Operator: Our next question comes from Mohit Bansal with Wells Fargo.
Mohit Bansal: Maybe a question on Nurtec, the trends in market share as well as pricing. Just wanted to make sure that is there a significant price delta between Nurtec price versus the competitor price, I mean, the discounts that they are offering, given that your competitor has multiple offerings in the headache market. And if there is a delta, do you expect this to grow or decline over 2024 on pricing?
Albert Bourla: Thank you, Mohit, very much. Aamir, about Nurtec and in general, the migraine franchise.
Aamir Malik: So Mohit, thanks for the question. So we were encouraged by Q4 for Nurtec, and I’ll also include some comments on ZAVZPRET as part of my response. We were up more than 30% versus the prior year and 20% — over 20% versus the prior quarter. And there’s a few things that are encouraging. Nurtec continues to be the number one prescribed CGRP, so we have leading TRx volume and share. Interestingly, more than 90% of new prescribers in the category, many of whom are primary care physicians are prescribing Nurtec. And our pills per Rx has also, over the last several quarters, been steadily writing. So we continue to see opportunity. And there’s a few things to keep in mind. One is, there’s still a lot of unmet need. Albert referred to it in his written remarks.
But there’s a lot of patients undiagnosed. Very few get an Rx therapy. Oral CGRPs are still only less than 20% of the Rx market. But as you point out, this is also a very competitive category with Qulipta and Ubrelvy. And I won’t comment specifically on their pricing strategies versus ours and GTMs play a role in all of it. But our focus for Nurtec, one, I think we want to be sharper and more competitive in our patient engagement and activation. Two, we have an opportunity with our field force to focus on both the most relevant CGRP writers, and as I said, PCPs. PCPs write two-thirds of triptans but only about a little over one-third of CGRP so there’s an opportunity there. And then patient access and experience, there’s an opportunity to really reduce the friction there.
And I will also mention ZAVZPRET because with an intranasal, we think we can have a very nice complement to an oral for either rapid pain relief, and there’s also an unmet need for patients that have nausea and vomiting from the use of an oral. So we want to continue to invest in growing our Nurtec and ZAVZPRET franchise.
Operator: Our next question comes from Steve Scala with TD Cowen.
Steve Scala: Two questions. First, on Danuglipron, I know Pfizer doesn’t want to provide an update. But clearly, the company has greater insight than we do into how the once-daily version is performing in the Phase I PK trial. So I’d like to ask how would you characterize that performance so far? In the absence of any visibility, it’s kind of hard for us to be confident in the outlook for this program. Second question is a new weight loss agent was added to Phase I, designated 6016. Can you tell us what the mechanism is, please?
Albert Bourla: Yes. Steve, I’m going to disappoint you because you are asking things that we have said we are not willing to disclose at this stage for multiple reasons. Clearly, on Danu, we have more information than is very normal with everything that we are doing because we’re having a very complicated, as I said, multiple experiments plan right now. But because we don’t have new data, we’re not going to comment on that. And on the new weight loss molecule also, we said that unfortunately, we are not going to disclose the mechanism of action. The reason is because, first of all, it’s too early. We don’t want to keep competition, nothing strange about that. So I’m sorry to disappoint you but there is not much to offer at this stage. Hopefully, as we said, mid-year is where we expect to have more information on that.
Operator: Next, we have David Risinger with Leerink Partners.
David Risinger : Thanks for all the updates. So I have two questions, please. First is for Dave. Could you please discuss the ’24 gross margin [indiscernible] some detail. I think on the last call, you had discussed potentially a low 70% gross margin. But if you can comment on that in more detail, that would be helpful. And the second question is for Mikael. If Danuglipron once-daily does have a profile that you’re looking for, would the company then conduct a Phase 2A dose ranging study to assess the efficacy and tolerability in order to design a dose to advance Phase 2B or Phase 3?
Albert Bourla: Thanks, Dave. Very quickly, Mikael, resolve Danu and then we’ll go to Dave.
Mikael Dolsten: Yes, you heard Albert say that we are running a number of clinical experiments to garner insight in that molecule, and we have a second lift. Pfizer has always been open to consider different types of clinical study design. And in general, we tend to move into directly whenever data is supportive, if there is a large safety database into Phase 3 with a lead-in phase. But we have to look at each program by program. So when we have all the data, we will be able to share with you.
Albert Bourla: Yes. Let’s go to the gross margin where we can serve a little bit more information.
David Denton: So David, this is Dave, and I’ll be very brief here. Obviously, we’ve indicated our ’24 gross margin expectations are in the low 70s as we discussed previously. As you know, as we cycle into ’24, there’s a few things that are happening, as I indicated earlier. One is, as COVID comes down, we’re kind of deleveraging as COVID had absorbed a lot of fixed overhead. So that’s compressing gross margins. Secondly, we’re in the process of in-sourcing many of the acquired products over the last couple of years. And as we in-source, the short-term effect of that is dampening on gross margin, which gives us an opportunity to improve gross margins as yields improve over time. And then finally — or two things finally here is new launches have that same characteristic, as we launch a new product, yields and performance in — are not at peak performance.
That will be an opportunity for us going forward. And then finally, we have absorbed some inflation over time that is an opportunity for us to take out over the next several periods. So again, an opportunity for us to enhance performance over time. But again, we’re in this roughly low 70s for 2024 is our expectation.
Albert Bourla: And David, let me add a little bit more color here, but the Comirnaty and Paxlovid are big products, but they are manufactured in the same facilities, but they are separate facilities so they are not affecting the margins of the other products. So the margins were really absorbing in those facilities when you had such a huge volume production and value reduction, of course, the margins were seriously — those products are seriously taking a lot of the overhead. Now, as we are reducing our expectations for COVID into very realistic within targets, this doesn’t mean that we have eliminated our capacity to produce more if the demand is there because that would be not responsible, first of all, from a public health perspective but also from our investors’ money perspective.
