Albert Bourla: Thank you, Mikael. So to summarize the Prevnar, which I know it is in the minds of all, let’s start with the commercial front. In the U.S., clearly, the adult opportunity, we have taken the cream basically of the catch-up opportunity. This is happening once you are getting a recommendation from CDC for a catch-up. This market, the pool of patients has been largely exhausted. We have already 96% market share of that. So this is not a market, the adult now that we expect that will continuously grow in the U.S. Pediatric, very different story because our market share is now growing, and we have indications that we’ll continue growing very strongly. So we expect in the U.S., the Prevnar situation to be a strong growth story in pediatrics.
International, both, we expect to see growth because the products have just been launched, and then the recommendations are following. So there is a delay in international higher than usually there is in the U.S. So we expect to see growth in adult and pediatrics. I want to reemphasize that we have basically exclusivity of Prevnar 13 in more than 100 countries, 113 countries in of tenders. And we plan to convert that now to 20. And then on the fourth generation, we are moving full speed. We think that our expertise will allow us to build a polyvalent vaccine that will really compete very, very nicely as a fourth generation and will do that successfully and fast. So that’s the story and let’s move to the next question, please.
Operator: Next, we have a question from Trung Huynh with UBS.
Trung Huynh: Trung from UBS. Two, please. So in your prepared remarks, you noted you took a $1.4 billion impairment charge associated with etrasimod. Can you add more color here? What prompted that reevaluation? And any feedback of how that launch has gone? Secondly, on Abrysvo, so can you give us some color on how your contracting has evolved in ’24 versus ’23? And based on that, what’s your market share do you think you can capture this year versus the 35% last year?
Albert Bourla: Thank you very much. Why don’t you take the impairment question and then I will move to commercial?
David Denton: Yes. So on etrasimod, keep in mind that this product, we still anticipate to be over $1 billion in peak sales. As you know, there are multiple indications attributed to this medicine. And financially, as you look at that medication, there were additional indications that met the financial criteria for an impairment of which we took in the quarter. Clinically, obviously, clinically, there’s still some work that will be ongoing in support of the asset. So with that…
Albert Bourla: Thank you very much. So Aamir, maybe etrasimod commercially, how the launch is doing and the Abrysvo?
Aamir Malik: Sure. So I’ll start with etrasimod or VELSIPITY as we call it. So just in terms of the product value proposition, we think this is a very promising oral option for moderate to severe UC patients. It’s got strong efficacy that patients and physicians we’ve exposed this to. They want to start transitioning from conventional therapy to advanced therapy. And it gives them an option also to maintain once-a-day oral routine, which many are already on instead of beginning with an injection or infusion. So about 80% of those patients that haven’t progressed to an advanced therapy prefer an oral option, but only about 10% of those patients actually get one. So there’s a very clear need here that VELSIPITY can help us fit.
And the benefit risk profile for VELSIPITY is also very, very strong. So we approved — we received approval at the end of last year. And so we’ve invested efforts in building HCP and patient awareness on the label and on the value proposition. But I just want to remind you that with any immuno-inflammatory product, it takes time to get broad national access. And that is where our focus is right now is ensuring that we secure VELSIPITY access as a first-line advanced therapy oral option, and that’s going to take some time to put in place. And when we have that in place, we see upside momentum from the launch.
Albert Bourla: What about Abrysvo?
Aamir Malik: On Abrysvo, I’ll comment briefly on the adult and then on the maternal. On the adult vaccine, I think the market was clearly ahead of everyone’s expectations and not limited by shared clinical decision-making versus a routine recommendation. We would like to do better than the 30-some percent share that you referred to as well. So we’re very focused going forward on retail contracting for the ’24, ’25 season. But I will also mention that we are doing that with real thoughtfulness on ensuring that we secure a profitable share in those contracts and also differentiating using our maternal indication. We also see opportunities in the non-retail setting, where for example, with the system and with IDNs, we have strong share.
And we’re going to also focus on new opportunities that we’re currently studying with Abrysvo, adults aged 18 and older with underlying medical conditions as well as a new packing presentation to better fit our customer needs. So we see momentum there. And on the maternal side, we’re only a few months in, but we’re encouraged by what we’re seeing as the first maternal vaccine to prevent infants from birth to six months when they are the most vulnerable. More than 65% of women prefer to get the maternal vaccine versus having their infant immunized with a monoclonal antibody. And we think that the label provides us opportunity to grow that segment as well.
Operator: Our next question comes from Terence Flynn with Morgan Stanley.
Terence Flynn : Two for me. I guess the first one is just Comirnaty rest of world was ahead of consensus expectations this quarter. Just wondering if there were any one-time benefits in that number, if that’s a fair go-forward sales level to think about through 2026, given the existing EU contract? And then the second one is, I noticed that Danuglipron wasn’t mentioned in the PR or the prepared remarks. Just wondering if that once-daily PK trial completed yet and what the next steps are there?
Albert Bourla: Thank you very much. Maybe very quickly on Danuglipron, we didn’t mention because we don’t have anything to say more. So that’s the only thing. There is a program, which is composed with a lot of experiments that we are doing now. In terms of moving it to once-a-day and we will speak only when we have data. We don’t want to become now the focus again of another earnings call. But that being said, I’m moving it to Alexandre to discuss about Comirnaty in the rest of the world outside the U.S. What are the dynamics of Comirnaty?
Alexandre de Germay: That’s why there are several elements playing out on the Comirnaty franchise. First, what we see is restrictions on vaccination guidelines, right? So versus the previous years, we see that the guidelines are really focusing on the older population as well as the at-risk population. But we have, as you know, already signed several contracts with the European Commission, Canada, UK and Australia. And following the approval in August last year, we started to execute on our contract with the European countries. As a matter of fact, some countries have decided to advance some of their order in 2024 into 2023 so that they can execute their activation campaign properly. The other trend that we see is that actually, we don’t see major vaccination uptakes in the future year.
