輝瑞 (PFE) 2023 Q4 法說會逐字稿

Good day, everyone, and welcome to Pfizer's Fourth Quarter 2023 Earnings Conference Call. Today's call is being recorded. At this time, I would like to turn the call over to Francesca DeMartino, Chief Investor Relations Officer and Senior Vice President. Please go ahead, ma'am.

大家好，歡迎參加輝瑞 2023 年第四季財報電話會議。今天的通話正在錄音。現在，我想將電話轉給首席投資者關係長兼高級副總裁 Francesca DeMartino。請繼續，女士。

Good morning, and welcome to Pfizer's earnings call. I'm Francesca DeMartino, Chief Investor Relations Officer. On behalf of the Pfizer team, thank you for joining us. This call is being made available via audio webcast at pfizer.com. Earlier this morning, we released our results for the fourth quarter and full year 2023 via a press release that is available on our website at pfizer.com.

早安，歡迎參加輝瑞的財報電話會議。我是首席投資者關係官 Francesca DeMartino。我謹代表輝瑞團隊感謝您加入我們。此次電話會議透過 pfizer.com 上的音訊網路廣播進行。今天早些時候，我們透過新聞稿發布了 2023 年第四季和全年的業績，該新聞稿可在我們的網站 pfizer.com 上取得。

I'm joined today by Dr. Albert Bourla, our Chairman and CEO; and Dave Denton, our CFO. Albert and Dave have some prepared remarks, and we will then open the floor for questions. Joining for the Q&A session, we also have Dr. Chris Boshoff, EVP and Chief Oncology Officer; Alexandre de Germay, EVP and Chief International Commercial Officer; Dr. Mikael Dolsten, Chief Scientific Officer and President of R&D; Doug Lankler, EVP and General Counsel; and Aamir Malik, EVP and Chief U.S. Commercial Officer.

今天我們的董事長兼執行長 Albert Bourla 博士也加入了我的行列。以及我們的財務長戴夫丹頓 (Dave Denton)。艾伯特和戴夫做了一些準備好的發言，然後我們將開始提問。參加問答環節的還有執行副總裁兼首席腫瘤學官 Chris Boshoff 博士； Alexandre de Germay，執行副總裁兼首席國際商務長； Mikael Dolsten 博士，首席科學長兼研發總裁； Doug Lankler，執行副總裁兼總法律顧問；以及執行副總裁兼美國首席商務官 Aamir Malik。

Before we get started, I want to remind you that we will be making forward-looking statements and discussing certain non-GAAP financial measures. I encourage you to read the disclaimers in our slide presentation, the press release we issued this morning and the disclosures in our SEC filings, which are all available on the IR website on pfizer.com. Forward-looking statements on the call are subject to substantial risks and uncertainties, speak only as of the call's original date, and we undertake no obligation to update or revise any of these statements.

在開始之前，我想提醒您，我們將做出前瞻性陳述並討論某些非公認會計準則財務指標。我鼓勵您閱讀我們幻燈片演示中的免責聲明、我們今天早上發布的新聞稿以及我們 SEC 文件中的披露內容，這些都可以在 pfizer.com 的 IR 網站上找到。電話會議中的前瞻性陳述存在重大風險和不確定性，僅在電話會議原始日期發表，我們不承擔更新或修改任何這些陳述的義務。

With that, I will turn the call over to Albert.

這樣，我會將電話轉給艾伯特。

Thank you, Francesca. Good morning, everyone, and thank you for joining us. I'm pleased to discuss some of the highlights from the fourth quarter and full year 2023 and, of course, the compelling year we have had. I would like to begin with a few reflections for -- on 2023. As you know, we missed our initial internal projections and Street expectations predominantly related to our COVID products, which affected our stock price performance. Despite, however, this challenging year, there were a few great things that happened in 2023 that may have gotten lost amidst the missed expectations.

謝謝你，弗朗西斯卡。大家早安，感謝您加入我們。我很高興討論第四季度和 2023 年全年的一些亮點，當然還有我們度過的引人注目的一年。首先，我想對 2023 年進行一些思考。如你所知，我們錯過了最初的內部預測和華爾街預期，主要與我們的新冠產品相關，這影響了我們的股價表現。然而，儘管這是充滿挑戰的一年，但 2023 年發生的一些偉大的事情可能會在未達到預期的情況下被遺忘。

First, in 2023, Pfizer impacted the lives of more than 620 million (sic) [618 million] people approximately around the world. We believe there is no other company that can reach as many people and patients as Pfizer. If you multiply this with our brand equity and awareness, it creates a connection with consumers that can be a very strong asset for us.

首先，2023 年，輝瑞影響了全球約 6.2 億（原文如此）[6.18 億]人的生活。我們相信沒有任何一家公司能夠像輝瑞一樣覆蓋如此多的人和病人。如果將其與我們的品牌資產和知名度相乘，它將與消費者建立聯繫，這對我們來說是一筆非常強大的資產。

Second, despite the decline in revenue from our COVID products, as of the reported results of the first 9 months of 2023, we were the #1 pharmaceutical company in terms of revenues from pharma-only products, a marked improvement from our fourth position in 2019.

其次，儘管我們的新冠病毒產品收入下降，但截至 2023 年前 9 個月的報告結果，就純製藥產品收入而言，我們是排名第一的製藥公司，比我們的第四名顯著提高。 2019.

Next, 2023 was a record year for FDA approvals with 9 new molecular entity approvals from Pfizer and many more approvals for new indications in already approved products, marking a very productive year of pipeline execution for Pfizer.

接下來，2023 年是FDA 批准創紀錄的一年，輝瑞批准了9 個新分子實體，並批准了更多已批准產品的新適應症，這標誌著輝瑞在管道執行方面非常富有成效的一年。

Finally, we closed the Seagen acquisition. In the current regulatory environment, being able to close such a large acquisition demonstrates our ability to successfully engage with regulatory bodies.

最後，我們完成了對 Seagen 的收購。在當前的監管環境下，能夠完成如此大規模的收購表明我們有能力成功與監管機構打交道。

Our deliberate and strategic efforts throughout 2023 created a strong foundation to support us. We are now focused on maximizing the opportunities that have positioned us for success, and our team is driving confidently as we start 2024.

我們在 2023 年進行的深思熟慮的策略努力為我們的支持奠定了堅實的基礎。我們現在專注於最大限度地利用使我們成功的機會，我們的團隊在 2024 年開始充滿信心。

From the advent of penicillin to the development of the COVID-19 vaccine, Pfizer has been at the forefront of medical and pharmaceutical breakthroughs for the past 175 years. This year is our 175th anniversary, that have not only changed patients' lives but have changed history.

從青黴素的出現到 COVID-19 疫苗的開發，過去 175 年來，輝瑞一直處於醫療和製藥突破的前沿。今年是我們成立 175 週年，我們的努力不僅改變了患者的生活，也改變了歷史。

Our strategy to continue to build on our proud history of innovation and commercial excellence is supported by the power and strength of our unmatched global scale and footprint spanning commercial, financial, medical, regulatory, manufacturing and government relations. We have a clear view on how we will deliver operational, commercial and financial success across our business.

我們在商業、金融、醫療、監管、製造和政府關係方面無與倫比的全球規模和足跡的力量和實力為我們的策略提供了支持，繼續發展我們引以為傲的創新和卓越商業歷史。我們對如何在整個業務中實現營運、商業和財務成功有著清晰的看法。

Our confidence stems from the opportunity we have to bring additional focus to our business by executing 5 strategic priorities. We will get into each in more detail, but the 5 key priorities for Pfizer this year are: first of all, to achieve a world-class oncology leadership; to deliver the next wave of pipeline innovation; to maximize the performance of our new products; expand margins by realigning our cost base; allocate capital to enhance shareholder value. I'm confident that Pfizer is well positioned to execute and that we can deliver meaningful value for our patients and our shareholders.

我們的信心源自於我們有機會透過執行 5 項策略重點來更專注於我們的業務。我們將更詳細地討論每一項，但輝瑞今年的 5 個關鍵優先事項是：首先，實現世界一流的腫瘤學領導地位；提供下一波管線創新；最大限度地發揮我們新產品的性能；透過重新調整我們的成本基礎來擴大利潤；分配資本以提升股東價值。我相信輝瑞在執行方面處於有利地位，並且我們能夠為我們的患者和股東提供有意義的價值。

Let's start with our first priority, which is to achieve a world-class oncology leadership, which I believe we are in a strong position to do. As a reminder, 1 in 3 people will be diagnosed with cancer in their lifetime. Oncology represents one of the largest and fastest-growing therapeutic areas. Completing the acquisition of Seagen doubled our oncology research and resources overnight and meaningfully expanded the reach and medical impact of our U.S. commercial and medical footprint, with a range of portfolio expansion opportunities boosted by Seagen's broad and deep pipeline.

讓我們從我們的首要任務開始，即實現世界一流的腫瘤學領導地位，我相信我們有能力做到這一點。提醒一下，三分之一的人一生中會被診斷出罹患癌症。腫瘤學是最大且成長最快的治療領域之一。完成對Seagen 的收購後，我們的腫瘤學研究和資源一夜之間增加了一倍，並有意義地擴大了我們在美國商業和醫療足跡的覆蓋範圍和醫療影響，Seagen 廣泛而深入的產品線帶來了一系列投資組合擴張機會。

Seagen's in-line medicines are expected to immediately enhance Pfizer's top line growth, and our combined portfolio provides the opportunity to lead genitourinary cancers and be a leader in breast cancer and deliver at least 8 potential blockbuster products by 2030. We look forward to providing more information about our oncology platform at our Pfizer Oncology Innovation Day on February 29.

Seagen 的線上藥物預計將立即促進輝瑞的營收成長，我們的組合產品組合提供了引領泌尿生殖系統癌症並成為乳癌領域領導者的機會，並在2030 年之前提供至少8 種潛在的重磅產品。我們期待提供更多在 2 月 29 日的輝瑞腫瘤創新日上了解有關我們腫瘤平台的資訊。

As we build our leadership position, we have multiple potential key oncology catalysts in 2024 that we are acutely focused on. On the commercial side, the PADCEV launch in locally advanced/metastatic bladder cancer in combination with pembrolizumab and XTANDI launch in nonmetastatic castration-sensitive prostate cancer. We are excited by the strength of our PADCEV EV-302 data and recent FDA approval, as it represents an opportunity to broaden the reach of this potentially practice-changing, platinum-free regimen to even more patients in the frontline metastatic urothelial cancer setting.

在我們建立領導地位的過程中，我們將密切關注 2024 年多種潛在的關鍵腫瘤學催化劑。在商業方面，PADCEV 與 pembrolizumab 合併治療局部晚期/轉移性膀胱癌，XTANDI 合併治療非轉移性去勢敏感前列腺癌。我們對PADCEV EV-302 數據的強度和最近FDA 的批准感到興奮，因為它代表了一個機會，可以將這種可能改變實踐的無鉑療法的覆蓋範圍擴大到更多一線轉移性尿路上皮癌患者。

Essentially, the recent approval doubles the addressable population, which had already doubled this past spring. We are also looking forward to Phase III data readouts from vepdegestrant in second-line HR-positive metastatic breast cancer; and Braftovi in first-line BRAF colorectal cancer. We also plan to advance our late-stage pipeline with Phase III starts of CDK4 in post-CDK4/6 metastatic breast cancer and B6A in non-small cell lung cancer. Building on Pfizer's potential medicines, the pipeline across breast cancer, genitourinary cancer, hematology and CRC, our CDK4 inhibitor could be a compelling follow-on to IBRANCE.

從本質上講，最近的批准使可尋址人口增加了一倍，而去年春天這一數字已經增加了一倍。我們也期待 vepdegestrant 在二線 HR 陽性轉移性乳癌的 III 期數據讀出；和 Braftovi 治療一線 BRAF 大腸直腸癌。我們還計劃推進我們的後期產品線，開始 CDK4/6 後轉移性乳癌的 CDK4 和非小細胞肺癌的 B6A 的 III 期臨床。基於輝瑞的潛在藥物、乳癌、泌尿生殖癌、血液學和大腸癌的產品線，我們的 CDK4 抑制劑可能成為 IBRANCE 的引人注目的後續產品。

And finally, in the early-stage pipeline, we look forward to initiating first inpatient studies of 4 new ADC candidates this year, where we believe we have acquired the expertise to be a leader.

最後，在早期階段，我們期待今年啟動 4 種新 ADC 候選藥物的首次住院研究，我們相信我們已經獲得了成為領導者的專業知識。

Our second priority is to deliver the next wave of pipeline innovation with discovery and development across our therapeutic areas outside of Oncology in Vaccines, Anti-Infectives, Internal Medicine Metabolic Diseases and Inflammation and Immunology.

我們的第二個優先事項是透過腫瘤學之外的疫苗、抗感染藥物、內科代謝疾病以及發炎和免疫學等治療領域的發現和開發來實現下一波管道創新。

In 2024, we plan to continue to make meaningful investments in R&D. In fact, Pfizer's R&D budget is one of the highest in the industry and supports our robust pipeline. We are pursuing cutting-edge science across modalities and platforms to deliver the next generation of potential breakthroughs. We are also leveraging AI and other digital tools across the value chain to increase speed and success rates.

2024年，我們計劃繼續在研發方面進行有意義的投資。事實上，輝瑞的研發預算是業內最高的之一，並支援我們強大的產品線。我們正在跨模式和平台追求尖端科學，以實現下一代潛在突破。我們還在整個價值鏈中利用人工智慧和其他數位工具來提高速度和成功率。

Starting first with our fourth-generation PCV vaccine candidate, which recently entered the clinic and received FDA Fast Track designation. Building on our deep heritage with Prevnar, we aim to solidify our leadership in the pneumococcal vaccine space by increasing valency and serotype immunogenicity while maintaining our unique FDA label, which includes both IPD and pneumococcal pneumonia in adults.

首先從我們的第四代 PCV 候選疫苗開始，該候選疫苗最近進入臨床並獲得 FDA 快速通道指定。基於我們與Prevnar 的深厚傳統，我們的目標是透過提高效價和血清型免疫原性，同時保持我們獨特的FDA 標籤（包括成人IPD 和肺炎球菌肺炎），鞏固我們在肺炎球菌疫苗領域的領導地位。

Respiratory vaccine combinations are another area where we are poised to lead, building upon our successful COVID vaccine. With the first-generation stand-alone mRNA flu vaccine, data demonstrated relative efficacy versus a recommended flu vaccine in 18 to 64-year-olds, but did not meet success criteria for immunogenicity for the B strains.

呼吸道疫苗組合是我們準備領先的另一個領域，以我們成功的新冠疫苗為基礎。數據顯示，第一代獨立 mRNA 流感疫苗在 18 至 64 歲族群中與建議的流感疫苗相比具有相對功效，但不符合 B 株免疫原性的成功標準。

Our second-generation flu vaccine was tested in a Phase II COVID/flu combination study for 18 to 64-years-old and has shown encouraging results in both the A and the B strains. This new construct has now moved already into a Phase III COVID/flu combination trial.

我們的第二代流感疫苗在針對 18 至 64 歲人群的 II 期新冠肺炎/流感聯合研究中進行了測試，在 A 型和 B 型病毒株中均顯示出令人鼓舞的結果。這種新結構現已進入第三階段的新冠肺炎/流感聯合試驗。

Moving next to GBT601. Our next-generation and potentially best-in-class HbS polymerization inhibitor represents a potential step-wise evolution over Oxbryta for sickle cell disease. Recent data presented at ASH 2023 demonstrated multiple blood parameters approaching normal ranges with treatment, suggesting GBT601 may have the potential to deliver strong efficacy with the convenience of a once-daily pill. We have reaffirmed our commitment to our emerging cardiometabolic programs, with several early clinical development compounds.

接下來是GBT601。我們的下一代且可能是同類最佳的 HbS 聚合抑制劑代表了在治療鐮狀細胞疾病方面相對於 Oxbryta 的潛在逐步進化。 ASH 2023 上公佈的最新數據表明，治療後多個血液參數接近正常範圍，這表明 GBT601 可能具有透過每日一次藥丸的便利性提供強大療效的潛力。我們透過幾種早期臨床開發化合物重申了對新興心臟代謝計畫的承諾。

On the other end of the weight management spectrum, we have ponsegromab, our GDF-15 neutralizing antibody for cancer cachexia with Phase II data expected later this year. Ponsegromab has the potential to be first-in-class and the first FDA-approved treatment for cancer cachexia, which accounts for 20%, 30% of all cancer deaths, a significant statistic.

在體重管理領域的另一端，我們有 ponsegromab，這是我們用於治療癌症惡病質的 GDF-15 中和抗體，預計今年稍後將獲得 II 期數據。 Ponsegromab 有潛力成為同類首創，也是 FDA 批准的第一個治療癌症惡病質的藥物，癌症惡病質佔所有癌症死亡的 20%、30%，這是一個重要的統計數據。

Our third priority is, of course, to maximize the performance of our new products and core franchises through a relentless focus on execution to continue growing our top line. To do this, we are prioritizing and focusing while leveraging data to make changes quickly and adapt. Our Pfizer U.S. Commercial and our Pfizer International Commercial organizations will leverage a more focused, efficient structure to drive executional excellence in their respective markets and expand reach to drive growth over the next several years.

當然，我們的第三個優先事項是透過不懈地註重執行來最大限度地提高新產品和核心特許經營權的性能，以繼續提高我們的收入。為此，我們在利用數據快速做出改變和適應的同時，確定優先順序和重點。我們的輝瑞美國商業部和輝瑞國際商業部將利用更專注、高效的結構來推動各自市場的卓越執行力，並擴大影響力，推動未來幾年的成長。

To discuss a few examples, we continue to be very enthusiastic about the potential of Nurtec to help the more than 1 billion people living with migraines worldwide. As access and prescriptions in the U.S. and globally continue to increase, we will continue to focus on direct-to-consumer marketing and reducing barriers to access and affordability for health care practitioners and patients.

舉幾個例子，我們仍然對 Nurtec 幫助全球超過 10 億偏頭痛患者的潛力充滿熱情。隨著美國和全球的獲取和處方不斷增加，我們將繼續專注於直接面向消費者的行銷，並減少醫療保健從業者和患者獲取和負擔得起的障礙。

With Oxbryta, we will continue to educate health care practitioners and patients on the importance of proactively treating the underlying cause of sickle cell disease by reframing treatment goals to chronic/proactive treatment.

透過 Oxbryta，我們將繼續教育醫療保健從業者和患者，透過將治療目標重新調整為慢性/主動治療，主動治療鐮狀細胞疾病的根本原因的重要性。

With Abrysvo, we are focused on increasing overall RSV market growth and market share by establishing RSV vaccination as a year-round discussion and expanding our retail contracting and offerings.

透過 Abrysvo，我們致力於透過將 RSV 疫苗接種作為全年討論並擴大我們的零售合約和產品來提高 RSV 市場的整體成長和市場份額。

With ELREXFIO, we are focused on educating health care practitioners in both academic institutions and in the community, awareness building and new patient trialists.

透過 ELREXFIO，我們專注於教育學術機構和社區的醫療保健從業人員、意識建立和新患者試用者。

Coming off the initial launch of VELSIPITY, we are focused on helping ensure patient access to VELSIPITY as a first-line advanced therapy oral option.

首次推出 VELSIPITY 後，我們致力於協助確保患者獲得 VELSIPITY 作為第一線先進治療口服選擇。

With LITFULO, we continue to accelerate the consideration of advanced systemic treatments for appropriate alopecia areata patients and further unlock access to LITFULO.

透過 LITFULO，我們繼續加速考慮針對合適的斑禿患者進行先進的系統治療，並進一步解鎖 LITFULO 的可及性。

In addition, of course, we continue to protect and grow our core franchises and key blockbusters, including Prevnar, VYNDAQEL and Eliquis, while exploring further opportunities to advance a number of innovative combination regimens. We believe we are well positioned to bring our global commercial manufacturing and supply capabilities to accelerate current and future marketed products.

當然，此外，我們還將繼續保護和發展我們的核心特許經營權和關鍵重磅藥物，包括 Prevnar、VYNDAQEL 和 Eliquis，同時探索進一步的機會來推進一些創新的組合療法。我們相信，我們有能力利用我們的全球商業製造和供應能力來加速當前和未來的產品上市。

We believe all these components support our growth potential through 2024 and drive growth potential into 2025. We plan to provide updates throughout the year on how we are advancing these strategic priorities.

我們相信所有這些組成部分都將支持我們到 2024 年的成長潛力，並推動到 2025 年的成長潛力。我們計劃全年提供有關如何推進這些策略重點的最新資訊。

And with that, I will turn the call over to Dave, who will discuss our financial performance, our initiative to realign our cost base and our capital allocation strategy to enhance shareholder value. Dave?

接下來，我將把電話轉給戴夫，他將討論我們的財務表現、調整成本基礎的舉措以及提高股東價值的資本配置策略。戴夫？

Thank you, Albert, and good morning, everyone. As we enter 2024, we are clearly focused on a small number of critical priorities. These priorities include building a world-class Oncology organization; ensuring the next wave of pipeline innovations; maximizing our new product portfolio performance with a more efficient commercial structure; and finally, rightsizing our cost base.

謝謝你，阿爾伯特，大家早安。進入 2024 年，我們顯然將重點放在少數關鍵優先事項上。這些優先事項包括建立世界級的腫瘤學組織；確保下一波管道創新；透過更有效率的商業結構最大限度地提高我們的新產品組合績效；最後，調整我們的成本基礎。

With that said, I'll start this morning with our full year and our fourth quarter results, then I'll touch upon our capital allocation priorities. I'll finish this morning with a few comments on our 2024 guidance and the near-term expectations that set this year as a foundational year to drive our growth potential in the latter half of the decade.

話雖如此，我今天早上將首先介紹我們的全年和第四季度業績，然後我將談到我們的資本配置優先事項。今天早上，我將對我們的 2024 年指導方針和近期預期發表一些評論，這些預期將今年作為基礎年，以推動我們在本十年後半段的成長潛力。

For the full year 2023, we recorded revenues of $58.5 billion, achieving 7% operational growth, solidly in line with our expectations when excluding contributions from both COMIRNATY and PAXLOVID. The significant sales decline in our COVID products, including a $3.5 billion revenue reversal for PAXLOVID, were the primary driver of an overall 41% operational decrease year-over-year. And with the expectation that Seagen will be a substantial growth contributor in 2024 and beyond, our full year and fourth quarter results include approximately $120 million in Seagen product revenue after the close of the acquisition on December 14.

2023 年全年，我們的收入為 585 億美元，實現了 7% 的營運成長，完全符合我們在排除 COMIRNATY 和 PAXLOVID 貢獻後的預期。我們的 COVID 產品銷售額大幅下降，包括 PAXLOVID 收入逆轉 35 億美元，是整體營運年減 41% 的主要原因。預計 Seagen 將在 2024 年及以後為成長做出重大貢獻，我們的全年和第四季業績包括 12 月 14 日收購結束後 Seagen 產品營收約 1.2 億美元。

On the bottom line, we reported full year 2023 diluted EPS of $0.37 a share, a 93% year-over-year decline and adjusted diluted earnings per share of $1.84, down 72% versus LY. This decline is primarily due to a significant decrease in sales for both COMIRNATY and PAXLOVID; the impact of the $3.5 billion reversal for PAXLOVID revenues in the fourth quarter related to an expected return of an estimated 6.5 million unused EUA-labeled treatment courses from the U.S. government; and finally, a noncash inventory write-off and other charges of $5.6 billion recorded in the third quarter for PAXLOVID and, to a lesser extent, COMIRNATY.

就利潤而言，我們報告 2023 年全年攤薄後每股收益為 0.37 美元，年減 93%，調整後攤薄每股收益為 1.84 美元，較 LY 下降 72%。這一下降主要是由於 COMIRNATY 和 PAXLOVID 的銷售大幅下降所致；第四季 PAXLOVID 收入逆轉 35 億美元的影響與美國政府估計 650 萬個未使用的 EUA 標籤治療課程的預期回報有關；最後，PAXLOVID 以及 COMIRNATY 第三季記錄的非現金庫存沖銷和其他費用為 56 億美元。

Now turning to the quarter, I'd like to highlight that we delivered a solid 8% year-over-year operational revenue growth, again, excluding COMIRNATY and PAXLOVID. Contributing to the strong performance were our newly approved RSV vaccine as well as VYNDAQEL and Eliquis, partly offset by lower revenues from IBRANCE and the Prevnar family. However, our Q4 results, both top and bottom line, continued to be significantly and negatively impacted by our COVID products on a year-on-year basis. Revenues declined 42% operationally, the result of a significant decrease in both COMIRNATY and PAXLOVID sales.

現在轉向本季度，我想強調的是，我們的營運收入比去年再實現了 8% 的穩定成長，不包括 COMIRNATY 和 PAXLOVID。我們新批准的 RSV 疫苗以及 VYNDAQEL 和 Eliquis 為強勁業績做出了貢獻，但部分被 IBRANCE 和 Prevnar 系列收入下降所抵消。然而，與去年同期相比，我們第四季的業績（無論是頂線還是底線）繼續受到新冠產品的重大負面影響。由於 COMIRNATY 和 PAXLOVID 銷售額大幅下降，營運收入下降了 42%。

Adjusted cost of sales as a percentage of revenues increased by 12 percentage points, driven primarily by the $3.5 billion noncash PAXLOVID revenue reversal and, to a much lesser extent, unfavorable changes in sales mix. Overall, our adjusted operating expenses declined 10% compared to Q4 of last year.

調整後的銷售成本佔收入的百分比增加了 12 個百分點，這主要是由於 35 億美元的非現金 PAXLOVID 收入逆轉以及銷售組合的不利變化（在較小程度上）推動的。總體而言，我們調整後的營運費用比去年第四季下降了 10%。

Adjusted SI&A expenses increased 1% operationally in the quarter, primarily driven by the timing of marketing and promotional activities, including those related to recently launched and acquired products. And consistent with our strategy, we have been focused on reprioritizing our R&D spending to enhance overall returns. Adjusted R&D expenses decreased 24% operationally, driven primarily by lower spending across both vaccine programs and certain acquired assets as well as lower compensation-related expenses.

本季調整後的 SI&A 費用在營運上成長了 1%，這主要是由於行銷和促銷活動（包括與最近推出和收購的產品相關的活動）的時機推動的。根據我們的策略，我們一直致力於重新調整研發支出的優先順序，以提高整體回報。調整後的營運研發費用下降了 24%，這主要是由於疫苗項目和某些收購資產的支出減少以及薪酬相關費用的減少。

Both our reported diluted loss per share of $0.60 and our adjusted diluted earnings per share of $0.10 for the quarter were negatively impacted by the $3.5 billion PAXLOVID revenue reversal, which dampened EPS by approximately $0.54. Continued declines in both COMIRNATY and PAXLOVID sales also negatively affected our performance in the quarter. Foreign exchange movements had an immaterial impact compared to last year's fourth quarter.

我們報告的本季稀釋每股虧損為 0.60 美元，調整後稀釋每股收益為 0.10 美元，均受到 35 億美元 PAXLOVID 收入逆轉的負面影響，每股收益減少約 0.54 美元。 COMIRNATY 和 PAXLOVID 銷售額的持續下降也對我們本季的業績產生了負面影響。與去年第四季相比，外匯波動的影響並不重大。

As we are increasingly focused on prioritizing our investments to drive forward-looking growth, our GAAP results include a $1.4 billion intangible asset impairment charge associated with etrasimod, based on changes in the development plans for additional indications and overall revenue expectations. But I will point out that this product is still projected to contribute over $1 billion in peak annual sales. Additionally, we recorded a nearly $1 billion intangible asset impairment for Prevnar 13, reflecting a transition to vaccines with higher serotypes coverage.

隨著我們越來越注重優先投資以推動前瞻性成長，我們的 GAAP 結果包括與 etrasimod 相關的 14 億美元無形資產減損費用，該費用基於其他適應症的開發計劃的變化和整體收入預期。但我要指出的是，預計該產品的年銷售額高峰仍將超過 10 億美元。此外，我們為 Prevnar 13 記錄了近 10 億美元的無形資產減值，反映出向更高血清型覆蓋率的疫苗的過渡。

As discussed in prior quarters, our capital allocation strategy is designed to enhance shareholder value and is based on 3 core pillars: first is growing our dividend; second is reinvesting in the business; and finally is making share repurchases after delevering our balance sheet.

正如前幾季所討論的，我們的資本配置策略旨在提高股東價值，並基於三個核心支柱：首先是增加股利；其次是對業務的再投資；最後是在資產負債表去槓桿化後進行股票回購。

For 2023, we returned $9.2 billion to shareholders via our quarterly dividend; we've invested $10.7 billion in internal R&D; and finally, we've invested approximately $44 billion in completed business development transactions, net of acquired cash, essentially for the acquisition of Seagen.

2023 年，我們透過季度股利向股東返還 92 億美元；我們在內部研發方面投資了 107 億美元；最後，我們在已完成的業務開發交易中投資了約 440 億美元（扣除所獲得的現金），主要用於收購 Seagen。

Our expectation is to maintain and grow our dividend while delevering our capital structure, with a gross leverage target of 3.25x and a goal to preserve our credit rating and access to Tier 1 commercial paper. Upon achieving our delevering goals, we anticipate returning to a more balanced capital allocation strategy, inclusive of share repurchases.

我們的期望是維持和增加股息，同時去槓桿化我們的資本結構，總槓桿目標為 3.25 倍，目標是保持我們的信用評級和獲得一級商業票據的機會。在實現去槓桿化目標後，我們預期將回歸更平衡的資本配置策略，包括股票回購。

Now given that we issued our full year 2024 revenue and adjusted diluted earnings per share guidance on December 13, let me just hit a few of the highlights. We expect total company full year '24 revenues to be in the range of $58.5 billion to $61.5 billion, which reflects our expectation of strong contributions across our product portfolio. Importantly, excluding COMIRNATY and PAXLOVID, we anticipate operational revenue growth of 8% to 10%. We remain confident on delivering at least $4 billion of net savings from our cost realignment program by the end of this year. We believe rightsizing the cost base will put us on a strong footing towards margin expansion and increased operational efficiency moving forward.

鑑於我們已於 12 月 13 日發布了 2024 年全年收入和調整後稀釋每股收益指引，讓我簡單介紹一些要點。我們預計公司 24 年全年總收入將在 585 億美元至 615 億美元之間，這反映了我們對整個產品組合做出強勁貢獻的預期。重要的是，不包括 COMIRNATY 和 PAXLOVID，我們預計營運收入將成長 8% 至 10%。我們仍然有信心在今年年底前透過我們的成本調整計劃實現至少 40 億美元的淨節省。我們相信，調整成本基礎將為我們未來擴大利潤率和提高營運效率奠定堅實的基礎。

We expect adjusted diluted earnings per share to be in the range of $2.05 to $2.25 a share for the full year of 2024. And as a reminder, this range is inclusive of an anticipated $0.40 of earnings dilution from the Seagen acquisition and again, with the vast majority of this dilution resulting from the financing costs associated with the deal. Cycling into 2024, we have significantly invested in our business to fuel our long-term growth, and the foundation is set to deliver on our commitments to enhance long-term shareholder value. We are acutely focused on driving near-term performance while solidifying our growth expectations for the back half of this decade.

我們預計 2024 年全年調整後的稀釋每股收益將在 2.05 美元至 2.25 美元之間。提醒一下，這個範圍包括因 Seagen 收購而帶來的預期 0.40 美元的收益稀釋，而且，絕大多數稀釋是與交易相關的融資成本所造成的。進入 2024 年，我們對業務進行了大量投資，以推動我們的長期成長，基金會也將兌現我們提高長期股東價值的承諾。我們高度重視推動近期業績，同時鞏固本十年後半段的成長預期。

And with that, I'd like to turn it back over to Albert to begin our Q&A session.

說到這裡，我想把它轉回給阿爾伯特來開始我們的問答環節。

Thank you. With that, let's start the Q&A session. Operator, please assemble the queue.

謝謝。那麼，讓我們開始問答環節。接線員，請整理隊列。

(Operator Instructions)

（操作員說明）

And our first question comes from Robyn Karnauskas with Truist Securities.

我們的第一個問題來自 Truist Securities 的 Robyn Karnauskas。

So maybe I'm stupid on this question, but if I'm doing your math for your guidance of margins in low 70s for fiscal year '24, by my math, the margins for other biopharma would have to drop to about 60% in order to balance out the other margins. Can you just help me understand your guidance and triangulate that with your top line and bottom line guidance and triangulating that with your margin guidance?

所以也許我對這個問題很愚蠢，但如果我按照你的數學計算，將24 財年的利潤率控制在70 多歲以下，那麼根據我的數學計算，其他生物製藥的利潤率將不得不下降到60% 左右。以平衡其他利潤。您能否幫助我理解您的指導，並將其與您的頂線和底線指導進行三角測量，並與您的利潤指導進行三角測量？

Yes. So maybe -- this is Dave. Correct. Our guidance for gross margin, although we don't provide it specifically, we've given some color around the fact that it's approximately 70%. Obviously, our focus going forward is to improve our margin rate and, more importantly, improve our operating margin rate to the bottom line. I would -- as we look here at 2024, there's a few things that have compressed our margin rate versus as COVID has declined year-over-year, that has served to, I'll say, delever, if you will, the P&L as COVID takes up and cover some fixed overhead.

是的。所以也許——這是戴夫。正確的。我們對毛利率的指導雖然沒有具體提供，但我們對毛利率約為 70% 的事實進行了一些說明。顯然，我們未來的重點是提高我們的利潤率，更重要的是，將我們的營業利潤率提高到底線。我會——當我們展望 2024 年時，有一些因素壓縮了我們的利潤率，而隨著新冠肺炎疫情逐年下降，我會說，如果你願意的話，這有助於降低損益率因為新冠疫情佔用並覆蓋了一些固定費用。

But importantly, what's happening is we are in-sourcing products that we've recently acquired. Those -- that in-sourcing requires time before we get up to peak yield and performance so that in the short term, dampens gross margin rate but has a trajectory to improve gross margin rate over time. And then secondly, we have new launches that are coming online late in Q3 or -- late in the second half of 2023 and moving into '24. Again, those are not at peak performance yet. That will ultimately improve gross margin rate as we cycle into later years.

但重要的是，我們正在內購最近購買的產品。這些——內包需要時間才能達到峰值產量和性能，因此在短期內會降低毛利率，但隨著時間的推移，毛利率會有提高的趨勢。其次，我們將在第三季末或 2023 年下半年末推出新產品，並進入 24 年。同樣，這些還沒有達到最佳性能。隨著我們進入後幾年，這最終將提高毛利率。

And then finally, I will say that over the last several years, we have absorbed some amount of inflation within our cost of goods sold. That is an area of opportunity for us as we think about improving performance longer term. So I hope that gives you some color.

最後，我要說的是，在過去的幾年裡，我們已經在銷售商品成本中吸收了一定程度的通貨膨脹。當我們考慮長期提高績效時，這對我們來說是一個機會領域。所以我希望這能給你一些色彩。

Next, we have Carter Gould with Barclays.

接下來是巴克萊銀行的卡特古爾德。

Maybe another kind of finance question here. Certainly, R&D in 4Q was meaningfully below kind of where you guys had set the guide there. How should we think about that? Does it just reflect sort of faster cost cutting? Is it just more an artifact of the later integration of SGEN? And clearly, you're reaffirming your guide but just maybe if you can just sort of check that box for us, that would be helpful.

也許這裡還有另一種財務問題。當然，第四季的研發明顯低於你們設定的指導值。我們該如何思考這個問題？這是否只是反映了更快的成本削減？難道更多的是SGEN後期整合的神器？顯然，您正在重申您的指南，但也許如果您能為我們選中該框，那將會有所幫助。

Sure. Probably not much to read into that. Obviously, R&D came in a little favorable than our expectations previously. Part of this is the fact that we are very focused on our -- realigning our cost base, so consistent with the program. And then secondly, there probably is some timing that's dampening R&D in the fourth quarter that will slide into 2024 and into 2025. So there is some timing implications to that performance level.

當然。可能沒有太多值得閱讀的內容。顯然，研發的情況比我們之前的預期要好一些。部分原因是我們非常專注於重新調整我們的成本基礎，以便與計劃保持一致。其次，第四季的研發可能會受到一些時間的影響，而研發將推遲到 2024 年和 2025 年。因此，該績效水準會受到一些時間影響。

But I think importantly, back to my prepared remarks, is our focus is on delivering net savings of $4 billion. And if you look through the end of 2023, about half of that we've achieved already. We're now focused on achieving the additional $2 billion or so as we cycle into 2024, and all eyes are on that objective.

但我認為重要的是，回到我準備好的發言，我們的重點是實現 40 億美元的淨節省。如果你展望 2023 年底，我們已經實現了大約一半的目標。我們現在的重點是在 2024 年實現額外約 20 億美元的目標，所有人都在關注這個目標。

Thank you, Dave. We have high confidence on the number that we gave.

謝謝你，戴夫。我們對我們提供的數字充滿信心。

Our next question will come from Louise Chen with Cantor.

我們的下一個問題將由 Louise Chen 和 Cantor 提出。

Wanted to ask you on your Prevnar franchise. First of all, for the fourth-generation PCV, could you give more color on how it compares in contrast with Prevnar 20? And then just on the Prevnar order timing issue, was that U.S. or ex U.S.?

想詢問您有關 Prevnar 特許經營權的問題。首先，對於第四代PCV，您能否詳細說明一下它與Prevnar 20的對比情況？然後就 Prevnar 訂單時間問題而言，是美國還是前美國？

Thank you. Aamir, why don't you take the Prevnar question? And then maybe Alexandre, you can add a little bit color on the situation in the U.S. So what is the situation in Prevnar with the orders?

謝謝。阿米爾，你為什麼不回答 Prevnar 的問題呢？然後，也許 Alexandre，您可以對美國的情況添加一些色彩。那​​麼 Prevnar 的訂單情況如何？

Yes. So Louise, with regards to Prevnar, with the pediatric business, we often see some lumpiness in quarterly revenues given the timing and impact of CDC orders, so it's difficult to kind of map that all out quarter by quarter. So you should expect that on the pediatric business. But the pediatric business, otherwise, we're very happy with how our launch is progressing and the growth momentum that we see there.

是的。 Louise，關於 Prevnar 的兒科業務，考慮到 CDC 訂單的時間和影響，我們經常看到季度收入出現一些波動，因此很難按季度繪製出全部情況。所以你應該對兒科業務有所期待。但在兒科業務方面，我們對我們的推出進展以及我們在那裡看到的成長勢頭感到非常滿意。

On the adult business, I think it's different in the sense that we have a 96% market share that we closed the adult business with at the end of the year. But it's really important to keep in mind that we are operating in a market where the patient pool is steadily decreasing. There was a big catch-up opportunity versus the prior recommendation, and we've worked through that catch-up opportunity already. So the remaining patients are generally those that are aging into the 65-plus population as well as those with underlying medical conditions, and those are harder to activate patients. So we expect that business to continue to face that smaller patient population going forward. And we also expect competition with V116 emerging that will make the adult market more competitive, but we see a lot of growth potential in the pediatric market.

在成人業務方面，我認為這是不同的，因為我們在年底關閉了成人業務，擁有 96% 的市場份額。但重要的是要記住，我們正在一個患者群體正在穩步減少的市場中運作。與先前的建議相比，有一個很大的追趕機會，而且我們已經抓住了這個追趕機會。所以剩下的患者一般都是65歲以上的人群以及有基礎疾病的患者，這些患者是較難活化的患者。因此，我們預期該業務未來將繼續面臨患者人數減少的情況。我們也預計與 V116 的競爭將會出現，這將使成人市場更具競爭力，但我們看到兒科市場有很大的成長潛力。

Thank you. Alexandre, how was the Prevnar situation in the last quarter or in the year in international markets?

謝謝。 Alexandre，Prevnar上個季度或今年國際市場的情況如何？

Yes. Louise, good question. As you know, the majority of our ex U.S. business is driven by tender. And of course, we book the sales when we ship the product. It doesn't reflect utilization. And then the government schedule their campaign in their respective markets. The reality is that we continue to have an IP exclusivity in 113 markets around the world. And at the same time, we continue to progress both on the pediatric, as you saw last week, the CHMP positive opinion, and now we're going to go into the final approval and then vaccine technical committees and pricing in all those markets, so that will take a bit of time.

是的。路易絲，好問題。如您所知，我們的大部分美國前業務都是由招標驅動的。當然，我們在發貨時會預訂銷售。它不反映利用率。然後政府在各自的市場安排他們的活動。現實情況是，我們繼續在全球 113 個市場擁有智慧財產權獨佔權。同時，我們繼續在兒科方面取得進展，正如您上週看到的，CHMP 的積極意見，現在我們將進入最終批准階段，然後是疫苗技術委員會和所有這些市場的定價，所以這需要一些時間。

But at the same time, we see some positive traction on the adult franchise, where we have launched in over 30 markets. And we see some very good developments with the recommendation of the vaccine technical committee. To give you an example, we used to have very limited access on our Prevnar 13 in country like Germany or France and U.K. And we just received a recommendation from the VTC in Germany that actually recommended usage of Prevnar 20 in old adults over 60 as well as at-risk population from 18 to 59, which we believe we have a significant growth opportunity in increasing vaccination in the adult population ex U.S.

但同時，我們看到成人系列產品受到了一些積極的推動，我們已在 30 多個市場推出了該系列產品。在疫苗技術委員會的建議下，我們看到了一些非常好的進展。舉個例子，我們過去在德國、法國和英國等國家對 Prevnar 13 的使用非常有限。我們剛剛收到德國 VTC 的建議，實際上建議 60 歲以上的老年人也使用 Prevnar 20作為18 歲至59 歲的高風險族群，我們相信，在增加美國以外成年人口的疫苗接種方面，我們有很大的成長機會。

And Mikael, to conclude what about the fourth-generation Prevnar?

Mikael，總結一下第四代 Prevnar 怎麼樣？

Yes. I'm very pleased that the fourth generation has entered clinical studies. It has a Fast Track designation from U.S. FDA, indicating a unique product offering. And it includes some of the new technology we have developed that gives us a really cutting-edge toolbox, whether it's chemistry, carriers or reformulations. And of course, it relies on the unique Pfizer platform to have potential prevention of both invasive disease, which is the smaller disease burden and pneumococcal disease, which causes more than 150,000 hospitalizations. And to the best of my knowledge, we are the only one that can address both of them. So we feel very good about that entry.

是的。我很高興第四代已經進入臨床研究。它獲得了美國 FDA 的快速通道指定，表明其提供獨特的產品。它包括我們開發的一些新技術，為我們提供了真正尖端的工具箱，無論是化學、載體還是重新配方。當然，它依靠獨特的輝瑞平台，對疾病負擔較小的侵襲性疾病和導致超過 150,000 人住院的肺炎球菌疾病具有潛在的預防作用。據我所知，我們是唯一能夠解決這兩個問題的人。所以我們對這個條目感覺非常好。

Thank you, Mikael. So to summarize the Prevnar, which I know it is in the minds of all, let's start with the commercial front. In the U.S., clearly, the adult opportunity, we have taken the cream basically of the catch-up opportunity. This is happening once you are getting a recommendation from CDC for a catch-up. This market, the pool of patients has been largely exhausted. We have already 96% market share of that. So this is not a market, the adult from now that we expect that will continuously grow in the U.S.

謝謝你，米凱爾。因此，總結一下 Prevnar，我知道它在所有人的心目中，讓我們從商業方面開始。顯然，在美國，我們已經抓住了成人機會，基本上抓住了追趕機會的精華。一旦您收到 CDC 的補習建議，就會發生這種情況。這個市場的患者池已經基本耗盡。我們已經擁有 96% 的市佔率。因此，這不是一個市場，從現在開始，我們預計美國將持續成長。

Pediatric, very different story because our market share is now growing, and we have indications that we'll continue growing very strongly. So we expect in the U.S., the Prevnar situation to be a strong growth story in pediatric. International, both, we expect to see growth because the products have just been launched, and then the recommendations are following. So there is a delay in international higher than usually there is in the U.S. So we expect to see growth in adult and in the pediatric.

這是小兒科，完全不同的故事，因為我們的市場份額現在正在增長，而且有跡象表明我們將繼續強勁增長。因此，我們預計在美國，Prevnar 的情況將成為兒科領域的強勁成長故事。在國際上，我們預計會看到成長，因為產品剛剛推出，然後推薦也隨之而來。因此，國際市場的延遲時間比美國通常要高。因此，我們預期成人和兒科市場的成長。

I want to reemphasize that we have basically exclusivity of Prevnar 13 in more than 100 countries, 113 countries in NI of tenders. And we plan to convert that now to 20. And then on the fourth generation, we are moving full speed. We think that our expertise will allow us to build a polyvalent vaccine that will really compete very, very nicely as a fourth generation and we will do that successfully and fast. So that's the story.

我想再次強調的是，我們在 100 多個國家、​​113 個國家的招標中基本上擁有 Prevnar 13 的獨家經營權。我們計劃現在將其轉換為 20 個。然後在第四代上，我們將全速前進。我們認為，我們的專業知識將使我們能夠製造出一種多價疫苗，作為第四代疫苗，這種疫苗將真正具有非常非常好的競爭力，我們將成功且快速地做到這一點。這就是故事。

Next, we have a question from Trung Huynh with UBS.

接下來，我們有來自瑞銀的 Trung Huynh 的問題。

Trung from UBS. Two, please. So in your prepared remarks, you noted you took a $1.4 billion impairment charge associated with etrasimod. Can you add more color here? What prompted that reevaluation? And any feedback of how that launch has gone? Secondly, on Abrysvo, so can you give us some color on how your contracting has evolved in '24 versus '23? And based on that, what's your market share do you think you can capture this year versus the 35% last year?

來自瑞銀的特朗。請兩位。因此，在您準備好的演講中，您指出您承擔了與 etrasimod 相關的 14 億美元減損費用。你能在這裡添加更多顏色嗎？是什麼促使了重新評估？對於這次發布的進展有何回饋？其次，關於 Abrysvo，您能給我們一些關於您的合約在 24 年與 23 年間如何演變的資訊嗎？基於此，與去年 35% 的市佔率相比，您認為今年能獲得多少市佔率？

Thank you very much. Why don't you take, Dave, the impairment question and then I will move to commercial guys?

非常感謝。戴夫，你為什麼不接受減損問題，然後我就轉向商業人士？

Yes. So on etrasimod, keep in mind that this product, we still anticipate to be over $1 billion in peak sales. As you know, there are multiple indications attributed to this medicine. And financially, as you look at that medication, there were additional indications that met the financial criteria for an impairment of which we took in the quarter. Clinically, obviously, clinically, there's still some work that will be ongoing in support of the asset. So with that...

是的。因此，在 etrasimod 上，請記住，我們仍然預計該產品的峰值銷售額將超過 10 億美元。如您所知，這種藥物有多種適應症。從財務角度來看，當您查看該藥物時，還有其他跡象表明符合我們在本季採取的減損財務標準。顯然，在臨床上，仍然有一些工作正在進行以支持該資產。那麼這樣...

Thank you very much. So Aamir, maybe etrasimod commercially, how the launch is doing and the Abrysvo.

非常感謝。那麼阿米爾，也許是商業上的 etrasimod，發布情況如何以及 Abrysvo。

Sure. So I'll start with etrasimod or VELSIPITY, as we call it. So just in terms of the product value proposition, we think this is a very promising oral option for moderate to severe UC patients. It's got strong efficacy that patients and physicians that we've exposed this to. They want to start transitioning from conventional therapy to advanced therapy. And it gives them an option also to maintain once-a-day oral routine, which many are already on instead of beginning with an injection or infusion. So about 80% of those patients that haven't progressed to an advanced therapy prefer an oral option, but only about 10% of those patients actually get one.

當然。所以我將從 etrasimod 或 VELSIPITY（我們稱之為）開始。因此，就產品價值主張而言，我們認為這對於中度至重度 UC 患者來說是一個非常有前景的口服選擇。我們接觸過的患者和醫生都認為它具有很強的功效。他們希望開始從傳統療法過渡到先進療法。它還為他們提供了維持每天一次口服常規的選擇，許多人已經在這樣做，而不是從注射或輸液開始。因此，大約 80% 尚未進展到高級治療的患者更喜歡口服治療，但只有大約 10% 的患者真正接受口服治療。

So there's a very clear need here that VELSIPITY can help us fit. And the benefit-risk profile for VELSIPITY is also very, very strong. So we approved -- we received approval at the end of last year. And so we've invested efforts in building HCP and patient awareness on the label and on the value proposition. But I just want to remind you that with any immuno-inflammatory product, it takes time to get broad national access. And that is where our focus is right now is ensuring that we secure VELSIPITY access as a first-line advanced therapy oral option, and that's going to take some time to put in place. And when we have that in place, we see upside momentum from the launch.

因此，這裡有一個非常明確的需求，即 VELSIPITY 可以幫助我們適應。 VELSIPITY 的效益風險概況也非常非常強。所以我們批准了——我們在去年年底獲得了批准。因此，我們投入了大量精力來培養 HCP 和患者對標籤和價值主張的認識。但我只是想提醒您，任何免疫發炎產品都需要時間才能在全國範圍內廣泛使用。這就是我們現在的重點是確保我們獲得 VELSIPITY 作為第一線先進治療口服選擇，這需要一些時間才能落實到位。當我們做到這一點時，我們就會看到發布帶來的上升勢頭。

What about Abrysvo?

阿布里斯沃呢？

On Abrysvo, I'll comment briefly on the adult and then on the maternal. On the adult vaccine, I think the market was clearly ahead of everyone's expectations and not limited by shared clinical decision-making versus a routine recommendation. We would like to do better than the 30-some percent share that you referred to as well. So we're very focused going forward on retail contracting for the '24, '25 season. But I will also mention that we are doing that with real thoughtfulness on ensuring that we secure a profitable share in those contracts and also differentiating using our maternal indication.

關於 Abrysvo，我將簡要評論成人，然後評論母親。在成人疫苗方面，我認為市場顯然超出了每個人的預期，並且不受共同臨床決策與常規建議的限制。我們希望做得比您提到的 30% 左右的份額更好。因此，我們非常關注 24、25 季的零售合約。但我還要提到的是，我們在這樣做時是經過深思熟慮的，以確保我們在這些合約中獲得有利可圖的份額，並利用我們的母性適應症進行差異化。

We also see opportunities in the nonretail setting, where for example, with the VA system and with IDNs, we have strong share. And we're going to also focus on new opportunities that we're currently studying with Abrysvo, adults aged 18 and older with underlying medical conditions as well as a new packing presentation to better fit our customer needs. So we see momentum there.

我們也看到非零售環境中的機會，例如，透過 VA 系統和 IDN，我們擁有強大的份額。我們還將重點關注目前正在與 Abrysvo、18 歲及以上患有基礎疾病的成年人一起研究的新機會，以及新的包裝展示，以更好地滿足我們客戶的需求。所以我們看到了那裡的勢頭。

And on the maternal side, we're only a few months in but we're encouraged by what we're seeing as the first maternal vaccine to prevent infants from birth to 6 months when they are the most vulnerable. More than 65% of women prefer to get the maternal vaccine versus having their infant immunized with a monoclonal antibody. And we think that the label provides us opportunity to grow that segment as well.

在孕產婦方面，雖然我們推出的時間只有幾個月，但我們對我們所看到的第一種孕產婦疫苗感到鼓舞，該疫苗可以預防嬰兒出生至最脆弱的 6 個月大的嬰兒。超過 65% 的女性更願意接種母體疫苗，而不是讓嬰兒接種單株抗體。我們認為該品牌也為我們提供了發展該細分市場的機會。

Our next question comes from Terence Flynn with Morgan Stanley.

我們的下一個問題來自摩根士丹利的特倫斯·弗林。

Two for me. I guess the first one is just COMIRNATY rest of world was ahead of consensus expectations this quarter. Just wondering if there were any onetime benefits in that number, if that's a fair go-forward sales level to think about through 2026 given the existing EU contract? And then the second one is, I noticed that danuglipron wasn't mentioned in the PR or the prepared remarks. Just wondering if that once-daily PK trial completed yet and what the next steps are there.

給我兩個。我想第一個是世界其他地區本季的表現超出了共識預期。只是想知道這個數字是否有任何一次性好處，考慮到現有的歐盟合同，到 2026 年這是否是一個公平的未來銷售水平？第二個是，我注意到 PR 或準備好的評論中沒有提到 danuglipron。只是想知道每日一次的 PK 試驗是否已經完成以及下一步是什麼。

Thank you very much. Maybe very quickly on the danu, we didn't mention because we don't have anything to say more. So that's the only thing. There is a program, which is composed with a lot of experiments that we are doing now in terms of moving it to once-daily and we will speak only when we have data. We don't want to become now the focus again of another earnings call. But that being said, I'm moving it to Alexandre to discuss about COMIRNATY in the rest of the world outside the U.S. What are the dynamics over there then?

非常感謝。也許很快就達努了，我們沒有提及，因為我們沒有什麼好說的。所以這是唯一的事情。有一個程序，由我們現在正在做的大量實驗組成，將其改為每天一次，只有當我們有數據時我們才會說話。我們不想現在再次成為另一次財報電話會議的焦點。但話雖這麼說，我將把它轉移到亞歷山大來討論美國以外世界其他地區的交流。那麼那裡的動態是什麼？

That's why there are several elements playing out on the COMIRNATY franchise. First, what we see is restrictions on vaccination guidelines, right? So versus the previous years, we see that the guidelines are really focusing on the older population as well as the at-risk population. But we have, as you know, already signed several contracts with the European Commission, Canada, U.K. and Australia. And following the approval in August last year, we started to execute on our contract with the European countries. As a matter of fact, some countries have decided to advance some of their order in 2024 into 2023 so that they can execute their vaccination campaign properly.

這就是為什麼《COMIRNATY》系列中有多種元素。首先，我們看到的是疫苗接種指南的限制，對嗎？因此，與前幾年相比，我們看到指南真正關注的是老年人口和高風險族群。但如您所知，我們已經與歐盟委員會、加拿大、英國和澳洲簽署了幾份合約。去年8月獲得批准後，我們開始執行與歐洲國家的合約。事實上，一些國家已決定將2024年的部分訂單提前到2023年，以便能夠正常執行疫苗接種活動。

The other trend that we see is that actually, we don't see major vaccination uptakes in the future year. We think that what we have seen in 2023, 2024 campaign is really the type of vaccination we will see, and that will be carried on the next few years. The only area where there is a potential future growth in terms of vaccination uptake is if we can increase our co-administration with the flu vaccines where in all our key markets, the rate of vaccination in flu is actually higher than it is for COMIRNATY. So we believe that there is potentially here an opportunity.

我們看到的另一個趨勢是，實際上，未來一年我們不會看到大規模的疫苗接種。我們認為，我們在 2023 年、2024 年運動中看到的確實是我們將看到的疫苗類型，並將在未來幾年內繼續進行。未來疫苗接種率有潛在增長的唯一領域是我們是否可以增加與流感疫苗的聯合接種，在我們所有的主要市場中，流感疫苗接種率實際上高於社區。因此，我們相信這裡可能存在機會。

The last point that I want to say is, as you see that the COMIRNATY self pattern is evolving towards a seasonal pattern. So you saw you have a very strong Q4, like you expect in flu vaccination type of market. And that's what we see also to be expected in 2024. And actually, as I was reading some of your models in the financial community, I think there is some confusion that we will have higher Q1, Q2, which I believe will be more towards the second part of the year, but of course, in line with the guidance.

我想說的最後一點是，正如你所看到的，COMIRNATY自我模式正在向季節性模式演變。所以你看到第四季的表現非常強勁，就像你對流感疫苗類型市場的預期一樣。這也是我們預計2024 年會出現的情況。實際上，當我在金融界閱讀你們的一些模型時，我認為存在一些困惑，我們將有更高的第一季、第二季度，我相信這將更接近今年下半年，但當然符合指導方針。

Our next question will come from Umer Raffat with Evercore ISI.

我們的下一個問題將來自 Evercore ISI 的 Umer Raffat。

Albert, so I was looking at SEC filings from Cerevel and they disclosed that Pfizer was open to putting out a bid on Cerevel after Phase III data, which would have been in 2024, meaning I also noticed that you were saying you're not open to a buyback in 2024 and deleveraging remains a top priority. So I just want to balance those two, especially also in the context of where the stock stands.

Albert，所以我正在查看 Cerevel 向 SEC 提交的文件，他們透露輝瑞願意在 2024 年獲得第三階段數據後對 Cerevel 進行競標，這意味著我也注意到您說您不開放2024年回購和去槓桿仍然是首要任務。所以我只想平衡這兩者，特別是在股票現狀的背景下。

Well, look, I will ask Dave to speak about it. But the fact that we are looking everything and we are engaging in everything doesn't mean that, that's our obligation. We are doing all the work. It doesn't mean that our intention is to deviate the capital allocation strategy that we have just articulated. And that is the #1 priority is our dividend and the growing dividend. Then it's a year of execution. We try to delever, as David said.

好吧，聽著，我會請戴夫談談這件事。但事實上，我們正​​在關註一切、我們正在參與一切，但這並不代表那是我們的義務。我們正在做所有的工作。這並不意味著我們的意圖是偏離我們剛剛闡明的資本配置策略。第一要務是我們的股息和不斷增長的股息。然後就是一年的執行期。正如大衛所說，我們試圖去槓桿化。

And then once we bring our deleverage to the levels that we are aspiring, we will start also moving into share buybacks and, of course, M&A, which means that for '24, we will see everything in existence because we never say never to business development opportunities could come. But our strategy, it is that you will not see anything major in business development in terms of dollars. David, did I say it well?

然後，一旦我們將去槓桿化達到我們期望的水平，我們也將開始進行股票回購，當然還有併購，這意味著在24 年，我們將看到一切存在，因為我們永遠不會對商業說「永不」發展機會可能會到來。但我們的策略是，你不會看到任何以美元為單位的業務發展的重大內容。大衛，我說得好嗎？

You said it well. You are correct.

你說得好。你是對的。

Thank you very much. You are a good teacher. Thank you. And the other question, Umer? I think that was it, right? Yes. Thank you, Umer.

非常感謝。你是一位好老師。謝謝。另一個問題，烏默？我想就是這樣，對吧？是的。謝謝你，烏梅爾。

Next, we have Tim Anderson with Wolfe Research.

接下來是沃爾夫研究中心的蒂姆·安德森。

Maybe for Aamir. So Eliquis is the biggest drug on the initial list of 10 drugs for IRA. CMS has until February 1 to provide you the initial proposed negotiated price, so that's 2 days away. So 2 questions here. Can you confirm you haven't already received that initial proposal yet? And second question, can we expect that at some point between now and September 1, which is the deadline that they have to make the final price public, that you'll give some investors some sort of directional information on how those discussions are going? Are we going to be kind of in the dark until September 1?

也許是為了阿米爾。因此，Eliquis 是 IRA 最初 10 種藥物中最大的藥物。 CMS 必須在 2 月 1 日之前向您提供最初建議的協商價格，所以還有 2 天的時間。所以這裡有兩個問題。您能否確認您尚未收到最初的提案？第二個問題，我們能否期望從現在到9 月1 日（他們必須公開最終價格的最後期限）之間的某個時間點，你們會向一些投資者提供一些有關這些討論進展情況的方向性資訊? 9 月 1 日之前我們會一無所知嗎？

So Aamir, are you planning to give light to Tim more? Give us.

那麼阿米爾，你打算給提姆更多的啟發嗎？給我們。

So Tim, as you can appreciate, this whole price setting authority in Medicare, this is new and pharma companies obviously beginning to understand this process of the federal government. The rules are complicated, so we're wrapping our mind around it. Our alliance partner, BMS, is taking lead and engaging with CMS in an official process to determine the price for Eliquis in Part D that will begin in January 1, 2026. And also as I'm sure you can appreciate, we're not going to comment on an ongoing price-setting process and negotiation.

所以提姆，正如你所理解的，醫療保險的整個定價權是新的，製藥公司顯然開始了解聯邦政府的這個過程。規則很複雜，所以我們要全神貫注。我們的聯盟夥伴 BMS 正在牽頭並與 CMS 參與正式流程，以確定 D 部分中 Eliquis 的價格，該流程將於 2026 年 1 月 1 日開始。而且我相信您也能理解，我們不是對正在進行的定價過程和談判發表評論。

Yes. It's very difficult to comment on these things because they are ongoing. So it's very inappropriate and absolutely could complicate things. I understand that there is a need for people to understand because that's an important product. And we will try as soon as possible and practical to be able to provide the level of details that we are looking at, everybody is looking so that they can model it appropriately.

是的。很難對這些事情發表評論，因為它們正在進行中。所以這是非常不合適的，而且絕對會讓事情變得複雜。我知道人們需要理解，因為這是一個重要的產品。我們將盡快並切實可行地嘗試提供我們正在研究的詳細程度，每個人都在尋找，以便他們可以對其進行適當的建模。

Our next question will come from Andrew Baum with Citi.

我們的下一個問題將來自花旗銀行的安德魯鮑姆。

A couple of questions, please. First to Aamir, under your new leadership and commercial focus, what key products would you guide us to of recent launches that we should look for in terms of acceleration of rollout trajectory? And it doesn't have to be recently launched, established ones as well. And then second to Mikael. Could you just share a little bit more information about your next-generation PCV vaccine, specifically how many serotypes? And I'm assuming that given it's a new technology, you will lose the ability to grandfather the pneumonia claim from the CAPiTA trial into the product profile as it matures. If you could confirm, that would be great.

請教幾個問題。首先，阿米爾，在您新的領導和商業重點下，您將指導我們最近推出哪些關鍵產品，我們應該在加速推出軌跡方面尋求這些產品？而且它不必是最近推出的，也可以是已經建立的。然後是米凱爾之後的第二名。您能否分享一下有關下一代 PCV 疫苗的更多信息，特別是有多少种血清型？我假設，鑑於這是一項新技術，隨著它的成熟，您將失去將 CAPiTA 試驗中的肺炎聲明納入產品簡介的能力。如果你能確認的話那就太好了。

Thank you very much, Andrew. Your assumption, I don't think it is correct, but Mikael will answer that. But let's first go to Aamir to basically give us a view how you see in '24 the priorities of the commercial execution in the U.S.

非常感謝你，安德魯。我認為你的假設不正確，但米凱爾會回答這個問題。但我們首先請阿米爾來讓我們了解您如何看待 24 年美國商業執行的優先事項。

Yes. So Andrew, I'll take a step back and let me start by saying I've been very excited about this role and this opportunity. And also to do it with the team that we've built, which is a mix of both seasoned Pfizer leaders as well as experienced leaders from outside of Pfizer. I mean my focus and we can talk about specific products, we've touched on many of them already. But my focus overall is on execution excellence, right? So in our primary care and specialty care portfolio, we have a lot of great brands. We have some really enduring franchises, VYNDA, Eliquis, Prevnar. I spent quite a bit of time talking about that. Our focus there is to defend and grow where we can, and we do see some opportunities.

是的。安德魯，我退後一步，首先要說的是，我對這個角色和這個機會感到非常興奮。也要與我們建立的團隊一起做到這一點，該團隊由經驗豐富的輝瑞領導者以及來自輝瑞外部的經驗豐富的領導者組成。我的意思是我的重點，我們可以討論具體的產品，我們已經觸及了其中的許多產品。但我的整體重點是卓越的執行力，對嗎？因此，在我們的初級護理和專業護理產品組合中，我們擁有許多優秀的品牌。我們有一些真正持久的特許經營權，VYNDA、Eliquis、Prevnar。我花了相當多的時間談論這件事。我們的重點是盡可能地防守和成長，我們確實看到了一些機會。

And we also have to acknowledge that we have some brands that have great value propositions, but they happen to be in highly competitive categories with some very, very well-entrenched competitors. So in a situation like that, my focus is principally let's really prioritize the actions that can grow each of the brands and we can talk about the individual launches. There's a lot of operational focus on blocking and tackling, including contracting.

我們也必須承認，我們有一些品牌擁有巨大的價值主張，但它們恰好屬於競爭激烈的類別，有一些非常非常根深蒂固的競爭對手。因此，在這種情況下，我的重點主要是讓我們真正優先考慮可以發展每個品牌的行動，我們可以討論單獨的發布。許多行動重點都集中在攔截和攔截上，包括承包。

And then when we look at our main resources, we have our field force, our advertising and promotion dollars and our medical capabilities just prioritizing exactly where we put those. That is what I'm focused on with me and my management team. And as I mentioned, we see opportunities in some of the core franchises and defending and growing our share but then also in a number of our launches. And Albert mentioned in his opening remarks what we hope and expect to do with Abrysvo, with Nurtec, with LITFULO, CIBINQO. Those are all brands that we're going to continue to focus on, including some of our recent acquisitions like Oxbryta as well.

然後，當我們審視我們的主要資源時，我們有我們的現場人員、我們的廣告和促銷資金以及我們的醫療能力，我們只是優先考慮我們將這些資源放在哪裡。這就是我和我的管理團隊所關注的重點。正如我所提到的，我們在一些核心特許經營權以及捍衛和擴大我們的份額中看到了機會，但在我們推出的許多產品中也看到了機會。 Albert 在他的開場白中提到了我們對 Abrysvo、Nurtec、LITFULO、CIBINQO 的希望和期待。這些都是我們將繼續關注的品牌，包括我們最近收購的一些品牌，例如 Oxbryta。

Thank you, Aamir. Andrew, let me take the liberty to ask also the other commercial leaders to comment a little bit on their priorities because that will give you better sense of the whole picture. Alexandre, in international, as you are taking over, what are your key priorities?

謝謝你，阿米爾。安德魯，讓我冒昧地請其他商業領袖對他們的優先事項發表一些評論，因為這會讓你更好地了解整個情況。亞歷山大，當您接手國際業務時，您的首要任務是什麼？

Thanks for the question, Albert, and the opportunity to share my priorities. My main focus is really to focus on the area where we can generate material growth with improved return on investment. This is my mantra. How are we going to do that? My top 4 markets in the order: China, Japan, Germany, and France represents 40% of our international division. So it's quite concentrated. Those 4 markets will report directly to me so that we can have the resources and support the country to execute on their plan at best and to generate the most growth.

謝謝你的提問，阿爾伯特，也謝謝你給我機會分享我的優先事項。我的主要關注點實際上是專注於我們可以透過提高投資回報率來實現實質成長的領域。這是我的口頭禪。我們要怎麼做呢？我的前 4 名的市場是：中國、日本、德國和法國，占我們國際業務的 40%。所以說還是比較集中的。這四個市場將直接向我匯報，以便我們能夠擁有資源並支持該國以最佳方式執行其計劃並實現最大增長。

Our top 15 country represents 70% of our total international. So it's, again, quite concentrated. What I'm actually doing currently is in each of those markets, we are selecting our drivers of growth. What are the key in-line and the key new products where we can have material impact with improved return investment? So to give you an example, of course, it's going to be different from one country to the other because the archetype and the dynamic of those markets are different. So last week, I was in Japan. And so for instance, VYNDAQEL, diagnosis rate is half the diagnosis rate that we have in the U.S. and in France. So we reviewed last week the plan to go and catch those increased diagnosis rate. And we're going to continue to, of course, track on execution.

我們排名前 15 的國家占我們國際總數的 70%。所以它再次非常集中。我目前實際上正在做的是在每個市場中，我們正在選擇成長的驅動力。我們可以透過提高投資報酬率產生重大影響的關鍵內線產品和關鍵新產品有哪些？舉個例子，當然，每個國家的情況都會有所不同，因為這些市場的原型和動態是不同的。上週我在日本。例如，VYNDAQEL 的診斷率是美國和法國診斷率的一半。因此，我們上週回顧了去捕捉那些增加的診斷率的計劃。當然，我們將繼續追蹤執行情況。

In Germany, Eliquis has a very strong Eliquis franchise. We believe we have growth to untapped opportunity. And I'm next week in Germany to actually review the plan on the Eliquis precisely. And we'll do the same thing on the new product. And it's going to be, for instance, LORBRENA in China. As you know, lung cancer in China is unfortunately affecting a large proportion of the population. And as a matter of fact, the proportion of the lung cancer that can benefit from LORBRENA in the worldwide community is about 1.7%. In China, it's actually 7%. So we believe we have a huge opportunity.

在德國，Eliquis 擁有非常強大的 Eliquis 特許經營權。我們相信我們有未開發的成長機會。下週我將在德國實際審查 Eliquis 的計劃。我們將對新產品做同樣的事情。例如，中國的 LORBRENA。如您所知，不幸的是，肺癌正在影響中國很大一部分人口。事實上，全球可從LORBRENA獲益的肺癌患者比例約為1.7%。在中國，這個比例其實是7%。所以我們相信我們有一個巨大的機會。

What are we doing is actually developing a plan last week when I was visiting China to quickly get LORBRENA to those patients that could benefit from the clinical outcome. So this is really what I'm doing in each of our top 15 countries. Then frankly, the rest of the year will be simply tracking our execution, tracking all the metrics both from activities, medical activities and KPIs for each of our key products.

我們正在做的實際上是上週我訪問中國時制定了一項計劃，以便快速將 LORBRENA 提供給那些可以從臨床結果中受益的患者。這就是我在前 15 個國家所做的事情。坦白說，今年剩下的時間將只是追蹤我們的執行情況，追蹤我們每個關鍵產品的活動、醫療活動和 KPI 的所有指標。

Thank you. And then maybe, Chris, also on the commercial front. How do you think of the oncology in the U.S. evolving?

謝謝。克里斯，也許在商業方面也是如此。您如何看待美國腫瘤學的發展？

Thank you, Andrew, Albert. Our biggest priority right now is obviously continuity of the business. We've done a lot of work during the last 9 months during integration planning. And we don't want to miss a beat and it's now moving towards flawless execution with immediate priorities, obviously, the PADCEV launch for advanced metastatic bladder cancer from the EV-302 study, the launch of XTANDI in nonmetastatic, castration-sensitive prostate cancer from the EMBARK trial, the early launch, and also focus on access and awareness during 2024 for ELREXFIO in late-line multiple myeloma. And for TALZENNA where up to 25% of patients with metastatic castration-resistant prostate cancer would be eligible in the U.S. for the -- from the TALAPRO-2 indication.

謝謝你，安德魯，阿爾伯特。我們現在最重要的任務顯然是業務的連續性。在過去 9 個月的整合規劃過程中，我們做了許多工作。我們不想錯過任何一個節拍，現在正朝著完美執行的方向邁進，並立即優先考慮，顯然，EV-302 研究中針對晚期轉移性膀胱癌推出的PADCEV，針對非轉移性去勢敏感前列腺癌推出的XTANDI從 EMBARK 試驗開始，早期啟動，並在 2024 年重點關注 ELREXFIO 在晚期多發性骨髓瘤中的使用和認知。對於 TALZENNA 來說，在美國，高達 25% 的轉移性去勢抵抗性前列腺癌患者符合 TALAPRO-2 適應症的資格。

Thank you, Chris. And then let's go to Mikael Dolsten, if you can make some comments on the next generation as much as you can share about sales.

謝謝你，克里斯。然後讓我們請 Mikael Dolsten 發言，如果您能對下一代產品發表一些評論，就像您能分享有關銷售的評論一樣。

Yes. I think we have a very strong position with good momentum in the PCV conjugate. And I think Alexandre, you mentioned just the positive recommendation we got for PCV20 in Europe. Now we're building on that unique platform. And as Andrew did say here, we are able, what you call, grandfather in unique claims for the adult segment for pneumococcal pneumonia. It's really the major burden with 150,000 U.S. hospitalizations. And to the best of our knowledge, the Pfizer platform with a new fourth generation, as was with the third generation, will be the only one that can carry that claim based on, as you said, the original CAPiTA studies.

是的。我認為我們在 PCV 結合物領域擁有非常強大的地位和良好的勢頭。我認為 Alexandre，您剛剛提到了我們在歐洲獲得的 PCV20 積極推薦。現在我們正在這個獨特的平台上進行建置。正如安德魯在這裡所說的那樣，我們能夠，也就是你所說的，對成人肺炎球菌肺炎的獨特主張。這確實是美國 15 萬人住院治療的主要負擔。據我們所知，輝瑞的第四代平台和第三代平台一樣，將是唯一一個能夠根據您所說的原始 CAPiTA 研究進行此聲明的平台。

Now the new generation will contain more serotypes, has applicability for adult and possibly pediatric, as we have done with all of ours. And it also will include improvement on existing serotypes to, altogether, get a very good increased coverage versus the PCV20. And I do think we are the one that really can continue this expansion of more serotypes, but you need conjugation chemistry carry some reformulations. And I am cautious to abandon any serotype where you work on infant and adults as the characterization what caused disease, for example, pneumonia is not very well described so maintaining the coverage as we have uniquely and it's not really happening with the other product is a unique differentiation. So I feel very good about the fourth generation.

現在，新一代將包含更多血清型，適用於成人，也可能適用於兒童，就像我們對所有血清型所做的那樣。它還將包括對現有血清型的改進，以總體上獲得比 PCV20 更好的覆蓋範圍。我確實認為我們確實可以繼續擴大更多血清型，但需要結合化學進行一些重新配製。我謹慎地放棄對嬰兒和成人進行研究的任何血清型，因為對引起疾病的特徵（例如肺炎）的描述還不是很清楚，因此保持我們獨特的覆蓋範圍，而其他產品並沒有真正發生這種情況是一個獨特的差異化。所以我對第四代的感覺非常好。

Thank you, Mikael.

謝謝你，米凱爾。

Our next question will come from Geoff Meacham with Bank of America.

我們的下一個問題將來自美國銀行的傑夫·米查姆。

Albert, the Oncology franchise following Seagen, I suspect, will probably be one of your bigger growth drivers for Pfizer going forward. The question is, is there an intermediate or long-term target as a percent of revenue that you're looking to achieve for this segment? And then are there technologies beyond ADC that you think could be additive to the pipeline?

我懷疑，繼 Seagen 之後的 Albert 腫瘤專營權可能會成為輝瑞未來更大的成長動力之一。問題是，您希望為該細分市場實現一個佔收入百分比的中期或長期目標嗎？那麼您認為除了 ADC 之外還有哪些技術可以添加到管道中？

Yes. Very general, then I will ask Chris to comment a little bit on the technologies that we are having here. I can't say how much Oncology will contribute. But clearly, we have given expectations about Seagen, and we say that we expect it to be at $10 billion by year 2030 from $3.1 billion that we gave guidance in 2024. And actually, we feel very good about the $10 billion. The more data coming -- when we gave the $10 billion, we were not aware of some of the readouts that follow that projection. So we feel very, very good about that.

是的。非常籠統，然後我將請克里斯對我們這裡擁有的技術進行一些評論。我不能說腫瘤學會貢獻多少。但顯然，我們已經給出了對Seagen 的期望，我們預計到2030 年，Seagen 的營收將達到100 億美元，而我們在2024 年給出的指導值為31 億美元。實際上，我們對100億美元感到非常滿足。數據越多，當我們提供 100 億美元時，我們並不知道該預測之後的一些讀數。所以我們對此感覺非常非常好。

Now I have to say that the Pfizer pipeline in Oncology I think was also among the strongest in our [current] therapeutic areas. So I think the combination, in general, is giving us, let's say, a lot of strength. But Chris, why don't you comment a little bit about how you see the R&D evolution of oncology, the platforms you are going to base your strategies?

現在我必須說，我認為輝瑞在腫瘤學方面的產品線也是我們[當前]治療領域中最強大的產品線之一。所以我認為總的來說，這種結合給了我們很大的力量。但是克里斯，為什麼不評論一下你如何看待腫瘤學的研發演變，以及你將作為你的策略基礎的平台呢？

Thank you. So with the modalities we want to focus on for now are those where we see we have significant strength and capabilities, including with medicinal chemistry, our protein engineering as well as our strength in cancer biology. We therefore want to focus on small molecules, especially from our La Jolla; bispecifics, both La Jolla and the new Seattle site; and ADCs in Seattle. So small molecules, biologics.

謝謝。因此，我們現在要重點關注的是那些我們認為擁有顯著優勢和能力的模式，包括藥物化學、蛋白質工程以及癌症生物學的優勢。因此，我們希望關注小分子，尤其是來自我們拉霍亞的小分子；雙特異性，拉霍亞和西雅圖新基地；以及西雅圖的 ADC。所以小分子，生物製劑。

As you know, we do have an interest also in allogeneic CAR T cells with the formation of Allogene, the company we still follow and have a significant interest in. But for now focusing on those 3 modalities where we see significant opportunity also for combinations, for example, doing small molecules, ADCs, but also potentially in the future between ADCs and bispecific.

如你所知，我們確實對Allogene 的形成也對同種異體CAR T 細胞感興趣，我們仍然關注這家公司，並對這家公司抱有很大的興趣。但目前我們專注於這3 種模式，在這三種模式中，我們也看到了組合的重大機會，例如，做小分子、ADC，但未來也有可能在 ADC 和雙特異性之間進行。

Our next question comes from Mohit Bansal with Wells Fargo.

我們的下一個問題來自富國銀行的 Mohit Bansal。

Maybe a question on Nurtec, the trends in market share as well as pricing. Just wanted to make sure that is there a significant price delta between Nurtec price versus the competitor price? I mean the discounts that they are offering, given that your competitor has multiple offerings in the headache market. And if there is a delta, do you expect this to grow or decline over 2024 on pricing?

也許是關於 Nurtec 的問題，市場份額和定價的趨勢。只是想確保 Nurtec 的價格與競爭對手的價格之間是否存在顯著的價格差異？我的意思是他們提供的折扣，因為你的競爭對手在令人頭痛的市場上有多種產品。如果存在增量，您預期 2024 年定價上的增量是成長還是下降？

Thank you, Mohit, very much. Aamir, about Nurtec and in general, the migraine franchise.

非常感謝你，莫希特。 Aamir，關於 Nurtec 以及偏頭痛專營權。

Yes. So Mohit, thanks for the question. So we were encouraged by Q4 for Nurtec, and I'll also include some comments on ZAVZPRET as part of my response. We were up more than 30% versus the prior year and 20%, over 20% versus the prior quarter. And there's a few things that are encouraging. Nurtec continues to be the #1 prescribed CGRP, so we have leading TRx volume and share. Interestingly, more than 90% of new prescribers in the category, many of whom are primary care physicians are prescribing Nurtec.

是的。莫希特，謝謝你的提問。因此，我們對 Nurtec 第 4 季感到鼓舞，我也將對 ZAVZPRET 進行一些評論，作為我的回應的一部分。我們比去年成長了 30% 以上，比上一季成長了 20% 以上，比上一季成長了 20% 以上。有些事情令人鼓舞。 Nurtec 仍然是排名第一的處方 CGRP，因此我們擁有領先的 TRx 數量和份額。有趣的是，該類別中超過 90% 的新處方醫生（其中許多是初級保健醫生）正在開立 Nurtec 處方。

And our pills per Rx has also, over the last several quarters, been steadily writing. So we continue to see opportunity, and there's a few things to keep in mind. One is there's still a lot of unmet need. Albert referred to it in his written remarks. But there's a lot of patients undiagnosed. Very few get an Rx therapy. Oral CGRPs are still only less than 20% of the Rx market. But as you point out, this is also a very competitive category with QULIPTA and UBRELVY. And I won't comment specifically on their pricing strategies versus ours and GTNs play a role in all of it.

在過去的幾個季度中，我們的每次處方藥數也一直在穩步增長。因此，我們繼續看到機會，但有一些事情需要牢記。一是仍有大量需求未被滿足。阿爾伯特在他的書面發言中提到了這一點。但還有很多患者未被確診。很少人接受 Rx 治療。口服 CGRP 仍僅佔 Rx 市場的不到 20%。但正如您所指出的，這也是一個與 QULIPTA 和 UBRELVY 競爭非常激烈的類別。我不會具體評論他們的定價策略與我們的定價策略，GTN 在這一切中都發揮作用。

But our focus for Nurtec, one, I think we want to be sharper and more competitive in our patient engagement and activation. Two, we have an opportunity with our field force to focus on both the most relevant CGRP writers, and as I said, PCPs. PCPs write 2/3 of triptans but only about a little over 1/3 of CGRP, so there's an opportunity there. And then patient access and experience, there's an opportunity to really reduce the friction there. And I will also mention ZAVZPRET because with an intranasal, we think we can have a very nice complement to an oral for either rapid pain relief, and there's also an unmet need for patients that have nausea and vomiting from the use of an oral. So we want to continue to invest in growing our Nurtec and ZAVZPRET franchise.

但我們對 Nurtec 的關注點之一是，我認為我們希望在患者參與和激活方面變得更加敏銳和更具競爭力。第二，我們的現場人員有機會專注於最相關的 CGRP 編寫者以及我所說的 PCP。 PCP 的成分佔曲坦類藥物的 2/3，但僅佔 CGRP 的 1/3 多一點，因此這是一個機會。然後患者的訪問和體驗，就有機會真正減少那裡的摩擦。我還要提到ZAVZPRET，因為透過鼻內給藥，我們認為我們可以對口服給藥進行很好的補充，以快速緩解疼痛，而且對於因使用口服給藥而出現噁心和嘔吐的患者，也存在未滿足的需求。因此，我們希望繼續投資發展我們的 Nurtec 和 ZAVZPRET 特許經營權。

Our next question comes from Steve Scala with TD Cowen.

我們的下一個問題來自 Steve Scala 和 TD Cowen。

Two questions. First on danuglipron, I know Pfizer doesn't want to provide an update. But clearly, the company has greater insight than we do into how the once-daily version is performing in the Phase I PK trial. So I'd like to ask how would you characterize that performance so far? In the absence of any visibility, it's kind of hard for us to be confident in the outlook for this program. Second question is a new weight loss agent was added to Phase I, [designated 6016]. Can you tell us what the mechanism is, please?

兩個問題。首先關於 danuglipron，我知道輝瑞不想提供更新。但顯然，該公司比我們更了解每日一次的版本在第一階段 PK 試驗中的表現。所以我想問一下您如何評價迄今為止的表現？在缺乏任何可見性的情況下，我們很難對該計劃的前景充滿信心。第二個問題是第一階段添加了新的減肥劑，[指定為6016]。請您告訴我們這個機制是什麼？

Yes. Steve, I'm going to disappoint you because you are asking things that we have said we are not willing to disclose at this stage for multiple reasons. Clearly, on danu, we have more information than us is very normal with everything that we are doing because we're having a very complicated, as I said, multiple experiments plan right now. But because we don't have new data, we're not going to comment on that.

是的。史蒂夫，我會讓你失望的，因為你問的問題我們已經說過，出於多種原因，我們現階段不願意透露。顯然，在達努上，我們擁有比我們更多的信息，這對我們所做的一切來說是很正常的，因為正如我所說，我們現在有一個非常複雜的多個實驗計劃。但由於我們沒有新數據，因此我們不會對此發表評論。

And on the new weight loss molecule also, we said that unfortunately, we are not able to disclose the mechanism of action. The reason is because, first of all, it's too early and we don't want to take competition, nothing strange about that. So I'm sorry to disappoint you but there is not much to offer at this stage. Hopefully, as we said, midyear is where we expect to have more information on that.

對於新的減肥分子，我們表示不幸的是，我們無法透露其作用機制。原因是，首先，現在還為時過早，我們不想參加競爭，這沒什麼好奇怪的。因此，很抱歉讓您失望，但現階段沒有什麼可以提供的。正如我們所說，希望在年中我們能獲得更多相關資訊。

Next, we have David Risinger with Leerink Partners.

接下來是 Leerink Partners 的 David Risinger。

Thanks for all the updates. So I have 2 questions, please. First is for Dave. Could you please discuss the '24 gross margin prospect in some detail? I think on the last call, you had discussed potentially a low 70% gross margin. But if you can comment on that in more detail, that would be helpful.

感謝您的所有更新。所以我有兩個問題。首先是戴夫。能否詳細討論一下 24 年的毛利率前景？我想在上次通話中，您討論了 70% 的低毛利率。但如果您能對此進行更詳細的評論，那將會很有幫助。

And the second question is for Mikael. If danuglipron once-daily does have a profile that you're looking for, would the company then conduct a Phase IIa dose-ranging study to assess the efficacy and tolerability in order to design a dose to advance Phase IIb or Phase III?

第二個問題是問米凱爾的。如果每日一次的 danuglipron 確實具有您正在尋找的特性，那麼該公司是否會進行 IIa 期劑量範圍研究來評估療效和耐受性，以便設計劑量以推進 IIb 期或 III 期？

Thanks, Dave. Very quickly, Mikael, resolve danu and then we'll go to Dave.

謝謝，戴夫。很快，米凱爾，解決達努問題，然後我們去找戴夫。

Yes. You heard Albert say that we are running a number of clinical experiments to gather insight in that molecule, and we have a second glip. Pfizer has always been open to consider different types of clinical study design. And in general, we tend to move into directly whenever data is supportive, if there is a large safety database into Phase III with a lead-in phase. But we have to look at each program by program. So when we have all the data, we will be able to share with you.

是的。你聽到阿爾伯特說我們正在進行大量臨床實驗來收集對該分子的見解，我們還有第二個小插曲。輝瑞始終開放地考慮不同類型的臨床研究設計。一般來說，只要有資料支持，如果有一個大型安全資料庫進入第三階段並且有導入階段，我們傾向於直接進入。但我們必須逐一查看每個程式。因此，當我們掌握所有數據後，我們將能夠與您分享。

Yes. Let's go to the gross margin where we can share a little bit more information.

是的。讓我們看看毛利率，我們可以在其中分享更多。

So David, this is Dave Denton. I'll be very brief here. Obviously, we've indicated our '24 gross margin expectations are in the low 70s, as we discussed previously. As you know, as we cycle into '24, there's a few things that are happening, as I indicated earlier. One is, as COVID comes down, we're kind of deleveraging as COVID had absorbed a lot of fixed overhead. So that's compressing gross margins. Secondly, we're in the process of insourcing many of the acquired products over the last couple of years. And as we insource, the short-term effect of that is dampening on gross margin, which gives us an opportunity to improve gross margins as yields improve over time.

大衛，這是戴夫丹頓。我在這裡會非常簡短。顯然，正如我們之前所討論的，我們已經表明我們 24 年的毛利率預期在 70 左右。如你所知，正如我之前指出的，當我們進入 24 世紀時，正在發生一些事情。一是，隨著新冠疫情的消退，我們正在去槓桿化，因為新冠疫情吸收了許多固定管理費用。所以這壓縮了毛利率。其次，我們正在內購過去幾年收購的許多產品。當我們進行內包時，其短期影響會削弱毛利率，這使我們有機會隨著收益率隨著時間的推移而提高毛利率。

And then finally -- or 2 things finally here is new launches have that same characteristic. As we launch a new product, yields and performance are not at peak performance. That will be an opportunity for us going forward. And then finally, we have absorbed some inflation over time. That is an opportunity for us to take out over the next several periods. So again, an opportunity for us to enhance performance over time. But again, we're in this roughly low 70s for 2024 is our expectation.

最後，或最後有兩件事是新推出的產品具有相同的特徵。當我們推出新產品時，產量和性能並未達到高峰。這將是我們前進的一個機會。最後，隨著時間的推移，我們吸收了一些通貨膨脹。這是我們在接下來的幾個時期抓住的機會。這又是我們隨著時間的推移提高績效的機會。但同樣，我們的預期是 2024 年大約處於 70 多歲的水平。

And David, let me add a little bit more color here, but the COMIRNATY and PAXLOVID are big products but they are manufactured in the same facilities, but they are separate facilities so they are not affecting the margins of the other products. So the margins were really absorbing in those facilities when you had such a huge volume production and value reduction, of course, the margins were seriously -- those products are seriously taking a lot of the overhead.

David，讓我在這裡補充一點，COMIRNATY 和 PAXLOVID 是大產品，但它們是在同一工廠生產的，但它們是獨立的工廠，因此不會影響其他產品的利潤。因此，當產量如此巨大且價值下降時，這些設施的利潤確實很有吸引力，當然，利潤非常高——這些產品確實佔用了大量管理費用。

Now as we are reducing our expectations for COVID into very realistic within targets, this doesn't mean that we have eliminated our capacity to produce more if the demand is there because that would be not responsible, first of all, from a public health perspective but also from our investors' money perspective. So that's why so far, we maintain all this capacity although the revenues are down, so there's a significant bit.

現在，當我們將對新冠病毒的期望降低到非常現實的目標範圍內時，這並不意味著我們已經消除了在有需求的情況下生產更多產品的能力，因為首先從公共衛生的角度來看，這是不負責任的而且也從我們投資者的資金角度來看。這就是為什麼到目前為止，儘管收入下降了，但我們仍保持了所有這些產能，所以有很大一部分。

The second thing that David said, keep in mind, all basically our new acquisitions that brought so many new products, they were from smaller relative companies. They didn't really have their own manufacturing. So these were all outsourced and outsourced, of course, is way more expensive than when you are able to bring it. There are plans for everything to insource, but in manufacturing, that takes 3 years, right, to be able to reduce the margin. And the last but not least, we have disproportional amount of new loans. And those new loans are coming with a very big cost when you build infrastructure or something new to be developed, but of course, you build it for your peak revenues. But of course, you start with very low revenues and then those are going up.

大衛說的第二件事，請記住，基本上我們所有的新收購都帶來瞭如此多的新產品，它們都來自規模較小的相關公司。他們並沒有真正擁有自己的製造業。所以這些都是外包的，當然，外包比你能帶來的要貴得多。我們有計劃將所有東西都內包，但在製造業，這需要 3 年時間，對吧，才能減少利潤。最後但並非最不重要的一點是，我們的新貸款數量不成比例。當你建造基礎設施或新開發的東西時，這些新貸款會帶來非常大的成本，但當然，你是為了達到最高收入而建造它的。但當然，你一開始的收入非常低，然後收入就會上升。

So as the infrastructure is there, but then higher revenues for these new products are coming, it's always the case with new products, but margins are expected. So it's not something about gross margins. You can see it in months, you see it in years, the improvement. But clearly, this is an area that we know why it's happening what's happening and how we can improve it.

因此，隨著基礎設施的建立，這些新產品的收入將會增加，新產品總是如此，但利潤率是預期的。所以這與毛利率無關。你可以在幾個月內看到它，幾年後你會看到它的進步。但顯然，我們知道這個領域為什麼會發生什麼，以及我們如何改進它。

Our next question comes from Chris Schott with JPMorgan.

我們的下一個問題來自摩根大通的克里斯·肖特。

And maybe just for Dave and Albert, just kind of building on mid- to longer-term margin piece of the equation. It sounds like we should think about margin recovery as a gradual process versus a snapback. Is that fair? And I guess kind of the bigger picture question I was asking is just how do we think about reasonable longer-term margins? Maybe not giving specific time lines, but can we think about kind of like mid- to high 30% operating margins as still a reasonable target for Pfizer? Or just kind of factoring in some of the dynamics we're seeing now, do we need to kind of rethink where margins can go over time?

也許只是對戴夫和艾伯特來說，只是建立在中長期利潤的基礎上。聽起來我們應該將利潤率恢復視為一個漸進的過程，而不是突然恢復。這樣公平嗎？我想我問的更大的問題是我們如何考慮合理的長期利潤？也許沒有給出具體的時間表，但我們是否可以認為 30% 的中高營業利潤率仍然是輝瑞的合理目標？或者只是考慮到我們現在看到的一些動態，我們是否需要重新思考隨著時間的推移利潤率會走向何方？

No, I think you're absolutely correct. Mid- to high 30s is a reasonable target for us, with a slight caveat sense that the vaccine program, COMIRNATY, has a shared, as you know, gross margin level with our partner. And so that's dampening to gross margins and operating profit. So I'll say, slightly mix adjusted for that product. And then from a progression standpoint, yes, you can think about this as a gradual steady improvement story over the next several periods.

不，我認為你是完全正確的。 30 多歲的中高水平對我們來說是一個合理的目標，但需要注意的是，正如您所知，疫苗項目 COMIRNATY 與我們的合作夥伴具有共同的毛利率水平。因此，這會抑制毛利率和營業利潤。所以我會說，針對該產品稍微進行了混合調整。然後從進步的角度來看，是的，你可以將其視為接下來幾個時期逐步穩定改進的故事。

Our next question comes from Rajesh Kumar with HSBC.

我們的下一個問題來自匯豐銀行的 Rajesh Kumar。

Just on the medium-term margin profile. Thank you for the color you've provided. If you think about the growth aspirations you have, does that require you sacrificing some of the margins? So if you were to say hit the top end of your growth profile, would we be looking at mid-30s gross margin or lower? Or what is the balance there?

只是中期利潤率概況。感謝您提供的顏色。如果您考慮一下您的成長願望，這是否需要您犧牲一些利潤？因此，如果您說達到了成長曲線的頂端，那麼我們的毛利率是否會達到 30 多歲或更低？或者說那裡的餘額是多少？

And the second one, you briefly touched on your capital allocation priorities earlier. Obviously, cost cutting and deleveraging is a priority for 2024. In the medium term, which are the therapy areas where you would deploy more capital after 2024 deleveraging exercise done?

第二個問題，您之前簡單談到了您的資本配置優先事項。顯然，削減成本和去槓桿化是 2024 年的首要任務。從中期來看，2024 年去槓桿化工作完成後，您將在哪些治療領域部署更多資金？

David, why don't you take that?

大衛，你為什麼不接受這個？

Yes. So maybe on the margin discussion, obviously, what we've said is we have invested pretty substantially in our business over the past couple of years. So largely, the investment phase at least from a business development standpoint is behind us. We have work to invest to improve performance going forward, but the big dollars are already invested now. It's an execution story and a continued improvement story. So you should expect that to occur over the next several periods.

是的。因此，也許在利潤率討論中，顯然，我們所說的是過去幾年我們在業務上進行了大量投資。在很大程度上，至少從業務發展的角度來看，投資階段已經過去了。我們需要投資來提高未來的績效，但現在已經投入了大量資金。這是一個執行的故事和持續改進的故事。因此，您應該預期這種情況會在接下來的幾個時期內發生。

Obviously, the higher the revenue, the better performance because you get to leverage your fixed costs. So clearly, the higher those revenue targets and achievement happen, the better improvement from a margin perspective you should expect from us. And then from a capital allocation perspective, I think you said it right. We are, at the moment, focused on executing our plan, focused on supporting our dividend growth over time, but importantly, beginning to delever as we cycle into an integration of (inaudible) assets. And then from a priority standpoint, clearly, we've made a significant investment in oncology. You should expect us to put the investment thesis behind that franchise going forward. Clearly, that's number one.

顯然，收入越高，績效就越好，因為您可以利用固定成本。很明顯，這些收入目標和成就越高，從利潤率的角度來看，您應該期望我們有更好的改善。然後從資本配置的角度來看，我認為你說得對。目前，我們專注於執行我們的計劃，專注於支持我們的股息隨著時間的推移增長，但重要的是，隨著我們進入（聽不清楚）資產整合，我們開始去槓桿化。然後，從優先事項的角度來看，顯然，我們在腫瘤學方面進行了重大投資。你應該期待我們將投資主題放在該特許經營權的後面。顯然，這是第一。

And I would add that following the oncology, where clearly, we have right now the biggest part of our R&D expenses and we have a significant also part of our SI&A expenses. The other areas that we are putting a lot of emphasis when it comes to reserve, clearly, vaccines, it's a crown jewel and we plan to have significant productivity. In internal medicines, our metabolic franchise, it is an area that we are very excited. Obesity is part of that. We do believe that obesity is a big market and it's growing.

我想補充一點，在腫瘤學之後，顯然，我們現在研發費用的最大部分，我們的 SI&A 費用也有很大一部分。在儲備方面，我們非常重視的其他領域顯然是疫苗，它是皇冠上的寶石，我們計劃擁有顯著的生產力。在內科醫學領域，我們的代謝專營權，這是我們非常興奮的領域。肥胖是其中的一部分。我們確實相信肥胖是一個巨大的市場，而且還在持續成長。

And we do believe that Pfizer has the capabilities that allows us to play and win in that area. So that's an area that we will continue investing. Immune inflammation, we have significant investments is the other area. And of course, we have -- we are among the few that have antiviral and the anti-infectives still investments. So those are the areas that we will put money, oncology, number one, then vaccines, metabolic diseases, immuno-inflammation, antivirals are the ones that we are continuing to invest in.

我們確實相信輝瑞有能力讓我們在該領域發揮作用並取得勝利。所以這是我們將繼續投資的一個領域。免疫炎症，我們還有大量投資的是另一個領域。當然，我們是少數仍在抗病毒和抗感染藥物方面進行投資的國家之一。因此，這些是我們將投入資金的領域，腫瘤學是第一，然後是疫苗、代謝疾病、免疫發炎、抗病毒藥物是我們繼續投資的領域。

Next, we have Kerry Holford with Berenberg.

接下來是凱瑞·霍爾福德和貝倫貝格。

Just a couple of pipeline questions for me, please. Firstly, on RSV. Can we expect you to announce the date for Abrysvo following that third season in Q2? And then also on the 2 Phase III starts, you've highlighted today B6A in lung, CDK4 in breast. When can we expect Phase III data readouts for these 2 products?

請教我幾個管道問題。首先，關於RSV。我們可以期待您在第二季第三季之後宣布 Abrysvo 的日期嗎？然後也在 2 III 期開始時，您今天強調了肺部的 B6A，乳房中的 CDK4。我們什麼時候可以期待這兩種產品的第三階段資料讀出？

I'm not sure -- what was your question on RSV?

我不確定——您對 RSV 的問題是什麼？

To understand when are you going to publish the data from the following, the third season, third season of RSV?

想了解RSV接下來的第三季、第三季什麼時候會發布數據？

Yes. Yes, I got it. Thank you. Why don't you take that, Mikael, on the Abrysvo? And then Chris.

是的。是的，我知道了。謝謝。米凱爾，為什麼不把它帶到阿布里斯沃號上呢？然後是克里斯。

We continue to accumulate important RSV data and expansion of how the -- this important vaccine can be used. So you should expect this first half of the year, likely Q2, that we share more from our clinical trials, including full second season but also expansion in traditional age groups, as you can know, on clintrial.gov, we have active trials, and we think that will very nicely allow high-risk groups across a large age span to be addressed.

我們持續累積重要的 RSV 數據，並擴展如何使用這種重要疫苗。所以你應該期待今年上半年，可能是第二季度，我們會分享更多的臨床試驗，包括完整的第二季，但也會在傳統年齡組中進行擴展，正如你所知，在clintrial.gov上，我們有活躍的試驗，我們認為這將很好地解決大年齡跨度的高風險群體的問題。

Thank you, Mikael. And then Chris?

謝謝你，米凱爾。然後克里斯？

Thank you very much for the question. So the immediate readouts for this year, second half 2024 will be vepdegestrant in second-line hormone receptor-positive metastatic breast cancer, the VERITAC-2 study, also second half 2024. We expect to anticipate results from BREAKWATER, a very important indication, up to 12% of colorectal cancer with Braftovi in first-line BRAF CRC. The new study starting right now is CDK4, B6A and [dacetuzumab] in Phase III programs and then also I hope later this year for EZH2. Those will appear in clinicaltrials.gov and probably completion dates beyond 2025 and 2026. But obviously, there could be interim results with earlier results.

非常感謝你的提問。因此，今年（2024 年下半年）的直接數據將是二線荷爾蒙受體陽性轉移性乳癌的vepdegestrant，即VERITAC-2 研究，也是2024 年下半年。我們預期BREAKWATER 的結果，這是一個非常重要的適應症，在一線 BRAF CRC 中，Braftovi 治療大腸癌的比例高達 12%。現在開始的新研究是 III 期計畫中的 CDK4、B6A 和 [dacetuzumab]，然後我希望在今年稍後進行 EZH2。這些結果將出現在 ClinicalTrials.gov 上，完成日期可能會在 2025 年和 2026 年之後。但顯然，早期結果可能會出現中期結果。

Our next question comes from Chris Shibutani with Goldman Sachs.

我們的下一個問題來自高盛的 Chris Shibutani。

Two questions, if I may. Aamir, with your prior role, you had talked about a $25 billion in revenues by 2030 that the company was looking to deliver based upon M&A. We have the impairment with Arena. Is there an update for that? And now that you're in the role of U.S. Chief Commercial Officer, non-Oncology, non-COVID, what would be on your wish list in your current seat in terms of where you feel an opportunity to expand those revenues potentially through business development that could work to hit that $25 billion target by 2030?

如果可以的話，有兩個問題。 Aamir，在您之前的職位上，您曾談到公司希望透過併購實現到 2030 年實現 250 億美元的收入。我們對競技場有缺陷。有更新嗎？現在，您擔任美國首席商務官，非腫瘤學、非新冠疫情，您認為在當前席位上有哪些機會可以透過業務發展來潛在地擴大這些收入，您的願望清單上會包括哪些內容到2030 年能否實現250 億美元的目標？

Then secondly, with the M&A activity across the industry, investors are always paying attention to what's going on with the FTC. Having passed through this gauntlet with Seagen last year, is there anything you can comment about to help us think about how regulators are thinking about the M&A environment in terms of particularly size of deal or any other dimension that you think is worth being aware of that might have been your observations from your experience in '23?

其次，隨著整個產業的併購活動，投資人始終關注FTC的動向。去年與 Seagen 一起經歷了這一挑戰，您有什麼可以評論的，以幫助我們思考監管機構如何考慮併購環境，特別是交易規模或您認為值得關注的任何其他方面可能是您從23年的經歷中觀察到的？

Thank you very much. Aamir, why don't you take the question? By the way, let me clarify that Aamir's responsibility includes COVID revenue. So go ahead, Aamir.

非常感謝。阿米爾，你為什麼不回答這個問題呢？順便說一句，我要澄清一下，阿米爾的責任包括新冠疫情收入。所以，繼續吧，阿米爾。

Okay. So Chris, there's a lot in what you asked. Firstly, on the $25 billion goal that we put out there, I'll just remind that we guided to $20 billion for what we plan on getting to by 2030 for the deals that we had done. And I would also just remind you that the $25 billion was a 2030 goal, so there is lots of time between now and 2030 to achieve that goal, consistent with our capital allocation priorities that Dave described.

好的。克里斯，你問的問題很多。首先，關於我們提出的 250 億美元目標，我只想提醒一下，我們計劃在 2030 年之前完成的交易達到 200 億美元的目標。我還要提醒大家，250 億美元是 2030 年的目標，因此從現在到 2030 年有很多時間來實現該目標，這與戴夫描述的我們的資本配置優先事項一致。

On your second question, I mean, to be honest, yes, everyone's got a wish list, but my focus is on exactly what I described right now and what we talked about as a management team, which is delivering value from our launches and delivering value from the deals that we've done. So that's where my focus is. Now lastly, in terms of FTC, it's not appropriate for us to comment on what the FTC is going to do or not do. But what I can say is that we feel very good about how we have operated with all regulators in all regulatory bodies across the world to get done all the deals that we did. And I think that just speaks to our patient-centric approach and our collaborative nature with regulators.

關於你的第二個問題，我的意思是，說實話，是的，每個人都有一個願望清單，但我的重點正是我現在所描述的以及我們作為管理團隊所討論的內容，即透過我們的發布和交付提供價值我們所做的交易的價值。這就是我的重點。最後，就 FTC 而言，我們不宜評論 FTC 將做什麼或不做什麼。但我能說的是，我們對與世界各地所有監管機構的所有監管機構合作以完成我們所做的所有交易的方式感到非常滿意。我認為這恰恰說明了我們以病人為中心的方法以及我們與監管機構的合作本質。

Next, we have Akash Tewari with Jefferies.

接下來是阿卡什·特瓦里 (Akash Tewari) 和傑弗里斯 (Jefferies)。

Fair point on the Prevnar comments with the impairment charge and kind of the moving parts between adult, pediatric and international. Consensus had modest top line growth over the next few years for the entire franchise. Is that a reasonable expectation for investors, given the increased competition from Merck and the U.S. pool shrinking? And then do you have an internal view on what the ACIP recommendation will be regarding Prevnar and V116?

Prevnar 對成人、兒童和國際之間的損害費用和活動部件類型的評論是公平的。共識在接下來的幾年裡整個特許經營權的收入略有增長。鑑於默克公司的競爭加劇以及美國資金池的萎縮，這對投資者來說是合理的預期嗎？那麼您對 ACIP 關於 Prevnar 和 V116 的建議有什麼內部看法嗎？

Look, Aamir, why don't you take the -- is it the Prevnar expectations? We don't comment on what the expectations of the Street are, right? So are we -- and I think we gave a very good, let's say, high-level trajectory how we see this market. In the U.S., the adult opportunity, it is mainly as always with the adult, a catch-up opportunity. So when you come, you have a pool of all the people that are eligible, but some of them would choose to make the vaccine.

聽著，阿米爾，你為什麼不接受──這是 Prevnar 的期望嗎？我們不會評論華爾街的期望，對嗎？我們也是如此——我認為我們給了一個非常好的、可以說是我們如何看待這個市場的高層軌跡。在美國，成人的機會，主要是一如既往的成人，一個追趕的機會。所以當你來的時候，你就有了所有符合條件的人的池子，但其中一些會選擇生產疫苗。

Usually, that happens in the first year and maybe a little bit then on the second year. We have exhausted, I think, this opportunity with a 96% market share. So right now, I don't think that we will see in the U.S., in the adult, huge opportunity. Merck competition is coming into that. So this is not a very big growth area for us because, as I said, this is not where we plan to do it. It's huge when you launch them very quickly, goes down because then it is just the people that we are really [going to sway], they are going into this cohort in terms of age.

通常，這種情況發生在第一年，第二年可能會發生一點。我認為，我們已經用盡了這個擁有 96% 市場份額的機會。所以現在，我認為我們不會在美國的成年人身上看到巨大的機會。默克的競爭即將到來。所以這對我們來說不是一個很大的成長領域，因為正如我所說，這不是我們計劃要做的地方。當你非常快速地推出它們時，它是巨大的，會下降，因為那時我們真正[將搖擺]的人，他們在年齡上進入了這個群體。

The big opportunity it is the pediatric because it is 4 doses, it's not 1. And because it is a huge cohort every year, way bigger the cohort of newborns than people that are becoming 65 in the (inaudible). So that's how we should see it. So there is nothing much to add into that.

最大的機會是兒科，因為它是 4 劑，而不是 1 劑。而且因為每年都有一個龐大的群體，新生兒群體比 65 歲的人大得多（聽不清楚）。所以我們應該這樣看。所以沒有什麼好補充的。

Our last question will come from Evan Seigerman with BMO Capital Markets.

我們的最後一個問題將來自 BMO 資本市場的 Evan Seigerman。

Two questions from me. One, when you think about the additional $25 billion revenues by 2030, now that Seagen's part of this business, where are we in getting to that metric? And then my second question is really on Oxbryta on sickle cell disease. When you bought the asset, you really -- you noted that you plan to speed up the distribution of the drug to parts of the world most impacted by the disease. We haven't really seen much OUS, given recent competitive approvals of Casgevy in the Middle East. How do you think about the OUS opportunity in context of the competitive updates there? So Seagen and then thinking about some Oxbryta comments.

我有兩個問題。第一，當您考慮到 2030 年新增 250 億美元收入時，既然 Seagen 已成為該業務的一部分，那麼我們在哪裡可以達到該指標？我的第二個問題其實是關於 Oxbryta 治療鐮狀細胞疾病的問題。當您購買該資產時，您確實注意到您計劃加快將藥物分發到世界上受該疾病影響最嚴重的地區。鑑於 Casgevy 最近在中東獲得競爭性批准，我們還沒有真正看到太多 OUS。在競爭更新的背景下，您如何看待 OUS 的機會？所以 Seagen 然後考慮了一些 Oxbryta 的評論。

On Seagen, maybe I can take it because that's an easy answer. From Seagen, we expect to get $10 billion by year 2030. That was a number that we put out there when we announced the acquisition. Since then, a few things that have reinforced our confidence in this number have occurred. The first one, it is that ADC became the hottest thing on the M&A activity. Everybody wants an ADC, which basically our big bet was in this technology. So it looks like there is an overall consensus among investors, companies, analysts that this is a technology that will deliver a lot. So that gives us a lot of comfort that happened after we announced.

在 Seagen 上，也許我可以接受，因為這是一個簡單的答案。我們預計到 2030 年將從 Seagen 獲得 100 億美元的收入。這是我們在宣布收購時公佈的數字。從那時起，發生了一些事情增強了我們對這個數字的信心。第一個，就是ADC成為併購活動中最熱門的事。每個人都想要一個 ADC，我們基本上把賭注押在了這項技術上。因此，投資人、公司和分析師似乎達成了整體共識，認為這是一項可以帶來許多好處的技術。因此，在我們宣布這一消息後，這給了我們很大的安慰。

The second thing that also happened after we announced is $10 billion was that Seagen came out with significant readouts or significant products that were beyond our expectations. But also what you don't see but we see, they are advancing a lot of stuff that some of them we will show you in the 29th of February. So also, it was a bet in the technology, a bet in the company, we feel that we did very well in both.

在我們宣布 100 億美元之後發生的第二件事是 Seagen 推出了超出我們預期的重要讀數或重要產品。但還有一些你看不到但我們看到的，他們正在推進很多東西，其中一些我們將在 2 月 29 日向你展示。所以，這是對技術的賭注，對公司的賭注，我們覺得我們在這兩方面都做得很好。

So the $10 billion is $10 billion of the $25 billion, but we remain -- we don't change it, but we remain confident that we can make it. Then of course, in addition to that, there was an additional $10 billion for all the other things that we have done, and this $5 billion that we could execute. Now on Oxbryta, how Oxbryta is doing, Aamir?

因此，100 億美元是 250 億美元中的 100 億美元，但我們仍然——我們不會改變它，但我們仍然有信心實現這一目標。當然，除此之外，還有額外的 100 億美元用於我們已經完成的所有其他事情，以及我們可以執行的 50 億美元。現在 Oxbryta 上，Oxbryta 怎麼樣，阿米爾？

Yes. So Evan, with regards to Oxbryta and then I'll comment on the acquisition as well since you referred to that. We're pleased with the U.S. performance. Q4 was up 30% over the prior year and 14% over the prior quarter. The prescription trends are very solid. We've made a lot of investments in customer-facing teams since we made that acquisition. So we like the momentum that we're seeing in the U.S., and we expect to see more.

是的。 Evan，關於 Oxbryta，既然你提到了這一點，我也會對這次收購發表評論。我們對美國的表現感到滿意。第四季年增 30%，季增 14%。處方趨勢非常穩定。自從我們進行收購以來，我們在面向客戶的團隊上進行了大量投資。因此，我們喜歡在美國看到的勢頭，並且預計會看到更多。

Right now, the rest of the world is a very small part of Oxbryta revenue, and that is something that will take time to develop and we'll obviously look at that appropriately. And as you think about the GBT acquisition, it's important to look at Oxbryta, but I also would remind you that we're also very excited about GBT601, which we expect can bring a lot of value in addition to Oxbryta. Some of it will -- if it's successful from a clinical and regulatory perspective, some sales will be cannibalized, but there will also be room for Oxbryta in the market to continue to grow.

目前，世界其他地區只佔 Oxbryta 收入的一小部分，這需要時間來發展，我們顯然會適當地考慮這一點。當您考慮 GBT 收購時，關注 Oxbryta 很重要，但我還要提醒您，我們對 GBT601 也感到非常興奮，我們預計 GBT601 除了 Oxbryta 之外還能帶來很多價值。其中一些會——如果從臨床和監管的角度來看是成功的，一些銷售額將被蠶食，但 Oxbryta 在市場上也將有繼續增長的空間。

So when you look at the combination of the momentum in the U.S., an opportunity that's yet to be developed outside the U.S. and 601, where we presented great data at ASH in December, we think that there's a lot of value to be gained from this acquisition.

因此，當你看到美國的勢頭（美國以外尚未開發的機會）和 601（我們在 12 月的 ASH 上展示了出色的數據）的結合時，我們認為可以從中獲得很多價值獲得。

Yes. And I would add, it is the same exactly with the GBT acquisition. When we did the acquisition, we announced our projections for year 2030. Since then, things have improved in terms of our confidence to deliver these numbers. And I'm not talking only that Oxbryta is performing exactly as we thought it would, but the most important upside it is that we had data that we didn't have when we made the acquisition on the 601 but has the potential to become a transformative therapy in the sickle cell and really, really brings to the next -- it's a step change if that thing -- if the Phase III, let's say, reconfirms the Phase II results.

是的。我想補充一點，這與 GBT 的收購完全相同。當我們進行收購時，我們宣布了 2030 年的預測。從那時起，我們實現這些數字的信心有所改善。我並不是說 Oxbryta 的表現完全符合我們的預期，最重要的好處是我們擁有了收購 601 時沒有的數據，但有潛力成為鐮狀細胞病的變革性療法確實會帶來下一步——如果那件事的話——如果第三階段，比如說，重新確認第二階段的結果，那就是一個階躍變化。

So also over there, I think what we announced, we feel now we're more confident but we should be able to achieve and hopefully exceed.

因此，我認為我們宣布的內容現在更加有信心，但我們應該能夠實現並希望超越。

So with that, I think we start to end the call. In summary, we are optimistic about the year ahead. We have defined our 5 key priorities that will keep us focused. And I repeat again, this will be a year of execution. I have a sample, a team that are healthy, that I believe are the absolutely right leaders to execute. And I know that the whole world was impressed with the way that we executed our COVID strategies, how we were able to execute on the R&D front, on the manufacturing front and on the commercial front with 2 products, the vaccine with the highest market share and with the product in oral antiviral.

至此，我想我們就開始結束通話了。總而言之，我們對未來一年持樂觀態度。我們已經確定了 5 個關鍵優先事項，這將使我們保持專注。我再說一遍，這將是執行的一年。我有一個樣本，一個健康的團隊，我相信他們是絕對正確的領導者。我知道全世界都對我們執行新冠病毒策略的方式印象深刻，我們如何能夠在研發方面、生產方面和商業方面執行兩種產品，即市場份額最高的疫苗並與該產品一起口服抗病毒藥物。

We plan to repeat the same execution excellence level as we are building oncology leadership, as we are progressing the next wave of our pipeline, as we are maximizing the performance of all these new launches that have happened, as we execute our cost realignment program starting this year with SI&A, but also which you will see the results. But also of course, the program to improve the gross margin that you won't see results now because it takes long but we started now as we speak, and laser focus in maximizing value for shareholders with the way that we allocate our capital.

我們計劃重複相同的卓越執行水平，因為我們正在建立腫瘤學領導地位，因為我們正在推進下一波產品線，因為我們正在最大限度地提高所有這些新產品的性能，因為我們開始執行我們的成本調整計劃今年與 SI&A 一起，您也將看到結果。當然，提高毛利率的計劃現在還看不到結果，因為它需要很長時間，但正如我們所說，我們現在就開始了，並專注於透過我們分配資本的方式為股東實現價值最大化。

The team is there to make sure that this will happen, and I think we should meet again in 3 months, and we will see how we are progressing against those stated goals. Thank you very much all. Bye-bye.

團隊的職責是確保這一切能夠實現，我認為我們應該在 3 個月後再次見面，我們將了解我們在實現這些既定目標方面取得的進展。非常感謝大家。再見。

Thank you, ladies and gentlemen. This does conclude today's Pfizer's Fourth Quarter 2023 Earnings Conference Call. We appreciate your participation, and you may disconnect at this time.

謝謝你們，女士們、先生們。今天的輝瑞 2023 年第四季財報電話會議到此結束。我們感謝您的參與，此時您可以斷開連線。