必治妥施貴寶 (BMY) 2026 年第三季法說會：營收成長與調升每股盈餘指引

必治妥施貴寶 (NYSE: BMY) 在成長產品組合與 Eliquis 的支撐下，公布 2026 年第三季營收成長。管理層上調全年營收與 Non-GAAP 每股盈餘 (EPS) 展望，同時強調即將面臨的專利到期壓力及多項晚期研發管道數據公布。

重點摘要

• 扣除外匯影響的基礎變動下，第三季營收年增 7% 至約 131 億美元。
• 成長產品組合營收成長 12% 至 77 億美元。依據第三季銷售額計算，已有 8 款成長產品組合藥品的年化營收突破 10 億美元。
• 受到淨售價、需求與市佔率提升帶動，Eliquis 營收成長 26% 至約 47 億美元。管理層預計其在歐洲的專利獨佔權到期將影響第四季銷售額。
• 扣除收購進行中研發費用與授權收入帶來每股 0.58 美元影響後，Non-GAAP 稀釋每股盈餘為 1.35 美元。
• 必治妥施貴寶將 2026 年 Non-GAAP 每股盈餘展望上調至 6.35 至 6.55 美元，並調高全年營收預估。
• 研發管道進展包括 Zenbexus 獲批、特發性肺纖維化 60 毫克劑量三期臨床實驗結果正面，以及 RAISE 101 的中期無惡化存活期數據表現優異。

核心財務數據

業務與營運表現

Eliquis 仍為最大的營收貢獻來源，帶來約 47 億美元營收，成長 26%。管理層將此成長歸因於淨售價上揚、強勁需求與市佔率持續擴大。

在腫瘤學領域，由於美國與歐洲患者持續轉用 Qvantig，Opdivo 營收下降 6% 至約 24 億美元。Qvantig 帶來 3.34 億美元營收，季增 28%，年化營收超過 13 億美元。管理層指出，約有 17% 的靜脈注射使用者已轉用皮下注射產品，並維持轉換率達 30%-40% 的預期，表現朝向該區間高標發展。

受益於一線 MDS 相關貧血療法的採用，Reblozyl 營收成長 22% 至 7.5 億美元。在美國與國際市場強勁需求推升下，Breyanzi 成長 48% 至 5.26 億美元。Camzyos 成長 42% 至 4.2 億美元，反映出新患者採用增加與基層滲透率加深。

Zenbexus 本季獲得 FDA 加速批准用於多發性骨髓瘤。管理層表示初期醫師反饋正面，且基層診所與醫院機構已開始採用。公司計劃於 12 月的美國血液學會 (ASH) 年會上公布三期無惡化存活期數據。Mezigdomide 的 PDUFA 審查目標日期為 2027 年 5 月 13 日。

在特發性肺纖維化 (IPF) 計劃方面，60 毫克劑量組的三期研究達到主要終點，並展現良好的安全性與耐受性。120 毫克劑量組雖有所改善，但未達統計顯著性。管理層預計漸進性肺纖維化三期研究結果將於 2027 年第一季出爐。

RAISE 101 在接受鎦標靶治療後疾病惡化的患者中，取得了正面的中期無惡化存活期數據。管理層正在與 FDA 討論潛在的下一步監管事宜，並將初期商業機會形容為相對適中，同時強調廣泛的放射性藥物平台潛力。

管理層展望

必治妥施貴寶根據今年迄今的表現以及對今年剩餘時間的預期，上調了 2026 全年營收展望。

公司目前預計 2026 年 Non-GAAP 每股盈餘為 6.35 至 6.55 美元，其中包含第三季收購進行中研發費用與授權收入帶來的每股 0.58 美元影響。管理層指出，若扣除該影響，每股盈餘展望的中位數本會增加約 0.15 美元。

管理層維持對毛利率、營業費用與稅率的預測，同時略為下調其他收支項目的預期費用。

預計傳統產品組合全年將衰退 3%-5%。Eliquis 營收仍預計成長 20%-25%。公司亦表示，仍按計畫推進於 2027 年底前透過戰略生產力提升計劃實現 20 億美元效益。

風險與觀察重點

• 自第四季開始，Eliquis 的銷售額將面臨歐洲即將到來的專利獨佔權到期壓力。
• 學名藥參戰繼續對傳統產品組合中 Eliquis 以外的產品造成壓力。
• IPF 試驗的 120 毫克劑量組未達統計顯著性，管理層正在持續分析該數據。
• 多項重要的研發管道進展仍取決於事件驅動，包括用於二級中風預防與心房顫動的 Milvexian、狼瘡研究以及更廣泛的 ADEPT 計劃。
• 自體免疫 CAR-T 計劃仍處於暫停狀態，公司正與監管機構合作重啟臨床開發。管理層通報在 190 位一期患者中發生 1 起 5 級敗血性肺炎事件，並表示在確認試劑選擇與活化問題後已進行相應調整。
• 庫存變動影響了 Camzyos 及神經科學產品組合的單季營收，但管理層預期後續將趨於正常化。

分析師問答焦點

管理層對 60 毫克 IPF 的結果表示信心，但也承認無法預測漸進性肺纖維化研究中任一劑量的結果。公司表示目前正在對 60 毫克與 120 毫克兩種劑量進行測試。

針對 Milvexian，管理層表示二級中風預防研究是基於顯示可降低 30% 中風風險的二期數據所設計。預計結果將於 2026 年底前公布，隨後於 2027 年第一季公布心房顫動的數據。

管理層估計目前的 IPF 及漸進性肺纖維化市場規模約為 40 億美元，並表示隨著新療法擴大轉用與附加治療，市場規模可能會翻倍。這仍屬於公司的內部估計，而非正式發布的營收展望。

必治妥施貴寶重申，業務拓展仍是資本配置的首要任務。管理層表示正在評估合作夥伴關係、授權交易及收購，但必須符合科學、戰略與財務方面的一致性。

公司亦正將人工智慧引進研發與其他部門。管理層提出的目標包括將藥物測試時間縮短 20%-30%，並將從標的選擇到前導分子識別的時間縮短一半。

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管理層陳述

Operator

Welcome to the Bristol-Myers Squibb Third Quarter 2026 Earnings Conference Call. [Operator Instructions]. Please note this event is being recorded.

I would now like to turn the conference over to Chuck Triano, Senior Vice President and Head of Investor Relations. Please go ahead.

Charles Triano

Thank you, and good morning, everyone. We appreciate you joining our third quarter 2026 earnings call. With me this morning with prepared remarks are Chris Boerner, our Board Chair and Chief Executive Officer; and David Elkins, our Chief Financial Officer. Also participating in today's call is Adam Lenkowsky, our Chief Commercialization Officer; and Cristian Massacesi, our Chief Medical Officer and Head of Global Drug Development.

Earlier this morning, we posted our quarterly slide presentation to bms.com that you can use to follow along with Chris and David's remarks. Before we get started, I'll remind everybody that during this call, we will make statements about the company's future plans and prospects that constitute forward-looking statements. Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in the company's SEC filings.

These forward-looking statements represent our estimates as of today and should not be relied upon as representing our estimates as of any future date, and we specifically disclaim any obligation to update forward-looking statements even if our estimates change. We'll also focus our comments on our non-GAAP financial measures, which are adjusted to exclude certain specified items.

Reconciliations of certain non-GAAP financial measures to the most comparable GAAP measures are available at bms.com. Finally, unless otherwise stated, all comparisons are made from the same period in 2025 and sales growth rates will be discussed on an underlying basis, which excludes the impact of foreign exchange. All references to our P&L are on a non-GAAP basis.

And with that, I'll hand it over to Chris.

Christopher Boerner

Thanks, Chuck. Good morning, everyone, and thank you for joining our Q3 2026 earnings call. We reported another quarter of double-digit growth in our growth portfolio and progressed our plans to derisk the pipeline to position the company for long-term success.

We have seen several positive registrational readouts and regulatory approvals over the past few months, and we expect more to come, bringing the next wave of launches into sharper focus. We are executing well commercially -- our differentiated pipeline is advancing nicely and we continue to operate with discipline, which gives us strategic flexibility to invest for sustainable growth.

Based on the strength of our results, we are raising our full year guidance David will provide additional details on this shortly. Let me start with our Q3 performance on Slide 4. Our growth portfolio continues to deliver solid results with sales increasing 12% and driven by a broad set of differentiated products.

We generated strong performance in key brands, including Reblozyl, Brioni, Optulag, Huvantic and Camzyos. We also continue to expand the reach of our medicines -- in September, CEMZYOS received approval for an expanded indication and became the only FDA-approved therapy for pediatric patients with obstructive HCM. And we also achieved an important milestone in the quarter with the FDA's accelerated approval of Zenbexus, the first approved CELMoD and the newest addition to our portfolio.

Zenbexus is approved for the treatment of multiple myeloma, where the combination of a highly efficacious and convenient oral option is an important treatment advancement for patients in both community and academic settings. We are encouraged by positive early launch feedback and by the compelling Phase III data we announced earlier this month, whereas Impex's demonstrated a meaningful improvement in progression-free survival. We will present these data at ASH in December.

These results further strengthen our conviction in CELMoDs and our broader targeted protein degradation platform where BMS is a clear leader. Behind Zenbexus, our second CELMoD Mezigdomide has a PDUFA date of May 13, 2027. Mezigdomide offers the potential to introduce another highly efficacious and convenient oral option for a different segment of multiple myeloma patients.

We also continue to advance gocatomide in lymphoma and will present the first [indiscernible] for 4 registrational studies. These include Zenbexus PFS, as I mentioned earlier, at Milprint and idiopathic pulmonary fibrosis, interim results for RAISE101 in GetNet and Arlo cell in relapsed and refractory multiple myeloma. And -- let me comment on the last 3. At Millport met its primary endpoint at the 60-milligram dose with a favorable safety and tolerability profile that supports its potential as a first-in-class IPF treatment. IPF is a progressive and often fatal disease where there remains a need for effective, well-tolerated treatment options like admiperant.

We will discuss the IPF results with regulators and expect Phase III results in progressive pulmonary fibrosis in the first quarter of next year. PPF is a larger opportunity and another area where Admiprin has significant commercial potential. With respect to RAISE 101, our Tinuum based radiopharmaceutical therapy, we're encouraged by the interim readout in GepNets. These results demonstrated a clinically meaningful improvement in PFS in patients whose disease has progressed following existing lutetium-based therapy.

These were the first Phase III results for an alpha-emitting targeted RPT, representing an important milestone for Raise 101 and further strengthening our conviction in radiopharmaceuticals as a platform. We are engaging with the FDA on next steps towards regulatory submission.

Finally, local, our low cell GPRC5D directed CAR T delivered positive results in the registrational Phase II Quintessential study this September. A milestone that underscores its potential to set a new standard of care in the post BCMA multiple myeloma market. This study represents the only prospective trial exclusively conducted in the post-BCMA quadruple class exposed setting, a growing patient population with poor outcomes and no therapies approved specifically for this segment.

As these programs advance, we are building the manufacturing foundation for the next generation of our medicines with 2 U.S. investments recently announced. In Houston, we shared plans for a new state-of-the-art manufacturing campus at Generation Park and approximately $2.3 billion investment that will create nearly 500 skilled jobs.

This facility will give us manufacturing flexibility across small molecules, biologics and antibody drug conjugates. It is also designed to evolve and scale to meet patient needs for decades to come. In Indiana, Raise Bio is investing more than $170 million to establish a new radiopharmaceutical manufacturing facility complementing its existing footprint in the state and creating up to 100 new jobs by the end of 2029.

Together, these investments support the next wave of medicines coming through our pipeline and advance our U.S. manufacturing commitments.

Turning to Slide 5. As we look ahead, we have several meaningful readouts over the remainder of 2026 and into 2027. Before year-end, we expect Phase III data for Milvexian in secondary stroke prevention in SOTIC2 and lupus. With Coben fee, we will share open-label Alzheimer's disease psychosis data from the ADEPT 1 and from the long-term extension of DEP III studies at CTAD next month.

In 2027, we continue to expect results from Nivexiane and atrial fibrillation in the first quarter. We also anticipate additional data from the broader adept program, bipolar 1 data from the KobinfiBalsim studies and the first registrational data for gocatimide in high-risk first-line LVCL. So while we have made good progress in our pipeline, there's more to come.

As we close out the year and move into 2027, and we are focused on a few key priorities as noted on Slide 6. First, sustaining the momentum across our growth portfolio. We now have 8 growth portfolio medicines, each annualizing over $1 billion based on Q3 sales giving us a broad base of growth drivers; second, translating pipeline progress into filings, approvals and successful launches. Zenbexus is an early example of that progression. And as additional studies read out, our focus will be on launch preparedness and moving with urgency to bring these medicines to patients. Third, continuing to rewire how we operate.

We're focused on becoming faster and more efficient in R&D. And over the past year, we have made changes across the organization to strengthen how we design and conduct clinical trials. At the same time, we continue to drive productivity and efficiency, including through our organizational structure, capital allocation decision-making process and the use of technology. That discipline gives us flexibility to invest behind the growth portfolio and pipeline, pursue business development where it makes sense and return cash to shareholders.

Taken together, we are entering the final quarter of the year with real momentum. Our growth portfolio is performing well. We're advancing our pipeline with meaningful wins and remain highly disciplined in ensuring our cost structure is aligned with our revenue base. The team is energized and focused on delivering value for patients and our shareholders.

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

David Elkins

Thank you, Chris, and good morning, everyone. Our third quarter results reflect continued strong execution across our growth portfolio and continued strength from Eliquis. We remain focused on financial discipline, balancing investments in our growth drivers with continued productivity improvements. Based on our performance year-to-date and our outlook for the remainder of the year, we are further raising our full year guidance.

Let me begin with a review of our third quarter results. Starting with Slide 8. Total revenue in the third quarter increased 7% year-over-year to approximately $13.1 billion. Growth portfolio revenue rose 12% to $7.7 billion, driven by double-digit growth across several products. Our legacy portfolio revenue increased 1%, with growth in Eliquis more than offsetting the declines from generic entry across the remainder of the legacy portfolio.

Turning to product performance on Slide 9, starting with oncology. For Opdivo, revenue decreased 6% year-over-year to approximately $2.4 billion, primarily reflecting continued conversion to Qvantig in the U.S. and in Europe. Qvantig continued its strong launch trajectory with revenue of $334 million, representing sequential growth of 28% and is now annualizing at over $1.3 billion. Opdualag delivered another quarter of strong double-digit growth, driven by continued global demand and its leading position as a standard of care in first-line melanoma in the U.S.

Turning to Slide 10. Reblozyl grew 22% and to $750 million, reflecting continued uptake in first-line MDS-associated anemia. Breyanzi posted 48% growth, resulting in revenue of $526 million driven by its best-in-class profile and strong demand in both the U.S. and in international markets.

Moving to cardiovascular and Immunology on Slide 11. Eliquis revenue was approximately $4.7 billion, up 26%, driven by net price along with strong demand and continued market share gains. Eliquis sales in Q4 will be impacted by the upcoming LOE in Europe, which will be partially offset by the continued growth in the U.S.

Camzyos revenue increased 42% to $420 million, reflecting continued strong demand growth, including new patient starts and deeper penetration into the community setting. On a sequential basis, revenue was impacted by the typical inventory drawdown during the third quarter, which we expect will normalize in the fourth quarter.

Now moving to immunology. Global revenue for SutiKtu grew 25% and we are supporting the recent indication for psoriatic arthritis in adults and look forward to the upcoming Phase III readouts in lupus expected by year-end. I will wrap up our product performance review on Slide 12 with neuroscience.

The BAM fee revenue grew 33% to $57 million in the quarter. On a sequential basis, inventory destocking offset increased demand. We anticipate that revenue will more closely track prescription volume going forward.

Let's now move to the P&L on Slide 13. Gross margin in the third quarter was 68.4%, reflecting product mix and to a lesser extent, a onetime expense for a contract termination. Operating expenses for the third quarter were $4.1 billion, continue to benefit from our strategic productivity initiative, which is enabling us to reduce expenses in identified areas while maintaining flexibility to invest in multiple growth-oriented opportunities.

Our effective tax rate in the quarter was 14.1% and reflecting jurisdictional earnings mix and the impact of acquired in-process R&D charge. And we had a $0.58 per share impact from acquired in process R&D and licensing income in the quarter. Considering all these factors, diluted earnings per share was $1.35 for the quarter.

Turning to the balance sheet and capital allocation highlights on Slide 14. We remain in a solid financial position with approximately $13 billion in cash equivalents and marketable securities as of September 30, and we generated approximately $4.2 billion in operating cash flow during the quarter.

In terms of capital allocation, we maintain a strategic and balanced approach to deploying our strong cash flows. Business development remains a priority, and we are regularly evaluating opportunities in the therapeutic areas we know best. While continuing to return cash to our shareholders through our commitment to the dividend.

Now moving to guidance on Slide 15. We are increasing our full year revenue guidance based upon our year-to-date results and our current projections for the balance of the year. When excluding the third quarter acquired and process R&D charges and licensing income of $0.58 per share, the midpoint of our 2026 non-GAAP EPS guidance would have increased by approximately $0.15 per share.

After including the $0.58 per share previously referenced, our expected non-GAAP EPS guidance range for 2026 is now $6.35 to $6.55. We are maintaining our projections for gross margin, operating expenses and tax rate while slightly lowering the expense level on our other income and expense line.

Incorporated into these revisions is a total legacy portfolio revenue decrease, now expected to be between 3% and 5%, while we continue to expect Eliquis full year revenue growth of 20% to 25%. In closing, our strong performance year-to-date reinforces our confidence in the business. We remain focused on executing across our growth portfolio and pipeline, while maintaining financial discipline to deliver long-term value for our patients and shareholders.

And with that, I will now turn the call back over to Chuck for Q&A.

Charles Triano

If you could please, [indiscernible] for questions.

Operator

[Operator Instructions]. The first question today comes from Michael Yee with UBS.

分析師問答

Michael Yee

Congrats on the good quarter. Recently, you had results for the Admoparent drug, as you just mentioned. And there were some mixed results in the IPF study. Could you just comment a little bit about your confidence at the 120 mg high dose, which had some more mixed results and whether you still expect that dose to be working and that you still have high confidence in 60 and 120 in the PPF study to complete the packaging.

Christopher Boerner

Thanks for the question, Mike. Cristian.

Cristian Massacesi

Mike, thank you for the questions. First of all, let me tell you, I'm pleased with the positive top line results for the Phase III ALOFIPF study. We believe -- I believe that this drug has the potential to be the first-in-class LPA1 antagonist in a setting like pulmonary fibrosis, that's very difficult to treat and honestly, a very challenging drug development area.

As we announced, the trial met the primary end point at 60-milligram will be statistically significant improvement in -- and in addition, we have seen an excellent safety and tolerability profile. This is both with 60-milligram BID and 100-milligram BID for instance, the number of discontinuation for adverse events were lower or the same level of placebo. 120 going to your question, we have seen an improvement, a decline, but not statistically significant.

Our preclinical work demonstrated an adequate target coverage with both doses 60 and 120, but you may recall that we did not formally test the 120-milligram in Phase II setting clinically was modeling. And we had Raninin interface Phase III study. So we continue to analyze that we continue to dig into the data, we will present the data in medical meeting next year. Anyway, we are pleased with this outcome.

We will discuss these results with the authorities and we are looking forward to the outcome of PPF studies happening next year. We cannot predict what will be the outcome according to the doses, but we are testing both of them, and we will see the outcome.

Operator

The next question comes from Alex Hammond with Wolfe Research.

Alexandria Hammond

Since Burton was approved in August and [ Mediapolis ] expected kind of midyear next year. I guess what are you seeing on the ground in the early weeks of launch -- and what feedback are you hearing from the community and academic myeloma physicians on uptake, tolerability and where they're using it.

Christopher Boerner

Thanks for the question, Alex. Adam.

Adam Lenkowsky

So Alex, we are excited to have launched Zembexus. It's the first approved CELMoD in the market. Now it's still early in the launch, but our teams are executing well. We're pleased with the adoption that we're seeing over the first few weeks on the market and physician feedback has been positive, largely based on the strength of the MRD results as well as the simplicity of use.

We're seeing use come from both the community and the hospital setting. We do expect the majority of use to come from the community where 70% to 80% of patients are treated. So we'll see that longer term. Our teams are focused on establishing a broad base of prescribers and reinforcing the efficacy, the safety and, quite frankly, the simplicity of using Symbexis to replace REVLIMID and POMALYST-based regimens.

We also are excited about the PFS data, which will further augment the efficacy profile, and we look forward to presenting these data at ASH. So we're seeing good commercial potential for Zembexus. And for mezintimide, we're excited to launch it as well and aim for both products to be foundational therapies in the community by replacing IMiDs over time.

Operator

The next question comes from Seamus Fernandez with Guggenheim.

Zachary Dunn

This is Zach Dan on for Seamus Fernandez. Just to start, as you mentioned, there's been a series of positive Phase III programs that have read out successfully. And I'm not sure these are getting fully appreciated. So what do you think the market is missing from these readouts and then focusing on the upcoming readout for Milvexi in SSP, based on the baseline characteristics and assuming the acetone time from index event data are reliable.

How confident are you that SSP can still be successful? I know we what we have talked to have looked at those 4 slots from Oceanic stroke. If any color you can provide there would be helpful.

Christopher Boerner

Thanks for the question, Ben. Maybe on the Mibexion question, Cristian, you could start and then I'll close out with just your comments on the market.

Cristian Massacesi

And you same started with the readout. Let me go there first. We are pleased -- I'm pleased to see that 2026 we are getting a very good pace, a very good flow. Last year, when we started and we discussed we explained how much scrutiny we put in every single trial to try to mitigate risks that intrinsically a trial may have, and I think it is starting to pay off.

And what I'm pleased that we have positive outcomes across therapeutic areas. In hematology, in immunology, in we will have a cent therapy. So this is -- this looks good. And if we close this year because there are 3 remaining this SSP and the 2 SOC2 studies in lupus, with positive outcome, I think we can be very pleased on the rate of success that we will score in 2026.

Your specific question as to speak. I think I would put in the big picture first. This study was designed based on a very solid Phase II trial that we ran showing 30% risk reduction in strokes and with a very careful selection of the dose and the benefit risk profile, efficacy safety.

I imagine you refer to the randomization window that may be different, we compare some competitive studies. We based all the criteria when the patient randomized based on our own Phase II based on a prior Phase III studies. And what I can tell you that the data are pointing that the randomization window that we selected can provide -- could provide the best efficacy. So we're looking forward to see SSP data this year. And of course, we are also very eager to see the AFIB readout Q1 next year.

Christopher Boerner

Ben, the only thing I would just add on top of what Cristian just said is in our discussions with investors, we have been very focused on emphasizing that the long-term growth that we -- the long-term focus that we have is building a strong company that can deliver sustained growth, particularly as we get into the next decade.

To do that, we think we've got to continue to do -- frankly, what we've demonstrated this year, which is drive the business that exists today. You see that in our quarterly postings. Deliver on our late-stage pipeline, Cristian and team have done a really nice job of scrutinizing those studies -- we're obviously happy with the results that we've seen with Arlo sells ambexosat Milprondand Raise 101.

We're looking forward to the additional readouts we have through the rest of this year and into next year. And as we discussed in our prepared remarks, being very disciplined in how we operate from a financial standpoint and executing consistently. We're obviously happy with the performance we've seen thus far. But the team is heads down and making sure we continue to deliver across each of those areas going forward.

Operator

The next question comes from Akash Tewari with Jefferies.

Akash Tewari

Can you frame the admilliprint opportunity relative to some of the historical products in the space? And also maybe investor expectations around movie or be we're seeing Jackson have 1 of the best launches in IPF despite a modest FVC and PPF could be a bigger opportunity than IPF. So could this actually be one of your biggest products now that you have the IPF data. And did Millian print show a benefit on time to event or mortality in your IPF trial?

Christopher Boerner

Adam, do you want to take that? And then Cristian, you can try that.

Adam Lenkowsky

Yes, Akash, thanks for the question. So we think there is a significant need that remains for new and improved disease modifying therapies in both IPF and PPF that are both effective and well tolerated. And that includes impacting how patients feel. It includes how patients function and ultimately, the impact on survival rates. As you know, it's a dismal survival rates in both IP and PPS. We hear from KOLs that taking a holistic approach to the data is going to be important. And that includes, as you mentioned, looking at both the primary and the secondary endpoints of the study.

We know that safety and tolerability will be a key area of differentiation for Admilprod. Even with the advent of newer therapies, GI tolerability and cough, they are challenging to manage, especially in an older comorbid patient population. And Cristian talked about, the ALOT study showed a positive impact on FPC, but also at Milpro demonstrated a well-tolerated safety profile where discontinuations due to adverse events were similar to placebo. So there's a real opportunity to gain share as effective and well-tolerated treatments like in Milpro come to market. We also expect the market to grow significantly.

I talked about this previously, where today, it's a $4 billion market. We think this market could nearly double as we're going to start to see the creation of a large second-line switch and our add-on market with newer treatments available. We've got a number of prelaunch activities underway. -- with a focus on bringing in pulmonology expertise to the company, providing education to physicians on this new and promising mechanism. And we're also looking forward to the PPF readout early next year because that is the larger commercial opportunity that can complement the IPF results.

Cristian Massacesi

Akash, your question is more related to key secondary end point, some key secondary plan outcomes. We didn't disclose this -- we mentioned and we talked in the press release about the primary and some of the safety profile. I can tell you that we are pleased with the overall outcome of the trial, and we will present this data in a medical meeting next year.

Operator

The next question comes from Matt Phipps with William Blair.

Unknown Analyst

This is Erin for Matt Phipps. Just a question on the ADAPT trial. So with the depth time lines reiterated for 2027 again, I was wondering if you could give some specifics on current enrolling progress as well as, say, quality remediation. And if we should expect the Adept 1, 2 and 4 readouts to land together or be more staggered throughout the year?

Christopher Boerner

Thanks for the question. Cristian, do you want to take that?

Cristian Massacesi

Thank you, Matt, for the question. Let me start actually with the program status as you were asking for. Everything is tracking as we guided. We have a potential interim analysis for ADAPT-1 later this year, and we anticipate top line results readout for all the debt program throughout some readouts can coincide or can be more or less at the same time or can be staggered in the den is event driven, for instance, -- we -- I think Chris mentioned in his opening remarks, we also expect on top of a debt program, the readouts of our Polar 1 program in 2027. So very important for Coben in terms of data flow.

I want to point out when as better this is important to your attention. In November, we look forward to the CTAD presentation in Boston There, we will present 2 data sets. The first is the open-label leading period from the ongoing ADAPT 1 study. And the second set is from the open label extension rollover study adept. So both courts substantial number of patients or patient treaty recommend. This presentation will address some improvements in psychotic symptoms with Care -- and of course, we're waiting the randomized control studies to read out.

But I think the CETA data are encouraging in our view and support the delivery support ongoing development programs.

Operator

The next question comes from Carter Gould with Cantor.

Carter Gould

You've got a number of small cell lung lung cancer study is expected to read out over 27 and 28. I was hoping you could talk about your confidence and the relevancy of these studies in light of the IMDELTRA frontline data. And if that augurs any sort of changes to your strategy?

Christopher Boerner

Cristian?

Cristian Massacesi

Thank you for the good question. The data we have seen quite impressive. And actually, we welcome this data in such a difficult disease like extended disease small cell lung cancer. As you said, we have an ongoing registrational studies with go in combination of nivolumab and standard chemotherapy. The study is completed. We are just now looking at the readout. And we are running the combination with Pomitamegastandar chemotherapy.

We don't know, of course, the art commodity study and how they can benchmark. But I think these are studies that allow us, first of all, to benchmark the activity of a novel mechanism of action like Atego in this space, but targeting an important antigen expressed in most of the patients with small cell lung cancer tumors, but also for our PD-1 VGF, this will give us a benchmark because then we will prepare the next step.

As you know, we started the combination with Fumitamig plus engager from Baring and England that we announced. So we are paving the road with an extra way because we believe our asset can play in this space, of course through combinations with the majors.

Christopher Boerner

I think the only thing that I would add is just that as you look at impressive data, and I would agree, these are impressive data. Over time, in all of these hard-to-treat diseases small cell being 1 of them, what's likely to occur is you're going to see patients continue to be subtyped and additional therapies be required to treat patients not only in initial lines of therapy but subsequent lines of therapy.

And I think at the end of the day, there's going to be room for multiple agents to be engaged to help treat these patients.

Operator

The next question comes from Courtney Breen with Bernstein.

Courtney Breen

I just wanted to zoom into Milvixian and expectations in terms of the atrial fibrillation readout. Can you help us understand with regards to the Q1 release that we're expecting, are we likely to see the details and numerical details in that press release? Or are we just going to get a positive or not positive trial details there.

We're trying to figure out kind of how long do we need to wait throughout next year to actually get validation on the likely utilization of this product, given that, that non-inferiority number on the primary endpoint is going to be so critical and there's a wide range that can meet a successful trial?

Christopher Boerner

Thanks for the question, Courtney. First of all, we understand that the AFIB study is an important opportunity. It's an important opportunity for us. There's obviously a lot of focus. Of course, I would be remiss not to remind everyone that we need to put this study in the context of a much broader and very rich pipeline that we've got.

Having said that, we get how important this readout is -- in terms of how we're going to communicate in our initial press release, look, we're going to work to give an accurate view of the outcome of the study and a view that allows you to get a sense of the opportunity that we have with AFIB. We understand that in that context, providing more specifics in the press release will likely be important, but we're going to need to balance this, of course, with ensuring that we can communicate the data in a more fulsome way at a future medical conference. So what I can tell you is that we're going to be working with our partner on this program to strike that balance.

Operator

The next question comes from Chris Schott with JPMorgan.

Christopher Schott

Just 1 follow-up on an earlier question and then a second one. On IPF, I think you mentioned potential for add-on usage for the drug. I guess specifically there, do you think additional studies would be needed to maximize commercial value would your existing data set here be enough?

And then just kind of the core question I had was just as we think about 2027, just any initial pushes and pulls we need to think about in the business? And maybe just extending that a little bit longer term. Do you think if there's anything the Street is kind of getting wrong in terms of whether it's '27, '28, '29, kind of manage -- how the company is going to manage through this upcoming LOE cycle, as you just think about kind of again, where consensus is currently?

Operator

Thanks for the question, Cristian, do you want to start?

Cristian Massacesi

Let me start. First of all, the study that we ran -- as you know, as an equal distribution of monotherapy and add-on treatments, and we don't comment on the outcome on subgroups. You will see when we will present the data. Adam, do you want to add anything on that need.

Adam Lenkowsky

That's why I told Chris, about the increasing expanding size of the market because prior to the launch of this next wave of innovation in both IPF and PBF, there was very little add-on and switch use because of the high weight of mortality. In fact, 50% of patients in this disease that do not survive 5 years. And also, there's a very high level of innovation, half the patients discontinued treatment within 12 months. And so the creation of a very large second-line switch and our add-on market after the use of generic lab. And Esprit will become much more significant opportunity for these newer treatment options.

So I said, we look forward to the PPF readout, it's a larger commercial opportunity and ultimately will complement the positive IPF results.

Christopher Boerner

David, do you want to comment on the '27 question?

David Elkins

Yes. Thanks. And Chris, thanks for your question. Look, we feel really good about how the business is performing this year. And I think the 3/4 of beat and the momentum that we have as we exit going into the growth portfolio is really performing well. And as we talked about earlier, having 8 products that are now annualizing over $1 billion in that growth portfolio really shows the diversity of that.

Not to mention the Phase III trials that we've been talking about today coming out. We're looking forward to adding those to the portfolio as we head into next year. And then I would say is on the other side, as we already talked about with Eliquis, we anticipate that $1.5 billion to $2 billion step-down in -- and lastly, our strategic productivity initiative, that $2 billion worth of efficiencies that we're well on track to achieve that by the end of '27.

So and then as we look at -- from a cash flow perspective, continue to have strong cash flow generation. We ended with $13 billion of cash on hand, which gives us further strategic flexibility as we think about the portfolio. So feeling really good about the execution this year and that continuing as we go into '27.

Christopher Boerner

And Chris, the only thing I would add is just that we've been consistent in saying what we're focused on and executing against that -- as we think about the business today, we feel good about the momentum we have going into Q4. We hope that -- and anticipate that will continue into 2027. We've got some wind at our back with respect to late-stage development.

But clearly, there's a lot of focus we have as a company on strengthening R&D and continuing to deliver, not just on that late-stage pipeline, but also progress the earlier pipeline so that we drive sustained growth over time. And then, of course, we're going to be aligning our OpEx base, as David just alluded to, to the opportunity that sits in front of us while also investing in growth opportunities. We've been really disciplined about doing those things throughout the course of this year, and that's what we're going to stay focused on.

Operator

The next question comes from Asad Haider with Goldman Sachs.

Asad Haider

Great. A couple of big picture questions for Chris. First, just on given this remains a top capital allocation priority, I would be curious to hear any updated thoughts on how you're thinking about ideal stage of development, therapeutic area, deal structures and even transformative deals.

And then second, just would also be interested in hearing any updated framing on your efforts to embed AI across the research organization. I know that you have partnerships with both atopic on the Entropic announcement earlier this week, they said that they are looking to accelerate drug development with Claude. Bristol was named as one of the 6 partners in that effort. So what can you tell us about the progress you're seeing across the organization with these partnerships, particularly as it relates to any quantifiable metrics or KPIs that your teams are reporting back to you.

Christopher Boerner

Asad, maybe I'll start, and then Cristian can chime in with the AI question specific to R&D anyway. Let me start on the BD question. BD continues, as we said consistently to be a top allocation priority. We've got a very strong late-stage pipeline, but we're always going to be looking for opportunities to source innovation externally if it makes sense for us to do so.

And the criteria that we're going to continue to use as to how we do that is we're going to be looking for things that opportunities that make sense for us from a scientific standpoint, they've got to fit and align with us strategically. Clearly, if there are opportunities for us to strengthen the near-term growth portfolio. We're going to be keenly interested in looking at those. And ultimately, across all of these deals, they have to make financial sense.

In terms of size, we continue to be agnostic on the size of the deal. Far more critical to us is does it make sense for us to be the rightful owner of the opportunity, does it make strategic sense and can we show value to our shareholders. And then with respect to therapeutic areas, again, these are going to be -- we're going to focus mainly on those areas where we know well in therapeutic areas that make sense for us.

Just maybe before I turn it over to Cristian, let me comment briefly on AI investments. Look, AI, as we've said on previous calls, is an important area and investment for us we are focused really on thinking about how we can embed AI, where it makes sense across the entire value chain of the company, everything from early-stage discovery through commercialization, manufacturing and virtually all of our enabling functions.

And the way we think about that is setting very specific targets that ultimately can be incorporated into operational plans. We talked previously about the fact that we put forward a 20% to 30% reduction in drug testing time lines, cutting in half the time from drug target selection to lead molecule identification. Those are just 2 examples.

So while we're making AI tools broadly available at the enterprise level, we're also working towards targeted investments where we can articulate an ROI, and as it relates to anthropic specifically, I think that agreement fits broadly into that strategy. But Cristian, do you want to comment specifically on R&D.

Cristian Massacesi

Let me start telling through AI, we are accelerating actually our research and development projects. This is now a concrete fact that we can start to measure. You need to break down your research and development track journey because it doesn't exist 1 solution that can solve a ready.

So there are specific solutions that are more focusing on research, either from early development and then lay development projects. think in research and discovery, AI can impact the quality, but also the speed how you develop drug candidates and you bring a fundamentally new INDs to the organization.

This is very tangible. We have a multiple example, happy to share offline that we are now have in place. In development, AI can be helpful in increasing your efficiency in terms of optimizing costs, having a pace in the way you run your project and then there is a second aspect that is increase your probability of technical success.

And this is something that we are integrating more and more in the way of working just the announcement of 2 days ago with Tempus Patos is an example of it because we will put together data large dataset in neuroscience, and we will work to have models that can help us to predict target. So is a concrete thing that is happening and is helping in delivering our beautiful portfolio of drugs that, of course, require a pace.

Christopher Boerner

David, do you want to comment on the 3D question?

David Elkins

Yes. Thanks for the question on BD. Look, we're actively evaluating multiple opportunities across varying deal structures, partnerships, licensing and where appropriate acquisitions. So our north star on this is about strong, sustainable growth late into the decade, and that's what we remain focused on.

We're going to be financially disciplined around this approach, but also strategically aligned. And as we've done in the past, it's going to be in the therapeutic areas that we have the scientific capabilities, but as well as the commercial strength to maximize the value of that. So we remain very active, and we're going to stay focused and financially disciplined.

Operator

The next question comes from Mohit Bansal with Wells Fargo.

Unknown Analyst

I want to turn attention to Cube, if I may -- so it does look like this quarter, you saw 50% year-over-year growth, but the numbers still appear modest relative to what we were all thinking about how big this asset could be -- so maybe this is a question for Adam. Like what are you seeing as the largest constraint here is just the identification of patient or physician willingness to prescribe tolerability, what exactly is going on? And how do you think Alzheimer's may be different than what you're seeing in schizophrenia?

Christopher Boerner

Thanks for the question, Adam.

Adam Lenkowsky

Yes, Mohit, thanks for the question. So we expect bent to deliver continued growth in schizophrenia with significant upside potential from future label expansions. In the quarter, you're right, we saw 30% growth year-over-year, but we also saw quarter-on-quarter, roughly 3% to 4% growth in total prescription volume, but net sales were impacted by an inventory decrease, which follow an inventory build in Q2, like we see with many products in our portfolio. We expect that this will normalize in Q4.

And as such, the growth will continue to track along with the TRx increase that we expect to see. Now we're seeing several positive leading indicators to the brand. We're driving consistent increases in new prescribers with a number of prescribers doubling from last year. We've established differentiation across negative and cognitive symptoms of schizophrenia. However, we have clear areas where we need to make further progress. We need to accelerate new patient starts.

We need to improve repeat prescribing. I think 1 of the bigger challenges that we've seen is we've been educating visions on the importance of rapidly titrating covent fee to the effective dose of 125 milligrams. To do -- in order to do that, that's the way physicians will maximize efficacy. They can use antiemetics when needed to help minimize nausea and vomiting, which occurs within the first few weeks of initiation.

And there's still far too many patients that we see remaining on the 50 or 100-milligram dose. So when patients are on an effective dose and the GI toxicities manage appropriately, we have truly seen remarkable results for this product. Now as a result, as it pertains to Alzheimer's disease, as you know, this is a much larger market, roughly 7 million people diagnosed with Alzheimer's disease in the U.S. and 30% to 50% of patients have psychosis, whether that's hallucinations or delusions or agitation. They also have -- virtually all patients have cognitive impairment.

And so this is a fundamentally different market than schizophrenia. There are no approved treatments today in ADP, Alzheimer's patients with psychosis have been treated off label for many years with D2s. And unlike schizophrenia, -- what you see is PCPs and nurse practitioners and PAs are responsible for treating the majority of patients with 50% of patients treated in a long-term care facility. And why is that important?

Well, in addition, antipsychotics have significant safety limitations they carry box warnings that are specific to elderly patients with dementia. And we know that D2s are associated with long-term side effects like sedation, cognitive impairment and movement disorders that are significant issues for long-term care facilities where they need to carefully monitor all label utilization of antipsychotics. So safety becomes increasingly important in elderly patient population.

And we know Cobenpiis not associated with those adverse events, doesn't carry a box warning. But that said, we will take the learnings from schizophrenia, and we're going to need to set appropriate expectations with patients and physicians build confidence around managing the nausea and vomiting with be Cobenpis, but Covent would be the first product approved for ADP, and we believe has the potential to play a really important role in treating these patients over time.

Operator

The next question comes from David Amsellem with Piper Sandler.

David Amsellem

Another Phase III readout you had recently was raised 101. And with that in mind, I know it's only interim data, but maybe talk through just the path forward from a regulatory perspective and also contextualize the market opportunity here, the addressable patient population, both U.S. and ex U.S.? And are you thinking about peak sales potential?

Christopher Boerner

Thanks for the question. Maybe start with Cristian and then Adam.

Cristian Massacesi

Thank you, David, for the question. We're truly excited about this readout because, as Chris was mentioning in his opening remarks, is the first -- there are 3 reasons. The first is alpha actinium based radioligands are working, post location and potentially can work instead of petition. This is the first take on message for me.

The second is BMS is the first with this novel modality. And the third is the confidence in the platform because this readout in GAAP net very important. But as you know, Raise bio is a very important IND engine for our organization. We have programs in -- we have a decap molecule in this space, a better molecule. And we have programs in liver cancer, GPC3 and in prostate cancer, SEP3, other target.

And there are a few other courses that are coming up. So this is an important outcome that will be presented in terms of the Phase III readout next year. And of course, the team started interacting with the authorities. Adam?

Adam Lenkowsky

Yes. So just to add on to what Cristian said, we're pleased with the positive data readout over ES-101. This will be the first product launch from our radiopharmaceutical platform. So a positive PFS interim data in SSTR2-positive [indiscernible]. It does validate our highly potent actinium-based approach. Just remember, Getnet to our rare tumors. We estimate the incidence of Gap nets at approximately 18,000 patients diagnosed annually in the United States. When you look at patients who are progressing from Lutathera, it's roughly 70% of patients will go on to a subsequent therapy. And so while there are no approved treatments today, our focus will be on establishing Resi Bio as the clear standard of care aftolutithera.

Commercially, it's a relative modest opportunity. However, bigger picture, we see RAISEBIO as a true ID engine with multiple INDs expected in the next 5 years that will ultimately enhance our oncology portfolio with a unique platform and pipeline.

Operator

The next question comes from Geoff Meacham with Citibank.

Geoffrey Meacham

Right. I was curious on the pace of conversion to Kuvan tech. Maybe just help us with how far along that transition is today? And then strategically, -- how much of a priority is that relative to, say, permitamig or the Raisio program? I'm just trying to think of like how you guys view the oncology franchise for you over the kind of longer term and the mix there.

Christopher Boerner

Thanks for the question, Geoff. Maybe, Adam, you start with Cuvantic and then I can kind of chime in on the second part of that question.

Adam Lenkowsky

Sure. Thanks, Jeff. We're pleased with Cubanti performance. The team continues to deliver strong commercial performance and execution. Jeff, we've now converted roughly 17% of IV to subcu launch to date. We're seeing increasing use across multiple tumors with uptake in our monotherapy indications as well as in combination -- and we routinely hear feedback from the community, specifically Accuvantic improved practice efficiency with a 3-minute in-office subcutaneous injection. -- and patients prefer cuvantic when offered the opportunity for this formulation and truly novel technology.

So we're tracking well against our expectation that physicians will convert at least 30% to 40% of our IV business to Quvantig. We're tracking towards the higher end of that range. And we're pleased with the Kuvantic performance and what this means for patients and physicians.

Christopher Boerner

And look, the way we think about oncology treatments generally is that we're going to be looking for opportunities to, first of all, bring differentiated platforms and products to market to help patients across multiple tumors and different lines of therapy as we talked about to the previous question on small cell. And what I'm excited about as to where the pipeline is going is what you see playing out is that we've got very exciting platforms that are beginning to produce meaningful medicines. You see that in our CAR-T program, which continues to perform very well.

We're very excited about subsequent opportunities that we have there with products like Arlosol you see that in the CELMoD program with ISA brand and with iborn messy. And of course, that is a platform that's going to continue to produce new INDs as well as new products. We've referenced in the prepared remarks, colcatomide. The Raizen, as you just heard, is the first of what we believe is going to be an important radiopharmaceutical platform.

And then if you go beyond platforms and just look at potentially differentiated assets, you've got products like [indiscernible], which you referenced, I would be remiss to not mention Izobrand, which showed very good data at ESMO. So we have a number of products there. And we would put to Qvantig into that context.

Qvantig is an important new medicine for patients that improves upon the existing therapies that we have notably OPDIVO in immuno-oncology. So we've got a nice pipeline of differentiated products and platforms, and we're excited to continue to bring those forward and help a lot of patients across tumors.

Operator

The next question comes from Trung Huynh with RBC.

Trung Huynh

So you recently disclosed a patient in your Phase I autoimmune CAR-T trial, died of sepsis pneumonia after Zone cell infusion. You said it's unrelated to the June pause, but the patient had a late onset of non icons motor symptoms. Can you perhaps walk us through your updated thoughts on the path forward for solace in autoimmune and the risk reward for CAR T in Nordmin.

Christopher Boerner

Thank for the question. Cris, do you want to start.

Cristian Massacesi

Sure. Thanks, Trung, for the question. Let me start telling you that we truly remain excited about [indiscernible] program because when we look at the totality of our data, we had 190 patients treated in Phase I. The overall safety and efficacy profile of this product is truly compelling. Zell provided a meaningful benefit to patients that have severe autoimmune disorders, some of them with organ damage already. And many of these patients remain off disease-modifying therapies. So the potential is all there. As we said, we implemented a voluntary pose to review clinical data across the program. This is the reason why the program is posted currently.

But after an extensive analysis in our data, we identified that the root cause was a change that we made in the selection and activation of the reagent. We have now made the proper adjustment of it, and we are working with authority to restart the clinical program as soon as possible. Going to your question on the grade 5, that was 1 factor, unfortunately, 1 part case of setting pneumonia is the only grade 5 event across all Jonasel program out of 190 patients. So we are fully committed with all of our expertise in cell therapy to bring this product at this cart in autoimmune disease.

Christopher Boerner

Truck, maybe let me make 1 additional comment on Solocal. Look, I have the distinction of having been in cell therapy before we thought it would work in hematology. Never mind autoimmune diseases like late line lupus or MS. And remember, the patients that we're enrolling in these studies are patients with very severe debilitating and in many cases, life-threatening disease. And our goal here is to achieve immune reset and hopefully, by doing so, enable long-term durable remissions.

When you're doing drug development, as Cristian alluded to, in very difficult-to-treat settings with a new modality like this, you're always going to be evaluating the benefit risk profile. But the way you do that is the way we've done it, which is to be very rigorous in setting up a strong DNC, working with the best investigators in the field and engaging transparently with regulators. And what I will tell you with zolacell specifically is we are seeing potentially transformational activity. We're excited to continue this program.

So what we're going to do is continue to be rigorous in how we conduct the study and be transparent with the broader community. But I'll tell you, our investigators and we are excited to see the potential of this product in this modality.

Charles Triano

Operator, let's take our last question, and then Chris will give a quick wrap up.

Operator

The last question today comes from Evan Seigerman with BMO Capital Markets.

Evan Seigerman

I want to ask the BD 1 slightly differently. There's been a bit of a disconnect in the amount that you've spent in BD over the past 12 months versus some of your peers. So does this difference primarily reflect valuation discipline, confidence in your internal pipeline and your ability to grow the growth portfolio to fill the LOE gap? Any color would be great.

Christopher Boerner

Sure. Thanks for the question, Evan. Well, first of all, let me reiterate what I said before, which is that BD continues to be a top allocation -- capital allocation priority. I think David provided a nice view of how we think about the types of deals that we have and we'll continue to be looking at.

We're certainly not waiting for anything. If there's an opportunity that makes sense financially for us, can improve our ability to deliver sustained growth. We have the capacity to be in the mix. And what I would say is we continue to be very active in the space. And on the deal we think makes sense for us we're going to be engaged. That's been with the approach we've taken over the last number of years, and that's going to be -- continue to be our focus going forward.

So with that, I wanted to just say a big thank you to everyone for joining the call today. I know today, in particular, it is a busy day. Let me just say in closing that we are delivering strong performance from an increasingly diversified growth portfolio. As you've seen over the last few months, our pipeline is coming into focus and beginning to translate into new launches.

And importantly, we continue to be operating with financial discipline. As we continue to execute, we're well positioned to deliver long-term durable growth into the next decade. But of course, none of this happens by accident. So I want to give a very sincere thank you to my colleagues around the world for their continued focus and commitment on the mission that we have to serve the patients who need our medicines.

So thank you all for joining us today. And as always, the team is available for follow-ups.

Operator

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.