speaker
Nadia
Operator

and thank you for standing by. Welcome to the Tevis fourth quarter and full year 2022 earnings call. At this time, all participants are in listen-only mode. After the speaker's presentation, there will be the question and answer session. To ask a question during the session, you will need to press star one and one on your telephone. You will then hear an automatic message advising your hand is raised. To withdraw your question, please press star one one again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to our first speaker today, Ran Mir, Senior Vice President, Head of Investor Relations. Please go ahead.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Thank you, Nadia. Thank you everyone for joining us today. We hope you have had an opportunity to review our press release, which was issued earlier this morning. A copy of the press release, as well as a copy of the slides, Thank you for your attention. To begin today's call, Richard Francis, Teva's CEO, will provide an overview of Teva's 2022 results and business performance, recent events, and priorities going forward. Our CFO, Eli Kalif, will follow up by reviewing the financial results in more detail, including our 2022 financial outlook. Joining Richard and Eliyahu on the call today is Sven Dietles, Teva's Head of North America Business, who will be available during the question and answer session that will follow the presentation. Please note that today's call will run approximately one hour. And with that, I will now turn the call over to Richard. Richard, if you would please.

speaker
Richard Francis
Chief Executive Officer

Thank you, Ran, and welcome everyone. I'm excited to be here today, and I'd like to start by saying it was great meeting many of you in San Francisco at J.P. Morgan last month. And I look forward to getting to know Teva shareholders, investors, and analysts so that we can have an open dialogue going forward. I'm excited to be here because there's a lot of opportunity at Tether. The team has done a tremendous work to get the company back to a solid foundation and now there's an opportunity to get back to growth. Before I start my review of Tether's 2022 results and discuss our guidance for 2023, I would like to update you that I've already initiated a strategic review process with my leadership team. Our team is already hitting the ground running and we are working hard on analysing some of the core strategic questions that the segments we operate in are going to involve over time and really understand what options we have. It's going to be a very clear purposeful strategy with real intent behind it. Every function, every dollar should follow that strategy going forward. Once the work is done around mid-year, I'll come back with the team and we'll present that to the market. Now let's move on to some highlights for 2022. We ended 2022 with revenues of $14.9 billion and adjusted EBITDA of $4.6 billion. GAAP diluted loss per share was $2.12 and non-GAAP diluted earnings per share was $2.52. You should note that our revenues were still affected by the strengthening of the US dollar during the fourth quarter and we have therefore still seen significant headwinds from exchange rate movements on our revenues. We had a net impact of £780 million for the full year compared to 2021. Free cash flow in 2022 was £2.2 billion and we continue to reduce our debt in accordance with our strategic targets. Net debt is now down to £18.4 billion. Moving to the business overview, Estero, our leading brand, is growing very nicely, up 20% year over year. And Ajovi also grew across all three geographies, US, Europe and international markets. I'll further discuss these two products in a few minutes. We've also seen nice growth in our generics and OTC revenues in Europe, reflecting our strong position there, and also some successful product launches. We've also seen good growth in generics and OTC on international markets through a combination of volume growth as well as price adjustments to address inflation. So good to see 9% growth in Europe and 5% in international in local currency terms. We're also excited about the progress we're making on our pipeline. We recently initiated the phase three trial of subcutaneous long-acting olanzapine for schizophrenia. Together with Ysetti, a Respiradone long-acting product, which I'll talk about in a few minutes, we're developing an exciting franchise for patients suffering from schizophrenia. As for the Nationwide Opioid Litigation Settlement, we announced last month that we are moving on with these settlements after receiving broad support from the States Attorney Generals. We are already settled with 49 out of 50 states and the sign-on process for the state subdivisions has begun and given the very positive response from states, we remain optimistic that the settlements will garner similar support for them. Moving on to the next slide to look at our revenue and how it's developing. Overall, you'll see a fairly stable business with the portfolio of products and geographicals further well balanced. I'd like to point out that in 2022, Q4 was the strongest quarter in terms of revenue, similar to previous years. If you exclude the impact of FX, revenues in Q4 2022 were actually up 1% compared to the fourth quarter of 2021. So in local currency terms, we had a nice single digit growth in both Europe and international markets. Moving to the next slide, and explaining the comment I just made on Europe. It's a market that I'm very positive about. Europe is good, stable business with Teva. In markets like Europe, if you have a good pipeline, good go-to-market model, the business is predictable, and it can drive continued growth. And we believe we have all of those elements in our European business. We have good portfolio, good pipeline, and strong leadership in many of the markets. And this also supports a good margin profile, as you can see from the slide. and this is all paying out well. As you can see, revenues grew in Europe in the fourth quarter, 4% in local currency terms, which we're very pleased about. Now, moving on to Estedo, our next slide. Quarter four is a record quarter for Estedo as we continue to see strong growth in both total and new prescriptions. Revenues grew 20% for the full year and 22% in the fourth quarter. I'm happy to see strong continued development with nice increases in both revenue and the numbers of prescriptions. So all in all, the trajectory looks positive. Nellie will elaborate on it when we talk about our 2023 outlook. Now to better understand the potential of Esteda, I'd like to take a look at the next slide. As you can see, there are approximately 785,000 patients suffering from cardiac dyskinesia in the US. But unfortunately, only 15% of these patients are diagnosed. and then even more disappointing, 5% are getting treatment. So clearly there is a lot of unmet need. And of course we're working hard to broaden that base, making sure they can benefit, the benefit of the product reaches more patients who need this therapy. This will drive increased prescriptions and also presents a significant long-term growth potential for a startup. Now moving on to a journey. Full year, our revenues grew more than 20% globally. This was despite the foreign exchange headwinds we faced in Europe and international markets. Now I think Adobe is a great example of Teva's strong commercial and execution capabilities. As you know, Adobe was not first to market in the US and Europe, but we're still capturing really strong market share and actually second in Europe. So that's very impressive and another proof point to me that the innovative and commercial go-to-market capabilities of Teva are strong. What we're seeing now in the US is really about slow growth is around the injectable anti-CGRP therapies. and while most of the growth in migraine space is driven by the oral therapies. Outside the US, we expect the JV to benefit from continued patient growth and launches in additional countries in Europe and international markets.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Now moving on to the pipeline. The next slide, please.

speaker
Richard Francis
Chief Executive Officer

In my six weeks at Teva, I've met with R&D teams and I have to say I'm very impressed with the capabilities and the people we have. I was also pleasantly surprised by our innovative pipeline. We plan on sharing more details on it when we discuss our updated strategy around mid-year. Now let me highlight a couple of exciting assets that are under regulatory review. Firstly, our biosimilar to Humira is expected to launch in July 2023, pending FDA approval, which I'll talk about in a bit more detail in a few minutes. I'm also happy that the FDA has accepted for review the BLA for our biosimilar Stellara, and we anticipate that the review will be completed in the second half of this year. Moving to our innovative medicines pipeline, as I said before, we are building a strong foundation for the schizophrenia franchise. Ysedi, an important product for patients suffering from schizophrenia, which I will elaborate on in the next slide, and Elantabine Long-Acting, another exciting prospect in the treatment of schizophrenia, we recently moved into a phase 3 trial. Both Delantopene and Yiseddi represent complementary approaches to schizophrenia patient management by addressing unmet needs in the long-acting market, and together with Estella, which treats typhoid dyskinesia, a side effect for schizophrenia treatment. We're building a strong franchise of schizophrenia therapies. So moving on to the next slide to talk about Yiseddi. As you know, we have resubmitted the file to the FDA for review and expect to have a decision in the first half of this year. So just to frame the market landscape, there are approximately 2 million treated schizophrenia patients in the US and approximately 10% of them receive long-acting injectable products. And this long-acting category has grown steadily. In terms of sales, the overall schizophrenia long-acting market in 2021 was estimated to be 4 billion. Now, relative to other therapies in the market, Uceti, our product, will have more patient-friendly injection mechanism, which is subcutaneous, a small needle, and is lower volume. And it comes in a ready-to-use pre-filtering. Basically, an easy and effective way to get your therapy. And we're very much looking forward to bringing these benefits to the patients who are suffering from schizophrenia and who need stable therapy to avoid relapses. Given these profile advantages we have with USETI, we are talking about a 20% market share over time. Now let's talk about Humira, which I know has been getting a lot of attention recently and is the largest product in the history to face biosimilar competition with annual revenues of over $17 billion. Now based on our most recent updates from our partner, Albertep, we're preparing for the launch on the 1st of July this year. The FDA has confirmed that the target date for the decision on AlphaTec's application is April 13th of this year. The FDA has also confirmed that the date provided by AlphaTec is sufficient to support a determination of interchangeability. An approval of course requires a satisfactory outcome from the upcoming facility inspection, or re-inspection should I say, which is scheduled for March. It should be noted that while we are still waiting for the approval in the US, Algotex by Sumo Pumeric is currently being marketed in 17 countries around the world, including Canada and numerous markets across Europe. Now, to be clear, we have risk adjusted its contribution to our 2023 guidance, similar to the way we risk adjust other significant launches in the US market. That said, we believe biosimilar to Imura, like other biosimilar products, will continue to be an important part of products in our portfolio beyond 2023. Now moving on to the next slide. ESG is an everyone business at Teva. Let me be clear about that. The board and the executive management team firmly believe that ESG is critical and inseparable to our long-term sustainability and success. Over the last few years, the team has worked hard to lay strong ESG foundations and formalize our ESG strategy. We have set ambitious and meaningful targets that are tied to our business, enhance the reporting and disclosures, and strengthen our governance. Our ESG strategy focuses on advancing health and equity through our medicines, minimizing the impact of our operations and products on the planet, and dedicating the company to quality, ethics, and transparency. So now let's talk about our 2027 long-term targets. First of all, I'd like to say, as I said in the beginning, I do think the management team has done a great job over the last few years to get the company back to a solid foundation. As we define our strategy going forward over the next few months, we will look for the opportunities to prioritise and to reallocate the best positions ever for long-term growth and success. We'll come back and share that with you with our new strategy around mid-year. Please stay tuned. I'm very much looking forward to it. But with regard to these long-term financial targets, these will remain in place. And with that, I will hand over to Eli to walk you through the financials.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Thank you, Richard, and good morning and good afternoon to everyone. I'll begin my review of our 2022 financial results with my main focus being on the fourth quarter performance. This will be followed by an introduction to our 2023 9GAAP outlook and some of the important assumptions behind it, beginning on slide 16. I would like to start with our Q4 GAAP performance. Revenues in the fourth quarter of 2022 were $3.9 billion, representing a decrease of 5% or increase of 1% in local currency terms, compared to the fourth quarter of 2021. This increase was mainly due to high revenue from Andam generic products in our Europe segment, Ostedo, and Adjovi, partially offset by low revenue from generic products and certain respiratory products in our North America segment, as well as Copaxone. In Q4 2022, we recorded a gas operating loss of $855 million, compared to operating income of $78 million in Q4 2021. We had a net loss of $1.2 billion compared to $159 million in Q4 2021, and a gap loss per share of $1.10 compared to $0.14 in the same period a year ago. Gap operating loss, net loss, and loss per share were mainly due to goodwill impairment charges in the fourth quarter of 2022, partially offset by lower legal settlements and loss contingencies. The Google impairment charges were mainly related to exchange rate fluctuations in our international market and update projections in our Teva stocking business. The strengthening of the US dollar versus other currencies during the fourth quarter of 2022, including hedging effects, negatively impacted our revenue and GAAP operating income by $270 million and $132 million, respectively, compared to the fourth quarter of 2021. Turning to slide 17. You can see that the total NAND gap adjustments in the fourth quarter of 2022 were 2 billion, and this is versus 1 billion in Q4 2021. The most notable NAND gap adjustment was a goodwill impairment charted of 1.3 billion, which I just mentioned. Now, moving to slide 18 for review of our NAND gap performance. I've already discussed our fourth quarter revenues, which total approximately $3.9 billion. Annual revenues were $14.9 billion, a decrease of 6% or 1% in local currency terms compared to 2021. For the full year, we saw the same trend regarding US dollar appreciation, which including hedging assets negatively impacted revenues by $780 million compared to 2021. Now let's move down to the P&L and look at the margin. Our non-GAAP gross profit margin was 54.2% compared to 56.1% in Q4 2021. The decrease in non-GAAP gross profit margin was mainly due to the high revenue with the lower profitability from the ANDA in our North America segment, partially offset by high revenue from Mostedo in our North America segment, and a favorable mix of generic products in our Europe segment. Our NAS GAAP operating margin in Q4-22 was 29.1% versus 30.4% in Q4-21. This decrease was mainly driven by lower gross profit margin mentioned above, partially offset by lower operating expenses, which I will discuss in the next slide. 2022 for year NAS GAAP operating margin was 27.7%, similar level as in 2021. We ended the quarter with a non-GAAP earnings per share of 71 cents compared to 77 cents in Q4 2021 mainly due to the negative impact from foreign exchange fluctuations and a lower gross profit partially offset by lower operating expenses as well as lower tax rates. Now let's take a look at our spend base on slide 19. As you can see, our quarterly spend base declined by 97 million and increased by 38 million net of F6. For the full year 2022, our total spend base declined by 609 million or 174 million net of F6. Annual decrease in our spend base was due to a lower cost of goods sold related to a lower annual revenue as well as ongoing active management of operating expenses. Looking ahead to 2023, we expect the overall spend base to remain at the level of 11 billion as we continue with our ongoing efforts to transform our global operational networks and ongoing active management of operating expenses. If you look at slide 20, We continue our journey to improve margins by reaching 28% operating margin by end of 2023. Despite of some of the macroeconomic headwinds related to the inflationary pressures, and while we continue to face these pressures, our ongoing efforts to reduce and optimize our cost of goods sold and operating expenses are expected to continue to help us partially mitigate these global macroeconomic headwinds. As Richard mentioned earlier, we continue to target 30% operating margin by end of 2027. Turning to free cash flow on slide 21. Our free cash flow in the fourth quarter of 2022 was $1.1 billion. The increase in our free cash flow in the fourth quarter of 2022 compared to the fourth quarter of 2021 resulted mainly from the sale of accounts receivable under a U.S. securitization facility entered into November 2022, partly offset by changes in working capital terms. For the full year 2022, free cash flow was $2.2 billion, an increase of 2% compared to 2021 and on the high end of our 2022 guidance. Free cash flow in the 2022 was largely affected by the sale of accounts receivable under a new investor creditization facility entered into in November 2022, partially offset by an increase in inventory levels, lower proceeds from the investors of business and other assets, as well as higher payments of legal settlement in connection with the obvious litigation. Turning to slide 22. Our progress continues in terms of reducing down our debt. The net debt at the end of Q4 2022 was $18.4 billion, compared to $20.9 billion at the end of 2021. The decrease in our gross debt in 2022 was mainly due to the debt repayment partially offset by exchange rate fluctuations. The decrease in our net debt was mainly due to our free cash flow generation during the year. Our net death to EBITDA ratio continues to decrease, coming in four times for Q4 2022. Looking at slide 23. Debt reduction continues to be our primary focus. As you can see, we have made significant progress in the last six years as we have committed to reduce the level of the debt we had on our balance sheet. During these six years, we have paid back approximately 20 billion to our bondholders, including interest payments, and we expect our net debt to further decline as we continue to make progress towards 2027 long-term targets. Turning to slide 24, which represents our upcoming debt maturities. If you recall, we did a 5 billion SLB refinancing to address the 22, 23, and 24 maturities back in November 2021. We continue to assess market conditions for opportunities to refinance upcoming maturities. Given the interest rate environment, we expect this to result in a higher financial expenses in 2023, which I will discuss in a few moments. Looking at the cash conversion on slide 25, we established a target of 80% by end of 2023. In 2022, we made further progress on this. And as we keep focusing on our networking capital enhancements, Our efforts to optimize our working capital terms in light of our revenue mix is key for our liquidity. We are really happy to see that it came in at 80% up from 77% in 2021. As Richard mentioned earlier, we'll continue to manage our business and working capital with a focus on generating cash to earnings at this level. Now, let's turn our attention to our 2023 Nungap Outlook. which we are introducing for the first time today. Here, in slide 26, you will find the five main components of our outlook. Revenues, operating income, adjusted EBITDA, earning per share, and a free cash flow, as well as additional components including expected revenue range for key products. Our company worked hard throughout 2022 navigating and addressing the ongoing impact of the geopolitical and macroeconomic headwinds. We expect this volatile environment in the markets to continue in 2023 based on leading global financial institutions forecasts. With this in mind, we begin with 2023 total revenue, which we expect to be between 14.8 billion and 15.4 billion. This is very much in line with our revenue levels in 2022. We expect continual momentum of Astello, with a total annual revenue to grow to approximately 1.2 billion, or 24% in 2023. Furthermore, Adobe is expected to benefit from continued patient growth in the US, Europe, and international markets. Global sales for Adobe are expected to be approximately 400 million in 2023. We have factored into our guidance the continuous erosion of global Propactin revenues, which we expect to decline during 2023 to approximately 500 million. The majority of the decline is expected in the US. The expected ongoing growth of Postedo and Ajobi is greater than the offset effect by the decline in Propactin cells. Operating income is expected to be between $4 billion and $4.4 billion, and our non-GAAP-adjusted EBITDA is expected to be between $4.5 billion and $4.9 billion. As discussed earlier, we continue to explore opportunities to refinance the upcoming debt maturities to align our debt maturity profile for the coming years with our cooperation performance. There could be a meaningful step up in our finance expenses if we were to pursue any refinancing due to the higher interest rate environment. We expect an increase of approximately $100 million, reaching $1 billion in 2023. Looking at our tax rate in 2022, our Nangap tax rate was 11.7%. As we look ahead to 2023, we expect our tax rate to be in the range of 14-17%. You might recall that our non-GAAP tax rate in 2022 was below our initial guidance, as it was mainly affected by realization of a loss related to an investment in one of our US subsidiaries. These expected increase in our financial expenses tax rates expected to have significant impact on our EPS 2023 outlook in comparison to 2022. This brings us to the expected earnings per share in the range of $2.25 to $2.55 using a share count of approximately 1.1 billion shares. 2023 Free Cash Loan is expected to be in the range of $1.7 billion to $2.1 billion. This guidance reflects our expected higher tax expenses which I have outlined before, as well as increased legal expenses related to the nationwide opioid settlement. As you know, we do not provide quarterly guidance, but I thought it would be helpful to share with you how we are thinking about the progression of this, both revenue and earnings throughout the year. Based on our expectations today, we anticipate that similar to the progress in 2022, the first quarter will be the launch of our four quarters of revenue and earnings, with a gradual pickup in the second quarter. I hope this scholar will assist you with your modeling. This concludes my review of several results for the fourth quarter and fiscal year 2022. And now I will hand it back to Richard for a summary.

speaker
Richard Francis
Chief Executive Officer

Thanks Eliyahu. Before moving to the Q&A, I'd just like to summarize some key points. So I'm happy with the progress that has been made so far and I want to congratulate the entire team, all my colleagues across the globe on a solid Q4 and full year 2022. Esteto and Adobe continue to drive growth and as I mentioned before those are still a large unmet need that will drive growth in the future for Esteto in the US and Adobe continues to see good traction particularly in Europe and international markets. We have strong performance in Europe and international markets and our European business is steadily growing with leadership positions in most markets. We have an exciting pipeline across innovative medicines, biosimilars and generics and these interesting and differentiated assets will set us up for future growth. We remain committed to our long-term financial goals around growth, improving margin and driving down debt. and finally I look forward to sharing with you sometime in mid-year our updated strategy to ensure how we can position Teva for long-term success. With that, thank you for listening and I'll now hand you back to the operator for a Q&A.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Nadia, we're ready for the Q&A please. Hi everybody, we have some technical issues with the operator, we are working to fix it.

speaker
spk05

Dear speakers, please accept my apologies for the delay. Now we'll start the Q&A session.

speaker
Nadia
Operator

The first question comes now from the line of Umair Rafat from Evercore ISI. Your line is open. Please ask your question.

speaker
Umair Rafat
Analyst, Evercore ISI

Hi, guys. Thanks for taking my question. Umair here. A couple of things, if I may. First, on guidance, I think there's a little bit of confusion on how much Humira is in the number. And I guess said differently, what people are really focused on is, is it still a growth year off of 22 if there was no Humira? That was first. Second, I wanted to touch up on the TL1A program a little bit. Could you tell us if the asthma trial was a complete zero? I know it was terminated. And also, for the IBD Phase II you initiated in August last year, How's the recruiting tracking and could you be in a position to take an interim analysis on 14-week data perhaps later in 2022 which could inform a more accelerated phase 3 start just given how competitive this could get? Thank you.

speaker
Richard Francis
Chief Executive Officer

Hi, Evan. Thanks for the question. So on guidance, as I mentioned, we do have Humira in there. It's risk-adjusted. and I think your question was if we don't have Humira will we still be able to drive growth and I think I'll let Eliyahu contribute but what I would say is we have a number of opportunities to drive revenue in 2023. Humira is part of that but obviously we also talked about Stedo, we've also got Yoseti and we have other pipeline products that we haven't highlighted in this call. It is an important part. but we've risk adjusted it to take into account the uncertainty but maybe I'll let Eliyahu give some more call.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Yes Omar, you see the range that we have there and you can look on the midpoint versus the 22 revenue so you can see kind of a modest increase and I will say that to echo Richard what he mentioned, Eumera is in the guidance and is risk adjusted and we have a few other elements that might potentially hedge that element if it will not come true.

speaker
Richard Francis
Chief Executive Officer

Thanks, Eliyahu. And then going on to your question on the TL1A, Emma. I'm sort of glad you brought it up because I think this highlights some of the interesting assets we do have in our pipeline, which will, as I said, fully discuss in mid-year when we do a review of our pipeline and let people see some of the things that I'm excited about. But to try and answer your question, we have initiated a clinical phase 2 basket trial that started in August of 2022 in ulcerative colitis and Crohn's disease so that is underway I can't give much more information than that but as I said mid-year we'll probably be able to go into a lot more detail on the clinical development plans for that asset and some of the others thanks for your question thank you

speaker
Nadia
Operator

Now we're going to take our next question. Yes, of course. And the next question comes from line of Gary Natchman from BMO. Your line is open. Please ask a question.

speaker
Gary Natchman
Analyst, BMO Capital Markets

Okay, great. Good morning. Thanks. So Richard, you have a clear strategy of building out your biosimilar capabilities while a competitor decided to sell off its biosimilar.

speaker
Richard Francis
Chief Executive Officer

Yes, can you hear me? Please stick with it.

speaker
Gary Natchman
Analyst, BMO Capital Markets

That's okay. I'll start over. So you have a clear strategy of building out your biosimilar capabilities while a competitor decided to sell off its biosimilar business. So how much more critical mass do you need to maximize value in that market long-term? And then how do you see market formation, particularly with Humira biosimilars and the benefit of having an interchangeable available? How does that impact your payer discussions, if you could give us some color on that? And then just on the generics business, Richard, will you be able to get back to a billion per quarter or so in North America? You know, that was previously a target the company had. Just talk about some of the dynamics there. And you think you'll be able to stabilize that business? Will it continue to decline? Maybe talk a little bit at a high level about the pipeline and maybe how that could return that business to growth over time. Thank you.

speaker
Richard Francis
Chief Executive Officer

Thanks Gary, thanks for your questions and sticking with us on the technical issues. So on the biosimilar one, I'll take a stab at these questions and also maybe tag team it with Sven, my colleague. So on the biosimilar, I don't want to comment on other companies' strategies, we're focused on our own, but what I would say is, and I've got a history here, I do believe in the biosimilar opportunity in the market. and I think it's significant. And I think it's significant in the US and I think it's significant in Europe and the rest of the world. I do believe it as an opportunity to drive growth over the short, medium and potential long term. I do think to answer one of your parts of your question it does require you to have a deep pipeline and I think one of the things is you've got to be able to continuously launch biosimilar products as they become available and so I think the team has done a good job here in building out a pipeline we want to make sure we continue to do that we want to make sure we continue to have a geographical spread of that pipeline as we go forward but yes I see biosimilars as an opportunity to drive growth in the short and medium term. Now, when we talk about the market formation of biosimilar Humira, what I would say is let's not forget the size of the price here. This is over $17 billion in the US. I was part of the introduction of Humira into the European market. So this is a big asset where I think payers and healthcare authorities can garner some significant savings.

speaker
Jason Gerbery
Analyst, Bank of America

I think that's going to bear out over time.

speaker
Richard Francis
Chief Executive Officer

I'll let... Sven talked a bit about how quickly that can happen. I personally believe the interchangeability in some of the product profile characteristics we have for our biosimilar Humira really differentiates us and allow payers to think about actually switching and transferring patients a bit more easily than they would on other products that don't have those characteristics. But I'll let Sven answer a bit of that. And then on the GX, I'll take a step at that as well in that Look, I obviously don't have history with this 1 billion comment and so I can leave that behind from my perspective. What I would say is in the US, stability of our generic business should be driven about our pipeline, what we launch, when we launch and the ability to do that. and what we focused on and what we'll continue to focus on is complex generics. Now obviously they have unpredictability but when you do get them to the market they are very profitable and sustainable. So I think for me it's not so much about getting back to a revenue number, it's about making sure you have a GX business that is profitable, predictable and allows you to get the growth in the right areas and that comes back to profitability. But I'll hand over to Sven to give his view on those That's two questions.

speaker
Sven Dietles
Head of North America Business

Thanks, Gary. I think you were interested in UMIRA market formation and the benefit of interchangeability. So in what concerns market formation, I think we will go through three phases. Phase one is right now because Anjan already entered the market with a non-interchangeable UMIRA biosimilar. Then we have the next inflection point, which will be our market entry. It's July 1st. And then we see it We have a clear transition towards biosimilars with the formulary changes that come in 2024. So there will be basically three phases for your market formation. I believe we are well positioned. We have discussions with all our customers on the July 1 date. Our customers very well recognize the importance of interchangeability and I believe it has become even more important since EFI has guided to this year staying on formulary. And if you have the originator on formulary, of course you need an interchangeable biosimilar to really drive uptake of biosimilar generics in this space. And we also did recently market research on the question of pull through with pharmacists and HCPs. And here we also saw that interchangeability is acting well known in this professional community and especially HCPs look for interchangeability designation. and I believe overall our product profile is quite strong. We have high concentrations, citrate-free, interchangeable product. We are working towards FDA approval and for that reason I believe we can participate in this phase two market formation starting in July. And adding to Richard's comments about the complex generics of the U.S. generics Thank you very much. Thank you very much. and especially when you look at our cross margin structure, you can see how important complex generics became over the last years. So for this year, we talk about especially Forteo as an opportunity, Xudan as a second opportunity, and then the other complex generics that we also talked about in the previous years, such as Restasis or Centrostatin. And then we have a couple of other complex generics in the pipeline potentially to be launched in 2023 if we get FDA approval. Thank you.

speaker
Gary Natchman
Analyst, BMO Capital Markets

Great. Thank you very much. Thanks, Jack.

speaker
Jack

Thank you. We'll now take our next question. Please stand by. This is from the line of Glenn Santangelo from Jefferies. Please go ahead.

speaker
Glenn Santangelo
Analyst, Jefferies

Yeah, thanks for taking my question. Hey, Eliyahu, I just wanted to unpack the revenue guidance a little bit more if I could. Last quarter, you guided fiscal 22 revenues of 14.8 to 15.4. And now you're kind of just rolling that same guidance on 23. And obviously, you're building in some contributions from the growth in Ostito and some risk-adjusted contributions from Uzetti and Umaira. So I was wondering if you could just talk about the offsets to those numbers, to that growth. Will it be the same, you know, in 23 as it was in 22? Should we expect sort of a similar growth? type of deceleration in the U.S. generics business and a similar type of runoff in Capaxone or is there something else we should be thinking about for example like FX playing a bigger role?

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Okay, thank you, Glenn, for the question. So, a few dynamics in that range. First of all, if you look on the midpoint, 15.1, you will see versus 22, kind of a modest growth, call it like a 2%. But this is based on, you know, risk adjusted in terms of several launches, mostly related with North America. Now, if you think about the combination of Ostedo, Ajobi, and Copaxone, that's actually around 70 million higher than how we came in 22, and we believe that there is still modest opportunities both in Ajobi and in Ostedo, as we're actually running now the trend on the TRX. So that's one element. And then a few other elements really related to our stabilized business in Europe in terms of generics and OTC. We see there also kind of a modest growth. And we live in kind of an environment which is very volatile in terms of ethics and we keep kind of enough spread in order to make sure that we're capturing and any potential rebounding in terms of mostly on the Euro appreciation versus the Euros.

speaker
Glenn Santangelo
Analyst, Jefferies

Okay. Thank you for all those details. Maybe I can just ask one quick follow-up question on the balance sheet. Richard, you sort of seem to suggest that debt reduction remains a primary focus, but how do you think more broadly about the leverage situation, right? Because, you know, as Eliyahu sort of talked about in his prepared remarks, right, there's significant maturities coming up in the next sort of few years that are and many, many, many, many, many, many, many, many, many, many, many,

speaker
Richard Francis
Chief Executive Officer

What I'd say before I hand over to Eliyahu is we think and plan about our debt and repayment of our debt thoroughly and long term. So the way we think about some of the payments we have to pay in 23, 24 and 25 we've been working on for some time. So firstly just to give you that background and maybe Eliyahu if you could go into more specifics about that.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Okay, yes, Glenn. So looking mostly on liquidity and free cash flow and the debt. So I will start by, if you look on the guidance you gave for the free cash flow, 1.7 to... and to 2.1, that means 0.1, 0.9, if you compare it to where we actually end at 22, a quality on the 16% kind of reduction. This is most related to the fact that we are considering coming back to the market to, are 25 in maturity and that means that we will, according to the current interest rate environment, we need to step up in our funds. So this element that I mentioned already, this is a third out of this, I would say a decrease other elements according to the ongoing development with the timeline on the opiate settlement. We see ourselves paying the first payment and that's actually modeled in our free cash flow generation into Q3, 23. And this is around the incremental of additional 300 million versus what we paid in 22. So this is kind of the dynamic on that midpoint. Now, if you look on the lower end, it's actually 1.7. Part of the refinancing that we're planning in 2023, actually planning to actually get a bit lower debt stake for 2023, 4 and 5 to the level of 1.7, 1.8. in order to make sure that we have enough quotients to drive the business and mostly because of those two elements that I mentioned. And as I mentioned in my preferred remarks, we have ongoing actions going on our working capital and that cash conversion improvement in the last three years, mainly coming from those elements. So high level In terms of liquidity, we see ourselves really strongly positioned in order to have the ability to serve the debt as well, to meet our commitments in terms of obligations, mostly with the coming of the settlement. Okay, thanks for the details.

speaker
Jack

Thank you. We'll now take our next question. Please stand by. This is from the line of Jason Gerbery from Bank of America. Please go ahead.

speaker
Jason Gerbery
Analyst, Bank of America

Oh, hey, guys. Thanks for taking my questions. Just wanted to follow up on that free cash flow comment. I think that you used the term incremental for the 300 million of added opioid costs, but I think you had some payments for opioids in 2022. So, should we think about that as like the 300 plus, you know, what was kind of the run rate of payments in 2022? or just the total of about 300 million of opioid related payments. And then on the 23 guidance elements, just wanted to ask the Humira question a little bit differently. So everybody's saying 23 is going to be more of a modest year of biosimilar Humira uptake. But, you know, if you were able to get the interchangeability, mindful that you're giving guidance on a risk adjusted basis, but is there a big upside scenario? or is it too early to say and you need to kind of get to July contracting before you can kind of comment on that? Thanks.

speaker
Richard Francis
Chief Executive Officer

Okay. Thank you, Jason. Thank you for the question. I think I'll hand you, obviously, the opioids and the cash to Eliyahu and then Spike can talk about the opportunity with Humira and some of the variables in that. So, Eliyahu first.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Yeah. So, Jason, thanks for the question. I will clarify. As you recall, we had already before getting to that mature development on the nationwide, but already states that we settled. And during the 2022, we paid already around 130 million in our free cash flow. and that amount will have kind of carry over of around 150 million for next year. Now, this is not including the 200 million nationwide that we will need to pay according to the current trajectory of the process in Q3 2023. So we can actually model around 430 to 450 million that's going to be paid for opioids this year. Is it clear?

speaker
Jason Gerbery
Analyst, Bank of America

Yeah, that's clear. Thank you for clarifying that. Yeah.

speaker
Sven Dietles
Head of North America Business

Okay. Okay, you mirror our plan and the risk adjustment that we took. I think that was the topic. So first of all, we plan on having an interchangeable product in July so that we get approval for it. Just as a reminder, the review process by the FDA for the interchangeable product Emira from our partner Alvotek has been concluded and the outstanding issue for approval is now the site inspection that was scheduled for March 6th. So we expect if the site inspection will be successful we get approval for both BLAs that are with the FDA. The guidance that we have. So is there an upside? Of course there is an upside. We signed all the contracts and we have a limited number of competition within these contracts. We are quite confident that we can generate pull-through because of the product profile. But we have to wait and see for the next step and I would say we take it step by step. We're quite confident in approval. We also are quite confident in our ability to supply the market with the required volumes. That's all on track.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Jason, I know that we were down for... Thank you.

speaker
Jack

Yes, we'll now move to our next question. Please stand by. This is from Balaji Prasad from Barclays. Please go ahead.

speaker
Balaji Prasad
Analyst, Barclays

Good morning, everyone. Richard, you have articulated the importance of biosimilars for Teva over the next few years. And as I look at the long-term guidance that you provided of mid-single digits, I want to understand the role of specialty segments within this, especially as we look at the pipeline and the late-stage assets and specialty as parts. And secondly, coming to this year's guidance, Excluding FX and Bias from Humira, are there any other major variables which influence the $600 million revenue or $400 million EBITDA spread? Thanks.

speaker
Richard Francis
Chief Executive Officer

Thank you for the question. I'll take the first part and then maybe tag team with Eliyahu on the second part. So I think your question was around sort of Brian Gregg to our speciality portfolio going forward. So let me sort of touch a bit upon that. I think I highlighted within the call already that the opportunity we still see around Estedo and OJP, Estedo particularly when you look at the patient numbers that still are not being treated. I think the opportunity is significant to bring that therapy to a lot more patients. I see that as a major driver and a Jovi I see as a driver that can probably be are all worthwhile outside the US as we expand more into Europe and the international markets because of the introduction of the oral therapies to the US. But then I touched upon the pipeline as well. So you said either a Spiridone product, we have Olanzapine, that product has gone into phase three clinical trials. And then we have our innovative pipeline, which we'll talk about mid-year, which I see more as the medium term, Excited about it. I think that could bring some significant growth going forward, obviously, if that gets through the clinical development phase. So I think we have a number of assets already, and that's not mentioned some of the complex generics that Sven spoke about earlier, which we're still waiting for FDA approval. So I think we're well positioned with our pipeline across speciality, biosimilars, and complex generics. obviously the challenge always is making sure we get those to markets in a timely fashion and that's what we're going to be working hard on. Now with regard to the spread on the revenue, I'll let Eli take that and I think your comments are about you understand the effects, you understand the buyers and sellers but what else is driving that so Eli if you could help give clarity there.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Yes, so Balaji, thanks for the question. Yes, you know when you drive the kind of range when you start the year and you look on mostly on programs that require some risk adjustment. So in addition to Umira, in U.S. generics, we have a few of them that risk adjusted, so they might come and be better than what they expect. so this is part of that range and also the solid business that we have with Europe Generics and OTC even considering I would say the average of current run rate in 22 we see this one also with a great potential so this is those two elements I would say also part of those range.

speaker
Richard Francis
Chief Executive Officer

Thank you for the question.

speaker
Jack

Thank you. We'll now take our next question. Please stand by. This is from the line of Elliott Wilbur from Raymond James. Please go ahead.

speaker
Elliott Wilbur
Analyst, Raymond James

Thanks. Good morning. Maybe I could ask Sven to just follow up on the last question with respect to sort of the range of possibilities within the North American generic segment in 2023 and specifically thinking about new product launch opportunities. If there's anything you can highlight in terms of date certain items or launches with certainty pursuant to settlements, and maybe specifically, just some of the complex generics that could enter the equation in 2023. I know we've been feel like we've been talking about Terra Paratide and cyclosporine for three presidential administrations here. and obviously the FDA has been slow on complex generics, but any additional clarity you could add there with respect to the new product dynamic in 2023 would be helpful. And then for Richard, outside of the reiteration of the company's prior long-term financial targets, wondering if the strategic review or the updated strategic plan, in fact, could modify any of those parameters. And thinking specifically about the 2027 debt to EBITDA target of 2X, certainly seems like financial markets, equity holders would be much more comfortable with a higher leverage ratio, two and a half to three times, if they were comfortable with the company's use of discretionary capital in terms of pursuing pipeline enhancement initiatives, and additional strategic investments. So I'm wondering if there's maybe some flexibility, particularly with respect to that parameter, because it would free up quite a bit of cash flow for reinvestment into pipeline and longer term growth assets. Thanks.

speaker
Richard Francis
Chief Executive Officer

Thank you for those two questions, Eliyahu. To look up, I'm going to order you to deliver them, so I'll ask Ben to answer one around the almost complex generics approvals that you've been experiencing through the last three presidential campaigns.

speaker
Sven Dietles
Head of North America Business

Yes, so the usual suspects. Thanks for the question, Eliyahu. So US generics this year, overall, we'll see a weak patent expiry here. So this year doesn't have a lot of, let's say, launches that are naturally given by patent expiry dates. It will be more driven by FDA approvals and settlement entries, as you also pointed out. Yamira, we already talked about. Forteo, we received this year that we answered to the FDA. We are working with them closely to sort out this issue. Just as a reminder, this product has been launched many years ago in Europe already with IMA approval. and we know how to manufacture it, of course, and I believe the product is high quality and that we will get the FEA around to give us approval. Then we have the re-entry of revenue, of course, due to our settlement date. that is working on an annual cycle so we re-enter this market with a higher volume allocation within the settlement with BMS and then we have of course Xulane which is a new drug on the list for launch this year and then I have a couple of other products that we prepare for launch Assuming that we get FDA approval, but since we have made some experiences with the FDA about how difficult it is to get complex generics approved, I don't want to give you a certain, let's say, now. I think once we get approval, we will communicate more around that. but overall I can say that complex generics are still quite attractive for us because if you analyze in a classical 80-20 analysis our gross margin and the cash contribution within the generics portfolio, complex generics are certainly a major stabilizer in our business in North America. You also see that our price decline is quite stable in the base business. that has improved over the last year and we don't expect dramatic changes in that space. So overall, I would say U.S. generics will develop if we get all the approvals that we discussed on a regular basis in this course.

speaker
Richard Francis
Chief Executive Officer

Thank you, Sven. And then to answer your question about the pain and the death and the EBITDA target we gave in 2027 and flexibility around that, if I heard you correct me earlier. So look, we're in the midst of doing our strategic review and understanding our plan going forward and that's a strategy that's going to deliver growth. That's the whole point of putting that strategy together. I think what we think is important and what the team has worked hard on is to get credibility around our debt and our repayment of it over the last few years and so we don't want to I think as we work through the strategic review and understand the opportunities and the need for capital both within the company to reallocate resources to drive some of our pipeline on our in-market products as well as to do some BDNL we need to think about that but I'd also like to say that I think we think we have the ability to pay down that debt in the fashion that we've outlined and still be able to have and Capital to allocate to drive the company back to growth. But we're in the midst of that but I appreciate your point of view and your question to challenge that and we'll be able to give a bit more clarity on that mid-year.

speaker
Jack

Thank you.

speaker
Richard Francis
Chief Executive Officer

Thank you.

speaker
Jack

We'll now take our next question. Please stand by. This is from the line of Chris Schott from J.P. Morgan. Please go ahead.

speaker
Chris Schott
Analyst, J.P. Morgan

Great. Thanks so much for the questions. Just two for me. I guess first maybe, Eli, how should we be thinking about gross margins this year? I know you're targeting flat OPEX, but just maybe a little bit more color on the components of OPEX as we think about 23. And the second one was just kind of a bigger picture question on the biosimilar business. As you talk about this, as this continues to ramp and is an important growth driver for Teva, I guess there's a continued kind of partner centric approach make the most sense for the company or would these be capabilities you would want to develop I guess to be more in-house over time as you think about kind of really trying to maximize the value of this opportunity? Thanks so much.

speaker
Richard Francis
Chief Executive Officer

Thanks Chris, thanks for the question. So Eliyahu, you take the first one and then I can chime in with a few on the second.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Thanks, Chris, for the question. So we end up 22, around 54% growth margin. And actually, when we are looking on 23, we are going to see a bit higher, I would say additional 0.3%. and one of the things that we need to remember that the macroeconomic headwinds actually overall, if we look on the numbers, hit us around 2% on our revenues, so call it around 300 million. With all the activities that we've already done and all those, I would say, optimizations that were part of our long-term financial target, to expand our margin. They have helped us, as I mentioned in my program, partially offset that element. Now, there is also kind of element on revenue mix, and you can actually see that with the growth and a few other elements that we are actually working on. We're going to see a very modest increase but not more to the level of 54.5% that will stay in 2023 which means that our ability to keep the current level on the OPEX will stay the same and the residual amount will flow through the OPE margin.

speaker
Richard Francis
Chief Executive Officer

Thanks, Eliyahu. So I'm the biosimilist. So I think the question Chris was around, you know, as we move forward, we see it as a growth driver. Is this continued partner strategy or not? So firstly, let me clarify that although we have a good and productive partnership with Albert Tech, which is delivering a nice pipeline, we also have, I think it's six in-house biosimilars that we've developed ourselves. I'm going back to a comment I made on an earlier question. What I think is important with biosimilars is that we have a broad and deep pipeline that we can address most of these large biologics when they come off patent. And to do that effectively from a capital allocation point of view, I think it's a combination. It's a combination of partnering and it's a combination of doing some things in-house. And so that's what I see going forward, that combination. just to make sure we have the right pipeline and we launch the products at the right time. Thanks for your question, Chris.

speaker
Jack

Thank you. And we'll now take our final question. Please stand by. And the last question is from Rishi Parekh from J.P. Morgan. Please go ahead.

speaker
Rishi Parekh
Analyst, J.P. Morgan

Hi, how are you doing? Thanks for taking my questions. I just want to confirm a few things and then talk about or ask a few questions on your balance sheet. With regards to your free cash flow at 1.7 to 2.1, I want to confirm that that includes the $450 million of opioid payments or is it a different number?

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Yes, it's including.

speaker
Rishi Parekh
Analyst, J.P. Morgan

Okay, great. And then with regards to your maturities, if I heard you correctly, I think you said that you're going to address your 23, 24, and 25 maturities, which is different than what you have said at the JPMorgan conference. I was hoping that you could just walk us through What led to that change? Is it something related to your free cash flow or something related just to the interest rate environment? But we'd love to just have you walk through that.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Yeah, so, you know, when we actually set the market, you will appreciate that the interest rate environment is higher than what's expected to tender on our test stakes. And that means that we will have impact on our financial expenses. That will flow through impact on our fee cash flow. This is one. The second thing is that, you know, as we move forward and we see ourselves now more inside a positive momentum with opiates, we actually want to make sure that we have enough questions to manage that liability and coming back to your first question, and that's actually already embedded there. So, you know, We used to have kind of a 2.1 to a 1.9 range on the debt stake. Currently, the 23 is 2.1, 24 is 1.9. We're going to take it lower a bit in order to make sure that we have enough questions there to manage it, and it will be part of the coming refinancing, which majority will be focused on the debt stake of 25.

speaker
Rishi Parekh
Analyst, J.P. Morgan

And, you know, with the drop down in your AR financing next year to 500 million, One, can you walk us through why it's declining by $500 million next year, and is that also affecting your thoughts around how you're looking to address your debt maturities this year?

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

So I don't understand the drop on the AR for next year. Where are you actually considering that one? But I can mention the dynamics. This year in terms of working capital, we were able to optimize our date outstanding tables. as well as DSO and that's actually often part of inventory increase in order to support our production plan for mostly for the first half of the year.

speaker
Rishi Parekh
Analyst, J.P. Morgan

Yeah, sorry, I was just referring to the new AR facility that you entered into. I think it's a billion dollars through November of this year and then it drops to 500 million from November 23 onwards to November 25 and I was just hoping for an explanation behind that drop.

speaker
Ran Mir
Senior Vice President, Head of Investor Relations

Yes, so actually the facility is around $1 billion. We are not using the full of it. We use the $800. The opportunity for us to be flexible on that program by actually initiating further enhancement on other elements of the working capital, that will allow us to be more flexible and reduce that program going forward.

speaker
Rishi Parekh
Analyst, J.P. Morgan

Okay, great. I'll follow up with my direct questions later. Thanks.

speaker
Richard Francis
Chief Executive Officer

Thank you.

speaker
Rishi Parekh
Analyst, J.P. Morgan

Thank you for your questions.

speaker
Richard Francis
Chief Executive Officer

I'd like to thank everybody for that. Questions and interest on the call today and I'd like to also apologise for some of the technical issues at the start. That's always something you can't sometimes control, but I appreciate you bearing with us. And on that, I'd like to close the call. Once again, thank you for your interest and look forward to talking to you on future calls.

speaker
Jack

Thank you. This does conclude the conference for today. Thank you for participating and you may now disconnect.

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