I think replacement power and/or freshness index are valuable measures of the power of an innovation engine to replace sales within our sector and then ultimately to grow the sales of the company. Look, I think on Kymriah, just to provide a very realistic perspective, the DLBCL second line, the failure of Kymriah in the second-line DLBCL is beginning to hit demand and I think we will see Kymriah to have less growth over the coming quarters and years and potentially even declines as our two competitors build out their second-line DLBCL program. Bolt-on deals, most of the deals we've done, as I mentioned earlier, have been sub-USD 1 billion upfront with payouts for the total deal value of less than USD 2 billion, as in recent times, including the 4 deals that we recently signed. But the 2022 guidance in this division is somewhat disappointing. Richard, do you want to start? I think demonstrating that productivity power we have within the company. So realistically for us in cell therapies, of course, Kymriah has the is the only medicine indicated in pediatric ALL, has a broad label in later lines across DLBCL and FL, in the longer term, it really comes down to our next-generation T-Charge platform, which we provided data on at the end of last year at ASH, where we demonstrated pretty attractive data in both DLBCL and multiple myeloma. But I do want to reassure the audience that we're not at a standstill. There is no question that B-cell therapy is now the gold standard in efficacy. Your next question comes from the line of Matthew Weston from Credit Suisse. And we're going to continue to evaluate the options and watch how valuations move in the sector and then look for opportunity as they arise. It's a question on the impact of COVID, specifically to in 3 areas for you. Q. And we have started managed access programs where we already see quite high demand. So we confirm our USD 7 billion-plus peak sales expectations for Cosentyx. View the 2022 Q3 results presentation and read the transcript slide by slide. We have been, within our pricing policies on key brands, increasing in the mid-single to mid- to high single-digit range in list prices. We have also some OTC elements in the Sandoz business. So right now, we have over 2,000 patients treated worldwide, which I think demonstrates the profile of this gene therapy and the confidence providers are having using this medicine. And Harry will talk a little bit more about the specifics on the guidance. As Vas mentioned, Sandoz is still facing some challenges, mainly from pricing pressures, especially in the US, and COVID-related demand impacts. Now moving to the next slide. I know you'll present the data, but just wondering if you've got confidence there's at least no deterioration in those measures when switching from standard of care. Now that we have the listing, we also have access to a much broader population. As a reminder, the APPLY-PNH study related to the treatment of patients who had refractory anemia after treatment with an anti-C5 and the APPOINT study is in treatment-naive patients to anti-C5 antibodies, also expected to read out in 2022. We're building on our Lutathera experience with this medicine. Q. Next question operator. Kisqali demonstrated delivered 28% growth on the quarter, primarily driven again by ex-US performance. Moving to Slide 6. It's pretty attractive, we find with most practices that have gone through the process. Can I just ask about Zolgensma, please. And we remain on track. We also will, in the medium term, be driven by our ability to get new indications online. We have 55% of our alternative injection sites accounts now have purchased Leqvio, 30% repeat orders. A. Yes. And maybe, Andrew, just one additional point to John's comments. A. And as noted, both Scemblix and Pluvicto now are off to a good start and could one day be added to that list of six brands to also be potential multibillion dollar brands in the future, depending on how readouts go in the earlier lines. So we've got 3 main growth drivers for the Pharma business in China: Cosentyx, Entresto and Lucentis. Is that a fair assessment? We continue to evaluate the path forward for ligelizumab. We have submitted this data or plan to submit this data to an upcoming medical congress, where we would share not only the magnitude of the effect in the primary endpoint, but also secondary endpoints, which cover secondary endpoints, including transfusion independence, quality of life, overall response rate as well as other measures. And of note, PSMAfore, our current assessment is this would cover all pre-taxane metastatic patients, eliminating the need for one of the additional studies we had previously expected to be running in that setting. Yes. Our business dynamics in Sandoz, as you saw, in the quarter have really stabilized. If I move on to Slide 27. That's you are now saying USD 1.5 billion to USD 2 billion. Is it fair to assume Lutathera trajectory is a fair benchmark? Thanks, Matthew. And I think it's really premature for us to speculate, if there were a "sale," how we would use the cash. Should this spread bigger, there would be likely some impact. Q. And our approach will be that if the DMC advises us to make a change, we'll let the markets know. And the review of Lu-PSMA with the FDA is on track, given its action date later this quarter. Thanks, Graham. Now moving to Slide 10. This site is intended for a global audience, 2022 Q1 Results Presentation & Transcript, Diversity & Inclusion Governance and Community, Novartis Commitment to Patients and Caregivers, Novartis Gene Therapies Managed Access Program, Healthcare Professional Resources by Country, Novartis Institutes for BioMedical Research, Cardiovascular and metabolic disease research at Novartis, Autoimmunity, transplantation and inflammatory disease research at Novartis, Musculoskeletal Disease Research at Novartis, DAx: exploratory disease research at Novartis, Community Exploration & Learning Lab (CELL), Graham Glyn Charles Parry - BofA Securities, Research Division, Simon P. Baker - Redburn (Europe) Limited, Research Division, Matthew Weston - Crdit Suisse AG, Research Division, Wimal Kapadia - Sanford C. Bernstein & Co., LLC., Research Division, Andrew Simon Baum - Citigroup Inc., Research Division, Richard Vosser - JPMorgan Chase & Co, Research Division, Emmanuel Douglas Papadakis - Deutsche Bank AG, Research Division, Emily Field - Barclays Bank PLC, Research Division, Timothy Minton Anderson - Wolfe Research, LLC, Peter James Welford - Jefferies LLC, Research Division, Keyur Parekh - Goldman Sachs Group, Inc., Research Division, Florent Cespedes - Societe Generale Cross Asset Research, Sarita Kapila - Morgan Stanley, Research Division, Stephen Michael Scala - Cowen and Company, LLC, Research Division, Laura Sutcliffe - UBS Investment Bank, Research Division, Seamus Christopher Fernandez - Guggenheim Securities, LLC, Research Division, Kerry Ann Holford - Joh. Certainly, that's a priority for President Macron and his European Commission President. With the MONALEESA-2 data presented at ESMO, Kisqali demonstrated the longest median overall survival so far in advanced breast cancer, and we now have OS data across all eligible patient populations. 6 NOVARTIS Q1 RESULTS | APRIL 26, 2022 | NOVARTIS INVESTOR PRESENTATION Constant currencies (cc) is a non-IFRS measure; explanation of non-IFRS measures can be found on page 35 of Condensed Interim Financial Report. Could you just outline for us the differences between this 15,000 VICTORION-2P and the ORION-4 trial for Leqvio? It's another Russian question, one for Harry, please. Then moving to Slide 7. And clearly, the dynamic multiple sclerosis market, if you look at it, it is still below pre-COVID levels. I guess what I was trying to indicate is we even with respect to the higher demand and higher volumes we expect to see in quarter 4, those volumes could be even higher if we were to completely unconstrain the number of centers that would want to bring this medicine on board. Novartis is providing the information in this presentation as of this date and does not undertake any obligation to update any forward -looking statements as a result of new information, future events or otherwise. Are you limiting deliveries to only people who pay you upfront? And also, if you look at the margin of Sandoz, obviously, a lot of that was boosted by some of these onetime effects presumably in the easy comp. And so I think over 1,000 physicians plus have signed up for the free trial offer program at the last look, which was still a month ago. No. The expected Innovative Medicines core margin increase will be driven by good top line momentum and continuation of productivity programs, including the recently announced new organizational structure. Thanks, Richard. In terms, Kerry, of contract manufacturing, we have reported relatively small contract manufacturing business within other revenues. Media release:English (PDF0.2MB) | Deutsch (PDF0.2MB) | Franais (PDF0.2MB), Novartis ESG Update - July 20, 2022 (PDF0.4MB), April 26, 2022 Just Emily, a follow-on clarification also on Gilenya. And it's about driving more impact of the company on medicine. When there is a city or an area with a risk of lockdown, usually then wholesalers ship a bit earlier to ensure that pharmacies and hospitals on the ground have product. And we're also conducting a study in pretreated patients who may benefit from Zolgensma's onetime treatment. Second dose is at the 3-month time point, and having successfully been reimbursed in the Part B program. Overall, the group core margin increased by 111 basis points to 32.6% mainly driven by Sandoz' performance for the quarter. And when there are good deals out there, we're, of course, looking to do them. Is it fitting in our core therapeutic areas? Next, operator? Turning to the first nine months. I'm now going to walk you through some of the financials for the third quarter and the first nine months of the year. Disclaimer This presentation contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995, that can generally be id And if it happens, that would be terrific and we, of course, share that with all of you as soon as it does. We certainly increased our overall time line. Just as a reminder, our goal with this medicine is to be a first-line therapy for all patients with PNH. We certainly have the aspiration to get to USD 2 billion, but it's going to depend on how many more markets we're actually able to get on to national programs. We wish you a great year, and we'll look forward to speaking to you soon. Zolgensma grew 18% on the quarter, with increasing access outside of the United States. And then it would be determined by a review matter if the FDA would ultimately provide an approval. This presentation contains forward-looking statements within the meaning of the United States Private Securities Litigation Refo rm Act of 1995, that can generally be identified by words such as "potential," "expected," "will," "planned," "pipeline," "outlook," or similar expressions, or by express or implie d . For 2022, we are absolutely confident we can maintain Entresto's momentum in the US, in Europe, driving broader and earlier adoption, but we're also very excited about our opportunities in Asia. We continue to expect both top and bottom line to grow mid-single digit in 2022. Or should fourth quarter be higher than third quarter before you bring on next level of supply? Now roughly 2 points of those come from cost of goods, a little under 1% from SG&A and then 0.6% from OIE, where we would have these little divestment gains. And all 3 products are showing strong growth. Within the, I would say, dynamics we've historically seen for the brand, we saw good volume growth overall with Cosentyx, particularly in rheumatology. Obviously, currency impacts are significant this year given the strength in US dollar against many, if not all, currencies. Investor presentation 1 Investor Relations Q2 2021 Results Participants Company overview . So all on track. Notably, in China, at the moment, we do face headwinds with the ongoing lockdowns, but we continue to expect China to be an important part of our story. A. A. About 108,000 people of more than 140 nationalities work at Novartis around the world. Thank you, Vas. And if not, is that coming next quarter? On your second question in terms of go ahead. A. Now moving to the next slide, looking at Scemblix. This growth was driven by earlier usage in myelofibrosis and polycythemia vera. Good morning and good afternoon, everybody. Yes. And then lastly, you referenced, it was kind of part of the reorganization, but the creation of the strategy and growth function is to create a consistent top-level view of do what is the right things we need actions we need to take on our internal pipeline versus the external opportunities that we have before us in order to keep a consistent growth as we've guided of the mid-single 4% to 5% range in the coming years and then above peer median in the back half of the decade.
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