屑病和特應性皮炎的其他 I 期研究已發佈到臨床試驗網站，預計將在今年年底前啟動。

We expect to move to Phase II with this molecule in 2020.

我們預計該分子將在 2020 年進入第二階段。

Finally, I'd like to highlight 2 exciting diabetes programs.

最後，我想強調兩個令人興奮的糖尿病項目。

With our next-generation injectable incretin GIP/GLP glucagon tri-agonist, or GGG, we're testing the hypothesis that adding glucagon to GIP/GLP will have more metabolic activity and stimulate additional weight loss.

使用我們的下一代可注射腸促胰島素 GIP/GLP 胰高血糖素三激動劑 (GGG)，我們正在測試這樣一個假設，即在 GIP/GLP 中添加胰高血糖素將具有更多的代謝活性並刺激額外的體重減輕。

The initial Phase I study studied the safety of a single injection in healthy participants, and we're now studying multiple doses, including dose titration.

最初的 I 期研究研究了單次注射對健康參與者的安全性，我們現在正在研究多劑量，包括劑量滴定。

We expect this program to enter Phase II by late 2020 or early 2021.

我們預計該計劃將在 2020 年底或 2021 年初進入第二階段。

Just like the hurdle for tirzepatide to enter Phase III was a meaningful improvement over Trulicity, the bar here will be a step change over tirzepatide itself.

就像 tirzepatide 進入 III 期的障礙是對 Trulicity 的有意義的改進一樣，這裡的標準將是 tirzepatide 本身的一步改變。

Additionally, our commitment to oral incretins has continued to increase.

此外，我們對口服腸促胰島素的承諾不斷增加。

As we advance programs to development, we seek to approve upon administration or efficacy.

當我們推進項目發展時，我們尋求在管理或有效性方面獲得批准。

Our first oral incretin program, which we licensed from Chugai last year, is a small molecule nonpeptide agonist, the GLP-1, that entered Phase I earlier this year.

我們去年從 Chugai 獲得許可的第一個口服腸促胰島素項目是一種小分子非肽激動劑 GLP-1，於今年早些時候進入 I 期。

Our initial focus will be on PK with the expectation that it should be meaningfully better than a peptide as well as the PD response, which we should see even in Phase I. This molecule could enter Phase II in early 2021.

我們最初的重點將放在 PK 上，期望它應該比肽以及 PD 反應更有意義，即使在第一階段我們也應該看到。這種分子可能在 2021 年初進入第二階段。

In addition to this approach, we're also pursuing dual GIP and GLP-1 receptor agonist peptides for oral delivery.

除了這種方法，我們還在尋求用於口服給藥的雙重 GIP 和 GLP-1 受體激動劑肽。

These programs which are designed to give tirzepatide-like efficacy with a once-a-day oral peptide administration are also progressing preclinically and should enter Phase I next year.

這些旨在通過每天一次口服肽給藥來提供類似 tirzepatide 的功效的項目也在臨床前進展中，明年應該進入 I 期。

We look forward to tracking the progress of these assets over the coming years, and we'll share additional pipeline updates on our next earnings call.

我們期待在未來幾年跟踪這些資產的進展，我們將在下一次財報電話會議上分享更多的管道更新。

Now I'll turn the call back over to Dave for some closing remarks.

現在我將把電話轉回給戴夫做一些結束語。

Thanks, Dan.

謝謝，丹。

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

在進行問答之前，讓我簡要總結一下我們在第三季度取得的進展。

We delivered robust volume growth of 8% driven by our key growth products and an impressive performance outside the U.S. We continue to demonstrate our launch capabilities and have a diverse portfolio of commercial products to drive future growth.

在我們的主要增長產品和美國以外令人印象深刻的業績的推動下，我們實現了 8% 的強勁銷量增長。我們繼續展示我們的發布能力，並擁有多樣化的商業產品組合來推動未來的增長。

We advanced our productivity agenda, controlling operating expenses while investing behind key commercial growth drivers and our late-stage pipeline.

我們推進了生產力議程，控制了運營費用，同時投資於關鍵的商業增長驅動因素和我們的後期管道。

In addition, we made important progress toward our margin goals as the operating margin improved 60 basis points versus Q2 2019 to 28.6%.

此外，我們在實現利潤率目標方面取得了重要進展，營業利潤率與 2019 年第二季度相比提高了 60 個基點，達到 28.6%。

We made important pipeline progress, including the initiation of a new Phase III program with mirikizumab in Crohn's disease; sharing new registrational data for Olumiant, Taltz, Verzenio and selpercatinib; submitting new indications for Taltz and Cyramza; and receiving positive regulatory actions for REYVOW and Trulicity.

我們取得了重要的管道進展，包括啟動了一項新的 mirikizumab 治療克羅恩病的 III 期項目；共享 Olumiant、Taltz、Verzenio 和 selpercatinib 的新註冊數據；為 Taltz 和 Cyramza 提交新的適應症；並收到針對 REYVOW 和 Trulicity 的積極監管行動。

Finally, we returned nearly $600 million to shareholders via the dividend and completed $600 million of share repurchase as well.

最後，我們通過股息向股東返還了近 6 億美元，並完成了 6 億美元的股票回購。

We are proud of our strong business performance and excited about the opportunities ahead for the company.

我們為我們強勁的業務表現感到自豪，並對公司未來的機遇感到興奮。

There has never been a more inspiring time to be working on discovering new medicines, and patients and health care providers are waiting the next wave of innovation.

從未有過比這更鼓舞人心的時刻來努力發現新藥，患者和醫療保健提供者正在等待下一波創新浪潮。

We have grown through the headwinds of Cialis and Lartruvo, and we expect our strong business performance to continue driven by our newest products and our relative lack of patent exposure ahead and, of course, by the work of our scientists who continue to redefine what is possible for patients suffering from serious diseases.

我們在 Cialis 和 Lartruvo 的逆風中成長，我們預計我們的強勁業務表現將繼續受到我們最新產品和我們相對缺乏專利曝光的推動，當然還有我們的科學家的工作，他們繼續重新定義什麼是可用於患有嚴重疾病的患者。

Looking ahead, we are focused on a strong finish to 2019 as we prepare for next year.

展望未來，我們專注於為 2019 年做好準備，為明年做好準備。

This concludes our prepared remarks.

我們準備好的評論到此結束。

And now I'll turn the call over to Kevin to moderate the Q&A session.

現在我將把電話轉給 Kevin 來主持問答環節。

Thanks, Dave.

謝謝，戴夫。

We'd like to take questions from as many callers as possible (Operator Instructions) Leah, please provide the instructions for the Q&A session and then we're ready for the first caller.

我們希望盡可能多地回答呼叫者的問題（操作員說明） Leah，請提供問答環節的說明，然後我們就可以為第一個呼叫者做好準備了。

(Operator Instructions) Our first question is from the line of Chris Schott with JPMorgan.

（操作員說明）我們的第一個問題來自摩根大通的 Chris Schott。

Just two here.

這裡只有兩個。

I guess, first, broader 2020 pricing question.

我想，首先，更廣泛的 2020 年定價問題。

You're seeing with your price erosion with the U.S. portfolio this year.

你看到今年美國投資組合的價格下跌。

Is that a reasonable dynamic to expect in 2020?

這是 2020 年的合理預期嗎？

Or will we see some of these pressure start to ease as we get passed the donut hole fill and some of these kind of onetime items with Trulicity that you mentioned?

或者，當我們通過甜甜圈孔填充物和您提到的一些帶有 Trulicity 的一次性物品時，我們會看到其中一些壓力開始緩解嗎？

And my second question was just elaborating a little bit more on Trulicity in terms of access and price dynamics in 2020.

我的第二個問題只是在 2020 年的訪問和價格動態方面對 Trulicity 進行了更多詳細說明。

The pricing commentary in the prepared remarks is very helpful.

準備好的評論中的定價評論非常有幫助。

I guess with the approval though of oral sema, are you seeing a more difficult payer environment here than the past?

我想通過口頭 sema 的批准，您是否看到這裡的付款環境比過去更加困難？

Or any signs that payers are more aggressively managing the GLP-1 category?

或者有任何跡象表明付款人正在更積極地管理 GLP-1 類別？

Thanks, Chris.

謝謝，克里斯。

We'll go to Josh for the overall 2020 pricing, and then to Enrique for your second question more specifically on Trulicity.

我們將向 Josh 詢問 2020 年的整體定價，然後向 Enrique 詢問您關於 Trulicity 的第二個問題。

Thanks, Chris.

謝謝，克里斯。

I think as we look into 2020, just going back to the guidance that we gave in December of last year, we were planning for sort of low single-digit net price erosion across the portfolio for the period of '19 and '20.

我認為，當我們展望 2020 年時，回到我們去年 12 月給出的指導，我們計劃在 19 年和 20 年期間整個投資組合的淨價格出現低個位數的侵蝕。

I think that's what we see right now.

我認為這就是我們現在所看到的。

We are going to see variability in the quarters.

我們將看到季度的變化。

As you mentioned, we've got the donut hole and other things that are particularly I think acute in Q3 of this year.

正如你所提到的，我們有甜甜圈洞和其他我認為在今年第三季度特別嚴重的事情。

But I think the net as we look and project into 2020, I think the sort of low single-digit price decline is probably a fair place to be, and that's very consistent with how we thought about 2020 goals and our productivity agenda and otherwise.

但我認為，當我們展望和預測到 2020 年時，我認為這種低個位數的價格下跌可能是一個公平的地方，這與我們對 2020 年目標和生產力議程等的看法非常一致。

Thanks, Josh.

謝謝，喬希。

Enrique?

恩里克?

So Chris, when it comes to Trulicity coverage, we have unprecedented access.

所以克里斯，當談到 Trulicity 覆蓋範圍時，我們擁有前所未有的訪問權限。

We are right now in the mid-90s from a coverage perspective, which is outstanding, and we are projecting that into next year.

從覆蓋範圍的角度來看，我們現在處於 90 年代中期，這非常出色，我們將其預測到明年。

It is too early for us to be able to say exactly how the discussions of oral sema are going with the payers.

對於我們來說，現在要準確地說出與付款人有關的口頭 sema 的討論情況還為時過早。

Of course, we'll learn more as they basically get further into some of those discussions.

當然，隨著他們基本上深入其中一些討論，我們將了解更多信息。

And the next caller is from Umer Raffat with Evercore.

下一位來電者來自於 Evercore 的 Umer Raffat。

I don't know how to ask my first one, but I'll ask anyways given all the renewed interest.

我不知道如何問我的第一個，但無論如何我都會問，因為所有的新興趣。

My question is on the A4 trial.

我的問題是關於 A4 試驗的。

And I know you're using a super high dose of solanezumab tracked over 240 weeks.

而且我知道您正在使用超高劑量的 solanezumab，追踪時間超過 240 週。

So my question is this.

所以我的問題是這個。

Since this trial was fully enrolled about a couple of years ago, what have we learned to date from any interim analyses that have been conducted?

自從這項試驗在幾年前被完全招募以來，到目前為止，我們從已進行的任何中期分析中學到了什麼？

And I ask because almost every patient in this trial passed the week 76 follow-up.

我之所以這麼問，是因為該試驗中的幾乎所有患者都通過了第 76 週的隨訪。

And then secondly, on GLP and tirzepatide franchise broadly.

其次，關於 GLP 和 tirzepatide 的廣泛特許經營權。

My question is, what's the median duration on therapy real-world on Trulicity currently?

我的問題是，目前在 Trulicity 上治療真實世界的中位持續時間是多少？

And I ask about it relative to the 20-week titration being employed in Phase III.

我詢問了與第三階段使用的 20 週滴定有關的問題。

And I'm also curious, is there any observations to date from blinded bases in the ongoing titration regimen?

而且我也很好奇，到目前為止，在正在進行的滴定方案中，盲鹼基是否有任何觀察結果？

Thanks, Umer.

謝謝，烏默爾。

We'll go to Dan for the sola question, and then Enrique to talk about what we're seeing today with the duration for Trulicity.

我們會去找 Dan 來回答 sola 的問題，然後 Enrique 來談談我們今天看到的關於 Trulicity 的持續時間。

Thanks, Umer, for your question on solanezumab in the A4 trial.

感謝 Umer 提出關於 A4 試驗中 solanezumab 的問題。

Of course, this is a trial of solanezumab, as you pointed out, a 4x higher dose than we tested in the original Phase III studies.

當然，正如您所指出的，這是一項 solanezumab 的試驗，比我們在最初的 III 期研究中測試的劑量高 4 倍。

But what's really interesting about this trial is that we're testing it in asymptomatic elderly individuals who don't have a diagnosis of Alzheimer's, but do have amyloid plaque in their brain.

但這項試驗真正有趣的是，我們正在對沒有阿爾茨海默氏症診斷但大腦中確實有澱粉樣蛋白斑塊的無症狀老年人進行測試。

It's a 4-year treatment that's planned, and so we'll get data on this trial in mid-2022.

這是一項為期 4 年的治療計劃，因此我們將在 2022 年年中獲得該試驗的數據。

So we just have to wait patiently for those results to see if sola can have efficacy in this very early population.

所以我們只需要耐心等待這些結果，看看sola是否可以在這個非常早期的人群中發揮作用。

Thanks, Dan.

謝謝，丹。

Enrique?

恩里克?

So the -- when we look at Trulicity adherence, we -- and I think we've shared this before, we tend to see better adherence with Trulicity than with the other products.

所以 - 當我們查看 Trulicity 的依從性時，我們 - 我認為我們之前已經分享過這一點，我們傾向於看到 Trulicity 的依從性比其他產品更好。

One of the things that we measure is refill rate.

我們衡量的一件事是補充率。

So we measure the second refill rate, the fourth refill rates.

所以我們測量第二次補充率，第四次補充率。

Trulicity tends to have better adherence than the GLP-1 class.

Trulicity 往往比 GLP-1 類具有更好的依從性。

It tends to have better adherence than insulin, but also better adherence than orals, which is sometimes difficult to believe, but it's -- the value proposition is that simplicity.

它往往比胰島素具有更好的依從性，但也比口服藥物具有更好的依從性，這有時令人難以置信，但它的價值主張就是簡單。

Now it's a complication -- it's a complicated question when we look at medium duration of therapy because we do lose so many patients in the first fill and the second fill across all of the diabetes therapy.

現在這是一個並發症——當我們考慮中等持續時間的治療時，這是一個複雜的問題，因為在所有糖尿病治療的第一次填充和第二次填充中，我們確實失去了很多患者。

Just to give you a sense, by the fourth fill, we are basically -- Trulicity is basically in the 60s.

只是為了給你一個感覺，到第四次填充時，我們基本上是 -- Trulicity 基本上是在 60 年代。

What we basically see though is for patients that have stayed after the first year, we tend to lose about 1/3 of those patients every year going forward after that.

不過，我們基本上看到的是，對於第一年之後留下來的患者，此後每年我們往往會失去大約 1/3 的患者。

So that gives you a certain sense of what is the adherence of Trulicity as you're thinking about modeling this.

因此，當您考慮對此進行建模時，這讓您對 Trulicity 的堅持有一定的了解。

Next is the line of Terence Flynn with Goldman Sachs.

接下來是高盛的特倫斯·弗林（Terence Flynn）。

Maybe two from me.

也許我兩個。

Just wondering your latest thoughts on the ongoing policy discussions in DC, potential outcomes and impact to your business.

只是想知道您對 DC 正在進行的政策討論、潛在結果和對您業務的影響的最新想法。

And then as we think about Emgality for 2020, I know you don't give a product level guidance, but you've been focused on the second phase of growth here into the primary care market.

然後當我們考慮 2020 年的 Emgality 時，我知道您沒有提供產品級別的指導，但您一直專注於初級保健市場的第二階段增長。

Any update on the progress there as well as the initial European launch?

關於那裡的進展以及最初的歐洲發布的任何更新？

Great.

偉大的。

Thanks, Terence.

謝謝，特倫斯。

We'll go to Dave for the policy question and Patrik on Emgality in 2020.

我們將在 2020 年向 Dave 提出政策問題和關於 Emgality 的 Patrik。

Yes.

是的。

I wish I could provide a clear answer on the probable outcome of the policy debates in Washington.

我希望我能就華盛頓政策辯論的可能結果提供一個明確的答案。

I think it's really unclear, other than we probably know that the House Bill will probably pass the House completely on partisan lines, and then we'll see from there.

我認為這真的不清楚，除了我們可能知道眾議院法案可能會完全按照黨派路線通過眾議院，然後我們會從那裡看到。

There are, of course, a number of initiatives in the various senate committees that the industry is for and Lilly is certainly for.

當然，該行業支持的各個參議院委員會中有許多舉措，禮來當然也支持。

If a version of those came together and passed both chambers, in general, that would be I think a modest positive for us.

總的來說，如果其中一個版本聚集在一起並通過了兩個議院，我認為這對我們來說是一個適度的積極因素。

We see Reform to Part D is an important discussion that should happen, providing an out-of-pocket cap to seniors is an important benefit.

我們認為對 D 部分的改革是一個應該進行的重要討論，為老年人提供自付費用上限是一項重要的好處。

And any changes that can positively adapt the donut hole math and other pieces of the benefit, which we're talking about even on this call, that are helpful for products that are more commonly used for conditions like diabetes.

任何可以積極調整甜甜圈洞數學和其他好處的變化，即使在這次電話會議上，我們也在談論這些，這對更常用於糖尿病等疾病的產品有幫助。

So we track that closely.

所以我們密切跟踪。

We're very engaged in this whole discussion.

我們非常參與整個討論。

And of course, probably given the environment in Washington, the most probable thing is there isn't really legislation happening for some time.

當然，考慮到華盛頓的環境，最有可能的是一段時間內沒有真正的立法。

But we -- it's important to note to investors, we're promoting changes, in particular the Part D benefit and affordability measures that can impact the pocketbook at the pharmacy counter without throwing out the baby with the bathwater and wholesale change to the U.S. system, which obviously would be hugely damaging to the business model.

但是我們 - 重要的是要提醒投資者，我們正在推動變革，特別是 D 部分的福利和負擔能力措施，這些措施可以影響藥房櫃檯的錢包，而不會把嬰兒和洗澡水一起扔掉，並對美國系統進行大規模變革，這顯然會對商業模式造成巨大破壞。

Thanks, Dave.

謝謝，戴夫。

Patrik?

帕特里克？

Thank you very much.

非常感謝。

We are very pleased with the overall performance of Emgality and we actually became the leader in NRx in Q3 and we've been that for more than 10 consecutive weeks right now and we're also closing the gap in terms of total Rx.

我們對 Emgality 的整體表現感到非常滿意，我們實際上在第三季度成為了 NRx 的領導者，我們現在已經連續 10 多周保持這種狀態，而且我們也在縮小總 Rx 方面的差距。

When we look upon the access to Emgality, it's a best-in-class access with more of a 90% today in the U.S. And we are making steady progress in terms of the claims paid and we're today at 3 -- 3, 4 for the claims being paid.

當我們查看 Emgality 的訪問權限時，它是同類最佳的訪問權限，今天在美國超過 90%。我們在支付的索賠方面取得了穩步進展，我們今天是 3 - 3， 4 支付的索賠。

And we are making steady progress in that regards as well.

我們也在這方面取得穩步進展。

We still believe it's very early days for Emgality.

我們仍然相信 Emgality 還處於早期階段。

We know that we have a population in the U.S. of 6 million preventive -- eligible for preventative treatment.

我們知道，我們在美國有 600 萬預防性人口——有資格接受預防性治療。

And only 3 million of those are being treated today.

而今天只有 300 萬人正在接受治療。

And year-to-date, we have approximately 100,000 patients treated with Emgality.

年初至今，我們有大約 100,000 名患者接受了 Emgality 治療。

So we see a tremendous opportunity also moving forward.

因此，我們看到了巨大的機遇也在向前發展。

And also, the prescriber base in the U.S. is still limited.

而且，美國的處方藥基礎仍然有限。

So only 15% of our customers are regularly prescribers of Emgality.

因此，只有 15% 的客戶是 Emgality 的定期處方者。

So I think that signals very clearly the opportunity we foresee.

所以我認為這非常清楚地表明了我們預見的機會。

We're also excited about the opportunity outside of U.S. Migraine is not a U.S. phenomenon.

我們也對美國以外的機會感到興奮。偏頭痛不是美國的現象。

We have 30 million patients suffering from migraine in EU and 9 million in Japan.

我們在歐盟有 3000 萬偏頭痛患者，在日本有 900 萬。

And only 2 million of those are treated in EU and 300,000 in Japan.

其中只有 200 萬人在歐盟接受治療，30 萬人在日本接受治療。

It's still very early days.

現在還很早。

And we have just received the regulatory approval from [European Medicines Agency] (corrected by company after the call).

我們剛剛收到[歐洲藥品管理局]的監管批准（在電話會議後由公司更正）。

And we are in pricing reimbursement discussion on a country-to-country basis as we believe that the opportunity for Emgality is big also outside the U.S.

我們正在針對不同國家進行定價報銷討論，因為我們相信 Emgality 的機會在美國以外也很大。

Next is the line of Geoff Meacham with Bank of America.

接下來是美國銀行的 Geoff Meacham 線。

I just have a couple.

我只有一對。

Josh, on the SG&A side, are there opportunities for more cost savings looking forward beyond what you guys have talked about post the [Elanco] here?

喬希，在 SG&A 方面，除了你們在 [Elanco] 之後所談論的內容之外，還有更多節省成本的機會嗎？

I'm just trying to get a sense for whether the Q3 trends can be extrapolated.

我只是想了解是否可以推斷第三季度的趨勢。

And then Patrik, another one on the migraine side.

然後是帕特里克，另一位偏頭痛患者。

So I know obviously early in the REYVOW launch, but can you leverage the access you just mentioned with Emgality to help benefit REYVOW?

所以我在 REYVOW 發布的早期就知道了，但是你能利用你剛才提到的 Emgality 訪問來幫助 REYVOW 受益嗎？

I'm just trying to get a sense for the commercial synergies looking to 2020.

我只是想了解 2020 年的商業協同效應。

And with the CGRP space being a little bit more crowded, how has the pricing environment been so far?

隨著 CGRP 空間變得更加擁擠，到目前為止定價環境如何？

So go to Josh for SG&A and then Patrik on migraine.

所以去 Josh 去 SG&A，然後去 Patrik 去治療偏頭痛。

Okay.

好的。

Thanks, Jeff.

謝謝，傑夫。

welcome back.

歡迎回來。

On SG&A, yes, I think if you look at what we see in Q3 and what we've been talking about relative to our productivity goals for 2020, we are pretty comfortable with the absolute level of investment we have behind our new launches, even if you look at the last few Baqsimi which I mentioned on the prepared comments, and REYVOW, for example.

在 SG&A 方面，是的，我認為如果你看看我們在第三季度看到的情況以及我們一直在談論的與 2020 年生產力目標相關的內容，我們對我們新推出的絕對投資水平感到非常滿意，甚至如果您查看我在準備好的評論中提到的最後幾個 Baqsimi，例如 REYVOW。

We're putting those into existing infrastructures and we'll get good leverage there.

我們正在將它們放入現有的基礎設施中，我們將在那裡獲得良好的影響力。

So we'll continue to invest behind our key launches, but I think the absolute level of SG&A with our ongoing productivity efforts to get more out of each of the promotional dollars we spend, we feel pretty comfortable with that, so you should expect a modest to flat growth going forward on that line.

因此，我們將繼續投資於我們的主要發布，但我認為 SG&A 的絕對水平以及我們持續的生產力努力以從我們花費的每一筆促銷資金中獲得更多收益，我們對此感到非常滿意，所以你應該期待這條線上的增長溫和至持平。

Thanks, Josh.

謝謝，喬希。

Patrik?

帕特里克？

Well, thank you very much.

好的，謝謝。

We are also excited with the approval of REYVOW and we are waiting for the DEA to give out overall assessment by January next year and we're launching very early in 2020.

我們也對 REYVOW 的批准感到興奮，我們正在等待 DEA 在明年 1 月之前給出總體評估，我們將在 2020 年初推出。

Overall, we believe our existing is significant need in the acute treatment of migraine.

總體而言，我們認為我們現有的偏頭痛急性治療存在重大需求。

We know that currently 5 million of Americans are being treated for acute migraine, but 35% to 40% of those don't respond or can't tolerate the triptans and approximately 15% of those are contraindicated for triptans, so that's why we believe it's really a tremendous opportunity.

我們知道，目前有 500 萬美國人正在接受急性偏頭痛治療，但其中 35% 到 40% 的人對曲坦類藥物沒有反應或不能耐受，其中大約 15% 的人對曲坦類藥物有禁忌，所以我們相信這真是一個巨大的機會。

After 2 decades, the launch of new oral treatment for acute migraine.

時隔2年，推出新的急性偏頭痛口服療法。

We see some significant synergies with Emgality, both in terms of access and the overall infrastructure, and particularly being able to capitalize on the learnings that we have had with the launch of Emgality just the beginning of 2018, but we've rapidly been able to take a leadership position, not just in terms of access, but also in terms of NRx and closing the gap in TRx.

我們看到與 Emgality 在訪問和整體基礎設施方面的一些顯著協同作用，特別是能夠利用我們在 2018 年初推出 Emgality 時所獲得的經驗，但我們很快就能夠不僅在准入方面，而且在 NRx 和縮小 TRx 差距方面都處於領先地位。

Is the line of Tim Anderson with Wolfe Research.

是蒂姆安德森與沃爾夫研究公司的路線。

I'd like to come back to 2020 and contracting and diabetes.

我想回到 2020 年和收縮和糖尿病。

I know you were asked this earlier, but you didn't give much of an answer.

我知道你之前被問過這個問題，但你沒有給出太多答案。

The stock's down 5% today on a beat and raise, I think that reflects concerns about whether you can hit your operating margin guidance in 2020, the outlook for diabetes.

該股今天因節拍和上漲而下跌 5%，我認為這反映了對您能否在 2020 年達到營業利潤率指導的擔憂，即糖尿病的前景。

So specifically, on diabetes, you're in this window of kind of having an idea of where your coverage is going to be for Trulicity and Jardiance in terms of net live gains or lost and what the price concessions are.

因此，具體而言，在糖尿病方面，您正處於這個窗口，您可以了解您對 Trulicity 和 Jardiance 的覆蓋範圍在淨生活收益或損失方面以及價格優惠是多少。

So can you just hopefully give us a little more detail on how we should be thinking about Trulicity specifically and Jardiance as well going into 2020 because there have been changes in the competitive dynamics there?

那麼，您能否希望給我們更多詳細信息，說明我們應該如何特別考慮 Trulicity 和 Jardiance 以及進入 2020 年，因為那裡的競爭動態發生了變化？

Second question, just going back to Alzheimer's.

第二個問題，回到阿爾茨海默氏症。

It seemed like a couple of years ago, Lilly started to quietly pivot away from thinking that any monotherapy that's anti-amyloid would yield a benefit.

似乎在幾年前，禮來公司開始悄悄地擺脫認為任何抗澱粉樣蛋白的單一療法都會產生益處的想法。

And you started to really go down this combination route.

你開始真正走這條組合路線。

Given what Biogen disclosed yesterday and your ongoing work in this area, just how are you thinking about monotherapy in the anti-amyloid space?

鑑於百健（Biogen）昨天披露的內容以及您在該領域的持續工作，您如何看待抗澱粉樣蛋白領域的單一療法？

And really, anything you can offer, your impressions of the Biogen news yesterday would be helpful.

真的，你能提供的任何東西，你昨天對百健（Biogen）新聞的印像都會有所幫助。

Thanks, Tim.

謝謝，蒂姆。

So we'll go to Josh for outlook for 2020 and then to Dan for the question on Alzheimer's.

因此，我們將向 Josh 詢問 2020 年的展望，然後向 Dan 詢問有關阿爾茨海默氏症的問題。

Thanks, Tim.

謝謝，蒂姆。

As we said in the opening, I think if you look at Trulicity and strip out the things that we see in Q3 that we say are concentrated in that quarter, we feel good, as Enrique mentioned, feel very good about the access that we have now and the access we project into 2020.

正如我們在開場時所說，我認為如果你看一下 Trulicity 並剔除我們在第三季度看到的我們所說的集中在那個季度的東西，我們感覺很好，正如 Enrique 所說，對我們擁有的訪問權限感覺非常好現在和我們預計到 2020 年的訪問。

And as we said, you should think about Trulicity at a modest year-over-year price decline, which is really just a function of modest price increases.

正如我們所說，您應該以適度的同比價格下降來考慮 Trulicity，這實際上只是適度價格上漲的函數。

And we like that the price and the value that GLPs have in the U.S. today, so we'll do everything we can to preserve that.

我們喜歡今天 GLP 在美國的價格和價值，所以我們將盡我們所能來保護它。

And we feel confident as we head into 2020 that that's a very manageable dynamic.

當我們進入 2020 年時，我們對這是一個非常可控的動態充滿信心。

Thanks, Josh.

謝謝，喬希。

Dan?

擔？

Of course, with respect to the amyloid hypothesis in the Biogen data, I think there was a lot of thinking about this when they announced their futility that the main question was whether or not there was evidence that if you removed significant amounts of amyloid plaque from the brain, this could result in a slowing of cognitive decline.

當然，關於百健（Biogen）數據中的澱粉樣蛋白假說，我認為當他們宣布他們的主要問題是是否有證據表明如果你從大腦，這可能會導致認知能力下降的減緩。

So everyone was sort of waiting to see that the very highest doses, whether it was that high level of amyloid removal, what would happen.

所以每個人都在等著看最高劑量，無論是高水平的澱粉樣蛋白去除，會發生什麼。

So I think the data we saw yesterday from that respect is an important indicator on the amyloid hypothesis.

所以我認為我們昨天從這方面看到的數據是澱粉樣蛋白假說的一個重要指標。

We've thought for some time that complete removal of amyloid from the brain could be the goal here, doing it in early in the right patients could be important.

一段時間以來，我們一直認為從大腦中完全去除澱粉樣蛋白可能是這裡的目標，在合適的患者早期進行這項工作可能很重要。

And that underlied the design of our trial with our plaque removing antibody,Donanemab, which we said should be able to remove plaque more quickly and more deeply than anything else we've seen.

這就是我們使用我們的斑塊去除抗體 Donanemab 進行試驗設計的基礎，我們說它應該能夠比我們見過的任何其他東西更快、更深入地去除斑塊。

So I think yesterday's news is rooted to be a little more optimistic about that theory.

因此，我認為昨天的新聞根源於對該理論更加樂觀。

And as I said before, we're excited to see the results of that Phase II trial.

正如我之前所說，我們很高興看到 II 期試驗的結果。

With respect to your comment -- question on combination therapy, indeed, we do think that combination therapy is an important avenue in Alzheimer's disease, I think we're the first and probably the only company that tried a combination of 2 disease modifying therapies.

關於你的評論——關於聯合治療的問題，事實上，我們確實認為聯合治療是治療阿爾茨海默病的重要途徑，我認為我們是第一家也可能是唯一一家嘗試結合兩種疾病改善療法的公司。

Unfortunately, we had to stop that, one of the therapies was a BACE inhibitor, which proven not to be a productive avenue of investigation.

不幸的是，我們不得不制止這種情況，其中一種療法是 BACE 抑製劑，但事實證明這不是一種有效的研究途徑。

But given that we have both tau and amyloid approaches, I think combination in the future is a very rationale approach for Alzheimer's.

但鑑於我們同時使用 tau 和澱粉樣蛋白方法，我認為未來的組合是治療阿爾茨海默氏症的一種非常合理的方法。

Next caller, please.

請下一位來電者。

Next is Louise Chen with Cantor.

接下來是 Cantor 的 Louise Chen。

My first question here is, when you first gave your 2020 revenue outlook or your long-term revenue guidance, what did you assume for SKYRIZI and oral semaglutide, and how have those launches proceeded relative to your expectations there?

我的第一個問題是，當您第一次給出 2020 年收入展望或長期收入指導時，您對 SKYRIZI 和口服 semaglutide 的假設是什麼，以及相對於您的預期，這些發布進展如何？

And then second question is, how do you think the data readouts from ESMO impact your thinking on the commercial opportunities for Verzenio?

然後第二個問題是，您認為 ESMO 的數據讀數如何影響您對 Verzenio 商業機會的思考？

Is there more growth left in the U.S.?

美國還有更多的增長空間嗎？

And how much can your share increase with this positive data?

有了這些積極的數據，您的份額可以增加多少？

Thanks, Louise.

謝謝，路易絲。

We'll go to Dave for the 2020 revenue question and to Anne on ESMO data on Verzenio.

我們將請戴夫解答 2020 年的收入問題，並請安妮解答 Verzenio 上的 ESMO 數據。

Louise, thanks for the question.

路易絲，謝謝你的問題。

Of course, we set the 2020 guidance in the middle of 2016.

當然，我們在 2016 年年中設定了 2020 年的指引。

So many of the products we're facing competition from, et cetera, today, were a twinkle in the eye of the inventors back then and including some of our own launches at that time.

我們今天面臨的許多競爭產品，等等，在當時的發明者眼中都是一閃而過，包括我們當時推出的一些產品。

We set the guidance because we thought there was a distance between what's -- the people who do your work and the company thought about the long-term prospects, not line by line, but looking at a portfolio of opportunities that existed in front of us.

我們制定指導方針是因為我們認為在做你的工作的人和公司考慮長期前景之間存在距離，而不是逐行考慮，而是著眼於我們面前存在的一系列機會.

Of course, our ability to predict any one competitive situation or a product uptick for Lilly is not perfect.

當然，我們預測禮來的任何一種競爭形勢或產品升級的能力並不完美。

But at that time, we did project that we would launch 10 medicines by the end of '19 in the first 5 years of that period, and that -- because of the profound nature of those opportunities, we were confident we would find a way to grow the company.

但當時，我們確實計劃在那個時期的前 5 年到 19 年底推出 10 種藥物，並且 - 由於這些機會的深刻性，我們有信心找到一種方法發展公司。

At that point, the pharma business 6%, Elanco a bit slower.

那時，製藥業務 6%，Elanco 慢了一點。

We've actually raised that to 7% and I think are closing in achieving that goal despite the fact that probably how we predicted we'd get there isn't the same way we have.

我們實際上已經將這一比例提高到 7%，我認為正在接近實現這一目標，儘管事實上我們預測的實現方式可能與我們現在的方式不同。

But I think that was the nature of the exercise back then.

但我認為那是當時鍛煉的本質。

And I think we successfully closed the gap in understanding in terms of what the opportunity for the company to grow was during that time.

而且我認為我們成功地縮小了在那段時間公司發展機會方面的理解差距。

So we're proud of that achievement.

因此，我們為這一成就感到自豪。

If we look at the competitive threats we face across our big products, of course, they're there.

如果我們看看我們在大型產品中面臨的競爭威脅，當然，它們就在那裡。

I would just point out as well though that Trulicity volume growth in the U.S. was over 40% in Q3.

我還要指出，儘管第三季度美國的 Trulicity 銷量增長超過 40%。

That's in the face of 1.5 years of Ozempic.

面對 1.5 年的 Ozempic。

And that Taltz volume growth was substantial as well in the face of SKYRIZI and Tremfya uptake.

面對 SKYRIZI 和 Tremfya 的吸收，Taltz 的銷量增長也很可觀。

And in both those cases, it's important to understand that there is far more growth opportunity left in the classes we're participating in than share erosion threat, to our eyes.

在這兩種情況下，重要的是要了解，在我們眼中，我們所參加的課程中留下的增長機會遠多於分享侵蝕威脅。

A final comment on all this, because I know there's lot of interest in the Q3 pricing dynamics on Taltz and Trulicity.

對所有這一切的最後評論，因為我知道對 Taltz 和 Trulicity 的第三季度定價動態很感興趣。

Most of those effects were determined early in '18 and are now manifesting themselves in Q3 of '19.

大多數這些影響是在 18 年初確定的，現在在 19 年第三季度表現出來。

Whether it be the donut hole launchings which affect both of them, the rates we contracted on in the commercial mergers that occurred in the payer space or the contracting in the case of Trulicity in what we knew were lower-priced segments, but a good volume, and of course, at the margin are highly productive for us to make sure patients in VA or DOD, those segments, can reach our products.

無論是影響兩者的甜甜圈洞發射，我們在付款人空間發生的商業合併中的合同費率，還是在我們知道的價格較低的部分中的 Trulicity 的合同，但數量很大，當然，在邊際上，我們可以確保 VA 或 DOD（這些細分市場）的患者能夠接觸到我們的產品。

So just to put a perspective on all that, a long-winded answer, but thanks for the question.

所以只是對這一切有個看法，一個冗長的答案，但謝謝你的問題。

And maybe Verzenio, Anne can address.

也許 Verzenio，安妮可以解決。

Yes.

是的。

I'd be happy to.

我很樂意。

So thanks, Louise, for the question.

所以，謝謝，路易絲，你的問題。

And quarter-over-quarter, our Q3 U.S. sales are up 19% since Q2 and Q3 monthly sales look very strong as well.

與上一季度相比，我們的第三季度美國銷售額增長了 19%，因為第二季度和第三季度的月銷售額看起來也非常強勁。

So we do believe that we're seeing growth from the outstanding survival results that we've released.

因此，我們確實相信，我們正在從我們發布的出色生存結果中看到增長。

And we do hope that we'll see some growth for the CDK4/6 market, although maybe in the single digit area.

我們確實希望我們會看到 CDK4/6 市場的一些增長，儘管可能是個位數。

For us here at Lilly, this is a relaunch of Verzenio.

對於禮來公司來說，這是 Verzenio 的重新啟動。

So the top priority for our team is to ensure that doctors, typically those in the U.S., are aware of the statistically significant OS data, nearly 10 months of survival benefit.

因此，我們團隊的首要任務是確保醫生（通常是美國醫生）了解具有統計學意義的 OS 數據，以及近 10 個月的生存獲益。

And we'll work with them to share that benefit that patients that can have from Verzenio.

我們將與他們合作，分享患者可以從 Verzenio 獲得的好處。

And we do know that oncologists are data-driven, and we have extremely compelling data and a very strong commercial team that will ensure that we get the word out.

而且我們確實知道腫瘤學家是數據驅動的，我們擁有非常引人注目的數據和非常強大的商業團隊，這將確保我們得到消息。

So we do hope very much to increase our share of market.

所以我們非常希望增加我們的市場份額。

Obviously, not all the competitors in the space have been able to demonstrate specifically significant results, and so we'll make sure that, that data is well communicated.

顯然，並非該領域的所有競爭對手都能夠展示出特別重要的成果，因此我們將確保這些數據得到很好的溝通。

Particularly, we're going to encourage physicians to identify patients that are likely to do worse.

特別是，我們將鼓勵醫生識別可能病情惡化的患者。

So you probably saw that data that we released at ESMO on where the cancer recurred or when it recurred.

所以你可能看到了我們在 ESMO 上發布的關於癌症復發位置或複發時間的數據。

And those patients do particularly well on Verzenio with some very robust results.

這些患者在 Verzenio 上表現特別好，取得了一些非常穩健的結果。

Again, we see that as a differentiator as well from some of that competition.

同樣，我們也將其視為與某些競爭的區別。

And we do know that physicians and patients #1 goal is survival, and we've been able to deliver now, as I said, nearly 10 months of a survival benefit, which is really remarkable in this setting and I think really a bit of a game-changer for this molecule.

而且我們確實知道醫生和患者的第一目標是生存，正如我所說，我們現在已經能夠提供近 10 個月的生存益處，這在這種情況下真的很了不起，我認為真的有點這種分子的遊戲規則改變者。

So we look forward to next year.

所以我們期待明年。

And then just to comment a little bit outside the U.S. in addition to what I said is good growth in the U.S., we're seeing a great portion of our growth come from outside the U.S., particularly in Japan.

然後只是在美國以外發表一點評論，除了我所說的美國的良好增長之外，我們看到我們的大部分增長來自美國以外，尤其是日本。

And we just got the updated data that in combination -- in first line in combination with aromatase inhibitors, we have a 30% share now.

我們剛剛獲得了最新的數據——在第一線與芳香酶抑製劑的組合中，我們現在擁有 30% 的份額。

And in the second line in combination with fulvestrant, a 45% share.

並在二線與氟維司群聯用，佔有45%的份額。

So really outstanding work by our Japan team and a good growth there.

我們日本團隊的工作非常出色，並且在那裡取得了良好的發展。

And then great work in Europe as well, with continued uptake, strong patient uptake in the U.K., France and Germany.

然後在歐洲也有出色的工作，在英國、法國和德國持續被患者接受，患者接受度很高。

And many countries now having reimbursement and off and running.

許多國家現在都有報銷和關閉和運行。

So we look forward to next year with Verzenio and continue to grow based on this, we think, very significant contribution to this important medicine.

因此，我們期待明年與 Verzenio 合作，並在此基礎上繼續發展，我們認為，這對這一重要藥物做出了非常重大的貢獻。

Next caller, please.

請下一位來電者。

Is the line of Navin Jacob with UBS.

是瑞銀的 Navin Jacob 線。

You gave a lot of color on Trulicity and the pricing dynamics there.

您對 Trulicity 和那裡的定價動態進行了很多說明。

Just on Taltz, wondering if we could get a similar sort of color.

就在 Taltz 上，想知道我們是否能得到類似的顏色。

Specifically, UNH recently excluded Taltz from its 2020 formulary.

具體來說，UNH 最近將 Taltz 排除在其 2020 年處方集之外。

Can you just help us understand what -- how the access looks for 2020?

您能否幫助我們了解一下 2020 年的訪問權限如何？

As you go into those discussions, do you see any pressure there from some of the other newer entrants?

在您進行這些討論時，您是否看到其他一些新進入者的壓力？

And second question, on Jardiance, you have a couple of trials reading out over the next few years, the EMPEROR trials and heart failure.

第二個問題，在 Jardiance 上，您將在接下來的幾年中宣讀一些試驗，即 EMPEROR 試驗和心力衰竭。

How are you thinking about that opportunity?

你如何看待這個機會？

Are those trials meant to bolster the profile of Jardiance in the diabetes market?

這些試驗是否旨在加強 Jardiance 在糖尿病市場的形象？

Or do you actually view the heart failure opportunities as a individual stand-alone opportunity?

或者您是否真的將心力衰竭機會視為一個單獨的獨立機會？

And if so, could you help us understand if this could be a blockbuster opportunity by itself?

如果是這樣，您能否幫助我們了解這本身是否就是一個巨大的機會？

And then associated with that, wondering if the 6-minute function tests are fileable by themselves.

然後與此相關聯，想知道 6 分鐘的功能測試是否可以自己歸檔。

Thanks, Navin.

謝謝，納文。

We'll go to Patrick for the question on Taltz and Enrique for the question about Jardiance.

我們將向 Patrick 詢問有關 Taltz 的問題和 Enrique 詢問有關 Jardiance 的問題。

So thank you very much.

所以非常感謝。

And access continues to be a challenge in the field of immunology in the U.S. but we will continue to ensure that through a combination of Taltz clear access program and contract with payers that we continue to ensure that patients get the access to Taltz whenever they need.

在美國，訪問仍然是免疫學領域的一個挑戰，但我們將繼續確保通過結合 Taltz 明確訪問計劃和與付款人的合同，我們將繼續確保患者在需要時可以訪問 Taltz。

If we look specifically into 2020, we expect 2020 to be similar to 2019 and incrementally better in some areas.

如果我們特別關注 2020 年，我們預計 2020 年將與 2019 年相似，並且在某些領域會逐漸好轉。

And we know that not all plans just yet presented benefits -- drug benefit schemes for 2020.

而且我們知道，並非所有計劃都帶來了好處——2020 年的藥物福利計劃。

But we believe we are entering into 2020 with positive momentum.

但我們相信我們正以積極的勢頭進入 2020 年。

And with Taltz now replacing Cosentyx as the preferred IL-17 with OptumRx and their co-formularies which is covering than 14 million lives in the U.S. So in essence, we believe 2020 to be very similar to 2019, but with some incrementally better areas.

隨著 Taltz 現在用 OptumRx 及其聯合配方取代 Cosentyx 作為首選的 IL-17，覆蓋美國超過 1400 萬人的生活。因此，從本質上講，我們認為 2020 年與 2019 年非常相似，但在一些方面會逐漸好轉。

Thanks, Patrik.

謝謝，帕特里克。

Enrique?

恩里克?

So we do see heart failure for Jardiance as a significant opportunity for us.

因此，我們確實將 Jardiance 的心力衰竭視為我們的重要機會。

I think you described it as a blocks status type of potential, and I think that's right.

我認為您將其描述為潛力的塊狀態類型，我認為這是正確的。

Clearly, we do have a lot of opportunity for Jardiance in type 2 diabetes, so heart failure is on top of that block of opportunity in type 2 diabetes.

顯然，我們確實有很多 Jardiance 治療 2 型糖尿病的機會，所以心力衰竭是 2 型糖尿病的機會。

We do have, when it comes to the 6-minute walk test, we have a read out later this year.

我們確實有，當談到 6 分鐘步行測試時，我們會在今年晚些時候公佈。

You asked whether we believe that data would be fileable with the FDA, and we believe so, so we believe that we can get the data on our label.

你問我們是否相信這些數據可以提交給 FDA，我們相信，所以我們相信我們可以在我們的標籤上獲得數據。

Clearly, the outcome studies are also critical for us and they will be coming at the end of next year and then for HFpEF in early 2021.

顯然，結果研究對我們也很重要，它們將在明年年底推出，然後在 2021 年初對 HFpEF 進行。

So a very significant opportunity for Jardiance and for patients.

因此，對於 Jardiance 和患者來說，這是一個非常重要的機會。

And this is Dan.

這是丹。

I could just also add in that we are studying Jardiance in chronic kidney disease in a Phase III trial that will read out in 2022, just another exciting opportunity there.

我還可以補充一點，我們正在研究 Jardiance 在慢性腎病中的 III 期試驗，該試驗將於 2022 年公佈，這只是另一個令人興奮的機會。

The next is Seamus Fernandez with Guggenheim.

接下來是古根海姆的Seamus Fernandez。

So just a couple of quick questions.

所以只是幾個簡單的問題。

First off, for the diabetes market.

首先，針對糖尿病市場。

Enrique, can you just help us understand the mix of payers?

恩里克，你能幫我們了解付款人的組合嗎？

How that might be changing from a Trulicity perspective in terms of the next incremental script gain?

就下一個增量腳本增益而言，從 Trulicity 的角度來看，這可能會發生什麼變化？

And then similarly, where is Trulicity gaining the most traction incrementally amongst physicians?

然後類似地，Trulicity 在哪裡逐漸在醫生中獲得最大的吸引力？

Is it now really the growth driver growing beyond the endo market and pushing into the primary care physician portion of the market?

它現在真的是超越 endo 市場並進入初級保健醫生市場的增長動力嗎？

The reason that I asked that is because I think the mix of payers is really important, relative to the incremental acquisition cost for each script, considering the competition from an oral drug obviously moving and seeking to penetrate the primary care market.

我之所以問這個問題是因為我認為付款人的組合真的很重要，相對於每個腳本的增量收購成本，考慮到來自口服藥物的競爭顯然正在轉移並尋求滲透初級保健市場。

The other question is really a kind of bigger picture question on business development.

另一個問題實際上是關於業務發展的一個更大的問題。

I think, Dave, you said in the past that the focus now that Lilly has launched several successful products in the market today is to really reload the Phase II and the Phase III pipeline.

我認為，戴夫，你過去說過，禮來公司今天在市場上推出了幾款成功的產品，重點是真正重新加載二期和三期管道。

Can you just give us a sense of where you are focused?

你能告訴我們你的重點在哪裡嗎？

Do you feel like the current Phase I pipeline is sufficient to advance there?

您覺得目前的第一階段管道是否足以推進那裡？

Or is the focus more so or equally on areas outside?

還是更關注或同樣關注外部領域？

And maybe you can just give us a sense of where you're most excited about the science going forward.

也許你可以讓我們了解你對未來的科學最感興趣的地方。

Thanks, Seamus.

謝謝，西莫。

We'll go to Enrique first for the question on Trulicity mix of payers and then Dave for your question on business development.

我們將首先向 Enrique 詢問有關付款人的 Trulicity 組合的問題，然後向 Dave 詢問有關業務發展的問題。

Seamus, Trulicity continues to grow across all payers, so whether it's commercial or Part D. Of course, as we've highlighted, we have disproportionate growth in the VA and the DOD and other types of payers that are -- that tend to be lower priced.

Seamus，Trulicity 繼續在所有付款人中增長，所以無論是商業還是 D 部分。當然，正如我們所強調的，我們在 VA 和國防部以及其他類型的付款人中出現了不成比例的增長——這往往是價格較低。

But as we look at the future, we do continue to expect growth for the product across all of the different payers.

但是，當我們展望未來時，我們確實繼續期待該產品在所有不同支付者中的增長。

When it comes to endo vis-à-vis primary care, we do see the class continue to grow across all segments.

當談到 endo 與初級保健的關係時，我們確實看到該類別在所有領域都在繼續增長。

And in particular, Trulicity has been growing quite a bit when it comes to reaching more primary care physicians.

特別是，在接觸更多初級保健醫生方面，Trulicity 一直在增長。

So a big part of the growth is just having more primary care physicians try new -- try GLP-1 and start using and adopting this important class.

所以增長的很大一部分只是讓更多的初級保健醫生嘗試新的——嘗試 GLP-1 並開始使用和採用這個重要的類。

And because of the simplicity of Trulicity, it is an ideal product for that.

由於 Trulicity 的簡單性，它是一個理想的產品。

Thanks, Enrique.

謝謝，恩里克。

Dave?

戴夫？

Yes.

是的。

Thanks for the question on capital allocation and BD.

感謝關於資本配置和BD的問題。

You have it right that we see a significant investment in our own labs and our own efforts is very important and we've had good success.

您說得對，我們看到對我們自己的實驗室進行了大量投資，我們自己的努力非常重要，我們取得了很好的成功。

Dan commented the Phase I starts this year as an example.

Dan 以今年開始的第一階段為例進行了評論。

But we aggressively want to complement that with outside opportunities, really in all phases of development and across all therapeutic areas.

但我們積極地希望通過外部機會來補充這一點，實際上是在所有發展階段和所有治療領域。

Now of course, our opportunities to add value and find value are not uniform across stages of development or therapeutic areas, and so that does skew our work and our effort there.

當然，現在我們增加價值和發現價值的機會在不同的發展階段或治療領域並不統一，因此這確實扭曲了我們在那裡的工作和努力。

But we are open-minded about all 5 of the TAs we operate in and all phases of development.

但我們對我們運營的所有 5 個 TA 和所有發展階段持開放態度。

Where we can add value and find value, those are the most exciting and attractive opportunities.

在我們可以增加價值和發現價值的地方，這些是最令人興奮和有吸引力的機會。

Of course, this year, we did our largest acquisition ever with Loxo Oncology on the one end.

當然，今年，我們一方面對 Loxo Oncology 進行了有史以來最大的收購。

On the other end, you saw a nice tuck-in to our pain portfolio with the Centrexion deal as another.

另一方面，您看到了與 Centrexion 交易的另一個很好的組合。

We don't come at this with any particular financial framework other than finding value.

除了尋找價值之外，我們不會用任何特定的財務框架來解決這個問題。

And of course, valuations in biotech have dropped a little bit lately, so that always helps the equation.

當然，生物技術的估值最近有所下降，所以這總是有助於平衡。

They've been pretty high over the last 18 months prior to that.

在此之前的過去 18 個月裡，它們的價格一直很高。

So we continue to look at all mechanisms, all TAs, and all phases.

因此，我們繼續關注所有機制、所有 TA 和所有階段。

And probably because of the number of opportunities, I've said this before, you'll see us active in oncology, that's where a lot of early-stage biotech is, and earlier because that's where more of the opportunities lie.

可能是因為機會的數量，我之前說過，你會看到我們活躍在腫瘤學領域，這是很多早期生物技術的所在，更早是因為那裡有更多的機會。

Next is the line of David Risinger with Morgan Stanley.

接下來是摩根士丹利的 David Risinger。

So I just wanted to go back to the targets.

所以我只想回到目標。

So with respect to the 31% operating margin target for 2020 that was reiterated today, The Street isn't quite there, I don't think.

因此，關於今天重申的 2020 年 31% 的營業利潤率目標，我認為華爾街還沒有完全實現。

I think it's just a tad bit below 31%.

我認為它只是略低於 31%。

What is your sense that The Street is overprojecting in terms of costs, i.e., where do you think the costs will be lower than what The Street is currently assuming?

您認為 The Street 在成本方面過度預測是什麼感覺，即您認為成本會低於 The Street 目前假設的成本在哪裡？

And then with respect to the revenue target that was provided in the second quarter slide, are you still comfortable with that $23.6 billion figure for 2020?

然後關於第二季度幻燈片中提供的收入目標，您是否仍然對 2020 年 236 億美元的數字感到滿意？

Thanks, Dave.

謝謝，戴夫。

We'll go to Josh for both of those questions.

對於這兩個問題，我們都會去找喬希。

Thanks, Dave.

謝謝，戴夫。

One, on the targets themselves and margins.

一，關於目標本身和利潤。

I think if you look at how we've progressed since we've established those margins, you've been seeing multiple-hundred-basis point improvements per year and this year, we were clear in saying that wasn't going to be the case because of the Cialis overhang that we faced this year.

我認為，如果您看看自我們建立這些利潤率以來我們的進展情況，您會看到每年都有數百個基點的改進，而今年，我們明確表示這不會是案件是因為我們今年面臨的 Cialis 懸垂。

So I think when we look out into 2020, and of course, everybody's got different models, I think it's a combination probably of where we see revenue and how we think we can manage costs, again as I mentioned earlier on a prior question, we feel good about the overall SG&A investment that we have.

所以我認為當我們展望 2020 年時，當然，每個人都有不同的模型，我認為這可能是我們看到收入的地方以及我們認為我們可以如何管理成本的組合，正如我之前在之前的問題中提到的那樣，我們對我們擁有的整體 SG&A 投資感覺良好。

So as we lose the overhang from Cialis and Lartruvo, the volume gains that we are seeing in the new product portfolio and the price that we're projecting, gets us, I think, in a much better growth position on the top line with modest growth on the operating expense line.

因此，當我們失去來自 Cialis 和 Lartruvo 的影響時，我們在新產品組合中看到的銷量增長和我們預計的價格，讓我們在頂線上以適度的增長處於更好的增長位置營業費用線上的增長。

So again, we're confident.

因此，我們再次充滿信心。

We've reiterated -- as you know, we've raised this number a little bit and we've reiterated every opportunity we have that we'll get there.

我們已經重申——如你所知，我們已經稍微提高了這個數字，並且我們重申了我們將達到目標的每一個機會。

I think it's probably just the function of both top line and modest -- more modest increases in operating expense.

我認為這可能只是頂線和適度的功能-運營費用的增加更為適度。

But again, that is very much in the context of the competitive dynamics we face and the large growth opportunities we have long-term.

但同樣，這在很大程度上是在我們面臨的競爭動態和我們長期擁有的巨大增長機會的背景下。

We are going to invest behind those.

我們將在這些背後進行投資。

In terms of the revenue piece, I think the answer again is the same is you look at how the portfolio's performing on an underlying basis this year, we're confident in the minimum number that we need to achieve in order to get to the 7% compound annual growth rate target that we've outlined.

就收入而言，我認為答案還是一樣的，就是你看看今年投資組合在基礎上的表現如何，我們對達到 7我們概述的 % 複合年增長率目標。

Is the line of Steve Scala with Cowen.

是史蒂夫斯卡拉與考恩的路線。

Dave, for investors who choose to be skeptical, this quarter has provided things to point to.

戴夫，對於選擇持懷疑態度的投資者來說，本季度提供了一些值得指出的東西。

So you explained Trulicity and Taltz, but Basaglar and Alimta also fell short.

所以你解釋了 Trulicity 和 Taltz，但 Basaglar 和 Alimta 也沒有達到目標。

The beat was tax rate driven as was the 2019 guidance raise.

節拍是稅率驅動的，2019 年的指導上調也是如此。

Enrique is departing at a not ideal time.

恩里克離開的時間並不理想。

So why should we be confident that the weaknesses are temporary, the tax rate lowering won't create a tough compare in 2020 since one-time factors occur once and that Enrique's departure doesn't portend difficulty ahead in diabetes?

那麼我們為什麼要相信這些弱點是暫時的，因為一次性因素發生一次，降低稅率不會在 2020 年造成艱難的比較，並且恩里克的離開並不預示著糖尿病的困難？

So that's the first question.

所以這是第一個問題。

And with the stock unusually weak this year and given your confidence in the outlook, why not take this opportunity to be more aggressive with share repurchase?

由於今年該股異常疲軟，而且您對前景充滿信心，為什麼不藉此機會更積極地進行股票回購呢？

Why isn't this a phenomenal opportunity?

為什麼這不是一個驚人的機會？

Thanks, Steve.

謝謝，史蒂夫。

We'll go to Dave for the first handful of questions and then Josh on the share repurchase.

我們先問戴夫幾個問題，然後問喬什關於股票回購的問題。

Yes.

是的。

Great, Steve, thanks for synthesizing the barricades so effectively there.

太好了，史蒂夫，感謝您在那裡如此有效地合成路障。

We, of course, have an answer to all of those things.

當然，我們對所有這些事情都有答案。

And I -- honestly, I don't think there's been a more interesting or exciting time to be in this company or a more optimistic time.

而且我 - 老實說，我認為在這家公司中沒有比這更有趣或更激動人心的時刻或更樂觀的時刻了。

And we went through many of those reasons today.

我們今天經歷了許多這些原因。

We have a broad portfolio of products that are new in their life cycle, with Cialis behind us, remembering that Cialis is a 6-point growth head wind over the last 4 quarters, that's ending now, coupled with the onetime price effects which we went through today, which we really believe are substantially onetime, either a step down on big mergers with our payers or the 1-year effect of the donut hole, which falls disproportionately on companies like Lilly who have retail-oriented products.

我們擁有廣泛的產品組合，這些產品在其生命週期中都是新的，Cialis 在我們身後，記住 Cialis 在過去 4 個季度中是一個 6 點的增長逆風，現在已經結束，再加上我們去的一次性價格影響到今天為止，我們真的認為這基本上是一次性的，要么是與我們的付款人進行大規模合併，要么是甜甜圈洞的 1 年效應，這不成比例地落在了像禮來這樣的面向零售產品的公司身上。

And then we look ahead in diabetes.

然後我們展望糖尿病。

I have to be honest.

我必須誠實。

I think the diabetes pipeline, the growth opportunities ahead, whether it be with Jardiance or Trulicity or tirzepatide have never been stronger for the company.

我認為糖尿病管道，未來的增長機會，無論是 Jardiance 還是 Trulicity 或 tirzepatide 對公司來說都從未如此強大。

So I'll let Enrique answer the question on his timing.

所以我會讓恩里克回答他的時間問題。

But I think he is leading on top and there's another level to get to in Lilly Diabetes.

但我認為他處於領先地位，在禮來糖尿病領域還有另一個層次要達到。

That's certainly how I feel.

這當然是我的感受。

I think the -- of course, every category we're in we've talked about, we compete with companies, some of them bigger than ours, some of them more focused because we have more opportunities than the average company out there.

我認為 - 當然，我們討論過的每個類別，我們都與公司競爭，其中一些比我們的更大，其中一些更專注，因為我們比普通公司擁有更多的機會。

And that doesn't mean that every quarter or every line item, we're going to nail our goals.

這並不意味著每個季度或每個項目，我們都會實現我們的目標。

I think we're honest with ourselves about that.

我認為我們對此很誠實。

But we have more than half a dozen products that could scale in a significant way.

但我們有超過六種產品可以顯著擴展。

And given our base of pharma revenue, I think that continues to offer a unique situation.

鑑於我們的製藥收入基礎，我認為這將繼續提供獨特的情況。

And then you couple that with margin expansion which we're convicted on, as per the prior question, and given our placement in the league table there, certainly, we have upside on that one as the top line scales.

然後你把它與我們被定罪的利潤率擴張結合起來，根據前面的問題，考慮到我們在聯賽表中的位置，當然，隨著收入的增加，我們在這方面有上升空間。

I can't think of a better place to work in this industry to be honest.

老實說，我想不出在這個行業工作的更好地方。

We've got a great opportunity ahead.

我們前面有一個很好的機會。

Now on share buyback, I'll let Josh address that.

現在關於股票回購，我會讓喬希解決這個問題。

But certainly, that has been our thinking.

但可以肯定的是，這一直是我們的想法。

We've done aggressive share buyback this year as we think about sources of cash, et cetera, that's clearly on our list.

今年我們進行了積極的股票回購，因為我們考慮了現金來源等，這顯然在我們的名單上。

And when we have that discussion with the Board, I'm sure that will be a key topic as we plan capital allocation over the coming years.

當我們與董事會進行討論時，我相信這將是我們計劃未來幾年的資本分配的一個關鍵話題。

And Enrique, you want to touch on your retirement?

還有恩里克，你想談談你的退休嗎？

I think it's probably worth a mention here.

我認為這裡可能值得一提。

Look, I'm sad to be leaving and retiring from Lilly, I'm very proud I think of the business that we've built in diabetes.

聽著，我很難過離開禮來公司並退休，想到我們在糖尿病領域建立的業務，我感到非常自豪。

As good as I feel about building that business together with all my colleagues, I feel even stronger about the bright future that diabetes has and Lilly has ahead.

儘管我對與所有同事一起建立這項業務感覺良好，但我對糖尿病和禮來公司所擁有的光明未來感到更加強烈。

Just as I think about Trulicity and Jardiance, great momentum, leadership-type brands, but with important catalysts when it comes to Trulicity and REWIND and the higher doses.

就像我想到 Trulicity 和 Jardiance 一樣，勢頭強勁，領導型品牌，但在涉及 Trulicity 和 REWIND 以及更高劑量時具有重要的催化劑。

And when it comes to Jardiance, of course, heart failure and CKD on top of the -- with a huge opportunity in type 2 diabetes.

當然，當談到 Jardiance 時，心力衰竭和 CKD 是最重要的——在 2 型糖尿病方面有巨大的機會。

And I continue to feel very bullish about what tirzepatide could do on both the efficacy and the tolerability profile.

我仍然非常看好 tirzepatide 在療效和耐受性方面的作用。

So very exciting time for us in diabetes overall, and I couldn't be more excited about the future of Lilly in diabetes.

對於我們在糖尿病領域的整體而言，這是非常激動人心的時刻，我對禮來公司在糖尿病領域的未來感到無比興奮。

Just a couple of points -- it's Josh, on share repurchase, Steve, just to remind everybody.

只是幾點 - 喬希，股票回購，史蒂夫，只是為了提醒大家。

We did a $3.5 billion share repurchase in the first half of this year.

今年上半年，我們進行了 35 億美元的股票回購。

We did $600 million in the third quarter.

我們在第三季度做了 6 億美元。

And as you say, when we see opportunities on the margins to create value, we're going to be opportunistic in share repurchase.

正如你所說，當我們看到創造價值的邊際機會時，我們將在股票回購中投機取巧。

Of course, we want to be balanced here, as we mentioned in the comments.

當然，正如我們在評論中提到的那樣，我們希望在這裡保持平衡。

We want to ensure we've got the capital capacity to invest in the pipeline and business development opportunities when we see them.

當我們看到它們時，我們希望確保我們擁有投資管道和業務發展機會的資本能力。

But yes, you should expect that when we see outside movements, we'll do what we can.

但是，是的，您應該期望，當我們看到外部動向時，我們會盡我們所能。

Thank you, Josh.

謝謝你，喬希。

Is the line of Andrew Baum with Citi.

是安德魯鮑姆與花旗的路線。

A couple of questions, please.

有幾個問題，請。

In relation to Taltz, you spoke about access for next year.

關於 Taltz，您談到了明年的訪問權限。

You didn't talk about pricing -- net pricing.

你沒有談論定價——淨定價。

Perhaps you could talk to that.

也許你可以談談。

Given it's predominantly a commercial market, I'm assuming that rebating we've seen which looks like 40% is only going to go one way, I note that you're 25% higher rebate than consensus and your net price on our calculations at least is down 16% year-on-year.

鑑於它主要是一個商業市場，我假設我們已經看到的 40% 的回扣只會有一個方向，我注意到您的回扣比共識高 25%，而我們計算的淨價格為至少同比下降 16%。

So color on where it goes in 2020 would be helpful.

因此，對 2020 年的發展方向進行著色會有所幫助。

And then second, again, on net pricing in relation to Trulicity.

其次，再次是關於與 Trulicity 相關的淨定價。

We estimate that about 25% of Trulicity is Part D base by volume.

我們估計大約 25% 的 Trulicity 是基於 D 部分的體積。

I'm obviously coming from a point of view of trying to work out the contribution of the additional donut hole impact versus other factors.

我顯然是從試圖計算額外的甜甜圈洞影響與其他因素的貢獻的角度來看的。

If you confirm how close we are to where it is, that would be very helpful.

如果您確認我們離它有多近，那將非常有幫助。

Thanks, Andrew.

謝謝，安德魯。

We'll go to Patrik for the question on -- or Josh.

我們將請Patrik 詢問關於- 或Josh 的問題。

Okay.

好的。

Thanks, Andrew.

謝謝，安德魯。

On Taltz, first, I think that the Taltz pricing dynamics are a little bit different than Trulicity.

首先，在 Taltz 上，我認為 Taltz 的定價動態與 Trulicity 有點不同。

As Patrik mentioned, I think, earlier as we've talked about in other calls, about 1/3 of our prescriptions now just given the access challenges we have are not reimbursed or Lilly ends up being the primary payer.

正如帕特里克所提到的，我認為，正如我們之前在其他電話中談到的那樣，我們現在大約 1/3 的處方只是考慮到我們所面臨的訪問挑戰沒有得到報銷，或者禮來公司最終成為主要付款人。

So as we get incremental access, you see interesting price moves here.

因此，當我們獲得增量訪問權限時，您會在這裡看到有趣的價格走勢。

So we are happy to gain access and pay rebates for that volume because we're transitioning patients in some cases from free product to reimbursed product.

因此，我們很高興獲得該數量的訪問權並支付回扣，因為在某些情況下，我們正在將患者從免費產品轉變為報銷產品。

That being said, there are other cases where the product may not be on formulary but as we work through PA process and other things, we end up ultimately getting 100% reimbursement.

話雖如此，在其他情況下，產品可能不在處方集中，但當我們完成 PA 流程和其他事情時，我們最終會獲得 100% 的報銷。

So I think if you look at that piece, you're going to see -- it will be a little bit more difficult in Taltz to translate prescriptions to net price.

所以我認為如果你看那篇文章，你會看到——在 Taltz 將處方轉化為淨價會有點困難。

All that being said, I think if you look in the third quarter, the biggest dynamic we saw for Taltz on price was similar to Trulicity in that we saw a prior period adjustment.

話雖如此，我認為如果你看一下第三季度，我們看到的 Taltz 在價格上的最大動態與 Trulicity 相似，因為我們看到了前期的調整。

And again, this is just estimating the rebate liability.

同樣，這只是估計回扣責任。

And as we looked over the preceeding 12 months as we get invoices in, we had to make an adjustment there that, in total, when we look at the sort of in quarter adjustments, it was about 20 points of price as well.

當我們在收到發票時查看前 12 個月時，我們必須在那裡進行調整，總的來說，當我們查看季度調整時，價格也大約是 20 個百分點。

So we don't see that going forward.

所以我們看不到這種情況。

I think as you look into 2020, as Patrik mentioned, we've got some opportunities to gain some incremental access and that will show up as some price concession, but it's more than compensated for in volume.

正如帕特里克所說，我認為當你展望 2020 年時，我們有一些機會獲得一些增量訪問權，這將表現為一些價格讓步，但它的數量遠遠超過了補償。

So we see a relatively sort of steady price, but lots of things moving on -- moving around under the water.

所以我們看到一個相對穩定的價格，但很多事情都在繼續——在水下移動。

I think on Trulicity, your estimates are good.

我認為關於 Trulicity，你的估計很好。

About 30% of Trulicity right now is in Medicare Part D. We see that probably as pretty stable going forward.

目前大約 30% 的 Trulicity 位於醫療保險 D 部分。我們認為這可能會相當穩定。

And as we mentioned, we are -- we see the pricing environment on a contracted basis as being pretty stable as we head into 2020 as well.

正如我們所提到的，我們認為在合同基礎上的定價環境在我們進入 2020 年時也相當穩定。

Thanks, Josh.

謝謝，喬希。

The line of Damien Conover with Morningstar.

Damien Conover 與 Morningstar 的系列。

I just wanted to follow up on the Taltz study that showed encouraging data head-to-head versus Tremfya at 12 weeks.

我只是想跟進 Taltz 的研究，該研究顯示了令人鼓舞的數據，與 Tremfya 在 12 週時進行了正面交鋒。

And it looks like there is a 24-week endpoint -- secondary endpoint coming up.

看起來有一個 24 週的終點——即將出現的次要終點。

And my question is, is there any data points coming up after 24 weeks, maybe pushing into 48 weeks?

我的問題是，在 24 週後是否有任何數據點出現，可能會推遲到 48 週？

And I ask that because of the ECLIPSE data that showed favorable data from Tremfya versus a different IL-17 but really didn't show the strong data until week 48.

我之所以這麼問，是因為 ECLIPSE 數據顯示 Tremfya 的數據優於其他 IL-17，但直到第 48 週才真正顯示出強勁的數據。

And I'm just wondering how you're looking at Taltz positioned against Tremfya in those sort of longer duration of treatment.

我只是想知道你是如何看待 Taltz 在這種較長時間的治療中對抗 Tremfya 的。

And then maybe a follow-up to that is, when you position the product for physicians, is the quick response or potentially a longer response more important from your marketing perspective?

然後可能是後續行動，當您為醫生定位產品時，從您的營銷角度來看，快速響應還是可能更長的響應更重要？

Okay.

好的。

Thanks.

謝謝。

Patrik?

帕特里克？

Thank you very much.

非常感謝。

We are extremely excited of this first superiority trial of an IL-17 over an IL-23.

我們對 IL-17 優於 IL-23 的首次優勢試驗感到非常興奮。

We just got the data published a couple of weeks ago, so we are now in the same sort of disseminating this data among health care providers in the U.S. and the rest of the world.

幾週前我們剛剛獲得了數據，因此我們現在正以同樣的方式在美國和世界其他地區的醫療保健提供者中傳播這些數據。

The first cut was in 12 weeks, as you said, and we shared a -- or showed a superiority, both in terms of onset of action and clearance.

正如你所說，第一次削減是在 12 週內，我們分享了 - 或顯示了優勢，無論是在行動開始還是清除方面。

The next data cut and the last data cut will be at the week 24.

下一次數據削減和最後一次數據削減將在第 24 週。

And that is driven by the fact that we have seen also that the IL-23 they peak in terms of efficacy pretty much at that time.

這是因為我們也看到了 IL-23 它們在當時的功效達到頂峰。

If we look into the key attributes, particularly among patients treated for psoriasis, its onset of action is clearance and its durability.

如果我們研究關鍵屬性，特別是在接受銀屑病治療的患者中，它的作用是清除和持久性。

And I think this was the third Phase III trial that we actually could confirm that Taltz is superior, both as (inaudible) and now Tremfya in terms of both onset of action and clearance.

我認為這是第三個 III 期試驗，我們實際上可以確認 Taltz 是優越的，無論是（聽不清）還是現在的 Tremfya 在行動和清除方面。

And we have 5 years data confirming the durability of the efficacy as well.

我們也有 5 年的數據證實了功效的持久性。

We really believe that there is a lot of good momentum for Taltz right now.

我們真的相信 Taltz 現在有很多良好的勢頭。

And I would just add, the -- you mentioned another IL-17, but we don't see these 2 IL-17s as similar.

我想補充一下，你提到了另一個 IL-17，但我們認為這兩個 IL-17 並不相似。

And it's interesting to note that all our competitors who are doing IL-17 comparisons are choosing Cosentyx and not Taltz.

有趣的是，我們所有進行 IL-17 比較的競爭對手都選擇 Cosentyx 而不是 Taltz。

In fact I'm certain today, no one has actually compared any other psoriasis medicine to Taltz.

事實上，我今天可以肯定，實際上沒有人將任何其他牛皮癬藥物與 Taltz 進行比較。

And I think that tells you a lot about the powerful efficacy that we deliver with this leading medicine.

我認為這告訴你很多關於我們用這種領先藥物提供的強大功效。

Thanks, Dave.

謝謝，戴夫。

Damien, thanks for the questions.

達米安，謝謝你的提問。

And we'll go to Dave for the close.

我們會去戴夫為結束。

Great.

偉大的。

Well, we appreciate everyone's participation today and your interest in the company.

好吧，我們感謝大家今天的參與以及您對公司的興趣。

As I said earlier, we've made meaningful progress thus far in 2019, and we're committed to our revenue and operating margin goals in '19 as well as in '20, while we continue to invest in our innovation-based strategy.

正如我之前所說，到目前為止，我們在 2019 年取得了有意義的進展，我們致力於實現 19 年和 20 年的收入和營業利潤率目標，同時繼續投資於基於創新的戰略。

With the diversified and volume-driven revenue growth from one of the freshest portfolios in the industry and a complement -- complemented by a pipeline full of exciting opportunities, some of which Dan commented on today, we believe Lilly continues to be a compelling investment.

憑藉業內最新鮮的投資組合之一帶來的多元化和數量驅動的收入增長以及補充——再加上充滿令人興奮的機會的管道，丹今天評論了其中一些機會，我們相信禮來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。

And please follow-up with the IR team if you have questions we didn't address in today's call.

如果您有我們在今天的電話會議中沒有解決的問題，請與 IR 團隊聯繫。

Have a good day.

祝你有美好的一天。

Ladies and gentlemen, this conference is available for a digitized replay after 11:15 a.m.

女士們先生們，本次會議可在上午 11:15 後進行數字化回放。

Eastern Time today through October 23 of 2020 at midnight.

東部時間今天到 2020 年 10 月 23 日午夜。

You may access the replay service at any time by calling 1 (800) 475-6701 and enter the access code of 472869.

您可以隨時撥打1（800）475-6701訪問重播服務，輸入訪問碼472869。

International participants may dial (320) 365-3844 and use the same access code, 472869.

國際參與者可以撥打 (320) 365-3844 並使用相同的訪問代碼 472869。

That does conclude your conference for today.

今天的會議到此結束。

Thank you for your participation.

感謝您的參與。

You may now disconnect.

您現在可以斷開連接。