Eric Le Berrigaud: Thank you. Good afternoon. Two questions, Pluvicto related, please. The first on your slide as the footnote says that the 2,500,000 doses per annum will be achieved across all RLTs. If Lutathera is then included, could you mention how many doses currently are supplied for Lutathera today so that we can deduct how much is left for Pluvicto? And the second question, in terms of capacities yet to come and the split between the different sites, would it be a great and a fair assumption to say that Millburn once all lines are approved and operational will be of the same size of the Ivrea in Italy and that Indianapolis will be maybe the largest one, representing more than 50%. And also, could you repeat that Asia is not part of the 2,500,000 doses and we’ll have to come on top. Thank you.
Vas Narasimhan: Thank you, Eric. So, a multipart question, I’ll try to take them off one-by-one. So Lutathera is a very small volume product. So it’s not a meaningful contributor. So, I don’t think it would have a big — I don’t know the exact number, but I don’t think it will have a meaningful impact on the 250,000 dose target. Roughly speaking, when Milburn is fully online, it would more than double the capacity over standalone. And as we, of course, get that site fully ramped up, it could do potentially even more. But I think as a base case assumption, Milburn doubles our capacity versus Ivrea. Indianapolis is a much larger scale facility with those semi-automated and automated lines, which when running at full scale a few years from now would have significant capacity but it would add significant — it would be a larger site than either or Ivrea in terms of the capacity it could generate.
So, taken together, those three sites, obviously, have a lot of production capacity for Pluvicto and, of course, Lutathera. But Lutathera is not a production issue for us. Now in terms of the ex-US, we currently would plan to supply the ex-US from Ivrea and Zaragoza outside of Europe, outside of the US. So Asian markets, but we have plans in place to put up greenfield facilities in Asian markets. We’ve not disclosed exactly. But certainly, Japan is high in our mind amongst others to put forward those greenfield facilities to add capacity in Asia, particularly given the strong interest we’ve seen in Japan, Singapore and other markets for Pluvicto.
Eric Le Berrigaud: Thank you.
Vas Narasimhan: Next question, operator?
Operator: Thank you. Your next question comes from the line of Michael Leuchten from UBS. Please, go ahead. Your line is open.
Michael Leuchten: Thanks so much. Question for Harry, please. Going back to slide 27. There’s a lot of pluses and not that many minuses and obviously, Q1, the performance was very good. But your guidance increase seems a little bit modest in relative — in relation to that. So just wondering, as we think about phasing over the quarters, like what is it in the rest of the year that we should keep an eye on beyond the integration costs or the separation costs for Sandoz? Thank you.
Harry Kirsch: Yes. Thank you, Michael. I mean, we do have to note that on the bottom line, we upgraded to notches. So I think that’s not too small for quarter one update, clearly shows our confidence in the future. Now the one thing we have to watch a bit is inflation. That’s where we have to see. When you think about it, right, the inflation on the cost of goods, actually, the products we sell now, are from an inventory produced in the second half of last year, right? So the products we produce now will be sold in the second half of this year, right, with a huge standard cost approach and so on. It’s not a super big deal, but overall, we expect another $500 million of inflation after having $350 million last year. Again, our productivity efforts are expected to much more than offset.
But given the large part of the Sandoz as part of the total COGS, right? That hits them a bit over proportionately. But it’s something we have to watch as we go forward. And that’s why it’s the first of the three negatives, if you will. I mean when you look at our top line, you feel like there’s no generics, there is generic impact as we speak, right? Gilenya, and some of you pointed out, there’s a miss on Gilenya. I mean, we take — I would always assume normal modeling on the small molecule generics, right? It grows extremely fast in US and still outside of US, a bit slower. And, of course, we are holding some of the IP in Europe, in some European countries, but still — Lucentis in Europe, we haven’t seen the most massive effect. But I think I don’t want to overtalk it too much.
I mean, we are upgrading to high single digits, low double digits, right? So certainly, the green plus is by far outweigh the red minuses.
Vas Narasimhan: Thank you, Michael. Next question, operator?
Operator: Thank you. Your next question comes from the line of Andrew Baum from Citi. Please, go ahead. Your line is open.
Andrew Baum: Thank you. Please forgive the voice. I’m struggling with COVID. A question for Vas, I suspect you remember, historically, I’ve described the bases is suffering from syndrome in always being the early adopter and taking unnecessary risk relative to peers. I’m going to completely contradict myself. The early data from SET with RT CD19 in refractory autoimmune is remarkable. The biology is strong, patient access node patients is much easier in oncology. We understand that Bristol is about to open a very large program with their CAR T in lupus and multiple other fortune diseases. When I look at Novartis, the trial that’s posted that’s just opened has got a sum of 12 patients. So, this 12 patients just to start, and it’s materially going to expand, or is there some risk that the pendulum is overcorrected and Novartis risk missing out on a major commercial opportunity?
Vas Narasimhan: Yes. Thanks Andrew. So, we’re very excited about the potential of CAR therapy in immunology. We believe with YCB, perhaps unlike our competitors, we have a low-cost rapid manufacturing process with hopefully better safety profile and much more scalable, particularly for the immunology indications. I don’t know where the competitive set is on that technology. We’ve opened up an initial program in SLE. We plan to expand that across a range of other immunology indications. Once we have the initial data set that regulators have asked for us before safety data, before we can make an expansion cohort across multiple immunology. So, those protocols are all written I — this is our top priority for CAR therapy. I mean we are putting immunology ahead of DLBCL and multiple myeloma, our CAR teams are working around the clock now to expand as fast as we can given the very powerful case reports that we’ve seen out of Germany and other jurisdictions.
I’ve read those case reports myself and I would agree with you, it’s pretty remarkable to see what you can do with a full reset of the B-cell compartment, B cells come back, but you don’t have B-cell lineages that seems to target these self-antigens that lead to these diseases. So, full steam ahead, it’s going to be a race, we accept that, but we want to go as big and broad as we can given our long history in immunology. And we believe versus the two peers, given our experience running trials in immunology that should give us an advantage if we execute well. Next question, operator?
Operator: Thank you. Your next question comes from the line of Graham Parry, Bank of America. Please go ahead, your line is open.
