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辉瑞 (PFE) 2026年第三季度业绩电话会:收购产品增长32%,上调业绩指引

2026年11月3日 21:33
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辉瑞公布2026财年第三季度营收为166亿美元,调整后稀释每股收益为0.87美元。新上市及收购产品收入38亿美元,在运营层面增长32%。公司将全年营收指引上调至620亿至640亿美元,并将调整后稀释每股收益指引上调至2.95至3.05美元。辉瑞预计在2026年底前实现72亿美元净节约额,并在2027年至2029年期间额外实现25亿美元净节约额,以应对专利到期压力,同时推进肿瘤学和肥胖症等重点研发管线。

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核心要点

  • 辉瑞公布2026财年第三季度营收为166亿美元。受新冠产品收入下降拖累总销售额影响,非新冠产品在运营层面增长7%。
  • 报告的稀释每股收益为0.56美元,调整后稀释每股收益达到0.87美元,其中包含与信达生物(Innovent)交易相关的每股0.10美元费用。
  • 新上市及收购产品产生收入38亿美元,在Padcev、Nurtec及其他增长产品的带动下,在运营层面增长32%。
  • 辉瑞将其2026全年营收指引上调至620亿至640亿美元,并将调整后稀释每股收益指引上调并收窄至2.95至3.05美元。
  • 该公司仍按计划在2026年底前实现计划中近乎全部的72亿美元净节约额,并计划在2027年至2029年期间额外再实现25亿美元的净节约额。
  • 管理层重申了其目标,即在收购产品和后期研发管线的支持下,实现从2028年底至2033年底风险调整后营收年均复合增长率(CAGR)达到高单字位数。

核心财务数据

指标2026财年第三季度业绩变动或背景
营收166亿美元非新冠产品在运营层面增长7%
新上市及收购产品收入38亿美元运营层面增长32%
报告的稀释每股收益0.56美元—
调整后稀释每股收益0.87美元包含每股0.10美元与信达生物相关的费用
调整后毛利率77%得益于产品组合和成本管理
调整后运营费用68亿美元重点研发管线投资增加
调整后销售、一般及行政(SI&A)费用—运营层面增长2%
调整后研发费用—运营层面增长18%
调整后营业利润率36%包含信达生物在研研发(AIPR&D)费用
今年迄今经营活动现金流88亿美元2026财年前九个月
内部及外部研发投资92亿美元2026财年前九个月
向股东发放的股息73亿美元2026财年前九个月
杠杆率2.6倍略低于辉瑞2026财年2.7倍的目标

业务与运营表现

辉瑞收购的产品在本季度在运营层面增长了37%。在Padcev的推动下,原Seagen产品组合在美同比增长39%。在新上市及收购的产品组合中,Padcev贡献了2.65亿美元的收入增长,Nurtec贡献了1.35亿美元。

在需求和商业执行力的支撑下,Nurtec收入在运营层面增长了33%。辉瑞表示,公司在美国口服CGRP市场保持领先地位,并正在英国、意大利和日本等国家扩大市场准入。

新冠产品和沛儿(Prevnar)系列疫苗在本季度有所下滑。辉瑞正持续投资于更新的产品和适应症,以抵消即将到来的专利到期(独占权丧失)压力。

随着辉瑞推进重点肿瘤学和肥胖症项目,研发支出有所增加。公司计划在2026年开展及推进10项肥胖症三期试验,包括一项评估从已获批的每周给药疗法转换为每月给药的在研GLP-1肽类药物berobenatide的研究。管理层正致力于在2028年获得berobenatide的首批潜在批准。

在肿瘤学领域,Elrexfio在双重暴露多发性骨髓瘤中取得了第二个积极的三期临床数据。在MM32试验的中期分析中,接受Elrexfio治疗的患者中有超过75%未发生疾病进展或死亡,预估的18个月无进展生存率约为68%。

辉瑞还重点介绍了用于HR阳性、HER2阴性乳腺癌的atirmociclib。在二期FOURLIGHT-1研究中,该方案与研究者选择的治疗方案相比,将疾病进展或死亡风险降低了40%。对于用于一线非小细胞肺癌的tivunatamig,关键剂量下的确认客观缓解率约为80%,而在所讨论的两种组织学类型中,中位无进展生存期接近14个月。

管理层业绩指引

辉瑞将2026全年营收指引中值上调了15亿美元,达到620亿至640亿美元。公司维持对新冠产品收入约40亿美元的预期,受疫苗接种季节性因素影响,预计Comirnaty的大部分收入将在第四季度实现。

全年调整后稀释每股收益指引上调并收窄至2.95至3.05美元,中值增加0.10美元,同时吸收了与信达生物交易带来的每股0.10美元影响。

辉瑞目前预计2026年研发费用为108亿至118亿美元,并继续预计调整后毛利率保持在70%中段区间。

管理层预计到2026年底将实现计划中近乎全部的72亿美元净成本节约。第二阶段旨在从2027年到2029年再产生25亿美元的净节约额,以帮助缓解专利到期过渡期间的利润率压力。

辉瑞计划在12月中旬左右提供正式的2027财年指引。管理层指出,专利到期、新上市及收购产品的增长、价格变动以及成本节约是明年的关键因素。

风险与关注领域

即将到来的专利到期(独占权丧失)仍是核心关注点。管理层提到,在美国的Xtandi及其他产品,以及从2026年底开始在国际市场的艾乐妥(Eliquis),都是2027年需要考量的压力来源。

与《通胀削减法案》(Inflation Reduction Act)、340B计划以及最惠国待遇安排相关的定价动态将纳入未来的指引中。管理层表示,第三季度业绩主要由销量驱动,而非重大总额至净额(gross-to-net)收益的结果。

辉瑞预计在专利到期过渡期间,杠杆率将保持在当前水平附近或略高。研发管线的时间安排也依然取决于临床事件、监管结果和试验执行情况。

管理层提醒,辉瑞研发管线数据与竞争产品之间的对比属于跨试验对比,这意味着无法得出确定性结论。新冠治疗需求也将继续取决于感染率和使用率。

分析师问答环节亮点

  • 2027年展望:辉瑞预计专利到期带来的压力将被新上市及收购产品的增长部分抵消。正式指引计划于12月中旬发布。
  • 资本配置:公司继续优先考虑业务投资,随时间推移维持并增长股息,并保持资产负债表实力。管理层表示,未来的业务拓展将主要集中在与其四大治疗领域相一致的补充型交易上。
  • 成本结构:最初72亿美元计划节省的资金已部分重新投资于研发。新增的25亿美元计划预计将在2027年至2029年期间支持利润率。
  • 肥胖症管线:已完成受试者入组的SOLIS IIb期研究评估了单用淀粉素(amylin)以及与berobenatide联合给药的情况,预计将于2027年下半年公布疗效数据。I/IIa期数据更新预计将在2026年底前提供,不过该研究旨在评估安全性及药代动力学而非疗效。
  • MEVPRO时间节点:管理层目前预计MEVPRO-1将在2027年第一季度公布数据,MEVPRO-2将在2027年第四季度公布数据,具体时间取决于事件积累情况。
  • 莱姆病疫苗:欧洲药品管理局(EMA)已受理辉瑞与Valneva候选疫苗的上市许可申请,预计将在2027年获得人用药品委员会(CHMP)意见。辉瑞也已在加拿大提出申请,并预计在2026年第四季度向投资者更新与FDA讨论的最新进展。

业绩电话会议完整文字记录


完整财报电话会议逐字稿

管理层陈述

Operator

Good day, everyone, and welcome to Pfizer's Third Quarter 2026 Earnings Conference Call. Today's call is being recorded. At this time, I would like to turn the call over to Francesca DeMartino, Chief Investor Relations Officer and Senior Vice President. Please go ahead, ma'am.

Francesca DeMartino

Good morning, and welcome to Pfizer's earnings call. I'm Francesca DeMartino, Chief Investor Relations Officer. On behalf of the Pfizer team, thank you for joining us.

This call is being made available via audio webcast at pfizer.com. Earlier this morning, we released our results for the third quarter 2026 via a press release that is available on our website at pfizer.com.

I'm joined today by Dr. Albert Bourla, our Chairman and CEO; and Cecile Guegan, our CFO; and Chris Boshoff, our scientific -- our Chief Scientific Officer. After their prepared remarks, we will open the call for questions. Members of our leadership team will be available for the Q&A session.

Before we get started, I want to remind you that we will be making forward-looking statements and discussing certain non-GAAP financial measures. I encourage you to read the disclaimers in our slide presentation, the press release we issued this morning and the disclosures in our SEC filings, which are all available on the IR website on pfizer.com.

Forward-looking statements on the call are subject to substantial risks and uncertainty speak only as of the call's original date, and we undertake no obligation to update or revise any of the statements. With that, I will turn the call over to Albert.

Albert Bourla

Thank you, Francesca. Good morning, everyone, and thank you for joining our call. I'm pleased with another strong quarter for Pfizer, our excellent commercial execution including 32% operational revenue growth in the quarter for our [ loans ] and acquired products shows the underlying strength of our business.

Financial discipline and ongoing productivity improvement are driving efficiency and contributing favorably toward our margins. And with continued progress of our high-value R&D programs, we believe that we are on a pathway to the next stage of meaningful growth.

Before going further, I want to welcome Cecile Guegan as our Chief Financial Officer. Cecile brings more than 25 years of finance leadership and the proven ability to deliver new sources of growth. She stood out in our global [ search ] for her expertise, her deep knowledge of Pfizer and our industry and the strategic vision that I believe will help Pfizer unlock sustained long-term value for patients and shareholders.

I'm looking forward to Cecile's partnership, and I'm confident he will help us execute with a discipline and ambition this next chapter [indiscernible].

Now let me cover several highlights of our progress in this quarter. As you know, over the last few years, we have invested close to $80 billion in transactions that have equipped us with key products contributing to current commercial momentum and platforms with transformative potential.

About 80% of this investment was for Seagen, Metsera and Biohaven, and we are making good progress in maximizing the value of each one. We are pleased with the overall performance of our acquired products, which grew 37% operationally in this quarter.

Our legacy Seagen portfolio grew 39% year-over-year in the U.S. in the quarter, driven by the strong performance of Padcev, bringing Seagen's medicines together with the strengthened reach of our commercial organization has deepened our presence in the oncology community. We now offer physicians and care teams a broader set of options and more expertise, helping patients and driving growth for Pfizer.

Seagen did more than strengthen our commercial position. It also expanded our ability to discover oncology breakthroughs, doubling the size of our early-stage pipeline at the time we closed the acquisition.

In our late-stage development programs, we are advancing potential antibody drug conjugates that could bring meaningful improvements for patients with cans.

I'm pleased with the pace of progress over the past year, with our expansive clinical development program across our obesity portfolio. We plan to advance 10 active and planned Phase III trials in 2026 and including one evaluating a [ switch ] from approved weekly therapies to our investigational monthly GLP-1 peptide, berobenatide. We have made significant progress with enrollment across our pivotal berobenatide program, as well as our amylin combination program, where our Phase IIb study is now fully enrolled. We are working towards the first in a series of potential approvals for berobenatide in 2028, with planning of our go-to-market strategy well underway.

Biohaven also has been a strategically important addition for Pfizer. In the quarter, Nurtec grew by 33% operationally, driven by underlying demand and excellent commercial execution. We see a real opportunity to help patients with migraine and for the oral CGRP class to be a key growth driver, even as we manage market dynamics in a competitive field.

We are leading the oral CGRP class in the U.S. and are working to extend that position internationally. We are seeing international growth as more patients can now get this treatment in key countries, including the U.K., Italy and Japan. We are also encouraged by strong adoption when we are able to expand access.

2026 execution in R&D has been strong. and we continue to prioritize the highest value opportunities for patients and future growth across our four therapeutic focus areas. Our excellent progress showcases our momentum in advancing our strategy.

In recent months, we achieved two key regulatory decisions, one key pivotal readout and eight key pivotal study starts, alongside strong data we presented at several recent medical congresses.

We are excited by the pipeline opportunities in areas of strategic focus and commercial strength. This includes late-stage programs across tumor types in oncology, including multiple myeloma, breast cancer and lung cancer, within inflammation and immunology and of course, in [ neococal ] vaccines. Chris will share more detail about our recent advancement in various end months.

Our pipeline strategy is grounded in disciplined prioritization and accelerated execution. And we are confident that we are advancing our most significant opportunities for future patient impact and growth.

Today, we are raising our guidance for full year 2026 revenue and adjusted earnings per share. This reflects our strong performance through the third quarter and confidence in our ability to execute our strategy, along with our financial discipline and the progress we continue to make with our R&D pipeline, we believe Pfizer is well positioned to drive growth towards the end of the decade and create sustained value for patients and shareholders over the long term.

We have deployed AI in our business with the goal of improving efficiency in manufacturing and serving how we engage physicians and patients.

In R&D, we are working to accelerate innovation with faster target validation and better molecule and biomarker select. The recent launch of GENESIS, a new pharmacovigilance platform shows our commitment to harnessing advanced AI and intelligent automation for a global safety monitoring. This typically involves a lengthy manual process for more than 600 products in over 120 countries. GENESIS takes on the administrative burden of our safety scientists can spend their time where it matters most, assessing causality, detecting safety signals and protecting patients.

With that, I will turn it over to Cecile.

Cecile Guegan

Thank you, Albert, and good morning. I am proud to speak to you today as Pfizer's CFO. I'm looking forward to continuing to work alongside the executive leadership team and lead a world-class finance organization. I am genuinely excited about what we can achieve together, and I will approach this role with financial discipline and a focus on translating Pfizer scientific and commercial progress into durable shareholder value. I am confident in our strategy and that as a team, we can deliver durable long-term value for our shareholders with rigorous capital allocation and disciplined execution.

Now I am pleased to share our third quarter results, which demonstrate continuous commercial execution and financial discipline. The revenues from our non-COVID product delivered solid growth, while product mix, productivity and cost management supported margin expansion and enable continuous investments across our robust pipeline.

This year's performance gives us the confidence to raise our full year 2026 revenue guidance as well as raise and narrow our adjusted diluted EPS guidance.

Now on to the results. Third quarter 2026 revenue of $16.6 billion came in ahead of our expectations. We strong 7% operational revenue growth of our non-COVID products, driven by key brands in the U.S. and select international markets, offset by lower revenues from our COVID-19 products.

On the bottom line, third quarter 2026 reported diluted EPS was $0.56. In addition, adjusted diluted EPS of $0.87 exceeded our expectation and includes the $0.10 charge related to the Innovent transaction.

This outperformance reflects cost discipline, and improve productivity across the organization even as we increase investment towards future growth drivers and advanced several Phase III study stocks. We saw solid revenue contributions in the quarter from adequate [indiscernible], [ Venecal family ], Nurtec and our brand, while our COVID-19 products and the Prevnar family declined in the quarter.

Our launched and acquired product contributed $3.8 billion in revenues and grew 32% operationally in the quarter, primarily driven by Padcev, up $265 million, Nurtec up $135 million and [indiscernible] $114 million. We continue to invest behind this group of products to mitigate LOE headwinds over the next several years.

In addition, this quarter's performance demonstrates clear progress against our objective of returning to growth towards the end of the decade. Cost discipline and continued optimization across the company including our manufacturing footprint remain priorities. We are making meaningful progress with our productivity initiatives and remain on track to deliver nearly all of the anticipated $7.2 billion of net savings by the end of 2026 for ongoing cost improvement programs.

As we announced last quarter, we are initiating the next phase of these programs to deliver an anticipated additional $2.5 billion of net cost savings from 2027 through 2029. These savings support increased operating efficiency and contribute favorably to our margins.

At the same time, we continue to prioritize investment in pipeline programs that we believe have the greatest potential to deliver meaningful breakthroughs for patients and create long-term value for our shareholders.

Adjusted gross margin for the third quarter was 77%, primarily reflecting favorable product mix and continued cost management. When we look at the components of adjusted operating expenses of $6.8 billion, adjusted SI&A expenses increased 2% operationally, reflecting in part an increase due to a lower favorable adjustment of U.S. health care reform fees year-over-year, offset partially by lower and targeted marketing and promotional investments towards growth drivers and ongoing cost productivity improvements.

Adjusted R&D expenses increased 18% operationally, which includes planned investment in priority, oncology and obesity programs, including several Phase III study starts.

An acquired in-progress R&D decreased 52% operationally, primarily reflecting a $650 million charge related to the Innovent transaction this quarter, compared to $1.35 billion charge in the prior year quarter related to the 3SBio transaction.

Third quarter 2026 adjusted operating margin was 36%, reflecting effective cost management, strong non-COVID revenue performance higher investments in the business, and I will note, was tempered by the AIPR&D charge related to the Innovent transaction. And as I mentioned earlier, third quarter adjusted diluted EPS was $0.87.

Based on our year-to-date performance, including continued growth across our non-COVID product and disciplined execution, we are raising our full year 2026 revenue guidance by $1.5 billion at the midpoint to a range of $62 million to $64 million. We are reaffirming our expectation of approximately $4 billion for the COVID products with the majority of the [ ComeaNatio ] revenues expected in the fourth quarter, consistent with the vaccination season. Accolade utilization will continue to be in trend by infection rates and treatment demand.

In addition, we now expect full year 2026 R&D expense to be in the range of $10.8 billion to $11.8 billion. We are raising and narrowing our full year 2026 adjusted diluted EPS guidance to a range of $2.95 to $3.05. This represents an increase of $0.10 at the midpoint while absorbing the $0.10 per share impact of the Innovent transaction. We are reaffirming all other components of our financial guidance.

Our updated outlook reflects our confidence in a non-COVID product progress across our cost improvement initiative, an expectation of full year adjusted gross margin in the mid-70s percent range and continued investments in our priority pipeline programs.

Turning to capital allocation. Our capital allocation priorities remain unchanged. We invest in the business at appropriate returns maintain another time, grow our dividend and deliver shareholder returns while preserving flexibility for future value-enhancing actions, including share repurchases.

Following the Innovent transaction, which closed in the third quarter, our current BB capacity is approximately $6 billion. In the first month -- 9 months of 2026, we invested $9.2 billion in internal and external R&D and returned $7.3 billion to shareholders through our quarterly dividend.

Our third quarter year-to-date 2026 operating cash flow was $8.8 billion, and leverage ended the quarter at 2.6x, slightly below our 2026 target of 2.7x. Given the impact of upcoming we expect leverage to remain around current levels or modestly higher due to the -- during the LOE transition period. We remain focused on maintaining our strong financial position while continuing to invest in innovation and support shareholder returns.

In conclusion, I want to leave you with two key takeaways: First, operational excellence. The non-COVID product continued to perform well, growing 7% operationally and our launched and acquired product with 32% operationally, providing further evidence of our strength capabilities and consistent execution.

Second, financial discipline. We are improving operating efficiency while enabling increased pipeline investment in program waiver offers a greatest potential for patients and shareholders.

Together, this performance demonstrates that we are executing our strategy, managing the upcoming LOE transition and strengthen the foundation for a return to growth towards the end of the digital.

With that, I'll turn it over to Chris.

Chris Boshoff

Thanks, Cecile. Across our four therapeutic areas, we made strong progress last quarter. I'll provide color on recent developments of some of these programs. starting with Elrexfio, our internally discovered BCMA bispecific, which has now delivered two positive Phase III readouts in double-class exposed multiple myeloma. Most recently, in MM32, Elrexfio monotherapy demonstrated a statistically significant and clinically meaningful improvement in progression-free survival versus investigators choice of three established standard of care regimens.

This is important because the choice of three standard of care regimens provides a robust representation of how CD38 refractory multiple myeloma is treated today in a patient population that is growing as anti-CD38 therapy moves in the first-line setting.

And the results themselves were strong. At the time of the interim analysis, more than 75% of patients receiving Elrexfio had not experienced disease progression or death from any course and the estimated 18-month progression-free survival rate was approximately 68%.

Safety in MM32 was consistent with our Elrexfio's known profile and also potentially differentiated with infection prophylaxis measures incorporated from the start of MM32, rates of grade three or higher infections were lower than those observed in MM5, Elrexfio's first positive pivotal trial in double [ plastic posed ] multiple myeloma. For context, such infection prophylaxis measures were not in place at the start of MM5. These were instituted following early deaths due to infections that were concentrated in China and two other countries during the COVID wave impacting the overall hazard ratio of MM5. MM5 data expected at a medical meeting before year-end and will provide further information on efficacy and safety.

Taken together, these positive Phase III results from MM32 and MM5 strengthen our confidence in moving Elrexfio into earlier lines of treatment. We are building a compelling case of fixed-dose Elrexfio monotherapy from first relapse regardless of prior CD38 exposure. And with additional pivotal studies in newly diagnosed myeloma underway, Elrexfio's eligible patient population could grow approximately 5-fold, pending clinical and regulatory success.

Moving next to atirmociclib, our potential first-in-class, highly selective CDK4 inhibitor, building on the leadership we established with IBRANCE, we are advancing atirmociclib as a potential next-generation backbone for first-line and early HR-positive breast cancer. Our KAT6 inhibitor, prifetrastat, is being developed in later-line settings.

Atirmociclib was designed in-house to improve upon CDK4/6 inhibitors, the current standard of care backbone for HR-positive breast cancer. A key limitation of this class is safety and tolerability with CDK6 inhibition being a key contributor to adverse events. We designed atirmociclib to maximize efficacy through greater CDK4 inhibition while improving tolerability by minimizing CDK6 engagement.

Atirmociclib is 33x more selective for CDK4 versus CDK6 comparing favorably versus the standard of care. Year 2 data sets fueling enthusiasm for atirmociclib, on the left, our data presented at ESMO from the Phase II FOURLIGHT-1 study of atermaciclib plus fulvestrant in patients with HR-positive HER2-negative breast cancer. All participants had previously received a CDK4/6 inhibitor. And notably, 92% of atirmociclib participants were randomized within 3 months of discontinuing a CDK4/6 inhibitor. The atirmociclib regimen reduced the risk of disease progression or death by 40% compared to investigators' choice of fulvestrant or everolimus plus exemestane. These results in a population with highly refractory or resistant disease, increase our confidence in our ongoing Phase III trial of atirmociclib versus investigators choice of CDK4/6 inhibitor in the first-line setting.

On the right, our data for atirmociclib Phase II study in early breast cancer. With the combination of atirmociclib plus [ letrozole ], 88% of participants tumors demonstrated complete cell cycle arrest compared to only 18% versus [ letrozole ] alone. These results support our plan to combine atirmociclib with a selective estrogen receptor degrader giredestrant in a Phase III early breast cancer trial expected to initiate within the next few months.

This study design has been aligned with the regulators building on the expected approval for giredestrant in this setting. This slide shows for light on safety and tolerability data alongside results from pivotal studies of the three approved CDK4/6 inhibitors plus fulvestrant. These are cross-trial comparisons. Therefore, definitive conclusions cannot be drawn. These data further address that high state selectivity drives improved safety and tolerability enabling continuous dosing excellent adherence and potentially greater efficacy. [ Great through ] or higher neutropenia was numerically low with the atirmociclib than with any of the approved agents with no grade four pipe neutropenia reported. Any great diarrhea was lower than with atirmociclib and comparable to [ palbociclib and ribociclib ]. Dose reductions due to adverse events were 14% with atirmociclib compared to 32% to 43% with the improved age.

Turning to tivunatamig. We are advancing an extensive program for this potentially best-in-class PD-1 VGF bispecific antibody with over 1,200 patients treated globally and a consistent safety profile. This includes two ongoing Phase III trials with two additional Phase III trials expected to begin this year.

Updated results at ESMO strengthen our confidence as we expand tivunatamig's development. Since [ SITC 25 ] confirmed response rate for the pivotal dose of tivunatamig plus doublet chemotherapy from the ongoing Phase II study have risen by roughly 20 percentage points in non-squamous and squamous first-line non-small cell lung cancer. They now stand at approximately 80%, exceeding those of tislelizumab plus chemotherapy in this study. Median progressive-free survival was nearly 14 months for both histologies, an improvement of roughly 4 to 5 months versus the comparators.

Notably, tislelizumab's efficacy was consistent with historical Phase III results for the leading PD-1 antibody [ pembrolizumab ] which supports the relevance of the control arms.

We are also encouraged by how tivunatamig efficacy and safety results compared with Phase III data for the PD-1 VGF bispecific antibody [ ivonescimab ], while recognizing the limitations of cross-trial comparisons.

Now for I&I, tilrekimig, a potential first-in-class trispecific antibody, tilrekimig was designed in-house to simultaneously target multiple complementary drivers of type 2 inflammation, IL-4, IL-13 and TSLP. Phase II results in atopic dermatitis provide compelling proof of concept.

At the top monthly doses, tilrekimig treatment led to placebo-adjusted response rate of about 50% for [ EASI 75], defined as 75% or greater improvement in the Eczema Area and Severity Index.

While cross-trial comparisons have limitations, these Phase II data suggests the potential for superiority over [ dupilumab ], the current standard of care biologic. Key secondary endpoints in our ongoing Phase III program are powered to test this hypothesis in a head-to-head setting.

For safety, tilrekimig demonstrated a favorable profile at subcutaneous doses up to 400 milligrams once every 4 weeks, the observed frequency of conjunctivitis and injection site reactions were lower than rates supported with [ dupilumab ] and comparable to placebo.

Beyond atopic dermatitis, tilrekimig a pipeline and a product opportunity, targeting pathways that are validated by approved therapies across nine different diseases, late-stage studies underway in severe asthma moderate-to-severe COPD.

Moving to our potential best-in-class pneumococcal conjugate vaccine program, building on Prevnar's 25-plus year legacy of effectiveness and safety. We're advancing next-generation candidates designed for leading serotype and invasive disease coverage.

In pediatrics, [ BCB 25 ] delivered strong Phase II results, all 20 serotypes shared with Prevnar 20, [ meth-olose-4 IgG ] criterion historically used to establish noninferiority. Since the pediatric licensure of Prevnar 20 in 2023, the [ FK ] established an updated more stringent 1.5-fold noninferiority criterion that is incorporated into our Phase III design.

Given the Phase II results and tighter confidence intervals expected with a much larger sample size in Phase III, modeling predicts this criteria and will be met with least 22 of 25 serotypes in our pivotal study, taken together with sero response data, functional OP test and the totality of evidence approach to licensure. These results provide confidence as we aim to deliver a best-in-class pediatric pneumococcal vaccine protecting against serotypes that collectively caused an estimated 84% of invasive disease cases in U.S. children under 5.

This would represent an incremental increase of approximately 25 percentage points versus Prevnar 20. Our Phase III program is well underway with the Phase III lot-to-lot consistency study already fully enrolled.

In adults, PCB 35 extends the enhanced serotype three technology we validated with PCB 25 to other key serotypes with a Phase I start expected this year.

Looking ahead, we expect a strong cadence of regulatory decisions, data readouts and pivotal study starts over the next 12 months. These include a readout from MEVPRO-1 on which based on the current event rate is now expected in the first quarter of 2027. If successful, MEVPRO-1 could support approval for mevrometostat, our in-house discovered with potential first-in-class EZH2 inhibitor for prostate cancer, expanding our franchise.

With that, I'll hand it back to Albert.

Albert Bourla

Thank you, Chris. And in closing, operational excellence is driving a commercial momentum across our key growth brands. And I would say importantly, with our launch and acquired products. .

Our capital allocation strategy, on the other hand, is designed to create long-term shareholder value. And our late-stage pipeline progress with a significant number of pivotal readouts expected near term, is strengthening our opportunity to extend our leadership in key areas and make a difference for patients.

I'm confident Pfizer is well positioned for growth towards the end of this decade. And for long-term shareholder value creation. We have line of sight to our aim of delivering a risk-adjusted high single-digit revenue CAGR and from year-end 2008 through year-end 2033.

Now we will move to Q&A. And operator, please assemble the queue.

Operator

[Operator Instructions] Our first question today will come from Chris Schott with JPMorgan.

分析师问答

Christopher Schott

I just had two pipeline ones. Maybe first on the trispecific tilrekimig. How are you thinking about the positioning of this one in atopic derm as you consider I guess, first-line versus second-line usage maybe just think about the very strong data you presented versus a very well-entrenched standard of care?

And maybe just a second part of that, can you just talk about the time lines for the indications beyond AD that you're pursuing?

The second question was then just pivoting over to the upcoming Phase I/IIa amylin and combo data that we're going to see here, can you just help set some expectations about how you're thinking about that data and then the type of titration schedule that's being used to that study just to help us kind of frame out what we're going to see with that readout.

Albert Bourla

No. Thank you. Chris, would you like to cover the time lines of trispecific and, of course, the amylin and berobenatide questions. And then maybe Alexandre, you can speak a little bit about the commercial positioning.

Alexandre de Germay

Thank you very much for the question. So as you know, we've now started the Phase III program for recommend in atopic dermatitis II studies. One of those studies include a head-to-head against [ dupilumab ], and we also started the Phase II/III study, a continuous design for COPD and Phase III studies for severe asthma with expected readouts in 2028 and 2029.

Regarding amylin GLP-1, as you with the [ SOLIS ] study has now completely recruited, that is the robustly designed Phase IIb study called amylin single agent and amylin plus and berobenatide in different doses and different titrations. We expect the readout for that study for efficacy the second half of 2027.

The ongoing Phase I -- Phase IIa study, we'll give an update at the end of this year, recognizing that study was designed for safety and [ PK ] clinical pharmacology, not for efficacy.

Albert Bourla

And then what about the positioning of the trispecifics?

Unknown Executive

Chris, thanks for the questions. I think we all know that this is a very large category. What we have learned with our [ Sibinco ] and overall dermatology franchises, there is a lot of patient profile that requires different type of therapy. And we see that very much with the [indiscernible] this is the map and we see that there are some patients that actually move from one to the other, they drop off. There's a lot of circulation of those of those patients.

We are building capabilities across U.S. and international, and we see that we are making good progress. So for instance, as you saw in this quarter, in international, we reached like $100 million combined between our two assets in dermatology for the quarter. So we start having a nice base and as I said, as we move into the result of the study, we will be able to actually capture some of those lapsed patients and naive patients with a very specific profile that we are defining. So first-in-class, strong efficacy and clearly unmet medical lead in the category.

Albert Bourla

Thank you very much. Next question, please.

Operator

Next question comes from Dave Risinger with Leerink Partners.

David Risinger

Yes. And I wanted to say congratulations to Cecile on your new role as CFO of Pfizer and look forward to working with you. My question is on U.S. net price in the third quarter and going forward. Could you comment on any gross to net benefits to net sales in the third quarter, including from any [ 340B ] scrubbing and discuss U.S. net price prospects looking forward in the near term?

Cecile Guegan

Thanks very much. First, for your good wishes. So as it relates to the pricing in Q3, with the exception of, as we were expecting the impact on adequate, we started in Q3 of the January price decrease. I would say there is not really any very material change into our gross to net dynamics during the third quarter.

So the performance that we are seeing is, for most part, driven by strong market performance and volume rather than dynamics around the growth unit.

As we are looking into the future, obviously, not commenting today on 2027, but we will obviously reflect into our guidance for 2027, the various dynamics that we are seeing being [ IRI ] with two of our products entering in 2027 and any of the dynamics around the [ 340B ] impact and changes, including a credit rebate model implemented starting in January and also, obviously, some of the [ MFN ] impacts that we have following the agreement with we have this environment.

But as a summary, the performance into Q3 is really a reflection of the strong execution rather than dynamics around gross to net that would not continue.

Albert Bourla

Very well. Thank you very much. next question, please.

Operator

Next question comes from Umer Raffat with Evercore ISI.

Umer Raffat

Albert, there's clearly been a lot of progress on SG&A improvements over the last couple of years. and I acknowledge that. It's not step function, but there's been improvement.

But then I recall, Dave, before he moved on had mentioned that majority of the total net cost savings of $7.2 billion will be delivered by the end of '26. So when I look now back at the Pfizer P&L, I'm seeing [ SGN ] R&D was about $24.5 billion back in 2022. It's about the same in 2026 as well. And I acknowledge R&D has gone up a bit, SG&A has come back a bit. But the broader dynamics on OpEx are still broadly in that $24 billion to $25 billion camp. And I guess, how do you think about that heading into the dividend integrity, the cost lever heading into Padcev [ race ]?

Albert Bourla

Cecile, why don't you take this question?

Cecile Guegan

Yes. So as I mentioned earlier, we are on track to delivering the $7.2 billion of savings that we had implemented as part of our first phase of the cost improvement programs.

Those savings were in different places is one in our manufacturing footprint for cost, two in R&D, but reinvested and we are indeed increasing our R&D investment in order to support the pipeline products and programs that we have in addition to obviously the acquisition that we made.

And then on the [ SINA ] side, mostly coming from the commercial and marketing expenses as well as SG&A. So what we are seeing today in our operating expenses. And I would then relate to just the third quarter, which had some onetime dynamics that drove [ SINA ] up. We are still expecting, based on guidance, we'll see a decline in [ SINA ] versus last year. So that's the first piece that I would say.

Going forward, we have announced our second phase of the program with a $2.5 billion of savings both in SG&A and in our case manufacturing. Those will translate into savings. So we are expecting to see those translating and mitigating the margin erosion as part of the LOE transition in 2027 to 2029.

Operator

We'll go next to Akash Tewari with Jefferies.

Akash Tewari

Just a couple. I know in the spring, you had a kind of 45, 50 patient biomarker analysis on your stat sticks. And you were going to make a decision on whether to go from stage 1 to stage 2. Is there an update on that program? And really, how do you think about [ tork ] reduction and biomarker reduction to what we've seen with some of the degraders?

And then on your GLP-1 amylin, I think your Phase I/II, you just updated on clinic trials to 201 patients, I think it was originally planned to be closer to 400, any color on what drove that decision with the amylin GLP-1 combo with Metsera?

Albert Bourla

Chris, both questions goes to you.

Chris Boshoff

Okay. Thank you very much. So the first on STAT6, potentially first-in-class oral STAT6 program. Thanks for the question. This is an area very important for us or the I&I portfolio. As we previously stated, we've adapted the program to incorporate some additional DDI studies. So we should give you a readout for the STAT6 this year.

Regarding the amylin and berobenatide. As I stated earlier, the [ SOLIS-1 ] study is fully recruited, that study [indiscernible] out end of next year. And Phase I/IIa study was adapted for the additional PK studies we are doing. But there's nothing really -- nothing material changes to the trial.

Operator

We'll go next to Vamil Divan with Guggenheim.

Vamil Divan

Again, maybe on the pipeline, One, we noticed that you posted a new Phase I trial for your [ PIK3CA ] inhibitor on [indiscernible] last week, I heard what you said around atirmociclib and your KAT6. Curious if you could maybe just talk about how you see that asset sort of fitting into your broader breast cancer strategy?

And then the other question may be coming from ESMO, we saw the [ Volga ], the AstraZeneca release that could suggest maybe less need for they use a fewer cycles of Padcev in patients with bladder cancer. Curious if you have any reactions to that data center outline impact, do you think the use of pads may play out in the future?

Albert Bourla

Yes. So firstly, on the [ PLPK ], we started a Phase I study on an internally discovered [ PIK3CA ] inhibitor, the reminder that [ gedatolisib ] with salute is also prize discovered medicine. We have an ongoing clinical trial with relay with the [ PIK3CA ], [ alpha-pan, alpha-isoform ] selected inhibitor called, and the advanced also in combination with atirmociclib.

The advantage of atirmociclib is we do not see DDIs, which has been experienced with all the other [ CDCs ] combining with the [ PIK3CA ]. So it's a potentially significant advantage to your point, up to 40% of breast cancer -- positive breast cancer, up to 20%, 25% of two positive breast cancer will harbor a [ PIK3CA ] mutation. So it's an important area for us.

The second question was on the bulker data. Just I'll start briefly. Firstly, this reinforces the use of Padcev for massive invasive bladder cancer. It reinforces the use of Padcev in combination with the PD-1 for muscle-invasive bladder cancer. It also reinforces the confidence we have in the study, we've just started 309, which is blood is sparing Padcev [ pembrolizumab ] in a bladder sparing setting as well as the ongoing planned Phase III trial with Padcev plus tivunatamig, which should also start later this year.

I just want to remind on the [ BARDA ] study, this was a no cisplatin eligible population pathological complete remission was lower than what we've seen with [ pembro ] plus Padcev, which is important, including slightly lower event-free survival. And most importantly, this is a curative in setting, so we're not clear yet which patients can be escalated. So that's important proposition. Who can you actually give less therapy?

Operator

We'll go next to Evan Seigerman with BMO Capital Markets.

Evan Seigerman

As you inherit the capital allocation framework kind of established by our predecessor, how do you think about the marginal dollars that you can kind of invest from here between internal R&D, another bolt-on, you talked about BD capacity, deleveraging and eventually restarting buybacks, where do you currently see the highest perspective return for shareholders?

Cecile Guegan

So our priorities are clear, and they are not changing versus what was in place. I think they are -- we have a solid plan to get us through [ loan ] poster. So our priorities impact for growth maintain or our dividend over time and then keep a strong balance.

So through the LOE period, our operating cash flow, financial assets and access to capital market will give us the ability to continue to invest and maintain a dividend.

As we go post LOE target, our operating cash flow grows with the levers, and we have other options to continue to increase shareholder value. And in that situation, share repurchases become again, one of the levers that we have in order to be able to continue to enhance the shareholder right.

Albert Bourla

Thank you very much, next question, please.

Operator

We'll go next to Steve Scala with TD Cowen.

Steve Scala

Two questions. Given the pushout of MEVPRO-1 were there any changes to MEVPRO-2 and -3 timelines? So that's the first question.

Second question is for Cecile. So you started at Pfizer when Warner-Lambert was being consolidated have been through the acquisitions of [ Pharmacia ], [indiscernible] and Seagen and many BD deals, including that for [ Eliquis ]. I think it could be argued that Pfizer's most successful products that come through deals. And in each of those years, as it is now, Pfizer but its pipeline is very good. So given this history, why doesn't Pfizer make another big deal, its primary focus? Or would you say that the pipeline is significantly better now than at any time in the last 25 years?

Albert Bourla

Good question. Cecile, what do you think?

Cecile Guegan

Thank you. And just was a record, I came with [ wires ] and not -- so I don't have the history on all the deals. But I think is [ wires ] was one of the best acquisitions that we did, and I've seen since a transformation of Pfizer and strengthening definitely of our pipeline over the last 25 years. .

So what I would say is in terms of our priority, right? So we had, as Albert reiterated earlier, we have invested very significantly over the past few years in our key transaction and key acquisitions that are today are already kind of like driving success. We're talking about Padcev, we talked about [ MarTech ], and we see a lot of opportunity that still remains in the pipeline, in Seagen, in Metsera. So where we have a lot to execute both commercially and on the RT side and on the commercial side.

So really, as we look at -- as we look at BD going forward and considering our capital allocation priorities, our focus is really on more bolt-on acquisitions that are going to complement the large and rich portfolio that we have in the four therapeutic areas that we are having. So looking at BD acquisition is obviously strategically aligned building upon our expertise and then obviously, providing the financial returns, appropriate return that we would be expecting.

Albert Bourla

Thank you. Chris, you want to comment a little bit on the timelines of MEVPRO. And given the interest of the product, maybe Aamir, also you say a few things about the potential.

Chris Boshoff

Thank you very much. I'll be brief. Since we last spoke about it, the times have been updated for [ MEVPRO-1 and MEVPRO-2, a reminder, these are been driven studies. So it's based on when we expect events to happen. So MEVPRO-1 is will now read out Q1 2027 and MEVPRO-2, Q3 2027. And as you've seen with ESMO, we've got additional data including compelling 8.9 months PFS. Just to correct, MEVPRO-2 is actually Q4 2027, the updated in clinicaltrials.com.

Albert Bourla

And I think remember one you expect around February. This is the projections right now based on the way that events are accruing. And I mean why are we so excited about MEVPRO in terms of the commercial opportunity?

Aamir Malik

I think three things are probably why we're excited. One, I would just remind everybody that our current commercial footprint, we is anchored in the U.S. alongside [ Astellas ], but MEVPRO for us is a fully global opportunity in the U.S. and outside the U.S. So that is very significant and exciting.

Second, as Chris mentioned, MEVPRO-2 and -3, across MEVPRO-1, -2 and -3, I think we have the potential to position MEVPRO as a multi-indication franchise. So that gives us lots of surface area to compete in.

And finally, as we just think about the total patient populations, we're talking about over 50,000 in the U.S., close to 50,000 in the EU in U.K. another 14,000 in Japan and 30% of that population could be addressed even with Metro I. So there's a significant patient population, a global opportunity and clearly an area that we have deep commercial expertise, those are the things that get us excited about it.

Albert Bourla

Thank you, Aamir. And sometimes people forget that [ XTANDI ], which is one of our very big and strong products, we basically have half of the [ XTANDI ] in the U.S. and that's it. here, we are going to have in the whole U.S. and the whole global international market.

Operator

We'll go next to Geoff Meacham with Citibank.

Geoffrey Meacham

Just have two, the first bigger picture, Albert from a policy perspective, I know obviously, hard to have certainty on especially given today. But as you look to 2027, what are your thoughts on the potential risks of changes to MFN or perhaps greater scrutiny on the prior OUS agreements?

And the second question for Chris on berobenatide. You guys have studied -- have sort of a lot of studies across the metabolic indications and beyond obesity diabetes want to get your thoughts on expanding berobenatide as a combo strategy into inflammation or neuroscience or even oncology, for example, obviously, the science is really evolving here on GLP-1 synergies.

Albert Bourla

And really thank you, Geoff. On the policy perspective, clearly, policy affects a lot our industry, and we are monitoring it very carefully. We are waiting to see what will happen today in the elections.

But I think that, in any case, it looks like we will have a split government. So I don't think that many things can move legislation wise, I don't expect any changes in MFN. I think the agreements are signed and are going until the end of the term of this government. And I expect that there will be a renewed interest in the Congress to investigate several things. But it's -- I don't expect policy same, frankly.

It's a very big contract vis-a-vis what I was telling you a year ago. In 2025, I was really scared about the implications that either tariffs or MFN could have. I think through the successful navigation of those issues, we brought stability that it is now projected to last and has brought, I think, this confidence back to the investors to invest in the industry in our sector.

Now with that, I will turn it to Chris to comment on the GLP-1 and other things.

Chris Boshoff

Yes, I'll just quickly start. So our goal is initially to establish berobenatide as a potentially best-in-class monthly subcutaneous GLP-1 for obesity, and this is globally. We are starting, as you've seen additional studies now for a knee osteoarthritis as well as for obstructive sleep apnea with or without PAP. And we also will announce additional Phase III studies in the coming months.

In 2027, you're absolutely correct. We hope to announce some additional studies looking at the backbone of our portfolio, including [ Ignite ], retention in oncology, you're right, this an interesting area. And you'll also see the acceleration of Phase I programs and current programs that's preclinically that's highly differentiated in this space. Thank you.

Albert Bourla

Very good. Next question, please.

Operator

We'll go next to Alex Hammond with Wolf Research.

Alexandria Hammond

Two for me. So as you look at [ Siwen ] Biosciences GLP-1 launch in China, how are both the obesity and the diabetes markets playing out so far? And how is that shaping your thoughts on the commercial opportunity for berobenatide OUS?

And then on the line of the vaccine, can you update us on the regulatory path forward following the recent submission in Europe? How are your discussions with FDA progressing? And are there any meaningful differences between the FDA and EMA?

Albert Bourla

I'm not sure I understood the second question.

Unknown Executive

Lyme disease, Lyme vaccines.

Albert Bourla

Yes. So Alexandre, thank you, Alex, very much. Alexander, maybe you speak a little bit about our GLP-1 in China? And what do you expect from it? .

Alexandre de Germay

That's right. So thanks for the question. As you said, Alex, we've introduced oblate in China at the end of April of this year. and we are satisfied with the way we are progressing.

We're learning a lot through the launch of [ Egnoglutide ] in China. And the thing that we are clearly understanding is -- they are very different segments within this overall chronic weight management categories with patients that are all qualifying for the definition of product weight management, but some of them had more an esthetic driven purpose with a very different profile of product that they will be looking and their way of acquiring this product is actually very different than the way on the other opposite direction, which are very heavy people looking for much more efficacy, tolerability, it becomes a second [ fair ] point.

And so clearly, what we are learning is it's confirming our strategy that if we want to be successful in [ Polypoint ] management, we need to have a portfolio. And you need to have a portfolio also because you will need to activate all those different channels. And the cost of activations of those channels will be amortized across the portfolio. So those are very, very key confirmation of our strategy.

Now specifically to [ ecnoblotide ]. As you know, we also understood from the getgo that to be successful in the chronic weight management in China, in particular, you need two things. Of course, we did a good profile, and we have a very competitive profile, but you also need to have type 2 diabetes because it's opened up the hospital channel, but it also opened up for local regulations, the e-commerce channels. I'm very happy to say that since the end of October, we actually got the approval of our type 2 diabetes, which open up that channel.

Second thing, our competitors have also access to reimbursement, and this is very important to compete effectively. And so I'm also very happy to report that since June, we passed the -- an [ RDL ] committees and now we're expecting the final review by the end of this month. So that hopefully, we can introduce our product into the overall hospital reimbursement system. The combination of those two things will really be the start of our penetration of the market.

Albert Bourla

And then from my perspective, it's fascinating to see how the commercial model around the obesity is so different than anything else. And for us, reminds us really the times of the Viagra launch because there are a lot of similarities. People are willing to pay out of pocket for products that they value. Irrelevant if they are reimbursed or not, that creates dramatically different size in the international markets.

The second was that because of the consumer nature of these [ loans ], the e-commerce and the Internet hasn't happened with Viagra that was the first product that was available basically on Internet plays a key role. And of course, we are pretty much into that space already rather than if we have already launched an obesity product because our vaccines and our [indiscernible] COVID and our migraine product, they are really having significant channel through the Pfizer for all, which is our consumer, let's say, web port to the website.

So I think it's -- we are learning a lot right now in China after we have learned a lot in our Viagra thing. And to add another dimension, AI is changing the way that promotions are happening right now and not only at the physician level, actually, even more importantly, at the patient's level. So we are learning a lot and we are very happy that we are entering this market because I think we -- it's -- it is cut for our capabilities. With that, I will ask Chris to comment on the Lyme business.

Chris Boshoff

Thank you for the question. We all know Lyme disease incidents. It's now the burden of the disease is increasing globally. The EMA has validated the MAA for Pfizer and [ Valneva ] Lyme disease vaccine candidate with the validation, the CHMP will now begin its assessment of the MAA and the CHMP is expected to issue an opinion on marketing authorization in 2027. We've also now filed in Canada, and we continue our discussions with the FDA and should provide an update regarding this in Q4 of this year.

Albert Bourla

Alexander, any comments here?

Alexandre de Germay

Yes. No, I think it's a very exciting opportunity. Just to remind you that we already have an SME franchise in Europe, and we know how to activate tickborne populations in those endemic area because we have a sales force, we have a commercial play with pharmacies. And so we are very excited with the opportunity. The level of awareness of the population significantly higher than what we have in SME. So as we have built these muscles commercially, once we have the approval, we are very much looking forward for the opportunity to commercialize this vaccine.

Albert Bourla

And the awareness of the disease, of course, in the U.S., it's skyrocketing right now because we do have an increase of severity and incidents. So we are looking forward to concluding the discussions with FDA and submitting our filings.

Let's go to the next question, please.

Operator

Our next question comes from [ Michael Yee ] with UBS.

Unknown Analyst

Maybe two quick pipeline questions for Chris. On MEVPRO, you guys continue to be pretty bullish. I know there was a formulation change to lower the [ Cmax ] and improve the tolerability. Maybe you could comment on how you feel about dropouts and the change in formulation to drive your effect.

And then on tilrekimig, you're trispecific, again, something you're pretty bullish on. Can you just comment on neutralizing antibodies or ADAs, things that can be tricky for bispecifics and trispecifics and how you feel about that?

Unknown Executive

On the first question on [ protostat ], as you pointed out, we did for the Phase III study adapted to have a more tolerable dose with food, where we decreased the max but see a similar AUC to what we've seen in Phase I. So we're very confident in the PK data and the dosing was selected for the Phase III study.

Regarding tilrekimig we have not seen functional neutralizing antibodies or functional ADIs thus far, you absolutely correct any bispecific or trispecific that's a long-term risk. But so far, we haven't seen anything impacting efficacy. And in fact, longer-term follow-up on the studies we previously demonstrated or show us that we do not have an impact on efficacy. So, so far, so good.

Albert Bourla

Very good. Let's keep it that way if you can please. Next question, please.

Operator

Our final question today comes from Asad Haider with Goldman Sachs. .

Asad Haider

Congrats on the quarter, Cecile and also many congrats and best of luck to you. A couple for you. First, just on 2027, I appreciate the context provided earlier on price dynamics, with respect to [ IRA and 340B ], et cetera. But just any additional high-level qualitative framing on other pushes and pulls next year to be aware of ahead of formal guidance? And how should we be thinking about your guidance philosophy relative to Dave broadly speaking? .

And then looking out longer term, you are reiterating line of sight to high single-digit revenue CAGR towards the end of the decade off of a 2028 base. as well as siding operating leverage and margin expansion given the cost realignment initiatives. But consensus numbers are not really modeling that. There does seem to be a disconnect on both revenue and the earnings line. versus your own expectations. So as you examine Street forecasts, what are the key assumptions that you think are getting most mismodeled in the P&L relative to your own internal expectations as you look out towards that period?

Albert Bourla

Cecile, please make the comments on both.

Cecile Guegan

So thanks, Asad, for your question and also for your good wishes. So we'll provide 2027 guidance around middle of December like we did last year. So I will only point out to high-level key drivers that we are seeing in 2027.

It is one, obviously, the LOE impact, not only in the U.S. with brand [ XTANDI ] and some other products, but also in international, where we are seeing [ Eliquis ] being at the end of 2026. The other thing that I would say is, obviously, offsetting that is ramp up and the launch of our -- of the ramp-up of our launch and acquired portfolio, which, again, as you have seen, is having a very strong performance and opportunity for growth. And then obviously, pricing including MFN and, which we will reflect in our guidance.

And then on our cost initiative program that will allow us to continue to invest towards a growth opportunity that -- or the growth driver that we have on the [ SINA ] marketing and commercial space and then increase the productivity and deliver savings, both on the commercial spend and as well on the general and administrative spend. So that sounded like the key trends for 2027. But again, more to come as we release guidance later in time.

As it relates to our high single digit growth aspiration versus the Street is if you look at where that difference is coming from, it's not really coming from one place on one product. and so is our growth trajectory either. So what we are seeing as a building block for our growth trajectory, obviously, one is the continued growth of our new and acquired product not only because the market is still growing. Our penetration is still increasing. But also on top of it, we are bringing new indications on to those products in order to be able to continue to address more patients and grow our presence on the market.

The second thing is on the pipeline. So why there are some obvious products that are making a key difference in our view versus a review obesity being one, some of the oncology product that you want, what I will say is our growth trajectory doesn't rely on one single product or one single therapeutic area. We have a broad portfolio of products, several Phase III ongoing as well as our upcoming catalysts over the 18 to 24 months we should give confidence to the outside world also to see the opportunity that we are having in bringing breakthrough to patients in significant area of unmet need.

Albert Bourla

Thank you, Cecile. I would add that me as a CEO, when I see the difference between our internal projections and the street projections that, of course, creates to me the urgency to check our assumptions to make sure that in light of different opinions from the analysts, we are correct or not. So we have done that and repeated. And we came to the conclusion that we tell you that we expect to have a high single digit from 28% to 33%. And you know very well where the discrepancies between the products.

And as Cecile said, there are not only on the pipeline, which many analysts, they do not cover. So you have the phenomenal that from 12, 13 analysts that are forming the overall performance of 2031. For some products, only five analysts. They have this one and the others they don't.

So that's -- this is something that is expected in pipeline. But we see also very big discrepancies in already launched new products that are very big difference. I will mention to just examples that I think people need to reevaluate their assessment. One, it is regarding [ Norte ], but we are already close to $2 billion this way, if you analyze it and -- the Street has us to almost 2.5 by year 2030. So I think there is a discrepancy there.

I will also mention another example of the Elrexfio where for a competing product, the Street is forecasting $5 billion and for us, $600 million. We are to present the profile that is very similar in efficacy and better in tolerability and inside effects. Now it remains to be proven. But I don't think the $600 million vis-a-vis $5 billion, it is justifiable even with the current information.

So I think that as more information is coming for our pipeline and readouts, I think as more information is coming for the performance actually of the new products and that includes new launches and acquired products. I think the Street probably will start adjusting their numbers, and there will be a conversion, costly.

But with that, I think that we come to the end of our call, I want to say that I'm very proud of our performance through the third quarter and the execution. And my thanks goes to my Pfizer colleagues. As I visit with our people, and I do that in our labs and in manufacturing sites and in markets across the world, I see a team with tremendous talent, dedications, thriving for breakthroughs that change patients' lives. We look forward to sharing additional updates about our progress, and thank you for joining our call today, and thank you for your interest in Pfizer.

Operator

Thank you. This brings us to the end of today's meeting. We appreciate your time and participation. You may now disconnect.

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