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Operator
Operator
Good day, everyone, and welcome to Pfizer's first quarter 2019 earnings conference call. Today's call is being recorded. At this time, I would like to turn the call over to Mr. Chuck Triano, Senior Vice President of Investor Relations. Please go ahead, sir.
Chuck Triano
Senior Vice President of Investor Relations
Good morning, and thank you for joining us today to review Pfizer's first quarter 2019 performance and 2019 financial guidance. I'm joined today by our CEO, Albert Borla, Frank DiMiglio, our CFO, Michael Dolston, President of Worldwide Research and Development, Angela Huang, Group President, Pfizer Biopharmaceuticals Group, John Young, our Chief Commercial Officer, and Doug Lankler, General Counsel. The slides that will be presented on this call were posted to our website earlier this morning and are available at Pfizer.com forward slash investors. We'll see here that slide three covers our legal disclosures. Albert and Frank will now make prepared remarks, and then we'll move to a question and answer session. With that, I'll now turn the call over to Albert Borla. Albert?
Albert Borla
CEO
Thank you, Chuck, and good morning, everyone. It's been a busy and productive first few months as CEO. I've had the pleasure of meeting with many of you to discuss Pfizer's long-term growth prospects. I have also met with thousands of colleagues from around the world, all of whom are committed to driving sustainable growth through scientific and commercial innovation, value-creating capital allocation, and a renewed focus on our purpose, breakthroughs that change patients' lives. I'm pleased to report that we've begun the year with a strong first quarter. Revenues were up 5% operationally, company-wide. This was driven by 8% volume growth, offset by a net pricing decline of 3%. If we look at our biopharmaceuticals group, which represented 70% of our revenue base this quarter, we generated a strong 11% volume growth, and realized a net pricing decline of 3%. We saw volume growth in several key brands, emerging markets, and biosimilars, and we got our up-zone business up and running. Let's begin with the results from the biopharmaceuticals group. This business grew its top line 7% operationally, due primarily to the continued strength of several key brands, including Eliquis, Ibrans, Prevna 13, and Gelgens. Eliquis had a strong start to the year, drawing its revenues by 36% operationally in the quarter. Eliquis continues to extend its leadership in many major geographies around the world, and in the US, we achieved an all-time high prescription share for the brand this quarter. We remain pleased with the performance of Ibrans. Global revenues in the first quarter increased 25% operationally to $1.1 billion. As you know, the Ibrans growth story is now predominantly in international markets, where we saw 107% operational growth in the quarter. This was driven by continued strong uptake in developed Europe, Japan, and certain emerging markets. In the US, we saw 2% growth, which reflected continued moderating volumes in approved metastatic breast cancer indications. Prevna 13 revenues increased 10% operationally. We saw 31% operational growth in emerging markets, due primarily to favorable overall impact and increased volume associated with government purchases. These gains were partially offset by the non-recurrence of volumes associated with an adult national immunization program in the first quarter of 2018. We saw 6% growth in the US, driven by increased government purchases for the pediatric indication, partially offset by lower sales of the adult indication. Regarding the upcoming ACIP meeting in the US, we continue to believe that maintaining the current age-based recommendation for adults would prevent numerous cases of pneumonia, as well as the related hospitalizations and outpatient treatments. Zeldzins continues to perform well. Revenues in the quarter increased 34% operationally to $423 million. Volume growth in the US was strong, aided by the recent addition of new indications. While we are in the early days for both launches, 6% of the 38% volume growth in the US came from psoriatic arthritis, and 7% came from ulcerative colitis. So 30% of the total volume growth came from new indications. We look forward to these new indications potentially becoming even more meaningful contributors in the future. For extending, Alliance revenues in the US grew 6% operationally to $168 million. We believe our broad labeled indication, as well as the potential for new indications, represent a major opportunity to make a significant impact on patients' lives and change the standard of care in prostate cancer. Revenues from our biosimilars portfolio grew 7% operationally in the quarter. We received regulatory approvals during the quarter for two oncology biosimilars, and we see the potential for additional approvals in key markets later this year. In sterile injectables, manufacturing supply constraints continue to impact our top line in the US. We have made some progress towards fixing these issues, particularly since Frank de Mille assumed responsibility for our global supply organization on November 1st, 2018. We expect these issues to be significantly improved by the end of 2019, and continue to expect this business to be a solid growth contributor in the future. Our up-zoned business revenues grew 1% operationally in the quarter. Emerging markets were the primary driver, including strong volume-driven operational growth in China for such branches as Lipitor, Norvusk, and Celebrex. These gains were partially offset by lower revenues for Viagra and Pfizer's authorized generic for Viagra in the US, and for Greenstone, up-zones authorized generic subsidiary, primarily due to continued industry-wide pricing challenges in the US generic space. With its streamlined operating structure, relative autonomy, and its leadership located in China, we believe up-zone will help us seize the tremendous opportunity we see in emerging markets. As the global middle-class continues to rapidly expand, and as awareness and diagnosis and treatment options continue to improve, we believe the pharmaceutical segment will continue to enjoy significant expansion in greater China and other emerging markets. Pfizer's consumer healthcare revenues were down 2% operational in the quarter. This reflected an 8% decline in the US, due in part to a milder than expected cold and cough season. This decline was partially offset by 4% operational growth in international markets. Turning now to R&D. Today, we released our latest pipeline update, which you can see on this slide. We are very encouraged by our pipeline, both in terms of the breadth of opportunities and the science. And while we have said that we expect our 2019 adjusted EPS to be essentially flat operationally compared with last year, due to the Lyrica LOE, we believe a look at our pipeline will help bring our expected post-Lyrica growth drivers into clearer focus. Since the beginning of 2019, we have already received five approvals. EU approvals for Zirabev, a biosimilar to Avastin, for treatment of multiple forms of advanced or metastatic cancer. And for Vizinpro, for locally advanced or metastatic non-small cell lung cancer in adults. In the US, we received FDA approval for Trasimera, a biosimilar to Herceptin, for the treatment of certain forms of breast and gastric cancer. And for Ibrans, for the previously underserved male breast cancer population. The Ibrans line extension marks the first time a Pfizer medicine has received an expanded indication based on real world evidence. And in Japan, we received approval for Tafamidis, for the treatment of ATTR cardiomyopathy. As you can see in this next slide, we have a diverse range of assets spanning from phase two through registration. And they cut across each of our areas of focus. Overall, we are thrilled with the depth and breadth of our pipeline, as we are not overly reliant on a single pipeline opportunity. As you know, we announced our up to 15 in five cohort almost two years ago. I'm pleased to share that we are making good progress, despite experiencing some attrition, which is to be expected. Let me touch on just a few of the recent and upcoming milestones. I'll start with oncology. Data from the Javelin Rinal 101 trial showed that the combination of Bavencio and Inlyta significantly extended median PFS by more than five months compared with Sutent as a first line treatment for patients with advanced renal cell carcinoma. We have filed this data with the FDA with a PDUFA date in June. With K-3D plus Inlyta having been approved earlier this month, Bavencio will become the second Inlyta combination available to patients with advanced RCC. We are preparing to submit our extended ARCHES data in hormone-sensitive prostate cancer in the coming months. And in 2020, we expect to have data from a phase three EMBARC trial, studying extended for high-risk hormone-sensitive prostate cancer, as well as from two phase three trials evaluating IBRANs in early stage breast cancer. We recently presented data from phases two study of our 20-valent pneumococcal conjugate vaccine candidate for adults aged 18 years and older. We are now in phase three, and if the data is supportive, we expect to file by the end of 2020. We also expect phase two data from the infant studies later this year. Additionally, our phase three seed-deficit vaccine study is now fully enrolled, with pivotal data expected next year. In inflammation and immunology, we expect our first phase three data redoubts in May for our JAK-1 inhibitor in atopic dermatitis, as well as additional redoubts in the second half of the year. Our JAK-3 inhibitor for moderate to severe alopecia areata, which started a phase two B3 trial in December, have also received breakthrough therapy designation, and the pivotal redoubt is expected in the second half of 2021. In internal medicine, on April 18, we announced the results of the long-term osteoarthritis study for tenezumabs. As we stated in the press release, we are analyzing these findings in the context of the recent phase three results, as we assess potential next steps for this medicine. We plan to review the totality of data from our clinical development program for tenezumab with regulatory authorities. While we are very focused on continuing to advance our up to 15 in five cohort, I also want to provide an update on some of the exciting areas in earlier stages of development that we are pursuing. These areas combine novel science and significant unmet medical needs. You can see several areas on the chart, but today I will highlight three from the rare diseases space. Earlier this month, along with our partner at Sangam Therapeutics, Pfizer announced interim data from a phase one to study indicating that SB525 was generally well-related and demonstrated a dose-dependent increase in factor eight levels across the four doses cohorts in hemophilia A patients. Based on these results, the safety monitoring committee recommended cohort expansion at the high dose. In March, Pfizer acquired a 15% equity interest in Vivet Therapeutics, a privately held company dedicated to developing gene therapy treatments for inherited liver disorders. Pfizer and Vivet will collaborate on the development of VTX801, Vivet's proprietary candidate for the treatment of Wilson disease. At the upcoming PPMD annual conference in June, we expect to report data on our investigational mini dystrophin gene therapy candidate for the same muscular dystrophy. We will continue to explore both internal and external opportunities for the next generation of breakthroughs. At Pfizer, we are keenly aware that the breakthroughs coming out of our pipeline won't mean anything if people can't afford them. That's why we continue to work with policymakers, payers, providers, and other participants in the healthcare system to find solutions to patients' affordability. If you haven't already seen it, I would encourage you to read my testimony from the February 26th Senate Finance Committee hearing on affordable access to medicines. It outlines four proposals that we believe would drive meaningful reductions in costs for patients. In summary, Pfizer is off to a very good start in 2019. We deliver strong financial performance while reaching millions of people around the world with our medicines and then vaccines. Our new commercial structure is designed to maximize today's revenue growth opportunities while transitioning the company to a period post-2020 where we expect a higher and more sustained revenue growth profile. We remain focused on executing on our commercial strategies, managing expenses, advancing our pipeline, and prudently allocating our capital to position Pfizer for sustainable success. And now I will turn it over to Frank to provide details on the quarter and our outlook for 2019.
Frank DiMiglio
CFO
Thanks, Albert. Good day, everyone. As always, the charts I'm reviewing today are included in our webcast. Now, moving on to the financials. First quarter 2019 revenues were approximately $13.1 billion, which reflects operational growth of $664 million, or 5%, and the unfavorable impact of foreign exchange of $453 million, or 4%. Our biopharmaceuticals group business recorded 7% operational revenue growth in the first quarter, driven primarily by Eloquis and Celjans globally, IBRANTS primarily in international markets, and Prevna 13 in emerging markets in the US, all of which were partially offset by declines in our hospital and rare disease businesses. Revenues for our Upjohn business in the first quarter increased 1% operationally, primarily due to 25% operational growth in emerging markets, driven by strong volume-driven operational growth in China, primarily from Lipitor, Novask, and Celebrex, partially offset by a 9% operational decline in developed markets, primarily driven by lower revenues for Viagra and Upjohn's authorized generic for Viagra in the US due to increased generic competition, Lyrica primarily due to lower volumes in the US from wholesale or de-stocking in advance of anticipated generic competition beginning June 30th and in developed Europe from continued generic competition, and Greenstone, Upjohn's authorized generic subsidiary primarily due to industry-wide pricing challenges in the US. Revenues of our consumer healthcare business declined 2% operationally, reflecting an 8% decline in the US, partially offset by 4% operational growth in international markets. In the first quarter, we recorded gap earnings per share of 68 cents, a 9-cent increase compared to the year-ago quarter, which was primarily due to the favorable impact of higher revenues in the first quarter of 2019 compared to last year, lower purchase accounting adjustments, fewer shares outstanding, which were partially offset by foreign exchange, higher asset impairment charges, and higher net losses on the early retirement of certain outstanding debt securities. Adjusted diluted EPS for the first quarter was 85 cents versus 75 cents in the year-ago quarter. The increase was primarily due to higher revenues, fewer shares outstanding, which were partially offset by the impact of foreign exchange compared to the year-ago quarter. Finally, diluted weighted average shares outstanding declined by 307 million shares versus the year-ago quarter, primarily due to our share repurchase activity in 2018, as well as our first quarter 2019 share repurchases, which totaled $8.9 billion and included our 6.8 billion accelerated share repurchase agreement executed in February. This was partially offset by dilution related to share-based employee compensation programs. As I mentioned earlier, foreign exchange negatively impacted first quarter 2019 revenues by approximately 453 million and positively impacted adjusted cost of sales, adjusted SNA expenses, and adjusted R&D expenses in the aggregate by 315 million. As a result, foreign exchange had a two cents per share negative impact on adjusted diluted EPS compared to the year-ago quarter. Moving on to 2019 financial guidance, we reaffirmed our 2019 financial guidance for revenues, two items to note. Our financial guidance continues to assume that the age-based recommendation for Prevna 13 and adults is maintained by the ACIP when they vote in late June of 2019, and our guidance continues to reflect expected headwinds in China due to pricing reform, which is now being implemented. We increased guidance for adjusted other income by 100 million, primarily due to milestone income recorded in the first quarter of 2019. As a result, we increased the midpoint of our adjusted diluted EPS guidance range by one cent to an updated range of 283 to 293. This is the net impact of a three cents per share operational increase, primarily due to the aforementioned adjusted other income and some smaller favorable adjustments within our other guidance ranges, partially offset by a two cents per share impact due to unfavorable changes in foreign exchange rates since mid-January 2019. Moving on to key takeaways, we delivered strong first quarter financial results with 5% operational revenue growth and 13% adjusted diluted EPS growth compared to the year-ago quarter. We raised our 2019 financial guidance range for adjusted diluted EPS by one cent, reflecting a three cent operational increase, partially offset by a two cent unfavorable change in foreign exchange rates since mid-January of 2019. We accomplished multiple product and pipeline milestones since our previous quarterly update, and we returned 10.9 billion to shareholders in the first quarter through a combination of share repurchases and dividends. Finally, we remain committed to delivering attractive shareholder returns in 2019 and beyond. Now I'll turn it back to Chuck.
Chuck Triano
Senior Vice President of Investor Relations
Thank you, Frank and Albert, for your prepared remarks. At this point, we'd like to move to our Q&A session, please, operator.
Operator
Operator
If you would like to ask a question, please press star, then the number one on your telephone keypad. Your first question comes from Tim Anderson from Wolf Research.
Tim Anderson
Analyst at Wolf Research
Thank you. A couple of questions, please. On your 20-valent PrevNR follow-on, I'm hoping you can talk about when and you expect that to move into pediatrics. It's your largest product, PrevNR 13. It's a race between you and Merck to come up with a new and improved version of PrevNR 13. You guys are the incumbent, yet you're not yet in phase three in PDES and Merck is, and I'm wondering if that potentially foretells that there's some sort of formulation problems with your product in PDES, so asking for assurances that there aren't. Second question is on iBRANTS and just the longer-term international opportunity. If you look at major cancer drug precedents in the past by other companies, lots of times those products sell more outside the US eventually than they do in the US. Wondering if that could happen here with iBRANTS and the CDK46 class, because that's not how it's being modeled, or have there been too many price concessions made such that that's not really achievable? Thank you.
Albert Borla
CEO
Tim, thank you very much. Both excellent questions. I will ask Michael to address the question on our 20-valent compared to 15-valent from Merck, and then Angela will answer the question about iBRANTS. Mike?
Michael Dolston
President of Worldwide Research and Development
Yes, thank you. We are very pleased with our 20-valent pneumon-accentration vaccine that covers the certain serotypes of Pneumococcal 13 plus seven new ones. These seven new ones were carefully selected to make sure we have a broad coverage of emerging invasive pneumococcal disease, strains associated with high case fatality rates, and antibiotic resistance, in some cases combined with meningitis. We communicated our adult data at the ECMID conference recently, which showed a compelling profile, which also, of course, was linked to the breakthrough designation by FDA. We are moving with good and robust pace forward in the pediatric settings. As you know, in the pediatric settings, we have multiple immunization, as well as a boost, as is the current regimen for use of congugate vaccines, which is different from the adult trials that are fast, as it's only one immunization. We look forward to read out from the infant trial mid of this year in a phase two proof of concept study, and pending review of those data sets. We look forward to interaction with regulatory agency and SWIFT moving forward into a potential pivotal start. We're very pleased with the formulation. It was very well tolerated this far, and think that we have included all experiences from decades of pneumococcal work into our plan.
Albert Borla
CEO
And I would like also to remind that we have a very strong patent portfolio at Prävna. Angela, would you like to address the question with eyebrows, please?
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
Thank you. I-brand's revenue growth continues to be very strong as ex-US, and you heard Albert mention in his opening remarks that currently we're growing at 107% in Q1 of 2019. We believe this growth to be sustainable, as we see that there is still significant room to grow in the CDK class, as well as our own market share. Just as an example, in the EU-5, the CDK class is currently 35% of all first-line new patient starts, while we have 86% I-brand's class share. In Japan, as an example, the CDK class is only 21% first-line new patient starts, and 100% of the I-brand's class share. So while we're continuing to build our Japan and EU business, we are also intensely focused on our launches in the emerging markets. So far, we have seen 122% operational growth -on-year in the emerging markets, and led by double-digit growth that we're seeing in Argentina, India, Saudi Arabia, as an example. We have launches coming up, both in Brazil and China, which we're very excited about, and we expect these to be very strong contributors to our 2019 growth trajectory. So in view of the three key phases of growth for I-brands, the first being the U.S., which is where we began, with our first indication. Now, in our international launch, which are moving beyond the developed markets to the emerging markets, and then the anticipation of our adjuvant indications to come with I-brands, we continue to be extremely optimistic, and I feel very positive about the growth trajectory of I-brands.
Chuck Triano
Senior Vice President of Investor Relations
Great, thanks, Angela. Next question, please, operator.
Operator
Operator
Your next question comes from Vermeule Devon from Credit Suisse.
Vermeule Devon
Analyst at Credit Suisse
Great, thanks for taking my questions. The first on extending, the sales there were a little lighter than we thought, and I'm just wondering if there's any one-time items. The prescription trends also seemed a little lower last quarter than what we were seeing in the past. So comments there, and then just maybe you all look for that product longer-term, and I know you have the expanded label and new indications coming, so just so you could frame how you see that longer-term. And then second on the DMD data you mentioned coming in June, I think it's interesting, a lot of focus on that, even though it's pretty early data. Maybe if you could just sort of help sort of frame expectations around that in terms of what we'll actually see, what should we be expecting going into, just so people are sort of have appropriate expectations, given it is such early data.
Albert Borla
CEO
Thanks. Thank you very much, Vermeule. Ansel, I think you can cover the extended question, and then John, if you can please discuss the DMD data on June.
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
Thank you. Well, we've seen very strong prescriber adoption of Xtandi across all of our indications. I think that this demonstrates the confidence that prescribers have with Xtandi. Year on year, urologists have prescribed, prescribing has grown 45%, and oncology prescribing has grown 20%. We're also pleased with the uptake of Xtandi in non-metastatic CRPC, this is our PROSPER trial. Even though this was launched just eight months ago, its market share is already equivalent to our metastatic indication, which was launched seven years ago. And this market share is more than double that of our leader in non-metastatic CRPC. We have yet to realize the full potential of PROSPER, because the impact of patient accumulation and the longer days of therapy are still to come. And just as a reminder, the days of therapy for the PROSPER trial is 18 months. This quarter, as you say, the US net revenue did lag behind total patient demand, but this was due to some gross to net adjustments, some inventory differences, and our free drug program. But we continue to believe in the strong growth potential of all of our indications, and we look forward to our indications from both the ARCHES and the EMBARQ trials, which will continue to drive growth through expansion into new patient segments and offer longer days of therapy. So we need to stay the course with our strategies, and we believe the impact from PROSPER, as well as our new indications, will drive future growth, change the standard of care, and meet high patient unmet needs.
Michael Dolston
President of Worldwide Research and Development
Thanks. Hi, Vermeel. So thanks for the question about our DMD program. So Albert obviously touched on this in his prepared remarks, and just to emphasize again, we are going to be presenting data from our mini-distrophin DMD gene therapy candidate at the PPMD meeting in Orlando, which is at the end of June. For our DMD program, the first patient was those with an infusion of the mini-distrophin gene therapy in March of 2018. In total, six patients have been treated in two dose groups, one E14 and three E14 dose regimens. Per the trial protocol, muscle biopsies were to be taken at baseline, two months post-treatment and 12 months post-treatment. And to the extent that that biopsy data is available and mature, it will be presented at PPMD. We also intend to present an update on the safety profile of this therapy at PPMD. And we're excited to present the data, and obviously particularly to continue to work with the DMD community for a disease that is so devastating for so many boys with this condition.
Albert Borla
CEO
Thank you, John. It's a devastating disease, and we all hope that the solution that we are working, and others, but the solution that we are working will be really transformational. Next question.
Operator
Operator
Your next question comes from Chris Schott from JP Morgan.
Chris Schott
Analyst at JP Morgan
All right, thanks very much. Just two bigger picture questions. I guess the first one with the progress you've been seeing on the pipeline, can you just update us in terms of where you see business development fitting into the longer term view and strategy for the company? I guess specifically, I think you've been clear that larger deals are off the table for now, but when we think about bolt-ons, what type of size of deal could that encompass and what are the latest priorities in terms of, commercial stage assets versus clinical assets, et cetera? And my second question with the Upjohn division, do you believe it would be possible to eventually separate and spin this division from the rest of Pfizer? And if so, what are the factors and kind of data points we need to be watching that would make that type of separation something that would be possible over time? Thank you.
Albert Borla
CEO
Yeah, with the business development, I will ask John to comment, and you have heard our comments that we plan to invest significantly in business development is a little bit different the way that we plan to do it right now before we were targeting revenues now or soon. Right now, the focus it is how to, and because this is what we needed at the time. Now our growth trajectory, I think organically is going to be robust post 2020. So what we are looking for, it is to enhance even further our pipeline. So as regards to the direction and how we are selecting clinical or clinical John, can you please make a comment? John has the responsibility of managing this strategic area for us.
Michael Dolston
President of Worldwide Research and Development
All right, thanks Albert, and thanks Chris for the question. So I wouldn't repeat what Albert has already said about the reorientation of our focus of BBD from revenue now soon opportunities to really strengthening our pipeline with clinical stage assets. I think if you were to look into the future, I think you'll see us continue to be very active in business development, but I think with our focus generally on earlier to mid stage opportunities where clinical risk may be higher as data is less mature, but we believe that the opportunity for value creation is greater and the risk importantly of operational disruption to the pipeline, the internal pipeline, which is obviously maturing, we believe very nicely is going to be lower. Certainly in terms of what size we consider to be a bolt on generally, we don't comment specifically on size. I think you would say that assets that are in the range of a few billion dollars we would consider to be bolt on acquisitions and to really compliment our pipeline. So we are very excited about the opportunities that we have. And that's something that particularly we're gonna be focused on over the months ahead.
Albert Borla
CEO
Thank you John, and maybe I can provide some color to your question about that John. It's a good question and I received a lot this question and I understand the reasons. Right now, as I said, nothing has changed other than HAPSON performed very well in the first first quarter. Always I said that our focus, it is to make sure that we stand up this business in a way that will operate effectively. And effectively means that in a very new lean construct with management relocated in China, where most of the opportunities are as evident from the first quarter, but also where most of the challenges will come as we know that there are some reforms that the Chinese government are taking into this business. So right now I'm very, very pleased with the way that the whole thing is evolving. If we think that we could separate down the road, yes, it is a possibility, but this is not what it is in my mind right now. First, we need to make sure that we have a strong standalone business. So we are working to make sure that operates up zone fully as a subsidiary within a company.
Chuck Triano
Senior Vice President of Investor Relations
Great, thank you, Albert and John. Next question, please, I was operator.
Operator
Operator
Your next question comes from Jeff Meacham from Barclays.
Jeff Meacham
Analyst at Barclays
Morning everyone, thanks for the question. Mike or Albert just wanted to see if you had any additional color on the recent Tenesemab long-term data, just in particular the RPOA rates. And I know you're awaiting FDA feedback, but would you view the totality of the data so far or the unmet need is still warranting a filing at this point? And then another one on BD somewhat. So on the geotherapy front, you guys are obviously progressing a number of programs, hemophilia, DMD. There's been a lot of BD activity in this area recently. So the question is, has the decision to buy versus build or partner change for Pfizer over time? It doesn't seem like post the bamboo deal, you guys have a working platform that really could add multiple indications quickly. I just wasn't sure what the strategy is there. Thank you. Right.
Albert Borla
CEO
I will ask Michael and John to comment on Tenesemab. So John, why don't you start and then maybe Michael can give a little bit of the scientific information.
Michael Dolston
President of Worldwide Research and Development
Yeah, so look, thanks for the question, Jeff. Obviously we released fairly significant commentary on the study in our press release. I wouldn't comment on that, but I think, let me just say for Tenesemab, we're continuing to analyze the clinical profile based on the ongoing phase three development program in both OA and chronic lower back pain. That includes in totality five phase three studies in nearly 7,000 patients. And we plan to review the totality of the data with regulatory authorities and we'll assess potential next steps for Tenesemab. And as we engage with regulators, we will be in a position to provide an update in the coming months.
Michael Dolston
President of Worldwide Research and Development
That was very well summarized, John. And of course it's a very large data set from these recent phase three and previous phase three. So it's a real opportunity to put together the totality of data together with our partner, Lilly, and have a discussion with regulatory agency about that data set and
Albert Borla
CEO
pain
Michael Dolston
President of Worldwide Research and Development
landscape.
Albert Borla
CEO
Thank you, thank you, Michael. And then maybe I can give you an answer to your question about the gene therapy. It is, yes, as you said, gene therapy is an area of significant focus for us. And this scenario that we started much earlier. And our strategy was to combine our clinical expertise instead of therapeutic areas, together with biotech expertise as they were developing specific projects. And very early we realized that in this category, the bottleneck is going to be manufacturing. This is why Pfizer embarked into significant investments to build a platform in manufacturing, which is progressing very, very well. As we look to the future, we plan to do both. To grow our platform organically through projects that we are developing, and inorganically through the licensing and partnership that we are going to make. And actually the last partnership that we announced was in the gene therapy field for the Wilson disease, which is a liver disorder. We believe actually that exactly because of our track record of having successful partnerships, but also because we have built a significant manufacturing capability, we will become a partner of choice for biotechs that they will see that the combination will unlock value for them.
Chuck Triano
Senior Vice President of Investor Relations
Great, thank you for those responses. Can we move on to the next question, please? Thank you.
Operator
Operator
Your next question comes from Andrew Bound from Citi.
Andrew Bound
Analyst at Citi
Thank you, a couple of questions, please. Firstly, you referenced the pending ACIP review for Prevna 13. Given the replacement stereotype drift that we've seen because of pediatric vaccination, I know that your numbers and guidance include no change to that recommendation. What's your level of confidence, and if high, which seems to be exactly why it is high given the meeting has been scheduled to discuss this? And then, and second in reference to Eloquist, could you talk to what you see as the likely impact on realized pricing and volumes for Eloquist sales within your Medicare book of business, assuming rebate reform takes place as the administration seems to be pushing for the beginning of 2020,
Albert Borla
CEO
anytime. All right, why don't you, Angela, answer the ACIP question?
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
So our adult PCV13 vaccination program has been extremely effective. And it's difficult for me to speculate on the ACIP vote because that's still coming up in June. But I do want to emphasize that Pfizer strongly supports the continuation of the current adult vaccination program. This is because there are actually important serotypes, such as serotype three and serotype 19A that still have not reached acceptable protection levels. So keeping the current recommendation will prevent numerous individual cases of pneumonia, hospitalizations, and other outpatient treatments. Direct vaccination is important because there are also underserved populations still in our country where the disease risk is high. And just to give you a couple of examples, those that are living in rural communities have 50% less coverage than those that live in suburban areas. Or there is a 24 point gap among the low socioeconomic adults. I think you've also seen through the recent news reports the importance of direct vaccination for adults as well as for public health. And we also are looking forward to the filing of our next generation pneumococcal vaccine where we received FDA breakthrough designation. We expect to file this by the end of 2020. And so it underscores the importance of an uninterrupted adult vaccination program.
Albert Borla
CEO
Thank you. Andrew, you asked also about eloquence and how we think this will perform in the Medicare population, particularly given pricing volumes. And first of all, I would say that eloquence had a phenomenal performance, I think. I'm thinking highly about the profile of this product, but 36% growth is really something that will make us feel very proud. And actually in the US, the growth was even stronger, 38%, but the US, it's part of the business, right? So it is a very, very well diversified geographical brand. And I think that the pricing pressures, the growth is coming predominantly, those 38%, from volume. And all our strategies, it is how to make sure that the diagnosis rates are more accurate and people and physicians understand the profile of the product so that they can make the right choices when they choose to prescribe a medicine like that. So given that everything is the predominant growth, I think that we can see this volume, I think very good about the growth prospects of this product going forward.
Chuck Triano
Senior Vice President of Investor Relations
Thanks, Albert and Angela. Can we move to our next question,
Operator
Operator
please? Your next question comes from Umar Rafat from Evercore.
Umar Rafat
Hi, thanks so much for taking my questions. I wanted to focus on two broad topics. First, on I-brand's adjuvant, can you quantify for us how large an opportunity you think that is? And given the significance of it, I have to ask, is there an interim this summer? And secondly, on DMD gene therapy, my question is, do you think you have a -in-class asset? And I ask partially because I don't see this asset listed in your 15 blockbusters by 2022, which should theoretically be a very realistic possibility even if the pivotal were to start in early 2020. So just wanted to reconcile both of those. Thank you.
Albert Borla
CEO
Thank you. Angela, I think you can deal with the I-brand's, the market, the potential. And also let me say that on the studies, yes, there is an interim analysis, as with all studies, but the studies are designed to come to full completion. So we expect that the studies will be completed. And we expect that this completion will happen next year, although it is event-driven. So we need to see how the events will evolve. But Angela, let's speak about the commercial opportunity. And then, John, maybe you can give the clarification about DMD because what we have in 15 and five, it was not the gene therapy molecule. Please.
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
Sure. So we have the two phase three studies ongoing in the high-risk early breast cancer population. The first is the Penelope, which enroll patients with high-risk early breast cancer previously treated with the neoadjuvant therapy. And then we have PALLAS, which enrolled patients with a high-risk early breast cancer stage two and three. We're optimistic about both of these studies because of the ability to meet an unmet need, but also to your question more directly, if successful, we will have the ability from both of these programs to double the number of patients that are eligible for IBRAMs.
Michael Dolston
President of Worldwide Research and Development
Yeah, and thanks for the question about DMD again. Obviously, the 15 and five or up to 15 and five portfolio reflected the portfolio that we had at that time. And plainly, one of the sort of good things in our industry is that the portfolio is never static. And so, I think, as we begin to see data read out from our DMD gene therapy program, the profile of all of that medicine will become clear to us and to clinicians and to important people and, importantly, to patients. So, we would really see this having the potential to be an additional complement to that portfolio that we described last year. So, I think it's obviously premature for anybody to describe the relative profile of respective or other comparative gene therapy assets. The data is still emerging. It's still in relatively small patient numbers. And obviously, for us and other players in this field, we will see the totality of data as it emerges over the months and years ahead. But we feel cautiously optimistic about that program. As I mentioned in my comments earlier on, we look forward to presenting some clinical data from that later on this year.
Chuck Triano
Senior Vice President of Investor Relations
Thank you, John and Angela, for the background. Next question, please.
Operator
Operator
Your next question comes from Louise Chen from Can't Enter. This is Gerald.
Albert Borla
CEO
I don't think we can hear you. If you're asking a question, maybe you're on mute.
Gerald
Analyst at Can't Enter
Hold on. Unmute your phone. Can you hear me okay now? Yes. Yes, very
Operator
Operator
well.
Gerald
Analyst at Can't Enter
Okay, sorry about that. Thanks for taking my questions. I had a few here. First question I had was on TANASA map. Just curious how the recent data impacts your thinking with respect to the CLBP and cancer pain indications. And then secondly, on Tifamidus, how do you expect the initial launch to go if you do get approval this year? What's your anticipation for adoption, payer coverage, physician and patient awareness? And the last question is on your business development comments. Just curious if you have any interest in primary care or are you more focused on specialized medicines? Thank you.
Albert Borla
CEO
Thank you. John, what about TANASA
Michael Dolston
President of Worldwide Research and Development
map? Yeah, thanks for the question, Louise. And I think we've probably covered this mostly in our comments earlier on. So we obviously have issued fairly detailed press releases as each of our phase three studies have read out. And I think what we're just saying overall is we're gonna look at the totality of the data from all of our phase three studies. We have around about 7,000 patients worth of data. We're still in the process of analyzing the clinical profile and understanding its potential value across different indications. Our next step is obviously most importantly going to be to discuss that data with regulators. And we'll be in a better position to be able to provide you with an update once we've done so.
Albert Borla
CEO
Thank you. Angela, very exciting news for Tifamidus potential launch. So tell us.
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
Yes, well we are very excited about Tifamidus and that's because it's a transformative therapy for ATTRCM. Today it treats a fatal and a rare disease where there are no therapies and no alternatives. But it also addresses a large burden on the healthcare system because of the complications and the hospitalizations that arise from this disease. We do see this though as a rare disease. So approximately 100,000 patients in the US. But as you know today it is severely underdiagnosed. We estimate approximately a less than 1% diagnosis rate because of the lack of treatment and the use of invasive heart biopsies to drive the diagnosis. So as you can see, diagnosis is going to be key to growing this market. At launch, therefore, we're gonna be focused on creating suspicion of this disease by cardiologists and patients through educating them around the signs and symptoms of cardiomyopathy. We also need to increase the utilization of noninvasive methods such as scintigraphy versus a heart biopsy for diagnosis. So as you can see, this will all take time because we need to educate both physicians and patients on these red flag symptoms. We need to drive the utilization of scintigraphy and we also need to advocate for the changes in treatment guidelines which will help to drive both diagnosis and treatment. But as Pfizer, we are confident about our capability to build this market because we have a track record of success in creating new markets. And just to bring up an example from Zalcori, you may recall that at the time of launch of Zalcori, the diagnosis rate of the ELK mutation was only 1%. But today it is 80 to 93%. So tefamidus has excellent data, it has a compelling patient benefit, Pfizer has deep expertise and a commercial footprint in cardiology. So we look forward to bringing all of these capabilities to bear in launching this important medication to the patients who need it.
Albert Borla
CEO
Thank you, Angela. Maybe I can make some comments about your question, Louise, about if we would be interested to also in licensed primary care, potential candidates and medicines. And the answer is of course, yes. Let me be clear and specific what we mean. We have specific criteria, what we are interested in licensing in. So it's not just a blind check that we have given to people, go and license things. But those criteria involve that the potential medicines need to be breakthroughs, it's to be significant science that can create significant improvement in current standards of care. And they need to be within the areas of expertise of Pfizer so that we can add value to it. It's just to go on with the licensing, but we can add value. And we have six areas of expertise right now, but they are all from that aspect, from my perspective, are treated equally. Those are areas that we know we have the best science in the world that they can make fewer mistakes as we are selecting products. And this is where we have the scientific expertise to develop potential in licensing assets in the best possible way. Because the development path plays key role in unlocking the value of a molecule. And primary care is definitely one of the areas of significant expertise of us. From the long way that goes way back, but also in the current days, as we are having some of the best scientific programs running in metabolic diseases and other primary care conditions in our research centers. So the answer is yes, and the criteria that we are going to implement, I hope I made them clear. Great, thank you, Albert. Next question, please.
Operator
Operator
Your next question comes from Jason Gerberi from Bank of America, Merrill Lynch.
Jason Gerberi
Analyst at Bank of America, Merrill Lynch
Hey, good morning, thanks for taking my questions. I guess just firstly, coming back to the Tifamidus launch, can you give us a sense of what you view as maybe the best analogs for driving this diagnosis and treatment rate above this 1% level? I guess on the one hand, it looks like there's largely an educational element to this with a lot of these patients basically sitting in the cardiologist office just not diagnosed. But you also have a drug that's pretty easy to dose, no monitoring. So I'm just kind of curious if there are any analogs that you guys have thought about. I wouldn't think that Zalcori would be the greatest analog, but correct me if I'm wrong. And then secondly, on DMD gene therapy, it sounds like you haven't dosed any patients at the intermediate dose. I was curious, sort of the rationale for having an intermediate dose, was that more of a safety consideration or just seeing the above normal expression levels achieved with a surreptive program at a lower dose than your high dose was the decision ultimately to just have the optionality around a lower dose, thanks.
Albert Borla
CEO
Thank you. Angela, why don't you deal again with the Tafamidis question? There is a lot of interest on this product and I understand why.
Operator
Operator
Yeah, sure.
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
So actually we do think that Zalcori is a great analog for what we see coming up for diagnosis in for Tafamidis and cardiomyopathy. Today, this is a disease where the symptoms and the signs and symptoms are easily, I guess it could be confused with heart failure. So I think the ability for us to be able to find diagnostic approaches that will help us to really identify and to isolate who specifically the cardiomyopathy patients are are going to be really important. I think that there are some symptomatic attributes that we plan to be educating around at the time of launch, but really what we need is the ability to leverage technology such as syntigraphy as an alternative to what exists today, which is a heart biopsy, which is extremely invasive. And I think that the ability to use syntigraphy will allow us to more readily diagnose these patients. I think the qualitative attributes, the symptoms will allow us to create suspicion around what the right pool of patients might be, but the definitive diagnosis really needs to come with syntigraphy. There are 15,000 syntigraphy machines within cardiology offices today and 32 centers of excellence. So I think that this effort around education and awareness building is going to be key to both bring patients to the doctor's offices, but also to highlight the importance of these symptoms to prescribers and then to eventually diagnose and to treat. So as we said, I think we have deep expertise and capabilities in doing this, but then you can imagine with a disease that is so undiagnosed and up till now has had no therapeutic options, this is gonna take time for us to really educate and to bring the full benefit of tefamidus to bear.
Albert Borla
CEO
Thank you, Angela. And Michael, please, if you can comment on our dosing strategy with the DMD development program and maybe you can provide any color you would like about this breakthrough medicine.
Michael Dolston
President of Worldwide Research and Development
Thank you very much. Yeah, we worked with our bamboo colleagues in carefully designing this AV9 vector that contains muscle relevant specific promoter for expression of the transgene. And the protocol was designed intentionally based on our experience of many in therapy programs to allow some flexibility, which was the basis for dosing at one E to the 14 and three E to the 14 to gain experience across a reasonable dose range in what would be the expression of the transgene, the tolerability and clinical performance for young boys that as Albert alluded to earlier, we're aiming to have a transformative outcome. Now we look forward to share data at the PPP MD meeting in Orlando this late June. We think it is a good meeting for that purpose. It's one of the largest Duchenne muscular dystrophy gathering where both key scientists attend and patient representative. As you know, these type of devastating rare disease, you work very closely with the leading scientists and patient groups. So we look forward to be there and share data set as John alluded to earlier.
Chuck Triano
Senior Vice President of Investor Relations
Thank you very much, Mike. All right, thank you for that background also. Next question, please.
Operator
Operator
Your next question comes from Alex Arfe from BMO Capital Markets.
Alex Arfe
Analyst at BMO Capital Markets
Good morning and thank you. A couple of follow up questions on parameters. Congratulations on the approval in Japan. It was faster than we expected. We focus a lot on the US market, but could you also comment on the ex-US opportunity for tefamidase and following up on the diagnosis rate commentary. My understanding was that you were also working on blood tests to make diagnosis even easier. Could you give us an update on those efforts as well as your potential launch readiness in case of earlier approval in the US? Thank you.
Albert Borla
CEO
Thank you, Alex. Anzal, again, you have the ex-US opportunities. And on the testing.
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
So yes, with the Japan launch was very recent and I think that it, you know, I think that the opportunity there sets us up well for the kind of launches that we expect to see around the world. As you say, it's not just the US, it's Japan, it's also rest of world. In terms of rest of world, I think the filings have been submitted and I'm unable to comment on those for now because we're still awaiting for a commentary from the regulatory agencies. But I think that my general comment about tefamidase is really one that I mentioned earlier, which is the critical aspect of this is diagnosis. It really is a rare disease. It is severely under diagnosed today because of the lack of options. And so critical to our ability to drive tefamidase growth anywhere in the world is the ability for us to be able to find the patients and then be able to screen them and to be able to diagnose them and then send them onto treatment. So I see that these trends are pretty consistent wherever we are around the world.
Albert Borla
CEO
Michael, as a great physician that you are as well, can you please comment a little bit on the diagnosis opportunities for this? I
Michael Dolston
President of Worldwide Research and Development
want just to punctuate that the growing availability of skin tigrafe, a technetium-based, makes it increasingly easy to get that diagnosed after suspicion often raised by clinical symptoms and echocardiogram. We're also in parallel looking at potential future blood markers, but right now I think there should be no really hindrance to fast and easy diagnosis based on clinical sign, skin tigrafe. And in addition, we have made work on diagnostic algorithm including artificial intelligence to be able to advise on typical algorithm that makes a heart cardiomyopathy more likely to be TTR-related than unrelated.
Albert Borla
CEO
It's amazing how much work is happening right now on this field and particularly how AI also can help identify potential people that potentially could suffer from this disease. And we had multiple discussions with payers as well and a lot of them, they're having high interest to exploit this opportunity because when we say 1% is diagnosed, we don't mean that the 99%, they are just don't treat it. Usually all of these patients are presented with heart failure symptoms and they are treated for the wrong reason. And they're going, of course, doesn't work because the doctor haven't identified that this is the real cause of their cardiac issues and then they treat it and fail and treat it and fail and then eventually there's a fatal event. So payers are highly interested to diagnose this disease I think, but as Angela said, this is the key and we know how to do it very well but it will take time to pick up these diagnosis rates but we will do
Chuck Triano
Senior Vice President of Investor Relations
it. Great, thanks for that context as well. Next question please.
Operator
Operator
Your next question comes from Navin Jacob from UBS.
Navin Jacob
Analyst at UBS
Hi Navin and Jacob, UBS. Thanks for taking questions, a few if I may. Interesting slide on your treatments beyond up to 15 and five. Two in particular stood out, the oral GLP-1 and the HER-2 ADCs. Could you provide any context for how far along those assets are, particularly the oral GLP-1? Are those phase two assets, phase one assets? Any color would be helpful. And then I'll add to the questions on tefamidus.
Operator
Operator
With
Navin Jacob
Analyst at UBS
regards to the pair discussions, are most of those related to traditional contracts? Are you exploring outcomes-based contracting? And if so, to what extent is that? Do you think outcomes-based contracting will be a broad mandate or is it more of a experimental type of situation? And then finally, if you have any color on resolution of the sterile injectable manufacturing issues, is the resolution still expected for end of 2019? Thank you very much.
Albert Borla
CEO
Thank you very much. Michael, let's start with you and with the beyond 15 and five.
Michael Dolston
President of Worldwide Research and Development
Yes, I really appreciate your interest in the beyond 15 and five, which of course covered the next period beyond the 22 of the up to 15 and five. So for the oral GLP, that's been an area where we have deployed some unique chemistry and I'm very pleased to say that we are right now concluding a phase 1b trial in diabetic patients and I've seen some very encouraging performance of that drug related to control of diabetes and body weight. And we look forward to share those and we'll swiftly move into a larger phase two trial for diabetes. To the best of our knowledge, this is the only true small molecule that have come this far and shown this promise in PK and pharmacodynamic fable effects. The next generation, HER2-ADC is based on site directed conjugation of a tubulin inhibitor and has been going through those escalation and showed promising signs of activity. We continue to optimize those and expect to go into phase two expansion cohort relatively soon, including potential combination with P2-1 agents.
Albert Borla
CEO
Thank you, Michael. Let me give you a very brief comment on Tafamidis and then I will ask Frank to take the manufacturing question. On Tafamidis, as you know, breakthroughs requires breakthrough approaches also commercial. And we believe that we believe that Tafamidis is also a suitable product, given that we have strong clinical outcomes data for value-based agreement. So we are discussing with multiple payers is too early to comment because also we are in the middle of the year and usually contact starts from the beginning of the year. Nevertheless, there is significant interest and discussions between ourselves and payers on agreements that will really value the value that product brings to patients. So Frank, manufacturing.
Frank DiMiglio
CFO
On the manufacturing, yes, we do plan on having significant improvements implemented by the end of 2019. But please also know, along the way we've already implemented numerous preventive and corrective actions and we've seen a nice improvement in our overall supply to date.
Albert Borla
CEO
And I want to say, Frank is always a man of a few words and a lot of actions. I'm very, very pleased with the way that under Frank's leadership and the new leadership of PZS, we are progressing on addressing the issues with manufacturing.
Chuck Triano
Senior Vice President of Investor Relations
Good, thank you. Can we take our next question, please, at his operator?
Operator
Operator
Your next question comes from Seamus Fernandez from Guggenheim.
Seamus Fernandez
Analyst at Guggenheim
Yeah, oh, thanks very much for the question. So just a couple of quick ones. Can you just help us understand the number that you guys printed on your CRESA this quarter, as well as the sales for Zeljanz? What were the main impacts on both of those products? And then just a second question. If you guys wouldn't mind, again, this is a bit related to Zeljanz. Can you help us understand how differentiated the products in the dermatology phase three clinical trials, whether it be in alopecia or in atopic dermatitis, how differentiated those are from Zeljanz and perhaps from some of the other programs in development? Thanks so much.
Albert Borla
CEO
Right, and Zella, why don't you hit quickly the Eucrease and Zeljanz question, and then we can leave time to Michael, who is very passionate about the ZAK portfolio,
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
to
Albert Borla
CEO
speak about it.
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
Okay, great. So let me start with some comments on Zeljanz. So as you can see, Zeljanz had a 34% operational growth globally. In the US, Zeljanz grew 18%, but actually the scripts grew 37%. So if you look at some of the Q1 effects, some of that is due to higher rebating, unfavorable channel mix, and reauthorizations for patients that change insurance. And this is pretty typical of what we see every quarter. So I think we're really encouraged by the strong volume growth that we continue to see in the US and around the world for Zeljanz. And it's all three of our indications, strong growth from RA, exciting new launches for both PSA and UC. And we're beginning to see some very, very strong market shares for UC as well, coming out of the gate. For Euclid specifically, the number of Euclid patients in the US for the first quarter was actually up more than 80,000 patients. So that's a 55% increase compared to where we were last year there at this time. However, you do see revenues down slightly in Q1. And this is because despite the increased demand, we were negatively impacted by higher rebates in the US. So we need to continue to work on improving our formulary position and continuing to drive growth of Euclid in segments, both in the US as well as XUS.
Michael Dolston
President of Worldwide Research and Development
Michael. Yeah, so thank you for the interest in how we plan to grow the dermatology sector here. So for the topical dermatitis where we are in phase three and with a JAK-1 inhibitor, and the first readout of the Jade trial program is coming now in May and the second is coming this fall. We selected a JAK-1 because we think a JAK-1 selective has the advantage that it covers certain cytokines that are part of the disease pathophysiology, IL-4, IL-13, similar as Dupilomab. But on top of that, we cover IL-31 that's related to each phenomenon that bothers atropic dermatitis patients. And we saw a very profound and early relief of that in phase two that we're obviously looking to confirm in our phase three trial. For alopecia, it's a different type of underlying mechanism where we deal with cytotoxic cells destroying the hair follicles and the JAK-3 selective inhibitor in what we thought would be the best. And that was what we nicely recorded as a very effective agent in our phase two trial, and it also has a very clean profile. The most well tolerated agent we have seen so far, so we look forward certainly to the phase two B pivotal study and we also started a vitiligo study with this JAK-3 inhibitor.
Chuck Triano
Senior Vice President of Investor Relations
Great, thank
Michael Dolston
President of Worldwide Research and Development
you very
Chuck Triano
Senior Vice President of Investor Relations
much Michael. Next question please.
Operator
Operator
Your next question comes from David Reisinger from Morgan Stanley.
David Reisinger
Analyst at Morgan Stanley
Yes, thanks very much. So first, I'm hoping that you can talk about your expectations for organic revenue growth prospects for your up-john division relative to the 1% that you printed in the first quarter. I just don't have a sense for how we should think about that, whether that will grow, or since you put Lyrica in there that it's about to decline. So if you could help us understand the growth prospects for our up-john that would be helpful. Second, with respect to your patents that could potentially be blocking Merck's 15-valent launch in coming years, could you please talk about those patents and your level of conviction that Merck cannot launch? And then just a final tidbit, what are your planned biosimilar launches in the US in the second half of this year? Thank you.
Albert Borla
CEO
So let me start with up-john, and obviously, Doug can cover the Merck patent situation, and then Anzale, you can speak a little bit about the biosimilars. Our expectations for up-john this year, of course, is going to be a decline, because they will be seriously affected by the loss of patent of Lyrica that will happen in the middle of the year. And that will affect their growth also next year, because they will have to face full-year LOE, which will be next year, with only half a year LOE, which is this year. Following that, I see up-john as a very stable to low, low single-digit growth on the top line, and much higher on the bottom line, and leverage bottom line growth. But of course, that will be post 2020 period where the impact of Lyrica will be absorbed. Doug?
Doug Lankler
General Counsel
So we were pleased that the patent trial on the Peel Board denied Merck's IPR petitions on two of our US patents, covering compositions of pneumococcal vaccines. These patents stand as valid and will not expire until 2026. We believe that these patents and others in our portfolio present freedom to operate issues for Merck in its development of a 15-valent pneumococcal vaccine.
Albert Borla
CEO
Very clear.
Angela Huang
Group President, Pfizer Biopharmaceuticals Group
And then biosimilars. So we will have three biosimilar launches in 2019. Trastuzumab was already launched in the EU in the first quarter, and we look forward to the launch of TRAS in Japan in the third quarter. Rituximab will also be launched in Japan, and that will be in the fourth quarter. And then finally, Bevacuzumab will be launched in both the US and Japan in the fourth quarter. We've seen some nice uptake in the supportive oncology portfolio that we launched late last year, and we look forward to the oncology biosimilar portfolio contributing to our growth.
Albert Borla
CEO
Thank you,
Chuck Triano
Senior Vice President of Investor Relations
Anzala. Thank you. And Operator, if we could take our last question, please.
Kathy Miner
Analyst at Cowan
The
Operator
Operator
final question comes from
Kathy Miner
Analyst at Cowan
Steve Scala from Cowan. Thank you, this is actually Kathy Miner on for Steve. Just a question on Bovencio, please. We had been expecting Bovencio phase three data and second-line bladder this year. Is this still possible? And secondly, is there any chance for an interim on the Javelin Lung 100 this year, and what is the PDL-1 cutoff for that trial? Thank you.
Albert Borla
CEO
Two questions, Michael, for you.
Michael Dolston
President of Worldwide Research and Development
Yeah, so thank you for showing interest in our Bovencio portfolio. So we expect late this year or possibly early next year, as you know, these are event-driven trials that we will conclude. The bladder, it's actually a first-line trial, so it's quite an interesting trial where we have Bovencio as maintenance therapy of the chemo. We'll also have PDL-1 high-expression trial in line, which, you know, if positive, could be the second PDX available for monotherapy in PDL-1 high in line. And then we have a gastric first-line, also post-chemo patients in maintenance for Bovencio. So quite nice remaining cohort, and we look forward to review the data coming out of this. Thank you.
Albert Borla
CEO
Thank you, Michael, and I think this concludes the Q&A session. Just I wanted to say that I found this session very productive. I'm very pleased that the vast majority of the questions with the minus one or two, maybe, were focused on our pipeline, and were focused on Tafamidis new launch products. And I don't remember any other session, but Frank didn't receive any finance question, which is what happened today. I think this is exactly how a science-based company, when the results of the quarter are good, should be discussed in an earnings call. I'm very pleased about that. We continue to believe that Pfizer's position in the market is strong. We have great products. We have a strong R&D and marketing skills, prudent capital allocation, and perhaps most important, a clear path to sustainable growth. Thank you very much, and have a great day.
Operator
Operator
Ladies and gentlemen, this concludes Pfizer's first quarter, 2019 earnings conference call. You may now disconnect.
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