`
`BristolMyers Squibb CEO Discusses Q3 2013 Results Earnings Call Transcript
`
`BristolMyers Squibb CEO Discusses Q3 2013 Results
`Earnings Call Transcript
`
`BristolMyers Squibb (NYSE:BMY)
`
`Q3 2013 Earnings Conference Call
`
`October 23, 2013, 10:00 a.m. ET
`
`Executives
`John Elicker – Senior Vice President, Public Affairs and Investor Relations
`
`Lamberto Andreotti – Chief Executive Officer
`
`Charles Bancroft – Executive Vice President and Chief Financial Officer
`
`Giovanni Caforio, M.D. – President, U.S. Pharmaceuticals
`
`Béatrice Cazala – Executive Vice President, Commercial Operations
`
`Francis Cuss – Executive Vice President and Chief Scientific Officer
`
`Analysts
`Seamus Fernandez Leerink Swann
`
`Mark Schoenebaum – ISI Group
`
`Jami Rubin Goldman Sachs
`
`Christopher Schott – JPMorgan
`
`Alex Arfaei BMO Capital Markets
`
`Tim Anderson – Sanford C. Bernstein
`
`Andrew Baum – Citi
`
`Steve Scala – Cowen & Company
`
`Vamil Divan Credit Suisse
`
`Gregg Gilbert – Bank of America Merrill Lynch
`
`Operator
`Good day. Welcome to today’s third quarter earnings 2013 earnings release conference call. This call is being
`recorded. At this time, I would like turn the call over to Mr. John Elicker, senior vice president, investor relations
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`BristolMyers Squibb CEO Discusses Q3 2013 Results Earnings Call Transcript
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`and public affairs. Please go ahead, Mr. Elicker.
`
`John Elicker
`Thanks, operator, and good morning everybody. Thanks for joining us to review our Q3 results. With me this
`morning with prepared remarks are Lamberto Andreotti, our chief executive officer, Charlie Bancroft, our chief
`financial officer. And this morning, also with prepared remarks, will be Francis Cuss, our chief scientific officer.
`And then joining for Q&A are our two commercial leads, Executive Vice President Béatrice Cazala, and the
`president of U.S. operations, Giovanni Caforio.
`
`Before I turn it over to Lamberto, I just want to cover the Safe Harbor language. As you know, during the call,
`we'll make statements about the company's future plans and prospects that constitute forwardlooking
`statements. Actual results may differ materially from those indicated by these forwardlooking statements as a
`result of various important factors, including those discussed in the company's SEC filings.
`
`These forwardlooking statements represent our estimates as of today and should not be relied upon as
`representing our estimates as of any subsequent date. We specifically disclaim any obligation to update
`forwardlooking statements, even if our estimates change.
`
`We will also discuss nonGAAP financial measures adjusted to exclude certain specified items. Reconciliations
`of these nonGAAP financial measures to the most comparable GAAP measures are available at our website,
`bms.com.
`
`Lamberto?
`
`Lamberto Andreotti
`Thank you, John. Good morning everyone. This is an important time for BristolMyers Squibb. The third quarter
`marked our return to growth with respect to both sales and earnings, as we made our way through the Plavix
`loss of exclusivity. And that, combined with our continued pipeline progress positions us well for the future.
`
`Let me elaborate on these points. With respect to sales, not only was our growth strong, up 9%, but also it was
`diversified, cutting across our portfolio. We drove doubledigit growth in Yervoy, Orencia, Sprycel, and Onglyza,
`and the contribution to the top line results from Eliquis and Bydureon started to become meaningful.
`
`This is important. It demonstrates the breadth and quality of our diversified portfolio. Yervoy remains the
`cornerstone of our growth in our oncology platform. I’m excited, in fact I’m very excited, by the data presented
`at the European Cancer Congress in September, as it confirms long term survival with Yervoy in metastatic
`melanoma and reinforced the overall value of this product.
`
`Last quarter, Yervoy continued to deliver growth, most notably in Europe and our international markets. Yervoy
`results in the U.S. were also positive, notwithstanding the impact of a significant number of new clinical trials
`targeting melanoma patients with other agents. In Europe, the CHMP recently recommended that Yervoy be
`approved as firstline therapy in advanced melanoma.
`
`With respect to Eliquis, I’m encouraged. We are still very far from the sales levels these products can achieve,
`but we are seeing definite signs of progress, especially with cardiologists, a target audience for us. We continue
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`to execute against our strategy to clearly define the differentiated and unique profile of Eliquis.
`
`In other countries, we will increase our peertopeer medical education activities, and in the U.S. you may have
`seen that we began our DTC advertising campaign in September for Eliquis in atrial fibrillation.
`
`We are also working to expand our label, as we have filed an NDA for VTE prevention in the U.S., which is
`already an approved indication in Europe, and we plan to file our application in VTE treatment this year.
`
`With respect to our diabetes portfolio, we continue to find our way through this very competitive space. In the
`third quarter, Onglyza sales grew 19% year over year, and within our exenatide franchise, Bydureon sales
`showed encouraging gains.
`
`And with Dapagliflozin, we are looking forward to the FDA Advisory Committee meeting in December and the
`PDUFA date in January.
`
`Now, let me make a couple of comments about our pipeline. With respect to hepatitis C, we believe that we
`have an interesting opportunity and we are looking forward to AASLD conference next month, when we will
`present new data on the Phase III trials pretrial of our alloral dual regimen, and we are still on track for its
`important submission in Japan this year.
`
`And with respect to immunooncology, 2013 has been a year of exciting data for our immunooncology platform.
`Data we have presented so far this year spoke to the very real possibility of paradigmchanging treatments for a
`range of cancers, and next week we will present additional immunooncology data at the World Conference on
`Lung.
`
`Now, because there is much happening related to our work in immuneoncology, I’ve asked Francis to spend a
`few minutes this morning to walk you through our thinking with respect to this increasingly important area for us.
`Francis?
`
`Francis Cuss
`Thank you, Lamberto, and good morning everyone. As you well know, we’ve been focused on expanding our
`efforts in immuneoncology as an area where we see a potential paradigm shift in the treatment of patients with
`certain cancers. We believe that immunooncology has the potential to be transformational in the treatment of
`patients suffering from various types of cancer.
`
`The durability of response and long term survival in some patients are quite unlike anything we’ve seen in the
`past, as demonstrated by the long term survival data for Yervoy recently presented at the European Cancer
`Congress. Additionally, early data suggests that the immunotherapeutic approach has the potential to provide a
`benefit not only in tumors traditionally considered immunogenic, but also in other tumor types that have not
`typically been thought to be immune mediated.
`
`As the field continues to evolve and expand, we believe that there may be roles for monotherapy, combination
`therapy, and biomarkerdirected therapy, and we are therefore building our development programs to prepare
`for all possibilities.
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`Certainly, the approaches are likely to vary by tumor type as well as by line of therapy. Through our experience
`with Yervoy and broad programs with Nivolumab, we have a unique understanding in the field which gives us
`confidence that we are wellpositioned to find the ultimate way to utilize these innovative therapies.
`
`As you know, we’ve made a very large commitment to immunooncology. Currently, for Nivolumab alone, we
`have over 25 ongoing clinical trials across more than eight tumor types. We continue to explore Yervoy
`monotherapy in additional tumor types such as prostate and lung, as well as in combination with Nivolumab.
`
`In addition, we have a broad portfolio of exploratory immunotherapeutic agents with varying immune
`mechanisms of action that allows us to explore multiple combinations. Today I’d like to provide a brief update on
`the status of our major programs. Let me start with lung cancer.
`
`As a follow up to the data we presented at ASCO in June, we will be presenting updated twoyear survival data
`from the lung cohort of prior treated patients in the Nivolumab monotherapy study known as 003 at the World
`Conference on Lung Cancer at the end of October.
`
`Next up will be data from the Phase I combination study of Nivolumab with Yervoy in nonsmall cell lung cancer,
`which we expect to have in house by the end of the year. This study will provide important information on the
`feasibility of combinations in this tumor type and potentially inform our plans for Phase III trials starting in the
`first half of 2014.
`
`Following that, we expect to have data in the first part of 2014 from our Phase II study in third line squamous
`nonsmall cell lung cancer. If the results of the study demonstrate a favorable benefit risk profile, we plan to
`discuss the data with the FDA and other health authorities.
`
`Finally, we have two ongoing Phase III trials in second line nonsmall cell lung cancer, one in squamous and
`one in nonsquamous, with both studies collecting information on PDL1 tumor expression. We expect to have
`data from these studies later in 2014.
`
`In melanoma, we have a broad program ongoing with trials covering all lines of therapy, which includes
`monotherapy as well as combination of Nivolumab and Yervoy. In previously untreated patients, both
`monotherapy and combination Phase III trials are underway, and a Nivolumab monotherapy Phase III trial is
`ongoing in advanced patients who have progressed postYervoy.
`
`In renal cell cancer, our most advanced trial is focused on focused on metastatic disease, comparing Nivolumab
`with everolimus. Early trials are exploring the combination of Nivolumab and Yervoy in first line renal cell cancer,
`and we expect the data in house by the end of this year. And also, we expect early data on the potential role of
`biomarkers in this tumor type.
`
`In all these three tumor types, we remain committed establishing the benefitrisk profile of Nivolumab as quickly
`as possible, and are closely collaborating with health authorities.
`
`Now, regarding public data presentations, after the lung data at the World Conference on Lung Cancer, we
`expect the next set of presentations to be at ASCO in 2014, which may include data on the Phase I combination
`study in nonsmall cell lung cancer and potentially data from the thirdline squamous nonsmall cell lung cancer,
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`which is ongoing.
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`BristolMyers Squibb CEO Discusses Q3 2013 Results Earnings Call Transcript
`
`In addition to the programs for Nivolumab that I highlighted earlier, we’re also exploring its use in additional
`solid tumor types, including pancreatic, gastric, small cell lung cancer and triple negative breast cancer, as well
`as hematological malignancies.
`
`So, in closing, I think you can see that we have a significant commitment to advancing the field of immuno
`oncology through a broad program that is sciencedriven, diversified, and well resourced. We believe that this
`commitment, together with our expertise and experience, puts us in an excellent position in this tremendously
`exciting area.
`
`So now I’d like to turn it back to you, Lamberto.
`
`Lamberto Andreotti
`Thanks, Francis. Well, clearly we see immunooncology as an important and exciting opportunity for us, one in
`which we will continue investing heavily, dedicating even more resources, time, people, and money, not only in
`R&D but also commercially, as we prepare for potential launches.
`
`We are also committing the right commercial resources to our key growth drivers, most notably Eliquis,
`diabetes, and hepatitis C. These products and these therapeutic areas are our future, and my management
`team and I are determined to set the stage for long term, sustainable growth while at the same time driving
`short term performance.
`
`Now, with that, I will turn the floor over to Charlie to talk through some of our key numbers. Charlie?
`
`Charles Bancroft
`Thank you, Lamberto. Net sales were $4.1 billion in the quarter. We also had solid sales performance across
`our entire portfolio, especially for Yervoy, Sprycel, Orencia, and Bydureon. Let me provide a few highlights.
`
`Yervoy sales increased 33% year over year to $238 million. Yervoy continued to show strong performance in
`Europe. We recently received a positive opinion from the CHMP for first line use of Yervoy and hope to have
`marketing authorization later this year. This is an important addition to our label in Europe and will allow a
`broader set of patients to potentially benefit earlier in their treatment.
`
`In the U.S., Yervoy sales softened somewhat from the second quarter. As Lamberto mentioned, we have seen
`an impact from a significant increase in new clinical trials targeting melanoma. Patient enrollment in metastatic
`melanoma trials has more than doubled since the beginning of the year, with some of that increase coming
`from our own clinical trials with Nivolumab.
`
`While these clinical trials have affected the commercial opportunity at several large academic institutions, we
`continue to focus on growing Yervoy in the community setting, which represents approximately 60% of our U.S.
`sales. Recent weekly sales trends are encouraging.
`
`We believe having the first line indication in Europe, along with the survival data presented at the European
`Cancer Congress, will enable us to continue to deliver strong growth. Sales of Eliquis were $41 million during
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`the quarter.
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`BristolMyers Squibb CEO Discusses Q3 2013 Results Earnings Call Transcript
`
`As Lamberto mentioned, we have several initiatives focused on helping prescribers, patients, and payers
`understand Eliquis’ differentiated profile. Recent prescription trends are improving as we have seen consistent
`weekly growth during Q3. As an important leading indicator, our overall new to brand share has improved and is
`now nearly 20% with cardiologists.
`
`Our diabetes portfolio had sales of $411 million in the quarter. After a period of transition in our diabetes
`organization, we are beginning to see more positive trends in this business. Sales for the exenatide franchise
`were up $193 million, up nearly 14% from Q2, mostly due to renewed new to brand growth for Bydureon and
`GLP1 market expansion. Byetta sales were essentially flat versus Q2.
`
`Sales for the Onglyza franchise grew 19% year over year to $211 million. We have stabilized our market share
`in the U.S., where total prescription growth is slowing. We believe the data from the SAVOR cardiovascular
`outcomes trial provides important clarity regarding the safety profile of Onglyza. We continue to work through
`the pricing and reimbursement process for Forxiga in Europe and look forward to a potential launch in the U.S.
`next year.
`
`Orencia sales increased 22% to $375 million. Subcu sales have nearly doubled since Q3 2012, and now
`represent nearly onethird of all Orencia sales.
`
`Sprycel sales rose 20% to $316 million. First line use of Sprycel also is growing, as we reinforced Sprycel’s
`broad indication to treat patients in all phases of CML.
`
`Now, let me highlight two line items from the rest of our nonGAAP P&L. Advertising and promotion spending
`increased 16% to $194 million. This is driven by our increased investment behind our key commercial
`opportunities such as Eliquis and our diabetes portfolio. We expect to continue these investments as well as
`ensure we are prepared for the expected hepatitis C launch in Japan and potential launches for Nivolumab.
`
`As I mentioned during our second quarter call, the decrease in other income and expense is largely due to the
`change in the structure of our relationship with Sanofi, whereby we now record royalty income in net sales.
`
`As you have seen, we are confirming our full year 2013 GAAP and nonGAAP EPS ranges.
`
`Before we turn to your questions, I want to make a few comments about capital allocation. Business
`development continues to be our top priority, and we remain committed to the dividend. Regarding share
`repurchases, you will recall that overall repurchase has slowed significantly in Q2, and this trend continued in
`the third quarter. Moving forward, we do not anticipate future share repurchases at this time.
`
`We are now happy to answer your questions.
`
`John Elicker
`Thanks, Charlie. Lastly, we can go to Q&A now, and I would just remind everybody that in addition to Lamberto,
`Charlie, and Francis, we have both Giovanni and Béatrice here to handle any questions you might have.
`Operator?
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`QuestionandAnswer SessionOperator
`[Operator instructions.] And we’ll take our first question from Seamus Fernandez from Leerink.
`
`Seamus Fernandez Leerink Swann
`Just a couple of quick questions. First off, on the trajectory of the Eliquis franchise, can you just give us your
`thoughts and expectations for should we anticipate stronger performances internationally than in the U.S.? And
`then why has it been so difficult? Can you just give us a little bit of a lay of the land of the competitive landscape
`and perhaps what competitors may have convinced physicians of early on, and how you’re going to hopefully
`change their mindset?
`
`And then separately, Francis, you made an interesting comment with regard to how the Phase I trial in lung may
`inform a potential move into Phase III in 2014 for Nivolumab plus Yervoy in lung cancer. Can you help us better
`understand the thresholds as we think about it? There’s been a lot of circulating concern around potential
`toxicity there, but obviously the prospect of improved efficacy is something important. So just wondering how
`Bristol would be thinking about the threshold or at least how we should think about your move into Phase III with
`this potential combination, should that be the decision that you make in 2014.
`
`Lamberto Andreotti
`I will start, and then I will ask Giovanni and Beatrice to add comments on Eliquis. First of all, we expect growth
`for Eliquis in both the U.S. and international markets. And in some of the international markets we have just
`launched. In the U.S. we launched earlier. In other countries we launched earlier. So we are at a different stage
`of launch, but the launch continues in both the U.S. and internationally.
`
`We were third to the market, and we found two other agents that were entrenched in the market, especially one
`of them. The good news is that our clinical data is very significant, very differentiated, both the ARISTOTLE and
`the [unintelligible] data is good. Nobody can make the same claim.
`
`And so we are dealing with especially one agent that is basing their strength on having launched earlier, and
`speaking about convenience, which we don’t think it’s really a great claim. So we will continue to work and will
`continue to work, and Giovanni, why don’t you start with the U.S., saying what we are doing.
`
`Giovanni Caforio
`Just to follow up on what Lamberto said, if you think about our focus in 2013 in the U.S. market, consistent with
`what we discussed on the last call, we are focused in a number of areas. At the beginning, we had a very heavy
`focus on access, and we made rapid progress there.
`
`Then we, in parallel, shifted our focus on our presence in the hospital, and the process of entering the hospitals
`from a formulistic perspective and stocking is a process that requires time. We discussed that at the last call.
`We’ve made significant progress in the third quarter in that area.
`
`At this point, we are stocked and present in over 80% of our focus hospitals. Our use in the hospitals has been
`increasing, and we’re quite satisfied, at this point, that we are at the same level of hospital presence, where
`[unintelligible], for example, was at the same time during their launch.
`
`As we discussed earlier, we have a very heavy focus on medical education and peertopeer programs because
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`we really have the broadest and the deepest data set in atrial fibrillation of all agents, and understanding that
`profile requires time and the right setting for physicians. So we have actually increased very significantly our
`investment in that area. We are executing a very large number of programs, and we continue to see that when
`physicians have the time to understand the data, they really understand the differentiated profile of Eliquis.
`
`We also started DTC and the TV ads, and that will have an impact over time. As was mentioned before,
`although our uptake clearly has been slower than we had expected, we actually are making good progress in
`the third quarter.
`
`Our growth over the last four weeks in key Rxes is 23%, our growth in NB Rxes is close to 20%. When you look
`at the cardiology setting, in a quarter during which the new to brand prescriptions of both Pradaxa and Xarelto
`were flat, we experienced very, very good growth. Our NB Rx share in cardiology now is close to 19%, which
`compares to 12% for Pradaxa. So we are continuing to make progress, and the areas of focus going forward
`are the same as I just described.
`
`Béatrice Cazala
`Regarding international, first let me talk briefly about Europe. We have now launched Eliquis in about 13
`countries. And we saw significant growth, more than 100%, quarter over quarter. We are planning to launch in
`another four countries across Europe, including Italy. So this target launch also accounts for possibly the slower
`pace that you can see.
`
`We are feeling positive now about access. We are focusing our launch effort mainly on the cardiologists, and we
`are allocating resources strongly at the hospital, but also differentiating versus the level of [unintelligible]
`penetration in various markets.
`
`What makes Europe also is very different penetration of the [unintelligible], which gives us a lot of opportunities,
`because you go from countries where [unintelligible] are only at 2% penetration, and others where it’s already
`25%. So we are clearly differentiating our investment there, and we will be very competitive in other segments
`of the market, in all the various markets.
`
`We are continuing to do strong medical education. Let’s not forget that [unintelligible] [authorization] starts with
`the hospital. Most of the patients go to the hospital in Europe. Then we also [unintelligible] the cardiologists and
`the general practitioners. So we are trying to accelerate the hospital discharge and the prescription at the
`hospital [unintelligible], moving to cardiologists and general practitioners.
`
`A lot of education needs to take place, and this is happening now. We are reinforcing our resources there. And
`as we see now more recent market data, we see that the differentiated profile starts being perceived by the
`cardiologists, which are [unintelligible] very important for the long term growth of the products.
`
`Francis Cuss
`We were very encouraged with the melanoma data with the combination, and we were pleasantly surprised with
`the tolerability that we saw there. But as you appreciate, lung cancer is a different indication, and we will be
`looking, clearly, at the therapeutic index. We don’t have the data yet, and I can’t speculate about what we will
`see. But just to remind you that of course what we believe is one of the most valuable aspects of
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`immunotherapy is the durable response. And that data set will be evolving over the next 6 to 12 months. And of
`course our hope will be combination that we will see an enhanced, durable response.
`
`Operator
`We’ll take our next question from Mark Schoenebaum with ISI Group.
`
`Mark Schoenebaum ISI Group
`On diabetes, I was wondering if you could tell us what you were able to realize in price for the DPP4 franchise if
`possible, in the quarter, in the U.S., most importantly, if that’s possible. Number two, I’d love to get your
`perspective on the increased rates of hospitalizations for heart failure seen in the SABRE trial, whether or not
`you think that’s going to generate any kind of regulatory scrutiny. And then finally, on Nivo, the upcoming
`potentially pivotal Phase II third line refractory squamous trial, what level of response would you define as
`success in that trial?
`
`Francis Cuss
`So, as you noted, one component of our secondary endpoint hospitalization for heart failure did occur,
`specifically more than the untreated group. But it is important to note, I think, that there was no increased risk of
`death due to heart failure overall, and in patients who entered the trial with a history of heart failure, there was
`no statistical different between the treatment and the primary endpoint.
`
`So we’ve been discussing with consultants about what this may mean, and we’ve had discussions with the
`regulators and we’ll be making a submission of this data to see where any change to the labeling will come.
`That will be happening early next year.
`
`I think it’s important to also mention that if you take the SABRE trial overall, there was clearly some benefits
`there in terms of diabetic control. While that wasn’t the point of the trial, it was very reassuring from that
`perspective, that patients treated with [Onglyza] had better control, and I think there was reassuring data
`around pancreatitis, even though the numbers were small in the end, and pancreatic cancer. So, overall, we felt
`the SABRE trial did really inform quite considerably on the use of DPP4 inhibitors, specifically Onglyza.
`
`As far as squamous is concerned, unfortunately, like all these things, it will depend exactly on the data we see.
`We think, and I’ll repeat, it’s very important to consider that this is a patient population with no other options at
`all at the present time, and that it’s a very important aspect of this to see what the long term durable response
`rate is, not just the overall response rate. We think that’s important.
`
`Charles Bancroft
`Mark, I think your question was more related to the U.S. in regard to price. Overall, as we think of the Onglyza
`franchise, we continue to be at roughly parity with Januvia, and we did take a 5% [unintelligible] price increase
`in August of this year.
`
`Operator
`We’ll take our next question from Jami Rubin with Goldman Sachs
`
`Jami Rubin Goldman Sachs
`I just have a couple of questions. Lamberto, first to you, I guess that given the significant commitment to
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`immunooncology and the 25 trials ongoing with Nivolumab, and others, I’m just wondering if you’re signaling to
`investors that we should assume a change in the rate of growth in R&D, different from what we’ve seen the past
`couple of years?
`
`And my second question relates to the hep C program. Not sure who will take this, but if you could just help us
`to think about the commercial opportunity in Japan from your alloral dual regimen. The reason why I think this
`is tough for us to figure out is that Telaprevir was a big disappointment in Japan, even though it produced much
`higher cure rates from peg/riba. Your combination obviously excludes peg/riba. So how should we think about
`the commercial uptake, pricing, etc.? And then secondly, how long do you expect to be on that market without
`competitors, which, you know, as I understand, will be on your heels.
`
`Lamberto Andreotti
`Thank you for this question, because this allows me to expand on the subject of investments that both Charlie
`and I mentioned in our remarks. Let me say that we will continue to invest to support this immunooncology
`portfolio, and we will continue to invest behind Eliquis, hep C, and diabetes.
`
`And all this will get the resources that they deserve, and this will increase our expenses, mostly the commercial
`expenses, because within R&D we have a number of programs that are ending now, and therefore we will have
`resources coming from within R&D to finance the additional expenses that immunooncology will especially
`require. And they are significant, by the way.
`
`But in commercial, we have already eliminated a lot of the expenses behind the old products, and therefore we
`will think about increasing commercial expenses. We will be ready to launch Nivo, and we will continue to
`support Yervoy. And as we said, Yervoy will launch as a first line in Europe. So we will expand the commercial
`activities behind Eliquis in the U.S., in the early launches, and we will launch outside the U.S. and the most
`recent countries.
`
`And then Charlie will speak about the investments that will be required by the launch of hep C in Japan. And
`finally, we have Forziga hopefully approved next year, so we will have a launch of Forziga in the U.S.
`
`Having said that, we are extremely aware, my management and I are extremely aware, of how important it is to
`deliver short term results, and we will deliver them, but we consider equally, if even not more important, to build
`a solid foundation for sustained long term growth. So we will devote resources, in summary, as I said, to all the
`great opportunities we have.
`
`Charles Bancroft
`As Lamberto mentioned in his opening comments, we are very excited about our opportunity to bring the first
`alloral hep C regimen to market in Japan with our genotype 1B strategy. Our registrational Phase III study of
`daclatasvir and asunaprevir in Japanese genotype 1B patients will be presented at AASLD in a couple of weeks,
`and we plan to file in Japan later in this quarter.
`
`Remember that there are about 1.2 million people infected with hepatitis C in Japan, and about 70% of them
`have genotype 1B. These patients are largely elderly and many either cannot tolerate the current interferon
`based standard of care or are ineligible to receive it. So that speaks to the real opportunity and why the current
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`BristolMyers Squibb CEO Discusses Q3 2013 Results Earnings Call Transcript
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`standard of care has not done as well, to your earlier point.
`
`And finally, we believe we have up to an 18month lead on both [ABVI] and Gilead in Japan.
`
`Operator
`We’ll take our next question from Chris Schott with JPMorgan.
`
`Christopher Schott – JPMorgan
`Just had three here. I guess first, we’ve seen your competitors in the PDL1 space focusing a bit more on PD
`L1 status, particularly in nonsmall cell lung cancer. Can you just elaborate on your view on this dynamic and
`what implications it has either to the size of the market or the competitive positioning of Nivo?
`
`Second, on Eliquis, with the slower launch I know things are accelerating a bit now have you changed your
`internal peak sales assumptions on the product based on the experien