GSK plc American Depositary Shares (Each representing two Ordinary Shares)

Hello everyone, welcome to our half year in Q2 2023 comp score and webcast for investors and analysts. Presentation was sent to our distribution list by email and you can also find this on gsk.com. Please turn to slide two. This is the usual state harvest statement for comments on our performance using constant exchange rates or CR unless stated otherwise. As a reminder, following the consumer healthcare demerger in 2022 to form HAYIN, we're presenting performance and growth on the continuing operations for GSK. Please turn to slide three. Today's call will last approximately one hour and the management presentation will take between 30 to 55 minutes with the remaining time for your questions. For those who wish to ask a question, please join the queue by raising your hand. Press star nine to raise and lower your hand if you're on the phone and we request that you ask one question so that everyone has a chance to participate. Our speakers today are Emma Walty, Tony Wood, Luke Miles, Deborah Waterhouse and Julie Brown with David Redburn joining the rest of the team for the Q&A portion of the call. Shending to slide four, I will now hand the call over to Emma.

Thanks Nick and a very warm welcome to everyone joining us today. I'm delighted to be presenting to you all another set of excellent results for GSK. Please turn to the next slide. Sales and profits grew at double digit levels for the quarter, our sixth consecutive quarter of strong growth. Sales were £7.2 billion up 11% excluding pandemic solutions. Adjusted operating profit was up 12% to £2.2 billion and adjusted EPS were up 17% to £38.8. This is further evidence of a sustained step change in GSK's performance and this momentum supports our decision to upgrade our guidance for the year. Our performance also demonstrated delivery of the strategic choices we've made to develop the portfolio and the R&D pipeline. New products, notably in vaccines and HIV, all made healthy contributions to growth and reflect the investments we've made to prioritise these parts of our business. 62% of sales are now coming from vaccines and specialty medicines which we expect to provide durable and profitable growth through the decades. And new products launched since 2017 have contributed sales of £4.6 billion so far this year, adding nearly £1 billion of additional turnover compared to 2022. Equally, our general meds business continues to perform alongside the other parts of our portfolio. We are deploying capital in a financially disciplined way to invest in growth and deliver stronger returns to shareholders. We are delivering our commitments and as you can see from the slide, we are on track to hit all the targets we set out in 2021. As you all know, our very first priority for capital remains to invest in continued pipeline progress and we know this is the key question for shareholders. At the core of our work is an aggressive pursuit of organic pipeline delivery and targeted business development. We're making good progress on both and there is more to come. The Drupal Erexie this quarter is, we believe, transformational and set to bring enormous benefits to people aged over 60 who are at annual exposure of RSV. Erexie is spearheading the next wave of vaccine innovation at GSK. This quarter we presented positive clinical data for our Pentavalent meningitis vaccine, secured regulatory approval for shinwits in Japan in at-risk populations and achieved US FDA fast-track designation for our Candidate Vaccine to Prevent Golorrhea, a vaccine that is considered a high priority packaging by the WHO. National Institutes are recently at the management event. We have substantial innovation to come with potential new vaccines to prevent influenza, pneumococcal disease and herpes simplex virus. This all sits alongside other innovation in infectious disease like Becca reversin for hep B and a new portfolio of much-needed anti-infectives. We're also very pleased with the progress we're making in our HIV portfolio. A key aspect here is of course to develop the portfolio to replace the loss of exclusivity for Dolutegravir which, as a reminder, is not expected to start until 2028 in the US and 2029 in Europe. We are well on track to do this. We expect sales from our new long-acting regiments of around £2 billion by 2026 and to add to this, clinical development plans are advancing very well to support new -long-acting options launching from 2026. And with these innovations, we aim to replace the majority of revenues from Dolutegravir and support profitable growth for GSK well into the next decade. And we're looking forward to talking to you more about all this at our HIV meet the management event in late September. Equally, we continue to make good progress in our business development. Here, we're targeting acquisitions and partnerships to strengthen and complement our core therapy areas to help deliver above and beyond our current long-term outlooks. So you should expect to see us keep up probably the same levels and pace of BD as we have in the last 18 months. This quarter, we completed the acquisition of Bellis Health, building upon our respiratory expertise for the addition of Camelopixence, a phase three potential -in-class treatment for refractory chronic cough. Our pipeline and broader respiratory is developing well too across all three product areas and we're increasingly confident it will be a major source of new long-term growth. Next slide, please. Our focus is to deliver competitive performance and improved shareholder value in the short, medium, and long term. With our current momentum and further successful execution of our priorities, we are very confident in our ability to deliver profitable sales growth in all three of these timeframes. For 2023, we now expect to deliver sales growth of 80 to 10% and adjusted operating profit growth of 11 to 13%. For 2026, we expect to deliver sales of more than 5% and adjusted operating profit of more than 10% on a CAGA basis. And by 2031, we're confident we will have effectively absorbed any impact from the loss of exclusivity across the portfolio to deliver our stated ambition of more than 33 billion pounds in sales. We know the ambition is significantly higher than current market expectations and over the next year, we'll continue to bring you more clarity and specificity on our building blocks to deliver profitable results through a series of meet the management events, data readouts, and a more comprehensive update against our 2021 long-term plan. Let me now hand over to Tony who will talk you through his latest thoughts on R&D priorities and performance.

Thank you, Emma. And hello, everyone. It's great to be with you today. Please turn to slide nine. I'm pleased to report that we're making good progress in strengthening the pipeline. And we know there's more to come. Our absolute focus is to develop a robust pipeline that can drive sustainable, profitable growth. I see this being achieved through a combination of organic delivery and disciplined business development, overlaid with continuous improvement in R&D productivity. This is reflected in my three priorities for R&D shown on this slide. And in the delivery of our strategy, which is focused across four strategic areas and aims to leverage our deep understanding of the immune system and use of advanced technologies. Next slide, please. It's important that we allocate our capital and resources effectively. I think about this from two perspectives. First, from a therapeutic area standpoint, our priority is to build on our strengths and leadership in infectious diseases, HIV, respiratory immunology, and our emerging capabilities in oncology. This is by investing in both organic and targeted business development to deliver first or best in class innovation, balancing probabilities of success and sales potential. And we apply the same disciplinary returns criteria for both approaches. In addition, we also seek platform and data technology enabled opportunities. Second, from a time perspective, I want to develop a partner or acquire vaccines, specialty medicines, and technologies with significant commercial potential that can meaningfully contribute to sales and proper growth in the latter part of this decade and beyond. Ultimately, I want a portfolio of R&D innovation that offers a good balance of risk and return, and which can drive growth in the GSK above and beyond the ambitious, sorry, I'm just talking about. Slide 11, please. Our pipeline today comprises 68 assets in clinical development. Two-thirds of the assets within our development portfolio are focused on infectious diseases in HIV. In infectious diseases, we're focused on seasonal respiratory viruses, bacterial, fungal, and chronic viral infections. Vaccines are friends and centre over this effort. Emma has already mentioned the RxV and some of the innovation that is coming behind it. Our PentaVillain meningococcal vaccine candidate recently met all primary endpoints in the phase three trial and demonstrated immunological effectiveness against 110 diverse and NB strains. These account for 95% of circulating strains in the US. Five serogroups are responsible for most meningococcal infections and no single approved vaccine can yet protect against all five. If approved, then ABCWI would do so, offering a simplified immunization schedule and supporting increased vaccine uptake. This is important when you consider that only 30% of adults currently receive full protection from all five meningococcal serogroups. We're on track to submit the vaccine to regulators in 2024. Our novel -new-mococcal vaccine candidate, acquired through the AffiniVax Transaction, has also shown very positive immune response across stereotypes. We continue to examine potential acceleration options for the 24 and -day-old programs in infants and younger adults. With QVAC, we're looking to disrupt the influenza mark and deliver new multiviren combination vaccines using next-generation mRNA technology. Multiviren phase one and two flu and COVID trials are underway and we expect data from these towards the end of this year and the start of 2024. In chronic viral infections, in addition to geographic expansion, we're looking at new growth opportunities for shingrays. These include extending the population who might benefit from protection to a younger such as the recent Japanese approval to include adults aged 18 to 49. We continue to review the potential need for a booster. Additionally, a growing body of evidence suggests the shingles vaccination may reduce the risk of dementia. We're leveraging our expertise in herpesvirus, salvexostivirus, to develop a promising injectable treatment for the control of herpes simplex virus reactivation. Our plan is to initiate proof of concept studies later this year. In anti-infectives, we've now assembled a promising portfolio of new medicines. Jepotitis, in which we stopped early for efficacy and was anticipated to launch next year, has the potential to be the first oral antibiotic to treat uncomplicated human tract infections in more than 20 years. Complenting this is Tevita from Spiro Therapeutics, which, if approved, will provide us with access to a late-stage antibiotic with the potential to treat complicated human tract infections. Brexifam, a novel -in-class medicine to treat fungal infection, acquired through an exclusive license agreement with Synexis, completes this trio. The perivostal is another potentially transformative treatment which could help patients achieve a functional cure for chronic hepatitis B. We'll afford to present the data from our phase 2B trial, B2Gether, later this year. This trial is designed to answer whether interferons need to improve the durability of In HIV, we're entering an important period in our clinical development plans for potential -long-acting treatments and prevention options. These spearhead the transition we expect to deliver in the HIV portfolio over the next five years. We'll be setting out more detail on these in our third quarter investment bell. In respiratory immunology, we're prioritizing late-stage development of our IL-5 medicines at the moment. The addition of Camel Picsum to highly selective P2X3 antagonists for the treatment of refractory common cough also provides us with another asset in phase 3 development. Luke and I expect to be sharing more with you on our plans and opportunities in respiratory before the year end. In oncology, we're progressing the regulatory submission for mongrelotamin following the US FDA's recently extended review date to September. We're confident this new medicine will help tackle the significant and debilitating medical needs of myelofibrosis patients with anemia. Given the makeup of our current portfolio and capabilities, our approach in oncology is to prioritize the development of novel medicines to treat blood and women's cancers and to explore other potential breakthroughs in immunoncology. Champerley, our highly effective PD-1 inhibitor, is central to this approach and exploration is backbone treatment for using combination of further proven or promising therapies within development. You'll see how many of the elements I've just touched on are expected to play out over the next 12 or 18 months. I believe these, together with targeted business development and a series of important phase 1 and phase 2 investment decisions, will lead to significant progression in this pipeline in the short term. Alongside allocating resources to prioritize and accelerate clinical development, I want us to continue to improve overall R&D productivity. We've made progress. Success rates have cycled times our own proven, but more needs to be done. For me, this really means two things. First, doubling down on leveraging our scientific capabilities with the use of new platform and data technologies. And second, developing our partnering and external sourcing capabilities. With AI and machine learning applications now rapidly maturing, access to proprietary data to feed models and generate novel insights has achieved strategic differentiators. For example, we recently presented data results for Bepa-reversing. From the BeClear Phase 2B trial, this deep multimodal analysis helps us to develop a clear heterogeneity mapping chronic hepatitis B, stratifying individuals treated with Bepa-reversing to three subtypes, a highly enriched response, a mixed response, and a non-responded subtype. Each defined by distinct clinical, neurological, and molecular trajectories, and associated with a number of markers. These predictive models provide greater precision than existing markers and suggest potential enrichment strategies. We're competitively placed in platform technologies and have laid strong foundations in data technologies. I want us to now vigorously scale and build on these foundations to better de-risk targets and rapidly test and progress high-quality -and-class candidates, all with the aim of accelerating and improving the success rates of our development programs. In summary, let me close by saying I'm pleased with the progress we've made so far this year, and that we have clear plans in place to move forward at pace to deliver on our key objectives for R&B and support the overall growth ambitions to GSK. I'll now hand it over to Luke on slide 14. Thanks, Tony.

Please turn to the next slide. Pleased to say that quarter two was another quarter of continued strong commercial execution with growth across the business. All three of our product groups, vaccines, specialty, and general medicines, were up in the quarter with growing contributions across all three regions. Please turn to slide 16. In quarter two, we delivered 7.1 billion pounds of sales, up 11% of those of last year, excluding pandemic solutions. In vaccines, strong growth of 15% excluding pandemic solutions was supported by Shingrix, which was up 20%, and Bexero, which was up 18%. Shingrix delivered another record quarter of sales, and it's the sixth consecutive quarter of growth. In the US, we've now reached the most motivated consumers with about 32% penetration of eligible people receiving at least one dose. Moving forward in the US, we're resourcing for success by raising awareness about the potential for further expansion, especially among consumers who are less motivated to get vaccines. We remain confident in the US opportunity and believe we can reach flu-like penetration of around 60% to 65% over time. Ex-US remains an important growth driver for Shingrix and represented 46% of the revenue in the quarter. Shingrix is now available in 33 countries, with most with less than 3% penetration, indicating the potential for further expansion in these populations. We've got unconstraints that lie in strong global demand, and we continue to retain high value with US market pricing as we launch in private pay savings global. In specialty medicines, including HIV, which Deborah will speak about shortly, we increased sales by 12% excluding Zaloui to 2.5 billion pounds. Our market-leading blockbuster specialty medicine, Femalista and Mucala, continued to deliver double-digit growth. Femalista was up 19% in the quarter with sustained growth across all major markets, with further opportunities to drive increased penetration in both SLE and lupus nephritis, with about 25% biopenetration in the US and other key markets. We're focused on life-cycle management opportunities for Femalista as we explore further indications, including systemic sclerosis associated with institutional lung disease, which will be important to patients as well as having a continued halo effect across the entire product. Mucala was up 15% in the quarter and remains the first and only biologic approved in 40 synephyllic diseases, with new indications driving growth and differentiation. The severe asthma market continues to grow in the US, with opportunities for Mucala to drive biopenetration with our clearly differentiated profile in high EOS patients. We look forward to having COPData in 2024. In oncology, sales were down 3% in line with expectations. However, Jim Hurley continues to be a growing contributor and we're excited about the potential for our PD-1 development program, investigating the opportunity to help all patients with endometrial ovarian and potentially iron medications. Our general medicine portfolio grew 8%, driven primarily by Trilogy, which was up 30% in the quarter. Trilogy continues to have a -in-class profile across access versus competitors and is a leading share of OAS of key specialty ACPs like hormonologists and allergists. Considering this strong Q2 and H1 performance, we now expect specialty medicines to grow high single digit and general medicines to grow at low single digit in the full year. We still expect vaccines to grow in the 10. Please turn to slide 17. We're very excited about the upcoming launch of Arexie and we believe Arexie's profile and recommendations to support our market leadership and tradition with multi-billion annual sales potential. Additionally, the CDC has now adopted last month's ACIP recommendation and has been communicated broadly to healthcare providers, an important step that sets the guidance and establishes a trigger for prior coverage. Launch is now underway as we speak and we have a clear understanding of what is required for successful commercial execution. We're also building our relationship with retailers, given our expertise with older adult populations through Shingrix and we're playing to our strengths using our deep respiratory expertise and our experimental primary care cell calls. We've now shipped doses to distribution centers and we look forward to the impact that this support and medicine will have on help prevent the severe consequences of Arexie in the US and globally as we also prepare for more of this season across Europe. With that, now let me hand over to Debra on slide 18.

Thanks Luke. Our HIV business delivered sales of £1.6 billion in the second quarter of 2023, growing 12%. This growth was primarily driven by demand which contributed 8 percentage points of growth and US pricing favorability which contributed a further 2 percentage points of growth. Our performance benefited from strong patient demand for our oral, tudor regimen and long-acting injectable medicines which now constitute more than 40, more than 50% of our total portfolio. This demand helped grow our global market share by 2 percentage points versus last year. The inventory builds that we saw in the US at the end of last year have now materially burned and we don't anticipate any further significant burn this year. Davato delivered £430 million of the quarter. Market performance reflects HCP belief in Davato which is now our number one selling HIV medicine. We were also pleased that Donna Tegraveer received US FDA paediatric exclusivity in the quarter which extends the Donna Tegraveer loss of exclusivity in the US by a further 6 months to April 2029. We aim to further consolidate our leadership in paediatric HIV by following a similar approach with our foundational medicine Cabbage Agraveer. Senator Cabanuba's sales for the quarter were £176 million reflecting strong patient demand with high levels of market access and reimbursement across the US and Europe. Growth is being driven by positive sentiment towards the solar data presented at CROI earlier in the year and strong commercial execution. It is particularly pleasing to see that more than 70% of Cabanuba's sales are originating from competitor regimens. Moving on to prevention, Sales of Aperture, the world's first long-acting injectable for the prevention of HIV, delivered £6 million in the quarter and we're pleased by the growing momentum across the US. We were delighted that early this week the European Medicines Agency granted positive opinions for this medicine with more than 100,000 new infections every year across the continent. We very much look forward to the approval of Aperture which has the potential to significantly reduce the transmission of HIV in Europe. We're encouraged by the progress of our pipeline which is focused on innovative long-acting regimens. We have three clear target medicine profiles to provide the world's first self-administered long-acting regimen for treatment and to provide ultra long-acting regimens for treatment and prevention with dosing intervals of three months or longer. I'm pleased to confirm that next month we shall begin our phase two B study of Cabotegravir in combination with our broadly neutralizing antibody N6LS which offers the potential for ultra long-acting dosing. We are very excited about the potential of these medicine profiles and we'll be ready to regimen select in 2024. We remain very confident in our ambition to achieve a five-year mid single digit sales cager to 2026 and our strong future performance means we're in a position to raise our outlook for 2023 from mid single digit to a high single digit growth rate and with that I will hand to Julie on slide 19.

Good afternoon everyone. I am delighted to be here at my first set of results as a CFO for GSK. The biofiber industry is incredibly special to me. It's where I've spent most of my career and it is a sector that can create enormous value for patients and shareholders. GSK is a company that I've long admired and it has a clear purpose to positively impact the health of billions over the next decade and I'm really pleased to be part of the team that is going to deliver this. As this is the first time speaking to you and before we cover the financials I wanted to take the opportunity to highlight three areas of focus that are going to be important to me as CFO. So first disciplined capital allocation with two clear priorities to invest for growth and to deliver improved returns to shareholders. Second partnering with Tony to enhance returns on investment and improve R&D productivity with a strong focus on resource optimization and efficient funding. And third identifying sources of business efficiency to fund investment and deliver a competitive P&L. So first turning to the next slide in capital allocation. Our first priority is investment in the business driven towards development of the pipeline through both organic and targeted business development. We will also invest to support new product launches. My intention here is to be laser focused on prioritizing and accelerating investment in those assets and technologies which will help us to deliver growth. I intend to achieve this through an increased focus on ROI for organic and BG related investments and this will include an assessment of the market opportunity, first in class potential and best in class potential, peak year sales, probability of success and expected financial returns. For returns to shareholders our primary mechanisms of cash distributions will remain through the delivery of a progressive dividend and last year the payout ratio of 40 to 60 percent over the cycle was established and we expect to earnings increase over time. For completeness in the event of a surplus excess cash would be returned to shareholders using the most efficient mechanism available. However we do not expect excess cash in the median term given our priority is to invest in growth. And finally and very importantly we remain committed to maintaining a balance sheet with a strong investment grade and credit rating. Taken together I believe this represents a sensible capital allocation framework for GSK consistent with our strategic priorities and supportive of our commitments to deliver profitable growth through this decade. Turning now to the quarter as I cover the financials references to growth through a constant exchange rates unless otherwise stated and I will focus my comments on adjusted results. So starting with the income statement sales increased 11 percent excluding covid solutions and we're up four percent overall reflecting the strong delivery that Luke and Deborah have covered. Operating leverage primarily in cogs through a registered operating profit growth of 11 percent with the margin increasing to 30.2 percent excluding covid solutions adjusted operating profit group 12 percent. Turning to the reported results the growth in total profit was driven by a strong operating performance and favorable contingent consideration liability remeasurements. Please turn to slide 22 and turning to margin dynamics. As mentioned the adjusted operating margin was 30.2 percent a 200 basis point increase versus the prior year at constant rates excluding the impact of covid solutions the margin increased 20 basis points. Cost of goods sold decreased primarily reflecting reduced sales of low margins of UD and Q2 which resulted in a gross property increase of 11 percent. Excluding covid solutions cogs increased in line with sales with a neutral gross margin impact with favorable mix and efficiencies offset by higher freight and energy costs. SG&A reflects investment behind product launches such as Shingrix, Geographic Expansion, HIV and preparations for EREX's imminent launch. We expect the SG&A growth to reduce in the fourth quarter as investment levels stabilize and to be broadly in line with sales growth for the full year. In R&D there was increased investment across range of early and late stage programs including a number that Deborah and Tony discussed earlier. And royalties benefited from Gardasil, Biktarby and Casenta and there was a 70 basis point adverse move from foreign exchange. And next slide please. So earnings per share benefited from lower net finance expense and known controlling interests and now we're turning to the adjusted compared with our total results. Next slide please. So overall total unadjusted operating profits were similar in the second quarter at 2.1 and 2.2 billion respectively. In addition to CCL remeasurements the main other adjusting items of note were within divestments significant legal and other and this reflected dividend and distribution income received including Haleon Dividends and the fair value movements of Haleon shares which was partly offset by significant legal charges. Legal fees primarily reflected increased charges to Zantac of which the vast majority related prospective legal costs for the defense. Next slide please. Questionary from operations was 1.9 billion in the first half, 2 billion lower than the prior year and the key drivers are similar to those covered at Q1 and relate to the Gilead settlement and timing of the Voodie collections received last year together with pension payments and increased working capital this year. There was no change to our expectations that 2023 cash generated from operations will be slightly lower than 2022 and we remain committed to our 2026 projection of more than 10 billion pounds. Net debt increased to 18.2 billion reflecting the free cash outflow and net acquisition cost of Bellis Healthcare partly offset by disposal of investments including the monetization of part of our equity holding in Haleon. And turning now to guidance on slide 26. We have delivered a very strong first half and as Emma mentioned we're upgrading our guidance for the year. As a reminder all of this guidance excludes the impact of COVID-19 solutions. We now expect sales to increase between 8 and 10 percent up two percentage points. We expect adjusted operating profit to increase between 11 and 13 percent and adjusted earnings per share to increase between 14 and 17 percent. Within sales we are maintaining our full year vaccine's expectation of a mid-teens percentage growth and are upgrading our expectations for specialty and gen med. We now anticipate specialty medicines and HIV within it to grow a high single digit percent and for gen med to grow a low single digit percent. And turning to phasing and firstly on sales we expect that the second half for us will be below the first half informed by the partnerships. We would also expect sales growth to be slightly higher in Q3 relative to Q4. And secondly on operating profit we expect that the second half growth will be stronger than the first with a broadly similar growth rate in each quarter primarily reflecting SG&A growth expectations as mentioned earlier. Next slide please. In summary our business is performing well and with strong momentum. I look forward to connecting with you and updating you on our progress and continued delivery towards our 26th and 31 goals in the quarters to come. With that in mind slide 27 shares how we plan to keep you informed in four key areas. Execution, portfolio, capital allocation and investor events. Execution shares our major earnings and reviews. The portfolio component builds on the R&D catalyst shared in Tony's presentation. Capital allocation is being clarified further today. And the investor relations program shares how we plan to provide you with the building blocks and depending on opportunity to meet the management of two more events this year. The first will focus on HIV in September followed by respiratory and immunology in the fourth quarter. We will also continue to run a comprehensive program of meetings, participation in investor conferences and updates from key medical events. And thank you and with that I will hand back to Emma.

Thanks Julie it's great to have you with us. We continue to build trust by delivering in the front but I want to highlight one in particular. Of the more than two and a half billion people will reach this decade the majority will be through our infectious disease portfolio of vaccines and antibiotics, antivirals and global health products. And so we're delighted to see new third-party funding announced to advance M72 and tuberculosis vaccine candidate discovered and developed by GSK into phase three development. This could potentially look up the first new vaccine to help prevent hormone with TB in more than a hundred years. It is a true testament to GSK's vaccine scientists and our ability to partner with others to develop innovative global health assets in an economically viable and sustainable way. With more than 10 million people falling ill and more than one and a half million people dying from TB every year and increasing evidence of drug resistance the successful development of this vaccine could have a profound impact on human health. Final slide please. So in summary we are seeing stronger momentum in our performance of continued delivery of competitive sales and profit growth. We remain very focused on continuing to progress our pipeline to organic development, targeted complementary business development and our progress is providing us with high confidence to deliver our outlooks and ambitions to shareholders through the decades. And with that let's move to the Q&A with the team.

Thanks Emma. So just as a reminder to those that wish to ask a question please join me by raising your hands. If you're on the phone please press star nine to raise and lower your hands. And again just requested you ask one question in the first instance and then we can always come back for a second round. Let's take our first question from James Gordon at JP Morgan. So James you're unable to speak so over to you please.

Hello James Gordon, JP Morgan thanks for taking the question. I'll keep to one. My question's about Shingwix in the US so I think the sales declined 10% this quarter or maybe it's sort of flatish when we adjust for stocking but I saw you've refined the Shingwix global guidance so it's now high teams this year. I think it was double digit before and Luke made some comments about having reached the most motivated patients in the US and further penetration increases but that sounds like maybe that's going to be tougher in the less motivated patients.

So the

question is where are we on Shingwix and US growth specifically? Could we now be running out of growth out of road for the US growth and it's going to be more ex-US growth but the US is maybe sort of flat this year and then could even decline? Or is Q2 a bit of a blip and the stocking another one off factors and there's still plenty of US growth to come?

Thanks James. Obviously we're still very ambitious the scale and reach of Shingwix but Luke do you want to come up and don out to the US? Sure

James and I suspect you're probably not the only person with that question so I'll take a little bit longer to cover all those points. So the short answer is not yet. We've covered in past calls there will be a point which we're entering now that we need to work harder to develop this what is essentially a logarithmic growth curve but yeah I'll just I'll take a little bit to outline this dynamics because it's very much a non-retail effect right now and as you said with some stock movements. So for retail first we actually saw an 8% growth or up 8% versus last year and that was pretty much driven by 65 year old individuals coming in following the removal of the co-pay linked to the IRA. And it's interesting in Q4 and Q1 we added about 2% to the total vaccination rate each time. So we're now at penetration of around 32% on the latest data we have which is Q1. If you then sort of subtract that there's about 80 million more people to go if we were to get to 100% and we added around 4 million people who turn 50 each year. The other important element on stocking we actually changed the rules in terms of how much stock wholesalers could hold. So we had two categories category A category B historically machine bricks has been classified category B which just gave wholesalers more room and more flexibility in terms of the volumes that they hold. We've now tightened that up to try and remove some of the volatility. If you remember last year we had stock movements which was 1.3 to 1.8 and down to 1.9. So far this year we're pretty tight in the range of 0.6 to 0.7. Expected we'll go up a little bit at the end of Q3 the flu season but we're trying to keep a tighter cold on that so that hasn't affected as well. Now if we go to the non-retail this is the important component in the US and this is the key shift. So historically non-retail has been around -50% of the business but in Q1 that went down to 34% and in Q2 it's around 31% and it's very specific. We have a very small number of key customers who are now approaching 60% of the target population in their vaccination. Now we have about 197 other key customers that we can work for. So I guess the -on-pool look at this is that we can get to the types of penetrations that we're targeting in these sensors and that's an opportunity with other ones. You're right, we do need to work harder to get to those less motivated patients but we've always known that's coming and we've got plans to do that. If we look outside of the US, just to conclude, we try to explain historically that we have these three points here. The US which is down on that curve, we're now starting in Europe and we have very early data in markets like China and as you said, we're about 3% penetration, excuse me, excluding the US and Germany which are ahead of the deeper penetration. So we're in good shape overall and I think we're forward to updating you on Q3.

Thanks Luke and the other point to emphasize is, as Luke referred to, the cost of reaching deeper into the US obviously goes up and actually in the other markets we're looking at, we're not seeing any problems because we don't have advertising and because prices have been successfully globalized, it remains a very appealing business in adult immunization which of course we're now adding to the RSC and additional stuff beyond that. Next question please.

Next question is from Joe Walton at Credit Suisse OVT. Hello, thank

you. I would like to ask a question about IRA and two aspects of that. I wonder if you have a view about increased volume in anything other than vaccines given the change in patient co-pay going down and also if you could talk about penny pricing and how we should think about that. You have some old products which will have accumulated very large rebates which in theory would become a problem next year. We've seen the internet companies talk about it. How are you going to handle that in respiratory? Thank you.

Thanks Joe. Well I'll come to Luke and you're absolutely right and there are some really good things about the IRA that we're very supportive of. The co-pays in removal in vaccines is important for our portfolio. There are some other things alongside others in the sector we're concerned about in terms of unintended consequences and two parts of our portfolio, HIV will be more like in 2025 and then in gen meds from next year there is some impact, four of which is explicitly absorbed in our guidance and in our outlets. So you'll see some volatility there but Luke I don't know whether you'd like to comment more on the specifics in established respiratory. Sure.

I mean Joe you're bang on in terms of effects in terms of compliance and when we see patients drop out of products like trilogy in terms of that historical coverage gap. So that should help with volume. Then there's other aspects to the program that we're less involved and we need to see how that affects. In terms of AMCAP we've got a very clear list of products exactly as you said that have had pretty intensive discounting and historical price increases which have been ahead of inflation and those rebates in commercial place will have an effect. I mean the total exposure, this is just total revenue not impact, I'm going to really stress this, about 700 million US dollars. So that's Floatven, HFA, Floatven Discus, Advert HFA, Advert Discus, Serravent and Lamictal and the biggest of those is Lamictal. Now we've had a lot of warning that's coming and we're working, the US has done a great job in terms of developing authorized generics partnerships. We have options to diverse selected products and where we can't bring in authorized generics or we are unable to diverse of course we can always mark the whack to adjust that. So that's a collection of approaches that we're doing to protect the bulk of that business.

Thanks, so next question please.

So the next question is from James Cuddy at Morganstein. James over to you please.

Great thank you very much. So maybe a question for Julie picking up on one of her comments. So you mentioned building a competitive P&L. So what is your definition of a competitive P&L and what sort of focus, what would be the focus areas to generate that competitiveness in terms of margin ranges or growth potential? And then there are, are there any sort of early areas that could drive efficiencies or levers that you can use to get you into these competitive ranges? Thank you.

Thank you very much. Thanks, so in terms of I see a competitive P&L as one that's operating to full capacity and making optimal use of the resources in the business and capital allocation in the business and I think progress, the progress has been made in GSK already following the separation with the future REDI program. I mean clearly at the moment we're in the launch cycle with a number of important medicines and vaccines being brought to the market as Luke and Deborah both mentioned. As we move beyond this of course we will continue to look for efficiencies and we do anticipate once we're through the launch cycle that SG&A will grow at a lower rate than sales thereby improving that particular margin and working with Tony closely because obviously I've been in the pharma industry for a long time, worked with R&D for a long time, clearly investment and productivity and resource allocation in R&D is critical to a pharmaceutical business. So as you can imagine I will spend some time looking for continuous improvement and opportunities to fuel business efficiencies to fuel further growth.

Excellent, next question please.

So the next question comes from Emily Beals at Barclays. So over to you please Emily.

Emily Beals. Okay

can I propose to take the next question then from Peter Welter. So Peter over to you please. Oh no I'm here,

can you hear me? Can you hear me? Yeah. Sorry, sorry I didn't get the pop-up, I didn't get the pop-up, I apologize. Sorry so I wanted to ask a question on flu vaccine. I know that you had previously guided you know for a down year but that's now expected to be down 20% if you could give any color on what the driver is for that and then I believe on the pipeline slides you indicated that we could get an update on the go-forward plans for the mRNA seasonal flu vaccine and if you could just give any sort of high level thoughts on what we could expect from that decision in the back half of this year. Thank

you. Okay thanks Emily. I think you said on flu so I'll come to, I mean as you know our current flu business is in let's call it not the most modern technology platform and we are expecting it declining so I've got a last loop coming up very briefly on why we see that but once again to reiterate overall that the vaccine overall remains very strong for the year and then perhaps you can update. I know we're excited about the potential doublet pursuit that you can borrow onto with mRNA. Sure thanks.

Emily thanks for your question. So basically you've got a comparative issue as the demand around the time of COVID of course was very high and so there's pressure there and the fact is there's a lot of doses around there with people who are very motivated to come to upload them so we're seeing pricing pressure. In terms of volumes we expect around 43 million doses this year versus around 51 million that we sold in 2022 so you know our goal remains to evolve this technology and I'll hand over to Tony.

Yeah so first of all I mean as I said we're now moving with the mRNA partnership and COVID into evaluation of development options but we continue to be encouraged by the data that we see there on the move into phase one and phase two studies we expect in the case of both instances and we'll see VLAS on those towards the end of the year and at the beginning of next year. Probably the only other thing I would add is that I'm sure you follow this as well that you know the field continues to encounter difficulties in in soon this is us who coverage particularly in these strains and what would I say at this point is that is our studies are designed to account for on B strain coverage and looking at a broader range of antigens so all of that will come together when we have an opportunity to update you in more detail at the beginning of next year. We're very pleased with progress on that form.

Thanks. Next question please.

So our next question is from Peter Robert.

Hi yes thanks and I'd like to come back and apologize please but back to just US Shingrakes for a minute just to try and understand the cadence here that we're talking about. Presumably the retail segment is typically the segment that we would anticipate to increase towards the end of the year so just try and understand in that segment you're saying demand is still robust but presumably what we'll see the usual sort of detailing that you do together with this flu or is there any sort of issue I guess with with the rec speed perhaps taking over priority there going into the flu season for the retail channel this year and for the non-retail just trying to understand so the issue is that there's a large that the majority of the non-retail segment has yet to reach that 60 to 65 percent but but it's becoming is it well what could you talk about what is the challenge perhaps to get doctors there is it is it coverage or is it as insurance coverage or is it just you know getting these people back in to see the position well what is it exactly that this is the ceiling there with the doctors please thank you.

So Peter I'll start with non-retail first so we've had a couple of very very large players that we've intensively worked with and as natural when you've got momentum you try and go with that and we really wanted to see how high the penetration we can get them we still expect those large centers to keep vaccinating and our aim is to go beyond 60 percent but the curve does tend to flatten out at 60 percent now if we think long term this is why I'm personally fascinated with the relationship that we've seen in the welch study around vaccination and chingrix and a potential relationship with with dementia and we're going to be very busy with life cycle work that one both prospectively and retroactive retrospective analysis there are another 197 key customers that we have that are in the 30s or a range from sort of the 30s to the 60s that we are now putting more work behind we also pull back on on the primary set promotion on chingrix in these centers and we're concentrating on trilogy to give that a hard put along with as an experiment to see if pcbs with this form we're now switching that team back to chingrix so that that's all pointing in the right direction it's more a case of prioritization and just moving that up these larger centers put a flag in the system and we saw what was really moving so we just need to do the hard work to pick up the other ones now and I feel very confident we can do that in terms of retail you're right there is there's still a seasonal relationship and we expect that to continue it's not as extreme as it was in the first couple of years of chingrix but it still exists the unknowns are there's no push from pro the booster this year but we don't know what effect that is that has been a drag historically but as you correctly point out we're going to be very busy with rxv targeting the high risk individual which is a subset of the of the chingrix target universe so let's see we'll get some more color I of course have a crystal ball but I remain very confident about the demand for this product in the us and just

to remind everyone again ex-us and germany we're at less than three percent penetration so there is you know a monthly runway for this asset and it's an asset that we are planning to add to so next question please

so our next question comes from eric alberg over staple eric over to you please

uh yeah thank you nick good afternoon everyone just a question to get more clarity in terms of cash flow development we're now getting in terms of earning growth into the double digits and you're raising the guidance here but still guiding in terms of cash flow declining this year could you maybe give us a little bit more details about the push and pulls to make the difference between cash flow decline even though we we go beyond the data settlement and the covid impact and and whether getting into 24 and beyond we might see cash flow development more in line with earnings thank you

thanks eric well over to you julie and remember we're reiterating our 26 outlook for uh operating cash flow but

yeah thanks hamil very much and thanks for the question eric so this this year clearly um we've had an influence of a number of factors with the cash flow a couple of things happened last year that have obviously infected the comparator so last year with the cash flow we had the gilead settlement um that occurred at the beginning of the year and then we've also had as a voodoo receivables coming in last year um this year the the cash flow has been depressed somewhat partly by movements in working capital and also which we expect to resolve by the end of the year and also we've had an additional pension payment that's been made this year which was reasonably sizable over 350 million so there are you know some somewhat one off you may call them relating to the cash flow this is what this is why you see the two billion in the first half but we are maintaining the guidance for the full year for cash flow which is basically to be slightly lower than last year the major reason you do see this difference usually our cash flow waiting is very much towards the second half we normally have around 70 to 75 cents of the cash coming in in the second half of the year last year was very unusual it was 50 50 of the things i mentioned so that's why you're seeing the difference in terms of 2024 obviously we'll guide um when we come to that at the end of the year but you can be sure that we will care for cash or be very focused on cash conversion and the translation of profit into cash you can see us paying a lot of attention to that as we go forward right thank you next question

is that the next question from Michael Witts and it's you guys so to you Michael

thank you next question RSV and Luke's comment on prioritization please so i guess the ACIP recommendation could have been a little bit stronger than it was just wondering how you reacted to that will you throw more commercial resources at Rxv or is the plan executed as it was thank you

thanks well i know Luke's very excited about the pending law so just add a bit of color to that sure

look i think that my christmas wish list it would have been for a certain label but that's the label we've got um but i think to put it in perspective our strategy has always been to focus on these high-risk individuals who naturally would engage in that type of discussion with the health care provider are ready to visit us to the pharmacy because they're polypharmacy and uh we have market research that clearly says that and if you look at our label that secondary claims the 94 efficacy etc really plays to us so i think at the end of the day it doesn't have an enormous impact in the first couple of years we are now actively training team generating the data the ace that uh wants to see and we're confident we can bring that so i think if we look in the medium to long term we'll see this a fully supported you know discussions with insurers are very very encouraging there's also some really good work published by our friends in new york that looked at rates of rsc president hospital setting particularly use foot and those tests and they're looking at you know it's really an underdiagnosis by a factor of two so you know the demand is there the willingness to recommend is there so we remain encouraged and the pricing is as far as i think we have to see the full effect alternative the multi-season label but again for these high risk patients i think this is more of a reassurance and also arguably let's just move this out of the seasonal collar that we would normally typically have with flu because you've got that longer longer time frame in terms of courage so net net i think we remain very excited as emma said we're very much looking forward to a exciting battle with phyza and it's something that we relish and in the end this is going to be physicians and pharmacists are better informed and patients are going to get their vaccine

thank you next question next

question from graham harry at stanford america graham over to you please

hi thanks for taking the question um so actually i just want to follow up on i think a couple of people asked effectively if you can grow shingrix in the u.s i'll just throw that out i think he's been answered and then actually asked my question which is on zantac um so with the settlement you showed a willingness or even a desire to settle cases in california but is that still the attitude that you have towards the upcoming case in november and now the same lead plaintiff's attorney is representing the plaintiffs both in california and the delaware cases with any settlement of the entirety of the zantac litigation now need to include a delaware thank you

thanks very well um we'll come to see whether he wants to add anything more to his already reasonable comprehensive answer we are on the u.s but uh in terms of that we remain very confident in our position we continue to be guided by the science the evidence that's been in place we've got a dedicated team managing this we'll continue to defend ourselves vigorously we obviously won't comment on our specific legal strategy ahead of its uh execution happy to be where we are and we'll keep everybody updated as we progress through obviously um knowing that we've got delaware coming in the new year so nothing more to add than that uh is shaking his head with nothing new to add on the two groups so thank you thank you

um can we take the next question from jessic humara at hsbtc please

hi there uh just on the capital allocation piece uh you you suggested that you're going to you know focus on deals as well as uh you know investing organically in rnd so could could you run us through some uh you know criteria you look at when you deploy capital uh when when you pick between rnd versus external investment how do you compare the two what are the internal metrics you look at and if the management uh below the top management are incentivized similarly for doing deals versus organic investment

yeah so i'll comment on that and then um let's see if jimmy wants to go at it further but it should be really clear in our in our capital allocation framework that our number one priority is investing in growth as you saw both from julia's side and from tony's side that's about the pipeline and our launches and within the pipeline it is organic and inorganic i mean you will notice across the entire sector i think probably about half of pipeline is sourced outside that number is probably going up across the sector and you know we've been really pleased with the reset of our balance sheets great capacity to do that and i've had a you know very focused uh track record of executing against deals uh reasonably um swift pace particularly over the last 18 months so you should expect to see all be the same i think the most important point is because it's part of the way we do r&d our bd team reports into tony there is we've been very thoughtful about the incentive system and the goals that are set in terms of pipeline progression to keep it neutral regardless of whether it's sourced internally or externally because you're absolutely right and then there was a slightly perverse incentives around that which aren't helpful and our criteria are unchanged and i think we're laid out explicitly on tony's uh opening slide we like to look for assets to the best of 12 certain costs we look at rois ntvs we look at contribution to sales growth particularly in the latter half of the decade and beyond we look across the balance portfolio of risk across all therapeutic areas we're obviously investing in our specialty and vaccines uh pipeline but also in technology platforms that will allow us to continue to improve productivity so that's why we like to see the tech enablements of what we bring fit bring through the really important point is that regardless of whether it's internal or external regardless of ta we use the same set of criteria so i don't know if either of them are doing that set or yeah just an

extra point i think um i mean we have got also a very rigorous governance process that runs through both bd assets we get together regularly looking at the bd pipeline as well as the organic pipeline and as emma mentioned you know one of our jobs we see has been very important is also to accelerate the key assets so we identify the key assets we look to accelerate them we look to ensure that they've got the right resources to do that and that we remove any blocker that could be there in the organization and finally we also review assets whether it be bd or organic for success so we do post-deal reviews also so there's a very rigorous process around this right thank you next

question from rich at the mp paribas and you richard

thanks nick um so i just wanted to push you a little bit more to talk about your um expectations for the rsv launch based on the initial outreach i think with the new producers looking uncertain i think the market's skeptical on your previous shingrix-like target but given higher pricing clearly could be a more meaningful opportunity near them if you can drive rapid uptake and looking at consensus i think we've got 180 million of sales this year and growing to 570 next year i just wondered if you could give us your thoughts on whether you see potential to exceed those numbers or is the weaker asip recommendation and maybe lower vaccine uptake you're factoring into flu vaccine going to be a headwind to that i know you've not upgraded the vaccines guidance despite that higher pricing so does that moderate your expectations in terms of volume thank you very much

thanks well i mean first of all i'll start and i'll come to lou on any additional comments but there was absolutely no change to our outlook which was we emphasized again our meet the management update on infectious diseases that we see the potential of this to be around three billion pounds of sales so in that sense it's a multi-billion asset i think we've been clear right from the beginning that we didn't expect the start to be at the same rate as shingrix just for the simple factor of awareness of the scene of course you've got some competitiveness for arms space in there and but also as you know we have a very specific recommendation from asip for shingrix which was unusual as well as the bizarrely helpful initial sources fly which we are a long way from dealing with here we're also taking a different case of launching in multiple countries across the world we don't drive for individual courses of sales but we've got lately comments on some more details around the price as well yeah

thanks i mean i think you know there was no solution for rfc historically so it didn't really make a lot of sense for systems to focus on and then as you saw coded with pcr testing ultimately that was an accompanying test and better understanding of the character character and prevalence of rfc emerged so i think we're in a very different place that we were a couple of years ago and we as we start to promote and educate doctors and pharmacists and pharmacists are very enthusiastic about the product i think that's a very fair long-term ambition there's a heavy overlap with if you look at high dust flow and and of course the shingrix population and the pneumococcal population i said in the past and then i think there'll be a steady build that the people be very strong and this is outstanding data for i think it's very impactful the healthcare systems and individuals so i think we'll get there and the data we've generated so far is quite pricing wise again you know we we went into acep with a with a color of 270 to 295 and we've been able to keep within that at 280 so i think our credibility with acep is enhanced through that process and the reception we've received so far from payers and and and pharmacy change has been very encouraging so that's probably all i can say at this point i very much look forward to updating 123.

Thanks Luke.

Next question is from Andrew Balmastiff.

Many thanks so in relation to trilogy we're expecting it to be included in the IRA price negotiation list being enacted in in 2027 i'm curious as to how Luke is thinking about the ability of GSK to claw back the rebate in order to mitigate the impact of the list price reduction my understanding is that PBMs cannot exclude a drug once it's been selected for price negotiations do you think you can take away the rebate or do you think that the PBMs will make you pay by creating hurdles to other products in your portfolio and then just following up on an earlier question in relation to the impact of the outer pocket cap in driving increased volumes to what extent do you think because still the patients are going to have to pay two thousand dollars out of their own pocket how meaningful do you think that really is in getting patients off your patient assistance program on to pay drugs or do you actually think two thousand dollars is still a real barrier for many patients and therefore the volume impact isn't going to be that meaningful thank you

yeah

and i think two thousand dollars is still a large amount of money for many people particularly older individuals but it's an improvement it's more predictable for those patients so you know i don't see a massive adjustment in some of our assistance programs particularly in oncology areas like that in terms of trilogy i mean q4 this year will have a better idea in terms of how cms is defining those first you know party drugs and how the how it's going to be managed but we have as you said five very high rao rates on trilogy already i think pbns uh probably the more your second scenario is more likely to be reality um and i think we've been you know we're very rational to make that assumption but we're obviously starting to think about various combinations and initiating discussions with them i think the other factor with trilogy is whether you'll see a generic emerge at some point because the technical challenges of the current cmr and closing three in how medicines and editing that for a regulatory part is not simple as we've seen with that there so i think that's also another factor which we're starting to look at

right thanks

next yeah

this is a next question from karen halter at orenberg every to you karen

oh hi thank you nick um questions is for deborah on long acting hiv uh so can any cap and uva strong performers in q2 just whether you can talk to that growth is called certainly reflective of underlying demand or are there any one else to be aware of women modeling sales in the second half of this year and beyond um you also highlighted that together two drug regimens long acting represents i think you said around 50 percent of total vip so interested to see whether that run rate at this point is what you would have expected from the long acting also earlier in particular you're behind in line or ahead of those internal expectations at this point in the year and can i squeeze in a quick one just to remind us of the timelines for your three monthly dosing formulation thank you

thanks carrie well obviously we're extremely pleased with the performance of being through this year and to be able to innovation that we pioneered on uh coming through so strongly so

yeah thanks for the question um carrie neither say we're really pleased with the performance of our hiv business um in the quarter um really strong underlying growth for both our all two drug regimens and our long acting pixels and that is uh absolutely driven by demand so let's go into cabanuga it's all demands we've seen really positive demand for um our products from people who are living with hiv and we know this is set to continue because we know that many doctors offices have got people on waiting lists particularly in the u.s uh to be started on the drug so it's really strong underlying demand for people living with hiv we expect that to continue and this in turn gives us confidence that you know we can build this market and we can you know deliver greater and greater share of this market through our long-acting eject schools um in terms of expectation it's ahead of where we expected if i'm completely honest so to be at 51 percent of our overall portfolio in uh our all two drug regimens and long-acting ejects cause is ahead of expectation we're really delighted by the underlying demand and particularly the long-acting ejectable uptake uh from from cabin from cabanuga um it takes a long time to build a market and you're in this market on your own so um you know you always wonder how much will it take and can you unlock each stage of the journey each barrier that you face and actually the answer is yes we can and we're really optimistic really optimistic about this opportunity in terms of the pipeline i mean we'll talk more about this at the meet the management session in september but you know what we what we've said is that you know we're looking to target an ultralong acting version of cabotegravir so an ultralong acting every three months plus from 2027 onwards i've been making really good progress with our reformulation of cabotegravir that's going to be the backbone to the first wave of our innovation in threat and treatment and so what you've probably seen on some of the slides that toby presented was are starting to move forward the accompanying uh partners it be it maturation inhibitor be it catheter or be it armenia and so we're kind of moving those assets forward so that we can make a choice um in 2024 of the regimen that we will take forward um and so the date that we've given in our previous investor updates stand but we hope to be able to give you a little more specificity when we do the um the link to management in september but very optimistic you know positions being very from a pipeline and performance perspective in the hiv space

great thanks ever well um i guess there are still a few handful more questions so we'll keep going and try and give us some short answers looking for myself

oh yes just one correction or one clarification um the practice bar or loe for trilogy is 2027 but where i wrote him in fact was 2028 there's one i'm sure you'll see on there

right thank you yeah Simon bank over to you please at redburn

thank you good afternoon everyone and thanks for taking the question um going back um tony to slide 13 on r and d um two related questions so one really um firstly on the reduced cycle times could you give us some idea of how much that is down to therapeutic mix and how much is is underlying reduction uh in non-vaccine r and d times and also on the the probability trend you show a nice uh trend of improvement in phase two three and beyond probabilities of success normally that is matched by a reduction in success rates in phase one i.e. you are killing projects projects earlier i wonder if you could give us an idea how that has evolved over time thanks so much

thanks great so penny no key area for the story

yeah noting down both questions i'm sorry i forget and in terms of your your first question with regards to um cycle times and um obviously there's a component of vaccines in that however we are seeing cycle times coming down particularly across um our late stage portfolio so we a contribution from both and then in terms of success rates in in phase two of course all we want to do throughout the portfolio is beginning to take attrition earlier and earlier and one of the things that we're driving coming from our focus in human genetics and functional genomics and of course the benefits that we get in focusing in infectious diseases is to be able to take attrition on an efficacy terms much earlier than first time in humans so i'm expecting that or rather what we'll see for the future is those preservation of phase two success rates and it being accounted for by earlier attrition than um that than that necessarily in first time in human we're very much i'll be more focused on the quality of agents driving survival at that last stage thank you next question please next question from manuel pappadakis at dojabank to you manuel

thank you sir um perhaps just a quick follow-up i think luke you said the in response to the earlier question around rebates offsetting price negotiation you said the second scenario could you just clarify what you meant by that i do you mean you think you will be able to reduce rebating to offset that price reduction and then the question i wanted to ask is just a moment looking at the delay in the padufa to what extent do you think edipolas will now be diminished in demand by the delay given the emerging data we've seen on anemia benefit with prokrytonib and to what extent indeed then is prokrytonib's quarterly run rate of 20 million or so actually a better guide to how we should be thinking about launch thank you

yeah i just think we're going to have pressure and it's going to be difficult to evade those structures um which i think is my understanding of the ender is two options so i would expect the we've tried in terms of literally still out of the box but again we're looking at options to offset that and i think that um yeah we're making progress there in terms of monolotny i think the bolus will still be there it's really interesting some of the recent market research we've got uh is quite current admitted that some of the numbers just just for interest i mean 75 10 of doctors agree that fulfills an unmet need um this was quite interesting around 60 percent patients present with anemia within one year of diagnosis and about 46 meter transfusion and and the other interesting statistic which fits our strategy is about two-thirds of them are on that 10 to 5 and around us of of a russula here but in terms of prokrytonib i don't think it's an accurate analog because really their label is uh within that platelet subgroup versus border and media group there has been some obviously some creative posters etc presented but the ncc and guidelines if you look at the minutes they they decline to review that border recommendation so that product is very much anchored in that if in a low below 50 platelet group whereas we have a much broader opportunity we believe with or with any big pressures we'll wait and see what the fda or what they decide in terms of the label we thought the business case for the deal on a second line label second line in india hope that helps

i think last question do we have

last question so over to steve scarlet at count so steve i see please

oh thank you can you hear me

we can

okay uh thank you in adult rsv how has your success in contracting thus far compared to your expectations and versus what you think Pfizer has accomplished to date is your potentially superior data giving the edge versus Pfizer and if not then why do you think that's the case thank you very much

so in recognition that we are in a competitive commercial situation i'll let Luke answer the final questions thank you

and steve we encourage that it's happening right now so uh literally as we speak so we'll we'll have more to you and q3 hopefully that's quickness right sorry i can't hear anything more

thanks Luke uh well once again thanks everyone for joining us we've been very pleased to report another excellent course of performance with strong sales and earnings uh growth driven by new product sales and it's been hiv and vaccines ongoing progress in our pipeline the approval of the world's first rsv vaccine those are the best health uh deal and of course upgrading guidance and uh with this behind us a lot of confidence in delivering our short medium and long-term uh uh targets and we really look forward to keeping you informed over the course of the head thanks all