We understand the markets we’re in extremely well. We understand the competitive environment that we compete in those markets extremely well. We understand the patient journey and how that patient journey is affected by access to medicines to ensure that patients can get their medicines routinely and be able to get the benefit of those medicines. It takes all of those things I think to end up with kind of success that we see with assets like Skyrizi and Rinvoq. But it also takes I think a company that is very good at what I describe as read and react. There are always challenges in businesses as big and as complex as this. And I think the difference between companies that can continue to perform at the top tier, year in and year out is they’re good at seeing issues, and then quickly reacting to how they’re going to either offset those, or deal with those.
We had many of those examples. I’d say the label change on Rinvoq was a great example. But look at where Rinvoq is growing now. And despite that label change many would not have predicted that. Migraine, was a very challenging market for a period of time. We look at how we’ve operated with Ubrelvy and Qulipta. And the kind of success we’ve seen against the competitors in those markets. Neuroscience, very different kind of market with Vraylar. That’s all about trying to grow market-share and expand your position there with a very good asset. And so, we’re good at that, and I think that is the real differentiator. The other thing I’d say is, I think we have been very efficient at our R&D investment. We obviously don’t have the largest R&D investment in the industry.
But we produced a tremendous amount of return against that R&D investment. Now having said that, as we go forward, we know we need to increase R&D as I’ve said in my comments. We did a fairly significant increase last year despite dealing with the Humira LOE. And we’re going to do another fairly significant increase this year because we had some assets that had very, very significant opportunities like 383 and like 400 and several others. They are going to require a large Phase 3 — multiple large Phase 3 studies to be able to get the kind of label that we need, and that’s another thing, I’d say, we’re good at. Understanding how you have a competitive label and building your clinical programs to get that. So, I think it requires all of those things.
I don’t think there is one magic formula. I think those are the kinds of things that we have honed here at AbbVie an executive team. And we execute very well against those.
Liz Shea: Thanks, Steve. Operator, next question, please.
Operator: Yes, our next question comes from Evan Seigerman with BMO Capital Markets. Your line is open.
Unidentified Analyst: Hi, guys. It’s [Nachman] (ph) for Evan. I wanted to ask — thinking about the upcoming approval for Skyrizi, and you see how is management thinking about how that may or may not impact Rinvoq sales, obviously combined AbbVie offers some immpresive suite of inflammatory assets. But what is the expectation of cannibalism across these assets potentially? Thanks.
Jeff Stewart: Yes. Hi, it’s Jeff. I’ll take that one. We’ve learned a lot from watching Skyrizi and Rinvoq in Crohn’s. And to Rick’s points, look, we’re very careful about how we position these assets, you know how we basically represent them with our medical teams and our commercial teams. And so what we see certainly in our biggest markets, we see that they are actually complementary positioning. So, Rick highlighted the label change, right. So Rinvoq, in the US, is basically indicated for use after a TNF. So it’s basically a later-line therapy. Skyrizi, if you look at the Skyrizi, you see results, it’s very, very impressive. We’ve studied some very, very tough patients there. The bio-naive patients, the efficacy is just outstanding.
I would say it’s best-in-class. So we can see that based on the profile of the agents for many of our representatives, we’re able to talk to physicians about the consideration for Skyrizi frontline. And then in later lines Rinvoq. So the cannibalization or the overlap is very manageable and minimal. And what happens is you start to see this, this very significant build for total AbbVie share because of that complementary positioning. So we’re quite confident that we’ll be able to navigate this very well just as we see in the larger Crohn’s market.
Liz Shea: Thanks for the question. Operator next call — next question, please.
Operator: Yes, our next question comes from Tim Anderson with Wolfe Research. Your line is open.
Tim Anderson: Hi, I have a question on obesity drug impact on AbbVie’s Aesthetics business. So the uptake for obesity drugs could be a headwind or a tailwind. That’s a potential headwind if patients only have so many dollars to spend on Aesthetics and they reallocate their out-of-pocket spending away from dermal fillers and toxins towards obesity drugs? Or it’s a tailwind if patients using obesity drugs get things like the so-called Ozempic face and they end up using more toxins and fillers. So, what’s been the experience thus far. And what do you expect going forward over the next handful of years? Thank you.
Carrie Strom: Hi, this is Carrie. So the short answer is, we have not seen an impact on our Aesthetics business positive or negative so far. That said, absolutely, our customers and our consumers are participating in this market. We are seeing it integrated into some of these Aesthetics practices. And to your point, there are instances where a patient will make a trade-off in terms of her share of wallet. But that said, we do see it as a long-term tailwind anytime people are getting more engaged in their appearance, that’s a positive thing for Aesthetics. And as we ask our consumers and our customers about it, really that — what we’ve learned is that it does reinforce its long-term tailwind because the majority of people who engage in these medical weight-loss products are more interested in Aesthetics afterwards than they never before. So, that’s really how we see it in terms of the that dynamic impacting Aesthetics.
Liz Shea: Thanks, Tim. Operator, next question, please.
Operator: Yes. Our next question comes from Tim Lugo with William Blair. Your line is open.
Tim Lugo: Thanks for taking the question. After the two announced acquisitions in December, what are the team’s thoughts on M&A in 2024. Some of your peers have given guidance on expected deal sizes. Is that something you can provide the Street or at least talk about your capacity at this point?
Rob Michael: Hi, Tim, it’s Rob. I’ll take that question. So our BD efforts continue to be focused on identifying assets, really that can drive growth in the next decade across immunology, oncology, neuroscience, aesthetics and eye care. But we have what we need in our current portfolio to deliver on growth expectations in this decade. So our external efforts are really aimed at early-stage opportunities, which are typically smaller-sized deals. As we look across the growth areas, if you think about immunology Skyrizi and Rinvoq will drive robust growth into the next decade. So our focus in immunology in terms of BD is really looking for new mechanisms of action that can elevate standard-of-care whether monotherapy or in combination.
