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。我代表輝瑞團隊感謝您的加入。此次電話會議將透過 Pfizer.com 上的音訊網路直播進行。今天早些時候，我們透過新聞稿發布了 2023 年第四季和全年業績，可在我們的網站 Pfizer.com 上查閱。

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.

今天與我一起出席的還有我們的董事長兼執行長 Albert Bourla 博士；以及我們的財務長 Dave Denton。阿爾伯特和戴夫已經準備好了一些發言，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官 Chris Boshoff 博士； Alexandre de Germay，執行副總裁兼首席國際商務官；首席科學官兼研發總裁 Mikael Dolsten 博士； 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.

在我們開始之前，我想提醒您，我們將做出前瞻性陳述並討論某些非 GAAP 財務指標。我鼓勵您閱讀我們幻燈片簡報中的免責聲明、我們今天早上發布的新聞稿以及我們向美國證券交易委員會 (SEC) 提交的文件中披露的內容，這些內容均可在 IR 網站 Pfizer.com 上查閱。電話會議中的前瞻性陳述受重大風險和不確定性的影響，僅代表電話會議最初日期的觀點，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.

說完這些，我將把電話轉給阿爾伯特。

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，感謝大家的收看。我很高興討論 2023 年第四季和全年的一些亮點，當然還有我們度過的令人矚目的一年。首先，我想對 2023 年做一些思考。如您所知，我們沒有達到最初的內部預測和華爾街預期，這主要與我們的 COVID 產品有關，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 年仍發生了一些偉大的事情，這些事情可能因未達預期而被遺忘。

First, in 2023, Pfizer impacted the lives of more than [618 million] (corrected by company after the call) 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，輝瑞影響了全球約超過[6.18億]人（公告後公司更正）的生活。我們相信，沒有其他公司能夠像輝瑞一樣影響如此多的人群和病人。如果將其與我們的品牌資產和知名度相乘，就會與消費者建立聯繫，這對我們來說是一筆非常寶貴的財富。

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 COVID 產品收入有所下降，但截至 2023 年前 9 個月的報告業績，就純藥品收入而言，我們仍是排名第一的製藥公司，較 2019 年的第四位有顯著提升。

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.

其次，2023 年是 FDA 批准創紀錄的一年，輝瑞公司批准了 9 個新的分子實體，並批准了更多已獲批准產品的新適應症，這標誌著輝瑞公司在產品線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證明了我們成功與監管機構合作的能力。

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 年全年的深思熟慮和策略努力為我們奠定了堅實的基礎。我們現在專注於最大限度地利用那些為我們帶來成功的機會，我們的團隊在 2024 年伊始充滿信心地前進。

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.

從青黴素的問世到新冠疫苗的研發，175年來，輝瑞一直走在醫學和製藥突破的前線。今年是我們的175週年紀念，這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.

我們的策略是繼續發揚我們引以為傲的創新和商業卓越的歷史，而這項策略得益於我們無與倫比的全球規模和覆蓋商業、金融、醫療、監管、製造和政府關係的影響力。我們對如何在整個業務中實現營運、商業和財務方面的成功有著清晰的認識。

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五項策略重點來更加關注我們的業務。我們將對每個問題進行更詳細的討論，但輝瑞今年的五個關鍵任務是：首先，實現世界一流的腫瘤學領導地位；推動下一波管道創新；最大限度地提高我們新產品的性能；通過重新調整成本基礎來擴大利潤率；分配資本來提高股東價值。我相信輝瑞有能力執行，並能為我們的病人和股東創造有意義的價值。

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.

讓我們從首要任務開始，那就是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，每 3 人就有 1 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 的收購使我們的腫瘤學研究和資源在一夜之間翻了一番，並顯著擴大了我們在美國商業和醫療領域的覆蓋範圍和醫療影響，而 Seagen 廣泛而深入的產品線推動了一系列投資組合擴展機會。

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提升輝瑞的營收成長，而我們合併後的產品組合提供了引領泌尿生殖系統癌症和成為乳癌領域的領導者的機會，並在 2030 年前提供至少 8 種潛在的重磅產品。我們期待在 2 月 29 日的輝瑞腫瘤創新日上提供有關我們的腫瘤平台的更多資訊。

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.

隨著我們建立領導地位，我們將在 2024 年重點關注多個潛在的關鍵腫瘤學催化劑。在商業方面，PADCEV 與 pembrolizumab 聯合用於治療局部晚期/轉移性膀胱癌，XTANDI 與 pembrolizumab 聯合用於治療非轉移性去勢敏感前列腺癌。我們對 PADCEV EV-302 數據的強勁表現和最近獲得 FDA 批准感到非常興奮，因為這代表著一個機會，可以將這種可能改變實踐的無鉑方案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 3 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 3 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.

實質上，最近的批准使目標人口增加了一倍，而今年春天目標人口已經增加了一倍。我們也期待 vepdegestrant 在二線 HR 陽性轉移性乳癌治療中的 3 期數據讀數；以及 Braftovi 用於一線 BRAF 結直腸癌治療。我們也計劃推進我們的後期研發管線，啟動 CDK4/6 後轉移性乳癌的 CDK4 和非小細胞肺癌的 B6A 的 3 期研究。基於輝瑞的潛在藥物、乳癌、泌尿生殖系統癌症、血液學和 CRC 領域的研發管線，我們的 CDK4 抑制劑可能成為 IBRANCE 的有力後續產品。

And finally, in the early-stage pipeline, we look forward to initiating first in patient 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，我們期待今年首次啟動 4 種新的 ADC 候選藥物的患者研究，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.

我們的第二個任務是透過腫瘤學以外的疫苗、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，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，並且支持了我們強大的產品線。我們正在跨模式和跨平台追求尖端科學，以實現下一代潛在的突破。我們也利用整個價值鏈的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，該疫苗最近進入臨床並獲得了 FDA 快速通道資格。憑藉我們在 Prevnar 方面的深厚經驗，我們旨在透過提高效力和血清型免疫原性來鞏固我們在肺炎球菌疫苗領域的領導地位，同時保持我們獨特的 FDA 標籤，其中包括 IPD 和成人肺炎球菌性肺炎。

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在成功的 COVID 疫苗基礎上引領的另一個領域。對於第一代獨立 mRNA 流感疫苗，數據顯示，與建議的流感疫苗相比，該疫苗對 18 至 64 歲人群具有相對有效性，但未達到 B 株免疫原性的成功標準。

Our second-generation flu vaccine was tested in a Phase 2 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 3 COVID/flu combination trial.

我們的第二代流感疫苗已在針對 18 至 64 歲人群的二期 COVID/流感聯合研究中進行了測試，並且在 A 型和 B 型病毒株中均顯示出令人鼓舞的結果。這項新構建體目前已進入第三階段 COVID/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.

移至 GBT601 旁邊。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優於 Oxbryta 的潛在逐步演化。 ASH 2023 上公佈的最新數據顯示，經過治療後，多項血液參數接近正常範圍，表明 GBT601 可能具有透過每日服用一次藥丸的便利性發揮強大功效的潛力。我們重申了對新興心臟代謝計畫的承諾，其中包括幾種早期臨床開發化合物。

On the other end of the weight management spectrum, we have ponsegromab, our GDF-15 neutralizing antibody for cancer cachexia with Phase 2 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，這是用於治療癌症惡病質的 GDF-15 中和抗體，預計第 2 階段數據將在今年稍後公佈。 Ponsegromab 有可能成為同類首創藥物和首個獲得 FDA 批准的治療癌症惡病質的藥物，癌症惡病質佔所有癌症死亡人數的 20% 至 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.

我們的第三個優先事項當然是透過堅持不懈地關注執行來最大限度地提高我們的新產品和核心特許經營的性能，以繼續增加我們的營業收入。為了實現這一目標，我們要確定優先順序並集中精力，同時利用資料快速做出改變並進行適應。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，並擴大影響力，以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。隨著美國和全球範圍內藥品的可及性和處方量的不斷增加，我們將繼續專注於直接面向消費者的營銷，減少醫療從業者和患者獲得藥品和負擔藥品的障礙。

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定義為慢性/主動治療來積極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，我們致力於將 RSV 疫苗接種作為全年討論的主題，並擴大我們的零售承包和產品範圍，從而提高整體 RSV 市場的成長和市場份額。

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，我們專注於為學術機構和社區中的醫療保健從業人員提供教育、提高意識和開展新的患者試驗。

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.

自 VELSIPITY 首次推出以來，我們致力於協助確保患者能夠使用 VELSIPITY 作為第一線先進口服治療選擇。

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，我們將繼續加快為合適的斑禿患者考慮先進的全身治療，並進一步解鎖使用 LITFULO 的管道。

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.

此外，當然，我們也會繼續保護和發展我們的核心特許經營權和主要重磅藥物，包括 Prevnar、VYNDAQEL 和 Eliquis，同時探索進一步推進一系列創新組合方案的機會。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市場產品。

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，所有這些因素都將支持我們在 2024 年的成長潛力，並推動我們在 2025 年的成長潛力。我們計劃全年提供有關如何推進這些戰略重點的最新資訊。

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?

說完這些，我將把電話轉給戴夫，他將討論我們的財務業績、我們重新調整成本基礎的舉措以及我們的資本配置策略，以提高股東價值。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。當我們進入 2024 年時，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一流的腫瘤學組織；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新產品組合的性能；最後，合理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，今天上午我將首先介紹我們的全年和第四季度業績，然後再談談我們的資本配置重點。今天上午，我將就我們的 2024 年指引和近期預期發表一些評論，這些預期將今年定為推動我們在未來十年後半期成長潛力的基礎之年。

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 7% 的營運成長，在不包括 COMIRNATY 和 PAXLOVID 的貢獻時，這與我們的預期完全一致。我們的 COVID 產品銷售額大幅下降，包括 PAXLOVID 35 億美元的收入逆轉，是整體營運收入年減 41% 的主要原因。我們預計 Seagen 將在 2024 年及以後成為重要的成長貢獻者，我們的全年和第四季度業績包括 12 月 14 日收購結束後約 1.2 億美元的 Seagen 產品收入。

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.

總體而言，我們報告 2023 年全年攤薄每股收益為 0.37 美元，年減 93%，調整後每股攤薄收益為 1.84 美元，較 LY 下降 72%。下降的主要原因是 COMIRNATY 和 PAXLOVID 的銷售額均大幅下降；第四季度 PAXLOVID 收入逆轉 35 億美元的影響與美國政府預計退還約 650 萬個未使用的 EUA 標籤治療療程有關；最後，第三季度記錄了 PAXLOVID 和 COMIRNATY（較小程度上）的非現金註銷費用和其他費用 56 億美元費用。

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.

現在談到本季度，我想強調的是，我們實現了同比 8% 的穩健營業收入成長，這同樣不包括 COMIRNATY 和 PAXLOVID。我們新獲批准的 RSV 疫苗以及 VYNDAQEL 和 Eliquis 推動了強勁業績，但 IBRANCE 和 Prevnar 系列的收入下降部分抵消了這一增長。然而，我們第四季度的業績（包括營收和淨利潤）將比去年同期繼續受到 COVID 產品的顯著負面影響。由於 COMIRNATY 和 PAXLOVID 銷售額大幅下降，導致營運收入下降 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，這主要歸因於 35 億美元的非現金 PAXLOVID 收入逆轉，以及在較小程度上銷售組合的不利變化。總體而言，我們的調整後營業費用與去年第四季相比下降了 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.

調整後的 SI&A 費用在本季度營運中增加了 1%，主要原因是行銷和促銷活動的時機，包括與最近推出和收購的產品相關的活動。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。調整後的研發費用營運支出下降了 24%，主要原因是疫苗項目和某些收購資產的支出減少，以及薪酬相關費用減少。

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.

本季我們報告的每股攤薄虧損 0.60 美元和調整後每股攤薄收益 0.10 美元均受到 35 億美元 PAXLOVID 收入逆轉的負面影響，導致每股收益下降約 0.54 美元。 COMIRNATY 和 PAXLOVID 銷售額的持續下滑也對我們本季的業績產生了負面影響。與去年第四季相比，外匯變動的影響並不重大。

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.

由於我們越來越注重優先考慮我們的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，該費用基於額外適應症的開發計劃和整體收入預期的變化。但我要指出的是，該產品預計仍將貢獻超過 10 億美元的年銷售額。此外，我們記錄了 Prevnar 13 近 10 億美元的無形資產減值，這反映了向血清型覆蓋率更高的疫苗的轉變。

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，並基於三大核心支柱：首先是增加股利；第二是對業務進行再投資；最後是在降低資產負債表槓桿率後進行股票回購。

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，我們透過季度股息向股東返還 92 億美元；我們在內部研發方面投資了 107 億美元；最後，我們已投資約 440 億美元用於完成業務發展交易（扣除收購現金），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我們的股息，同時降低資本結構的槓桿率，總槓桿率目標為 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管道。在實現去槓桿目標後，我們預期將恢復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.

鑑於我們於 12 月 13 日發布了 2024 年全年收入和調整後每股攤薄收益指引，讓我簡單介紹一下其中的幾個亮點。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強勁貢獻的預期。重要的是，不包括 COMIRNATY 和 PAXLOVID，我們預計營業收入將成長 8% 至 10%。我們堅信，到今年年底，我們的成本調整計畫將帶來至少 40 億美元的淨節約。我們相信，合理調整成本基礎將為我們未來擴大利潤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 年全年調整後每股攤薄收益將在 2.05 美元至 2.25 美元之間。提醒一下，該範圍包括了收購 Seagen 預計帶來的 0.40 美元的收益稀釋，而且，其中絕大部分稀釋來自與該交易相關的融資成本。展望 2024 年，我們已對業務進行了大量投資，以推動我們的長期成長，並且該基礎將履行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，同時鞏固本世紀下半葉的成長預期。

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

現在，我想將話題轉回給阿爾伯特，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。現在，讓我們開始問答環節。接線員，請集合排隊。

(Operator Instructions)

（操作員指令）

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，但如果我為你對 24 財年的利潤率預測做數學計算，根據我的計算，其他生物製藥公司的利潤率必須下降到 60% 左右才能平衡其他利潤率。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以及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。我們對毛利率的預期，雖然我們沒有具體提供，但我們大致給出了大約 70% 的水平。顯然，我們未來的重點是提高我們的利潤率，更重要的是，提高我們的營業利潤率。展望 2024 年，有一些因素壓縮了我們的利潤率，而新冠疫情的利潤率則同比下降，可以說，這有助於去槓桿，因為新冠疫情佔用了損益表並覆蓋了一些固定間接費用。

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，我們正在購買我們最近收購的產品。這些——在我們達到峰值產量和性能之前，內部採購需要時間，因此在短期內，會降低毛利率，但隨著時間的推移，毛利率會增加。其次，我們有新產品將於第三季末或 2023 年下半年末上市，並延續到 2024 年。再說一遍，它們還沒有達到最佳性能。隨著我們進入後期，這最終將會提高毛利率。

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，我想說的是，在過去幾年裡，我們的銷售成本已經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。我希望這能給你一些啟發。

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.

這裡也許還有另一種財務問題。當然，第四季的研發支出明顯低於你們設定的水平。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？它是否只是 SGEN 後期整合的產物？顯然，您正在重申您的指南，但也許如果您能為我們勾選該框，那將會很有幫助。

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。可能對此沒有太多可解讀的。顯然，研發進展比我們之前的預期要好一些。部分原因是我們非常注重重新調整我們的成本基礎，以與計劃保持一致。其次，可能存在一些時間因素，會抑制第四季的研發，並將持續到 2024 年和 2025 年。因此，這會對該績效水準產生一些時間影響。

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 億美元的淨節約。如果你展望 2023 年底，你會發現我們已經實現了其中的一半。我們現在專注於在 2024 年實現額外的 20 億美元左右的目標，所有人的目光都集中在這個目標上。

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

謝謝你，戴夫。我們對我們給出的數字非常有信心。

Our next question will come from Louise Chen with Cantor.

我們的下一個問題來自 Cantor 的 Louise Chen。

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.?

想詢問您關於 Prevnar 特許經營權的問題。首先，對於第四代 PCV，您能否詳細介紹一下它與 Prevnar 20 相比有何不同？那麼關於 Prevnar 訂單時間問題，是在美國境內還是美國以外地區？

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？然後也許亞歷山大，你可以稍微介紹一下美國的情況。那麼 Prevnar 的命令情況如何呢？

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。因此，路易絲，就 Prevnar 而言，對於兒科業務，考慮到 CDC 命令的時間和影響，我們經常會看到季度收入出現一些波動，因此很難逐季度地繪製出所有這些圖表。所以你應該對兒科業務有這樣的預期。但就兒科業務而言，我們對於業務發布的進展以及所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.

就成人業務而言，我認為情況有所不同，因為我們擁有 96% 的市場份額，並且我們在年底關閉了成人業務。但我們必須牢記，我們所在的市場患者數量正在穩定減少。與先前的建議相比，這是一個很大的追趕機會，我們已經利用了這個追趕機會。因此，剩下的患者一般都是65歲以上的老年人以及患有潛在疾病的患者，這些患者更難激活。因此，我們預計未來該業務將繼續面臨患者數量減少的問題。我們也預期 V116 的競爭將使成人市場競爭更加激烈，但我們看到兒科市場具有巨大的成長潛力。

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

謝謝。亞歷山大，上個季度或今年 Prevnar 在國際市場上的表現如何？

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，我們在美國以外的業務大部分是由招標推動的。當然，我們在發貨時就會記錄銷售額。它並不反映利用率。然後政府在各自的市場安排他們的活動。實際情況是，我們繼續在全球 113 個市場擁有 IP 獨家經營權。同時，我們在兒科領域繼續取得進展，正如您上週看到的，CHMP 給出了積極意見，現在我們將進入最終審批階段，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，我們看到成人特許經營業務取得了一些積極的進展，我們已在 30 多個市場推出了這項業務。我們在疫苗技術委員會的建議下看到了一些非常好的進展。舉個例子，以前在德國、法國和英國等國家，我們的 Prevnar 13 的使用非常有限。我們剛剛收到德國 VTC 的建議，建議 60 歲以上的老年人以及 18 至 59 歲的高危險群使用 Prevnar 20，我們認為，在美國以外，我們在增加成年人口疫苗接種方面有巨大的成長機會。

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

米凱爾，最後您對於第四代 Prevnar 有什麼看法？

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。它擁有美國 FDA 的快速通道認證，表明其產品具有獨特性。它包含了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、載體還是配方。當然，它依賴獨特的輝瑞平台，可以有效預防侵襲性疾病（疾病負擔較小的疾病）和肺炎球菌疾病（導致超過 15 萬人住院）。據我所知，我們是唯一能夠解決這兩個問題的人。所以我們對於這個作品感覺非常滿意。

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。所以，為了總結 Prevnar，我知道每個人都在關注它，讓我們從商業方面開始。在美國，顯然，在成人機會方面，我們基本上已經抓住了追趕機會中的精華。一旦您收到 CDC 的補種建議，就會發生這種情況。這個市場的患者群體已經基本枯竭。我們已經佔有96％的市佔率。因此，這不是一個我們預計從現在起將在美國持續成長的市場。

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.

兒科的情況則完全不同，因為我們的市佔率正在成長，有跡象顯示我們將繼續強勁成長。因此，我們預計，在美國，Prevnar 的情況將成為兒科領域強勁成長的案例。在國際上，我們都預計會看到成長，因為產品剛剛推出，隨後會推出建議。因此，國際上的延遲比美國通常的延遲要高。所以我們預計成人和兒科的病例會有所增長。

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，我們基本上在 100 多個國家擁有 Prevnar 13 的獨家經營權，其中 113 個是北愛爾蘭招標的國家。我們計劃現在將這個數字擴大到 20。而對於第四代，我們將全速前進。我們認為，我們的專業知識將使我們能夠開發出一種多價疫苗，這種疫苗將作為第四代疫苗具有非常好的競爭力，而且我們將成功且快速地做到這一點。故事就是這樣的。

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?

瑞銀的 Trung 說。請給我兩份。因此，在您準備好的評論中，您指出您承擔了與 etrasimod 相關的 14 億美元的減損費用。你能在這裡添加更多顏色嗎？是什麼促使了這項重新評估？關於此次發布的進展有什麼回饋嗎？其次，關於 Abrysvo，您能否向我們介紹一下 24 年與 23 年相比您的承包合約有何變化？基於此，您認為今年您的市佔率相對於去年的 35% 能達到多少？

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，你為什麼不先回答損害問題，然後我再轉向商業人士？

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，關於 etrasimod，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，還有其他跡象表明該藥物符合我們在本季度採取的減值的財務標準。臨床上，顯然，臨床上仍需要繼續進行一些工作來支持該資產。那麼...

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

非常感謝。所以 Aamir，也許 etrasimod 可以商業化，發布會進展如何，以及 Abrysvo 如何。

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。因此我將從 etrasimod 或我們稱為 VELSIPITY 的藥物開始。因此，僅從產品價值主張的角度來看，我們認為這對於中度至重度 UC 患者來說是一種非常有前景的口服選擇。對於我們接觸過的患者和醫生來說，它具有很強的療效。他們希望開始從傳統療法過渡到先進療法。而且它也為他們提供了保持每天一次口服治療的選擇，許多人已經在這樣做了，而不需要從注射或輸液開始。因此，大約 80% 的尚未接受晚期治療的患者傾向於口服藥物，但實際上只有大約 10% 的患者得到了口服藥物。

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，VELSIPITY 可以幫助我們滿足。 VELSIPITY 的效益風險狀況也非常非常強勁。因此我們批准了——我們在去年年底獲得了批准。因此，我們投入了大量精力來提高 HCP 和患者對標籤和價值主張的認識。但我只想提醒你，任何免疫發炎產品都需要時間才能在全國廣泛推廣。我們現在的重點是確保 VELSIPITY 能夠成為第一線先進口服治療藥物，而這需要一些時間來實現。當我們實現這一點時，我們就會看到發布帶來的上行動能。

What about Abrysvo?

Abrysvo 怎麼樣？

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，我將先簡單評論一下成年人，然後再評論一下母親。關於成人疫苗，我認為市場顯然超出了所有人的預期，並且不受共享臨床決策與常規建議的限制。我們希望做得比您所提到的30%左右的份額更好。因此，我們非常注重 24、25 賽季的零售合約。但我還要提到，我們在這樣做時非常謹慎，以確保我們在這些合約中獲得有利可圖的份額，並利用我們的母體適應症進行區分。

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.

我們還在非零售領域看到了機會，例如，透過 VA 系統和 IDN，我們佔據了很大的份額。我們還將關注目前正在與 Abrysvo 共同研究的新機會、患有潛在疾病的 18 歲及以上成年人，以及新的包裝展示，以更好地滿足客戶需求。因此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.

在產婦方面，我們只花了幾個月的時間，但我們對看到的第一種孕產婦疫苗感到鼓舞，該疫苗可以預防最脆弱的嬰兒從出生到 6 個月的感染。超過 65% 的女性更願意接種孕期疫苗，而不是給嬰兒接種單株抗體疫苗。我們認為該品牌也為我們提供了擴大該領域的機會。

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 Terence Flynn。

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.

對我來說是兩個。我想第一個就是 COMIRNATY 本季世界其他地區的表現超出了普遍預期。只是想知道，在現有的歐盟合約下，這個數字中是否有任何一次性福利，這是否是一個公平的未來銷售水平，可以考慮到 2026 年？第二個問題是，我注意到在公關或準備好的評論中沒有提到 danuglipron。只是想知道每天一次的 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。也許很快就到了 danu，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。我們現在正在進行一個由大量實驗組成的項目，將其改為每天一次，並且只有當我們有數據時我們才會說話。我們不想再次成為另一場財報電話會議的焦點。但話雖如此，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 COMIRNATY。那邊的動態是什麼樣的呢？

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 系列有多種元素發揮作用。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，我們發現這些指南實際上不僅關注高風險族群，也關注老年人口。但正如你所知，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。並在去年8月獲得批准後，開始履行與歐洲國家的合約。事實上，一些國家已決定將 2024 年的部分訂單提前至 2023 年，以便能夠妥善進行疫苗接種活動。

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，我們預計未來一年疫苗接種率不會大幅上升。我們認為，我們在 2023 年、2024 年活動中看到的真正是我們將看到的疫苗接種類型，並將在未來幾年繼續進行。就疫苗接種率而言，未來唯一可能成長的領域是，如果我們能夠增加與流感疫苗的共同接種，那麼在我們所有主要市場中，流感疫苗的接種率實際上高於 COMIRNATY。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.

我要說的最後一點是，正如你所看到的，COMIRNATY 自我模式正在向季節性模式演變。因此，您會看到第四季度的表現非常強勁，就像您預期的流感疫苗市場一樣。這也是我們對 2024 年的期待。實際上，當我在閱讀金融界的一些模型時，我認為人們對第一季和第二季的銷售額是否會更高存在一些疑惑，我認為這將更多地出現在下半年，但當然，這符合指導方針。

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 3 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.

阿爾伯特，我查看了 Cerevel 提交給美國證券交易委員會的文件，他們披露，輝瑞願意在獲得第三階段數據後（也就是 2024 年）對 Cerevel 提出收購要約，這意味著我還注意到您說您不打算在 2024 年回購，去槓桿仍然是首要任務。所以我只是想平衡這兩者，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 at 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 from 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，看，我會請戴夫來談論這件事。但事實上，我們專注於一切、參與一切，並不代表這是我們的義務。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。我們的首要任務就是派發紅利，不斷成長的紅利。接下來就是一年的執行。正如大衛所說，我們試著去槓桿。

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?

一旦我們將去槓桿率提升到我們所期望的水平，我們就會開始進行股票回購，當然還有併購，這意味著，對於24年，我們將看到一切存在，因為我們永遠不會說永遠不會有業務發展機會的到來。但我們的策略是，你不會看到業務發展在美元方面有任何重大變化。大衛，我說得好嗎？

You said it well. You are correct.

你說得很好。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。還有一個問題，烏梅爾（Umer）？我想就是這樣了，對吧？是的。謝謝你，烏默爾。

Next, we have Tim Anderson with Wolfe Research.

接下來是 Wolfe Research 的 Tim Anderson。

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?

也許對阿米爾來說是如此。因此 Eliquis 是 IRA 初始 10 種藥物名單中最大的藥物。 CMS 必須在 2 月 1 日之前向您提供初步建議的協商價格，所以還有 2 天的時間。這裡有 2 個問題。您能否確認您尚未收到初步提案？第二個問題，我們是否可以預期，從現在到 9 月 1 日（這是他們必須公佈最終價格的最後期限）之間的某個時間點，您會向一些投資者提供一些關於這些討論進展的方向性信息？難道在 9 月 1 日之前我們都會一無所知嗎？

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

那麼阿米爾，你打算給提姆更多光明嗎？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，整個醫療保險的定價權都是新事物，製藥公司顯然開始了解聯邦政府的這一流程。這些規則很複雜，所以我們正在仔細研究它。我們的聯盟夥伴 BMS 正在牽頭並與 CMS 合作，以正式確定將於 2026 年 1 月 1 日開始的 D 部分中 Eliquis 的價格。而且我相信您可以理解，我們不會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。由於這些事情仍在進行中，因此很難對其進行評論。所以這是非常不合適的，而且絕對會使事情變得複雜。我知道人們有必要了解這一點，因為這是一個重要的產品。我們將盡快嘗試並提供切實可行的詳細程度，以便每個人都能夠查看並對其進行適當的建模。

Our next question will come from Andrew Baum with Citi.

我們的下一個問題來自花旗的 Andrew Baum。

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.

請問我幾個問題。首先請問阿米爾先生，在您的新領導和商業重點下，在加速推出軌跡方面，您會引導我們關注最近推出的哪些關鍵產品？而且不一定是最近推出的，也可以是已經成熟的。其次是米凱爾。您能否分享一些有關下一代 PCV 疫苗的信息，具體有多少种血清型？我認為，鑑於這是一項新技術，隨著 CAPiTA 試驗的成熟，您將無法將肺炎索賠從其納入產品概況。如果您能確認的話，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，安德魯。您的假設，我認為它不正確，但 Mikael 會回答這個問題。但我們首先請阿米爾介紹您如何看待 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。所以安德魯，我先退一步，首先我要說的是，我對這個角色和這個機會感到非常興奮。這也是我們與已建立的團隊共同完成的，這個團隊既有經驗豐富的輝瑞領導者，也有來自輝瑞以外的經驗豐富的領導者。我的意思是我的重點，我們可以談論具體的產品，我們已經討論過其中的許多產品。但我總體上關注的是卓越的執行力，對嗎？因此，在我們的初級保健和專科護理組合中，我們有很多優秀的品牌。我們擁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個問題。我們的重點是盡力防守和發展，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，我們擁有一些具有出色價值主張的品牌，但它們恰好處於競爭激烈的類別中，並且擁有一些根深蒂固的競爭對手。因此，在這種情況下，我主要關注的是讓我們真正優先考慮能夠發展每個品牌的行動，然後我們可以討論單獨的發布。很多操作重點都集中在阻止和解決問題上，包括簽訂合約。

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，我們會發現我們有外勤人員、廣告和促銷資金以及醫療能力，我們只是優先考慮將它們用在何處。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中看到了機會，並且在捍衛和擴大我們的份額的同時，也看到了我們推出的一些新產品中的機會。阿爾伯特在開幕詞中提到了我們希望和期待與 Abrysvo、Nurtec、LITFULO、CIBINQO 合作的事情。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，請允許我冒昧地請其他商業領袖就他們的優先事項發表一些評論，因為這將使您更好地了解整個情況。亞歷山大，在您接手國際業務期間，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.

感謝阿爾伯特提出這個問題，並給了我分享我的優先事項的機會。我的主要關注點實際上是集中在能夠透過提高投資回報率來實現物質成長的領域。這是我的口頭禪。我們該如何做呢？我最大的四大市場依序是：中國、日本、德國和法國，這四大市場占我們國際部門的 40%。所以它相當集中。這 4 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盡可能地執行其計劃並實現最大的成長。

Our top 15 countries 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.

我們的前 15 個國家占我們國際業務總額的 70%。因此，它再次顯得相當集中。我目前實際上正在做的是，在每個市場中選擇我們的成長動力。我們可以透過提高投資回報對哪些關鍵現有產品和關鍵新產品產生實質影響？舉個例子，當然，不同國家的情況會有所不同，因為這些市場的原型和動態是不同的。所以上週，我去了日本。例如，VYNDAQEL 的診斷率是美國和法國的診斷率的一半。因此，我們上週審查了該計劃，以解決診斷率上升的問題。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，我們擁有尚未開發的成長機會。下週我將前往德國仔細檢視 Eliquis 的計畫。我們將對新產品採取同樣的做法。例如，它將成為中國的 LORBRENA。眾所周知，不幸的是，肺癌在中國影響著很大一部分人口。事實上，全球範圍內能從 LORBRENA 中受益的肺癌比例約為 1.7%。在中國，這一比例實際上為7%。因此我們相信我們有巨大的機會。

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.

我們實際上正在做的是製定一項計劃，當時我上週訪問中國，以便迅速將 LORBRENA 提供給那些可以從臨床結果中受益的患者。這正是我在我們排名前 15 名的國家所做的事情。坦白說，今年剩下的時間我們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。然後也許，克里斯，也在商業方面。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。我們現在的首要任務顯然是業務的連續性。在過去 9 個月的整合規劃中，我們做了很多工作。我們不想錯過任何一個節拍，現在正朝著完美執行的方向發展，當務之急顯然是 EV-302 研究中針對晚期轉移性膀胱癌的 PADCEV 的推出，EMBARK 試驗中針對非轉移性去勢敏感性前列腺癌的 XTANDI 的推出，以及早期推出，同時也關注 2024 年 ELREXFIO 晚期 ELREXFIO 在 ELREXFIO 中的晚期。而對於 TALZENNA，在美國，多達 25% 的轉移性去勢抵抗性前列腺癌患者將有資格獲得 TALAPRO-2 治療。

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。然後我們請邁克爾·多爾斯汀 (Mikael Dolsten) 發言，請您盡可能多地分享關於下一代產品和銷售情況的評論。

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 結合領域擁有非常強勢的地位和良好的發展勢頭。我認為亞歷山大，您剛才提到了我們在歐洲獲得的有關 PCV20 的積極推薦。現在我們正在建立這個獨特的平台。正如安德魯在這裡所說的那樣，我們能夠，正如你所說的，為成人肺炎球菌性肺炎提供獨特的主張。對美國15萬住院患者來說，這確實是個沉重的負擔。據我們所知，輝瑞的第四代新平台與第三代平台一樣，將是唯一能夠基於您所說的原始 CAPiTA 研究實現這一主張的平台。

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的血清型，適用於成人甚至兒童，就像我們對所有血清型所做的那樣。它還將對現有的血清型進行改進，從而總體上獲得比 PCV20 更好的覆蓋率。我確實認為我們是真正可以繼續擴大更多血清型的人，但需要結合化學進行一些重新配方。而且，我謹慎地放棄針對嬰兒和成人的任何血清型，因為導致疾病的特徵（例如肺炎）尚未得到很好的描述，因此保持我們獨特的覆蓋範圍並且其他產品不會發生這種情況是一種獨特的區別。所以我對第四代感覺非常好。

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?

我認為，繼 Seagen 之後的腫瘤學特許經營權 Albert 可能將成為輝瑞未來更大的成長動力之一。問題是，您是否希望為該部分實現中期或長期收入百分比目標？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。非常普遍，然後我會請克里斯對我們在這裡所擁有的技術做一些評論。我無法說出腫瘤學將貢獻多少。但顯然，我們已經給出了對 Seagen 的預期，我們預計到 2030 年它將從 2024 年指導的 31 億美元達到 100 億美元。實際上，我們對 100 億美元感到非常滿意。隨著數據不斷湧現——當我們給出 100 億美元時，我們並不知道該預測之後的一些讀數。因此我們對此感到非常非常好。

Now I have to say that the Pfizer pipeline in Oncology I think was also among the strongest in our entire 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領域的產品線也是我們整個治療領域中最強的之一。因此我認為，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研發的發展以及你將以哪些平台為基礎制定策略呢？

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，我們目前想要重點關注的模式是那些我們認為我們具有顯著優勢和能力的模式，包括藥物化學、蛋白質工程以及我們在癌症生物學方面的優勢。因此，我們希望專注於小分子，尤其是來自拉霍亞的小分子；雙特異性抗體，在拉霍亞和新西雅圖均有生產；以及西雅圖的 ADC。所以是小分子、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.

如您所知，隨著 Allogene 的成立，我們也對同種異體 CAR-T 細胞感興趣，我們仍然關注這家公司，並且對其有濃厚的興趣。但目前我們專注於這三種模式，我們也看到了組合的巨大機會，例如，小分子、ADC，但未來 ADC 和雙特異性之間也可能存在組合。

Our next question comes from Mohit Bansal with Wells Fargo.

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?

也許是有關 Nurtec 的一個問題，包括市場份額和定價的趨勢。只是想確保 Nurtec 價格與競爭對手的價格之間是否存在明顯的價格差異？我的意思是，鑑於您的競爭對手在頭痛市場有多種產品，他們提供的折扣。如果有差異，您預期 2024 年價格會成長還是下降？

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

非常感謝，Mohit。阿米爾 (Aamir) 談論了 Nurtec 以及偏頭痛的特許經營情況。

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。所以 Mohit，謝謝你的提問。因此，我們對 Nurtec 的第四季度感到鼓舞，作為回應的一部分，我也將對 ZAVZPRET 發表一些評論。與去年同期相比，我們的成長了 30％ 以上，與上一季相比，成長了 20％ 以上。有些事情是令人鼓舞的。 Nurtec 繼續成為排名第一的 CGRP 處方藥，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% 的新處方者（其中許多是初級保健醫生）都在開立 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.

並且，在過去幾個季度中，我們每張處方的藥量也一直在穩定成長。因此，我們繼續看到機會，並且有幾點需要牢記。一是仍有許多未被滿足的需求。阿爾伯特在他的書面評論中提到了這一點。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，這也是一個競爭非常激烈的類別，有 QULIPTA 和 UBRELVY 參與。我不會特別評論他們的定價策略與我們的定價策略，GTN 在所有定價策略中都發揮作用。

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 的關注點首先是，我認為我們希望在患者參與和激活方面更加敏銳和更具競爭力。二，我們有機會讓我們的現場工作人員同時關注最相關的 CGRP 作家以及我所說的 PCP。 PCP 開出的曲坦類藥物佔 2/3，但 CGRP 只佔 1/3 多一點，因此這裡還是有機會的。然後，透過患者的訪問和體驗，我們有機會真正減少那裡的摩擦。我還要提到 ZAVZPRET，因為我們認為鼻內給藥可以很好地補充口服藥物，既可以快速緩解疼痛，又可以滿足因口服藥物而出現噁心和嘔吐的患者的需求。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 TD Cowen 的 Steve Scala。

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 1 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 1, designated 6016. Can you tell us what the mechanism is, please?

兩個問題。首先關於 danuglipron，我知道輝瑞公司不想提供最新消息。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，第一階段增加了新的減肥劑，編號為 6016。您能告訴我們其作用機理是什麼嗎？

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，我要讓你失望了，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，關於 danu，我們掌握的資訊比我們自己掌握的要多，這很正常，因為我們現在做的每一件事都非常複雜，正如我所說，有多個實驗計劃。但由於我們沒有新數據，因此我們不對此發表評論。

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.

關於新的減肥分子，我們也表示遺憾的是我們無法揭露其作用機制。原因是，首先，現在還為時過早，我們不想參與競爭，這沒什麼奇怪的。所以我很抱歉讓您失望，但現階段我還不能提供太多資訊。正如我們所說，希望在年中我們能獲得更多有關此方面的資訊。

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.

感謝所有的更新。我有 2 個問題，請問一下。首先是戴夫。能否詳細討論一下 24 年的毛利率前景？我認為在上次通話中，您討論過可能低至 70% 的毛利率。但如果你能更詳細地評論這一點，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 2a dose-ranging study to assess the efficacy and tolerability in order to design a dose to advance Phase 2b or Phase 3?

第二個問題是問 Mikael 的。如果每日一次的 danuglipron 確實具有您所尋找的特性，那麼該公司是否會進行第 2a 階段劑量範圍研究來評估其功效和耐受性，從而設計劑量以推進第 2b 階段或第 3 階段？

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 GLP. 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 3 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。您聽到 Albert 說過，我們正在進行一系列臨床試驗以深入了解該分子，並且我們有第二個 GLP。輝瑞公司一直願意考慮不同類型的臨床研究設計。一般來說，如果進入第 3 階段並擁有一個導入階段的大型安全資料庫，只要資料支持，我們就會傾向於直接進入。但我們必須逐一程序地進行審查。因此，當我們擁有所有數據時，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。讓我們討論一下毛利率，我們可以分享更多資訊。

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.

戴維，這是戴夫·登頓。我在這裡就講得非常簡短。顯然，正如我們之前討論的那樣，我們已經表明，我們的 24 年毛利率預期在 70% 出頭。如你所知，當我們進入24年時，正如我之前提到的，發生了一些事情。一是，隨著 COVID 的緩解，我們正在去槓桿，因為 COVID 吸收了大量固定開銷。所以這會壓縮毛利率。其次，過去幾年來，我們正在對許多收購的產品進行內部採購。而且，當我們進行內部採購時，其短期效應會抑制毛利率，但這給我們提供了一個機會，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——或者最後有兩件事，那就是新產品具有相同的特色。當我們推出新產品時，產量和性能尚未達到最佳水平。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內可以抓住的一個機會。所以，這再次為我們提供了一個隨著時間的推移提高績效的機會。但是，我們預計 2024 年的成長速度大約會達到 70 年代初。

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.

戴維，讓我在這裡補充一點，COMIRNATY 和 PAXLOVID 都是大產品，但它們是在同一工廠生產的，但它們是獨立的工廠，因此它們不會影響其他產品的利潤。因此，當生產量如此之大、價值降低時，這些工廠的利潤率確實在下降，當然，這些產品的利潤率確實佔了許多管理費用。

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 COVID 的預期降低到非常現實的目標範圍內時，這並不意味著我們在有需求的情況下就消除了生產更多產品的能力，因為這首先從公共衛生的角度來看是不負責任的，而且從我們投資者的資金角度來看也是如此。所以這就是為什麼到目前為止，儘管收入下降了，我們仍然維持了所有的產能，所以這是一個很大的下降。

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.

戴維說的第二件事是，請記住，我們所有新收購的公司，基本上都帶來了許多新產品，它們都來自規模較小的相對公司。他們實際上沒有自己的製造業。所以這些都是外包的，當然，外包比你能夠自己引進的時候要昂貴得多。我們有計劃將所有業務都轉為內部承包，但在製造業，這需要 3 年時間，以降低利潤率。最後但同樣重要的一點是，我們的新貸款數量不成比例。當你建造基礎設施或開發新事物時，這些新貸款的成本非常高，但當然，你建造它是為了獲得最高收入。但當然，一開始的收入很低，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，這些新產品的收入也將隨之增加，新產品總是如此，但利潤率是可以預期的。所以這與毛利率無關。你可以在幾個月內、幾年內看到它的進步。但顯然，我們知道這個領域為什麼會發生、發生了什麼以及我們如何改善它。

Our next question comes from Chris Schott with JPMorgan.

下一個問題來自摩根大通的 Chris Schott。

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?

也許只是對戴夫和阿爾伯特來說，只是在中長期利潤基礎上進行構建。聽起來我們應該把利潤率恢復看成一個漸進的過程，而不是突然反彈。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% 左右的中高水準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利潤率隨著時間的推移會達到何種程度？

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，我認為你完全正確。 35% 左右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，疫苗計劃 COMIRNATY 與我們的合作夥伴共享毛利率水平。這會對毛利率和營業利潤造成影響。所以我想說，對該產品進行稍微的混合調整。然後從進展的角度來看，是的，您可以將其視為接下來幾個時期逐步穩定改善的故事。

Our next question comes from Rajesh Kumar with HSBC.

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?

僅討論中期利潤率狀況。感謝您提供的顏色。如果您考慮自己的成長願望，這是否需要犧牲一些利潤？那麼，如果您說要達到成長曲線的最高點，我們會看到毛利率達到 35% 左右還是更低呢？還是那裡的平衡情況是怎麼樣的？

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，您之前簡要地談到了您的資本配置優先事項。顯然，削減成本和去槓桿是 2024 年的首要任務。從中期來看，在 2024 年去槓桿工作完成後，您將在哪些治療領域投入更多資本？

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，我們說過，我們在過去幾年中對我們的業務進行了相當大的投資。因此，至少從業務發展的角度來看，投資階段已經過去了。我們還需要投入大量精力來提高未來的業績，但現在已經投入了巨額資金。這是一個執行的故事，也是一個持續改進的故事。因此你應該預料到這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，業績越好，因為你可以利用固定成本。因此顯然，收入目標和成就越高，從利潤率角度來看，您應該期望我們的改善就越好。然後從資本配置的角度來看，我認為你說的對。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而增長，但重要的是，隨著我們進入（聽不清楚）資產整合的循環，我們開始去槓桿。然後從優先順序的角度來看，顯然我們在腫瘤學方面做出了大量投資。您應該期望我們在未來將投資理論放在該特許經營權的支持下。顯然，這是第一位的。

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，腫瘤學領域顯然佔了我們目前研發費用的最大份額，而且 SI&A 費用也佔了很大一部分。在儲備方面，我們非常重視的其他領域顯然是疫苗，它是皇冠上的明珠，我們計劃實現顯著的生產力。在內科領域，也就是我們的代謝特許經營領域，是我們非常興奮的領域。肥胖就是其中之一。我們確實相信肥胖症是一個巨大的市場並且還在不斷增長。

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地區發揮作用並取得勝利。因此，我們將繼續投資於這個領域。免疫炎症，我們在另一個領域進行了大量投資。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公司之一。所以這些是我們將投入資金的領域，首先是腫瘤學，然後是疫苗、代謝疾病、免疫發炎、抗病毒藥物，這些都是我們將繼續投資的領域。

Next, we have Kerry Holford with Berenberg.

接下來是 Berenberg 公司的 Kerry Holford。

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 3 starts, you've highlighted today B6A in lung, CDK4 in breast. When can we expect Phase 3 data readouts for these 2 products?

請問我幾個關於管道的問題。首先，關於 RSV。我們是否可以期待您在第二季第三季之後宣布 Abrysvo 的日期？然後同樣在第 2 階段第 3 階段開始時，您今天強調了肺部的 B6A 和乳房的 CDK4。我們什麼時候可以獲得這兩款產品的第三階段數據？

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

我不確定——您對 RSV 有什麼疑問？

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

了解何時會發布接下來的第三季、RSV 第三季的數據？

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

是的。是的，我明白了。謝謝。米凱爾，為什麼不把它帶到阿布里斯沃？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.

我們將繼續累積重要的 RSV 數據並擴展這種重要疫苗的使用方式。因此，您應該可以期待在今年上半年，可能是第二季度，我們會分享更多臨床試驗的信息，包括完整的第二季，但也包括傳統年齡組的擴展，正如您在 clintrial.gov 上所知道的，我們有積極的試驗，我們認為這將很好地解決大年齡跨度的高危人群問題。

Thank you, Mikael. And then Chris?

謝謝你，米凱爾。然後是克里斯？

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 3 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.

非常感謝您的提問。因此，今年（2024 年下半年）的直接讀數將是二線激素受體陽性轉移性乳癌中的 vepdegestrant，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 BRAF CRC 的第一線治療中，使用 Braftovi 的大腸直腸癌比例高達 12%。現在正在啟動的新研究是 CDK4、B6A 和達西珠單抗的 3 期研究，我也希望今年稍後能啟動 EZH2 的研究。這些將出現在 clinicaltrials.gov 上，完成日期可能在 2025 年和 2026 年之後。但顯然，早期結果可能會有中期結果。

Our next question comes from Chris Shibutani with Goldman Sachs.

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?

請問我有兩個問題。阿米爾，您之前在擔任職務時談到過，公司希望透過併購的方式，到 2030 年實現 250 億美元的收入。我們在 Arena 方面有缺陷。有更新資訊嗎？現在您擔任美國首席商務官（非腫瘤學、非 COVID），在您目前的職位上，您的願望清單上有什麼，您認為有機會透過業務發展來擴大這些收入，從而到 2030 年實現 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，投資人始終關注聯邦貿易委員會的動向。去年，您與 Seagen 一起經歷了這場嚴峻考驗，您能否發表一些評論，幫助我們思考監管機構如何看待併購環境，特別是交易規模或其他您認為值得注意的維度，這可能是您根據 23 年的經驗得出的觀察結果？

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？順便說一句，讓我澄清一下，阿米爾的責任包括 COVID 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 億美元的目標，我想提醒一下，我們計劃在 2030 年之前將已達成的交易金額設定為 200 億美元。我還要提醒你，250 億美元是 2030 年的目標，因此從現在到 2030 年還有很多時間來實現這一目標，這與戴夫所描述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，即從我們的發布中實現價值以及從我們已經完成的交易中實現價值。這就是我的關注重點。最後，就聯邦貿易委員會 (FTC) 而言，我們不宜評論聯邦貿易委員會將要做什麼或不做什麼。但我可以說的是，我們對與世界各地所有監管機構的所有監管機構的合作以及完成的所有交易感到非常滿意。我認為這體現了我們以患者為中心的理念以及我們與監管機構的合作性質。

Next, we have Akash Tewari with Jefferies.

接下來是 Jefferies 的 Akash Tewari。

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 對損傷費用以及成人、兒童和國際之間的變動部分的評論很公正。共識是，在接下來的幾年裡，整個特許經營的營收將實現適度成長。考慮到來自默克公司的競爭加劇和美國市場規模縮小，這對投資者來說是一個合理的預期嗎？那麼，您對 ACIP 對 Prevnar 和 V116 的建議有何內部看法？

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.

瞧，阿米爾，你為什麼不接受──這是 Prevnar 的期望嗎？我們不評論華爾街的預期是什麼，對嗎？我們也是──我認為我們對這個市場的看法給了非常好的、可以說是高層次的軌跡。在美國，成年人的機會主要還是跟成年人一樣，是一種追趕的機會。所以當你來的時候，你會有一群符合資格的人，但其中一些會選擇接種疫苗。

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，這種情況會發生在第一年，也許在第二年會發生一點。我認為，我們已經利用了這個佔據 96% 市場份額的機會。所以現在，我認為我們不會在美國成年人身上看到巨大的機會。默克公司的競爭對手正在加入這一行列。所以對我們來說這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。當你非常迅速地推出這些產品時，其影響是巨大的，因為那時我們真正要影響的就是那些從年齡上來說屬於這個群體的人。

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 catch up. So that's how we should see it. So there is nothing much to add into that.

兒科疫苗的巨大機會在於接種 4 劑，而不是 1 劑。而且每年的接種人數非常龐大，新生兒的數量遠大於補種時年滿 65 歲的人口數。我們應該這樣看待它。因此，對此沒有什麼可補充的。

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

我們的最後一個問題來自 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。首先，當您想到到 2030 年將增加 250 億美元的收入時，現在 Seagen 已經成為這項業務的一部分，我們在哪些方面能夠達到這一指標？我的第二個問題是關於 Oxbryta 治療鐮狀細胞疾病的療效。當您購買該資產時，您確實——您指出，您計劃加快將藥物分發到受該疾病影響最嚴重的全球地區。鑑於 Casgevy 最近在中東獲得的競爭性批准，我們實際上並沒有看到太多 OUS 的蹤影。鑑於 OUS 的競爭變化，您如何看待 OUS 帶來的機會？因此 Seagen 然後思考一些 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.

關於 Seagen，也許我可以接受它，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。這是我們宣布收購時公佈的數字。此後發生的一些事情增強了我們對這個數字的信心。第一，ADC成為併購熱潮中最為熱門的。每個人都想要一個 ADC，基本上我們把最大的賭注押在了這項技術上。因此看起來投資者、公司和分析師普遍一致認為這是一項能夠帶來巨大收益的技術。因此，我們宣布這一消息後感到非常欣慰。

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 發布了超出我們預期的重要讀數或重要產品。但您看不到但我們看到的是，他們正在推進很多東西，其中一些我們將在 2 月 29 日向您展示。所以，這也是對科技的賭注，對公司的賭注，我們覺得我們兩方面都做得很好。

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，但我們仍然有信心可以做到。當然，除此之外，我們還額外投入了 100 億美元用於我們所做的其他事情，以及我們能夠執行的 50 億美元。現在關於 Oxbryta，Aamir，Oxbryta 怎麼樣？

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。所以 Evan，關於 Oxbryta，既然你提到了這一點，那麼我也會對收購發表評論。我們對美國的表現感到滿意。第四季較上年同期成長 30%，較上一季成長 14%。處方趨勢非常穩定。自從我們完成收購以來，我們已經對面向客戶的團隊進行了大量投資。因此，我們喜歡美國目前的發展勢頭，並期待看到更多。

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，世界其他地區僅佔 Oxbryta 收入的一小部分，這需要時間來發展，我們顯然會適當考慮這一點。當您考慮收購 GBT 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，我們預計它除了 Oxbryta 之外還能帶來很多價值。如果從臨床和監管角度來看藥物成功，部分銷售額將會受到蠶食，但 Oxbryta 在市場上仍有持續成長的空間。

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，當您結合美國的發展勢頭、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）時，我們認為這次收購將帶來很多價值。

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 3, let's say, reconfirms the Phase 2 results.

是的。我想補充一點，這與 GBT 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不斷增強。我不僅僅是說 Oxbryta 的表現正如我們想像的那樣，最重要的好處是，我們擁有在收購 601 時沒有的數據，但它有可能成為鐮狀細胞的變革性療法，並且真正帶來下一步——如果那件事發生的話——如果第 3 階段重新確認了第 2 階段的結果。

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.

所以在那裡，我認為我們現在對我們所宣布的目標更有信心，但我們應該能夠實現甚至超越。

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 assembled a team that are hand-picked 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.

因此，我想我們可以結束通話了。總而言之，我們對未來一年充滿樂觀。我們已確定了 5 個關鍵優先事項，以幫助我們保持專注。我再次重申，這將是執行的一年。我組建了一支精挑細選的團隊，我相信他們都是絕對合適的領導者。我知道，全世界都對我們執行 COVID 策略的方式印象深刻，我們如何能夠在研發、製造和商業方面執行兩種產品，即市場份額最高的疫苗和口服抗病毒產品。

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 focused 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力，因為我們正在推進我們下一波管道，因為我們正在最大限度地提高所有新產品的性能，因為我們正在從今年開始與 SI&A 一起執行成本調整計劃，但您也將看到結果。當然，提高毛利率的計劃現在還看不到效果，因為它需要很長時間，但我們現在已經開始了，並且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.

團隊會確保這一點的實現，我認為我們應該在三個月後再次開會，看看我們在實現既定目標方面進展如何。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.

謝謝各位，女士們、先生們。今天輝瑞 2023 年第四季財報電話會議就到此結束。我們感謝您的參與，您現在可以斷開連接了。