As we’ve talked in the past, our opportunities for growth are significant as we look to continue to improve on adolescent vaccination rates, as we look to improve upon gender neutral vaccinations, as we look to really activate the mid-adult segment, but increasingly get to the lower income and middle income markets which will come at a different price point. As we sit here today, continue to be confident in the outlook for GARDASIL over both the near and the long term. As we look at the possibility of a single dose of GARDASIL, the study that we are conducting will be a comprehensive study and will take some time to unfold. What we’re seeing in the marketplace currently is where certain low income markets are implementing a single dose regimen, they are also increasing the numbers of people they are vaccinating by broadening the age cohort or also opting to vaccinate males at this stage.
We’ll have to see long term how the data plays out with regards to a single dose to ensure that we will price our vaccine based on the benefit that we’re bringing and we vaccinate as many people in the world that we can.
Operator: Our next question comes from Luisa Hector with Berenberg.
Luisa Hector: I also have questions on the WINREVAIR launch. I just wanted to check how straightforward the subcutaneous administration is and when you might expect to launch an auto injector. Also should we actually expect the Part D access to come online at a similar pace as commercial? I’m just not sure whether that’s something that’s maybe fitting more into next year. And if I can, just another question on all of that with Part D, is that you’ve priced for the Part D restructure next year. How do you expect payers to behave when this happens? I can see that the payer will take on a greater burden for higher priced oral therapies. Do you expect some push back within the actual drug that you would have higher rebates at that point or do you think that incremental burden for payers might be spread more broadly across all products? It’s a kind of bigger picture question but WINREVAIR brings it into focus.
Dean Li: I’ll answer your questions in terms of delivery of WINREVAIR. We have it in a vial and we have it in a situation where both a healthcare provider or self administration is both feasible, possible and will be used. We believe that the vast majority with time that people will use it as self administration, this is a patient population that’s quite used to doing injections. So we think that that will be able to navigate and that the patients will get access. But as you point out, further innovation will be demanded for and an auto injector will be critically important. We are doing the studies right now to evaluate how do we provide such an option and we hope to have those options and those plans more public in the near future. But we agree with you totally in the fact that a future auto injector will be important.
Caroline Litchfield: At this stage, we are seeing a real acceptance of the value proposition of WINREVAIR in the United States. We’re seeing policies for coverage equally across both the Medicare and Medicaid patient population, as well as the commercial segment. So as we move forward, we’ll look forward to just helping as many patients as we can across all of those segments irrelevant of their coverage.
Operator: Our next question comes from Seamus Fernandez with Guggenheim.
Seamus Fernandez: So I wanted to ask actually about your RSV targeted antibody, how you’re thinking about that, the optionality for it and the market size and Merck’s potential participation in this market as it relates to the competitors’ global supply constraints at this point in time? It seems like coming to market more aggressively or as aggressively as possible could actually make for a meaningful market opportunity for Merck? And then just a follow-up, Rob, wanted to just get your sort of qualitative view, three years, four years in, thinking about the evolution of the business, 2028, 2029 still represents a meaningful challenge with KEYTRUDA. But as you look forward to the rest of this year and heading into 2025, how important is business development to Merck from here in terms of the size and type of acquisitions I think investors have certainly applauded what Merck has executed on in the last year for sort of mid to later stage assets?
Dean Li: So I’ll take the RSV question. So clesrovimab, we’re excited about it. As many of the people know, it’s a monoclonal antibody and it’s a way to get passive immunity to infants, we think it’s really important as we have seen recently. And ours is a single fixed dose and has the durability in terms of covering a whole RSV season, I think it’s critically important. And the ability to give this to an infant anytime and versus for example alternative strategies, which is maternal vaccination. And then also we believe that this will be a distinguished monoclonal antibody and its high barrier to resistance. So we’re excited about moving — and we’re seeing that data and moving with both speed and rigor to get this to the market, because we think it will be an important contributor, especially given what we’ve seen in the RSV just this past season.
I do want to just take this one moment to just say it’s not just the RSV vaccine that we’re very excited, we’re also very excited because it’s very much in the lay press in our dengue V181, which is a live attenuated tetravalent vaccine and we’re moving with equal eagerness to move that forward into Phase 3 as we’ve already seen data from our colleagues in Instituto Butantan about the effectiveness and efficacy of this vaccine. But I’ll turn it back to Rob.
Rob Davis: So if I would just kind of, I guess, think a little bit about where we’ve been over the last three years, a few points I would want to raise. One, I think we’ve made tremendous progress in a relatively short period of time. And I give all credit to Dean, to our R&D colleagues for what they’ve been able to do, how they have been able to really move just flawlessly products through our pipeline. It’s amazing you think of it now three years in, we haven’t had really any major failures. The one maybe hiccup was with islatravir, but that’s coming back. And so I feel very proud of what our colleagues in R&D have been able to do. And then I think about from a commercial perspective, from a manufacturing perspective, we’re pulling the products through, we’re showing value.
The fact that we’re ready for the launch with WINREVAIR shows how we can build capability very quickly. We did it in KEYTRUDA, we did it in JANUVIA and now we’re doing it in WINREVAIR, and we’ll do it in new spaces coming forward. So feel very good about that. So across all elements, R&D, commercial, manufacturing, the business is delivering. And so as we sit here today, if our clinical success continues, I think, you’re going to see us with a more diversified set of growth drivers over time than frankly we’ve had in many years if ever. And that’s very important and it all is really what leads to the confidence you’ve heard me express in other settings that I’m increasingly less focused on 2028. And I would remind you by the way, it’s a staggered LOE, so it’s 2028 in the US and China, it’s 2031 in Europe and 2032 in Japan.
So it’s not a one moment event, it actually happens over time. But that being said, as you’ve heard me say, I see it as more of a hill than a cliff, and my confidence that we’re going to come back with fast growth after that is very high and we’re very focused on the sustainable engine from 2030 to 2040 at this point. So I feel good about where we are but I just want to reinforce it’s a team effort and I’ve been blessed with a great team.
Peter Dannenbaum: Great. Thank you, Seamus. And thank you all for your time and your interest today. I’m hoping to see many of you at our ASCO event on June 3rd or at a few of the conferences that we’ll be attending this quarter. So thank you all very much.
Operator: Thank you. And that does conclude today’s conference. We thank you for your participation. At this time, you may disconnect your lines.
