Tony Wood: Okay. In terms then of RUBY, particularly RUBY Part 2, just — and indeed the MMRp population from the results that we described earlier this week, important to recognize that the RUBY Part 1 study was not powered to look at OS in the MMRp population, but rather OS for the overall population. The way to think about this in context of both Part 1 and Part 2 is definitely isolating out the MMRp population, asking under what circumstances are we likely to see the most meaningful therapeutic effect for those. There are, for example, genotype considerations associated with PARP response in the Part 2 population that are important. I don’t want to get caught on the details of those at this point in time. We’re still waiting for the readouts, but it’s fair to say that the filing strategy that we’ll put around Jemperli in first-line EC will take account of all of the factors that I just described as well as the competitive position.
Luke Miels: Yeah. I think to build on that competitive position, I mean, I think we’re optimistic in terms of how the NCCN may read that. Of course, as you know, GY018 is not designed around an overall survival signal. And it’s very interesting, since that initial label, we’ve gone from 300 to 900 accounts now stocking Jemperli in the US. So that has a flow-on effect and sales are up 10 times after SGO. And it’s intriguing just looking at the marketing shares. If you look at that first-line setting where that was obviously non-promoted initially, I mean, Keytruda was picking up around 40% of that business. [Chemo] (ph) had dropped from 40% down to 27%. And we had around 13% of that market. So, I think there’s an opportunity now to start to make the case versus GY018, the elements of design and the survival signal to try and expand the usage of Jemperli in that setting.
So that’s something we’re quite excited about. And then of course, DUO-E helps inform the thinking around RUBY, too.
Tony Wood: Exactly. Just a couple of things to underscore to Luke’s point to remind you about GY018, different patient population. We had a larger degree of carcinosarcoma patients which are harder to treat, and importantly as well the resist sampling frequency for our study was smaller, which obviously is going to pick up failures more quickly than the GY018 case does. So, important to bear those two things in mind when you consider the comparison of the two studies. And Luke, I think, has guided you correctly in thinking about DUO-E as being informative with regards to how we might interpret the Part 2.
Emma Walmsley: Thank you. Next question.
Nick Stone: So, next question is from James Gordon at JPMorgan.
James Gordon: Hello. James Gordon, JPMorgan. Thanks for taking the questions. And I’m going to stick to Arexvy for my two. The first one was about Arexvy and stocking. So, it looks like about £460 million of Arexvy was stock in this quarter. And the guide for this year implies about £200 million to £300 million of sales in Q4. But what does this assume in terms of stocking unwind in Q4? How much stock do you need to keep in the market to support the product as an ongoing run rate? And also, what are you thinking about ex-US stocking in Q4? Could there be a US-sized stock up that we saw in Q3 in Q4? And the second question sort of leads into that, which is Arexvy and the ex-US launch. So, ex-US sales, I think, were only £9 million this quarter, but the product was approved in the EU back in June.
And my understanding is you’re not capacity constrained. So, could ex-US start to ramp in Q4 this year? And looking into next year, could we see a big launch for ex-US Arexvy? Could that be a big growth driver for next year? Or is it going to take a bit longer in Europe to get this going? And what are the gating factors to get ex-US Arexvy ramping like what we’ve seen this quarter in the US?
Emma Walmsley: Okay. Well, we’ll go to Julie first just to deconstruct the guidance for Q4, and then Luke around the globalization. But you’re absolutely right, this is a global opportunity. And I’ll even include in that, the recent commercial deals we’ve been doing in second biggest market in the world, which would be an option on that for the future. And just to repeat, we’re very ambitious for this being a multi-billion asset, as we’ve committed before. But in terms of the very short term, in its first season, Julie, do you want to comment on the guidance ahead?
Julie Brown: Yes, thanks very much, Emma. So, what we’ve definitely found so far is of the sales of £709 million, in terms of immunizations into people’s arms, we’ve got around equivalent of about £230 million to £250 million. We were expecting — I mean, the launch has been massively successful. We were expecting a stock in at this point, because it’s very, very analogous to what’s happening with flu. So, I think I’ll hand over to Luke in terms of the amount of inventory we expect to carry. Your figure for Q4, by the way, was absolutely spot on in terms of the level of sales we expect to see in the remainder £200 million to £300 million. And it’s all to do with the stocking. So, over to Luke.
Luke Miels: Yeah. I mean, if you look at the total market, I think it’s about [US$2.71 billion] (ph). And we’ve got [US$1.7 billion] (ph) of that in arm. Yeah, I won’t give too much more color. I mean, as Julie said, it’s two-thirds of sales so far. And we’ll obviously try and burn through that towards the end of the year to position ourselves well. What we don’t want is empty shelves or any window that Pfizer can get in there. That’s why I’m being a little bit cute with the numbers here because it’s very dynamic at this point. In terms of EU, look, it’s very early days. It’s private. We’ve kept the price in a very tight collar with the US like we’ve done with Shingrix. And our expectation is that we need to now navigate access.
We’ve got early wins in Canada. We’ve got some very encouraging signs coming in Europe and other markets. So, we’ll see the full effect of that in 2024. And of course, the advantage in the European markets like Japan and other international markets is once we get the NIP, then the level of resourcing we need to do to drive patients is significantly lower. And so, from a P&L point of view, it’s also very attractive. So, 2024 for rest of world for Arexvy and good start in the US.
Emma Walmsley: And just to repeat, we are definitely seeing increased openness and recognition of the value, literally financial value of investing in prevention. And so that is and definitely a part why we’re seeing this faster rate, even if it’s currently in the private market of approvals, because it’s just a lot cheaper and there isn’t a healthcare system or budget that isn’t burdened at the moment, and they have more infrastructure in place, not least through pharmacy channels for distribution in many countries. So, all of this underpins this broader confidence but with phenomenally tight discipline from Luke and his team as he’s alluded to around the shape of the financial contribution plan. Next question, please.