Jeff Stewart : Yes. It’s Jeff. I’ll take the first question. Yes, we’re very comfortable as we see things start to evolve and close here as we move into 2024. I mean if you think about all the indications that we’ve had 7 over the last 18 months, I highlighted in my remarks, 9 head-to-head trials. We’re just a very, very nice position for Skyrizi and Rinvoq as we move into ’24 to continue some very strong momentum that we’re seeing in the actual. So quite confident in terms of how we’re looking at that. And to your key point there on the price, we continue to see that we’re not going to have a repeat of what we saw this year. And remember, the background there were those 7 indications that came very fast all on top of each other.
And so that was the root cause of that — of those concessions that won’t repeat. Next year, we have really one more big indication, not 7, and that’s Skyrizi you see that Tom highlighted. So we’ll see the normalized price erosion more in line with industry forms versus what we saw this year.
Rob Michael : And then, Chris, this is Rob. On HUMIRA, I think if you think about the annualization rebates that given the rest increase in the second half of this year, so you have an annualization impact, and the additional rebates to secure parity access next year, really price should be the main driver of the erosion in ’24. I mean volume will have an impact, particularly in wax sensitive accounts, but price will make up the vast majority of the erosion next year. And while we’re not giving ’24 guidance today, as you’ve mentioned, Chris, I’ve highlighted the average, it was about $7 billion when I mentioned that was a reasonable expectation for U.S. Humira next year. Now there are a few animals who have forecasted U.S. Humira above $8 billion next year, which is just not a reasonable expectation given the price dynamic.
Operator: Next question comes from Terence Flynn with Morgan Stanley.
Terence Flynn : Obviously, you guys are very well positioned coming out of the Humira LOE in terms of the growth franchise. But I think there’s focus from investors on maybe bolstering the pipeline. So as you guys think about M&A and business development, maybe you could just walk us through your latest thoughts and anything in terms of therapeutic areas of interest and stated development.
Rick Gonzalez : Okay. Terence, this is Rick. I’ll cover it. That question for you. Yes, I think as we look at the business, as Rob indicated, we’re extremely comfortable with how the growth platform is performing. And I’d say how we’re managing the biosimilar erosion, which gives us a lot of confidence that we can deliver this high single-digit going forward. From ’25 — going forward through the end of the decade. So I’d say the bulk of what we’re looking at, and we’re in a fortunate position from that standpoint. There are many companies in our sector we need to go out and do lots of BD to be able to drive the growth that they’re trying to achieve. We’re not in that position. But I’d say the bulk of what we’re looking at is we’re looking to add assets that could give us incremental pipeline and revenue growth towards the end of this decade and into the 30s.
That’s what our — the bulk of our focus is on. . And I’d say if I look at AbbVie’s track record, certainly, BD has been a critical part of how we’ve grown this company over the last 11 years. And I’d say, for the most part, we have done a pretty good job when we acquire assets and bring them in we can make them perform quite well. Skyrizi is a good example of that. Certainly, Allergan was another good example of that, and there are many others. So I’d say we value BD as a very important tool and how we should grow the business and how we should position our leadership positions in these franchises. Our primary focus is within the franchises that we’re operating in. So let’s take immunology as an example. I would say our greatest focus in immunology is to continue to add additional mechanisms in particular, that could be used in combination in order to create deeper levels of clinical response in areas like IBD, rheumatology and other areas.
So we continue to look for those. We have several already that are in development now, like Luti, like RIPK1 and several others in our pipeline, but we’ll continue to look for additional assets that we could add to that. And like I said, especially focused on combination therapy because we think that is the way to get much deeper clinical remission or responses in those patients who aren’t responding to things like Skyrizi, Rinvoq, which obviously performed exceptionally well. So that’s a big area. Oncology is another big area. We have a high level of interest in next-generation CAR-T technology. We have a high level of interest in T cell engagers beyond our BCMA product. I think as we look at that asset continue to develop, we are very convinced it has a best-in-class profile.
And it shows us that for the right indication, T cell engagers can be extremely effective, and they’re much easier to use and can be much more broadly brought to patients and CAR-Ts, at least the current version of CAR-Ts. So I’d say that’s an area that we have a high level — in psychiatry, we’re interested in additional assets in anxiety and mood, and a variety of other assets, but that gives you some feel for it. And we obviously have the financial wherewithal to go out and do transactions. We need to make sure we find the right transaction. So it’s a value-enhancing asset for the company. And when we find them, we will act on and we will act on quickly.
Operator: Next question comes from Tim Anderson with Wolfe Research.
Alice Nettleton : This is Alice Nettleton on for Tim Anderson. A question on obesity and its interface with I&I and a lot of other drug categories, frankly, are views that payers have to cover OBD medicines. And if that’s correct, it’s a big expense, and payers will be looking for offsets. One-off that would be for payers to squeeze other therapeutic areas as hard as they can. An example could be I&I, where there’s now a really good product, your own HUMIRA at a much lower price. So we’re wondering how much payers might start to force a step edit for products like Skyrizi? It’s a relevant question because yesterday, one of the issues Bristol noted with its TYK2 product is step edits and they cite biosimilar Humira as the reason.
Jeff Stewart : Thank you for the question. It’s Jeff. And I think you’ve got to take a step back regardless of the obesity issues and think about the overall strategy that we pursued, which was 1 of fundamental distinction. And I’ll take your point over some of these head-to-head trials, and there’s 9 of them, right? So if you take Skyrizi, just in psoriasis, we have gross superiority versus every mechanism in the category. So a head-to-head of gross superiority versus Humira versus the leading IL-17 COSENTYX versus the oral Otezla, and we also have versus Stelara. So fundamentally, when payers think about stepping or not stepping or how they would think about that, there’s a medical dynamic there and that distinctiveness that we have across our program is very, very important to help manage maybe the urge of the payers to think of formulary structures like that.
