GSK plc Price & Performance (GSK)

Thank you, Jeff, and welcome to everyone joining us today. Today, we are reporting our 2024 results and providing you with updates on our growth outlooks, investment plans and focus on improving shareholder returns. Please turn to the next slide. 2025 will mark three years since the demerger, and the creation of GSK as a new dedicated biopharma company for patients and for shareholders. The deep merger enabled a fundamental restructure of GSK and its balance sheet bringing new capacity to invest in growth, and to deliver returns to shareholders. Three years on, I'm pleased to say that we've seized this opportunity and made significant progress, building a strong track record of performance delivery. Specialty medicines and vaccines now dominate our reshaped portfolio and pipeline. Our long term outlooks have consistently improved alongside the quality of our innovation, and we've delivered sustained year on year sharper operational performance underpinned by a stronger balance sheet. This all points to GSK having a platform to deliver sustained profit growth and returns in the short medium Next slide, please. Our 2024 performance demonstrates the transformation of the business. Sales grew 8% to over £31,000,000,000 with strong growth and increasing contribution from Specialty Medicines more than offset [indiscernible] Core operating profit was up 13%, and core EPS was up 12%.

This level of performance delivered two upgrades to guidance in 2024, and supports the increased dividend of 61p per share announced today. I'm also pleased to report that we maintained good progress in our six priority areas to build trust, not least retaining a leadership position in the Access to Medicine Index, where we've been placed first or second in the industry, since its inception in 02/2008. And of course, during the year, we also resolved the Zantac litigation. Prioritizing shareholder interests. Next slide, please. Operational delivery in 2024 reflected strong growth and accelerating momentum of Specialty Medicines, with double digit growth in all therapy areas and sales of Oncology oncology nearly doubling to more than £1,400,000,000 for the year. Vaccine sales reflected the challenges we've seen from external pressures in The U. S. And China for Oraxi and Shingrix. Going forward, we expect these to continue in 2025. But equally remain confident that Oraxvi, Shingrix and our vaccines pipeline will contribute meaningfully in the medium and long term. Importantly, 2025 will see further At the forefront are potential step changes in treatment with BLENREP, our novel ADC treatment for multiple myeloma, And depimogumab, our new long acting IL-five medicine for the treatment of severe asthma, Of these two, Blenrep will be the first to launch with an expected FDA PDUFA in July.

Next slide, please. Last year, GSK had 13 positive Phase three readouts, a record achievement for our R and D organization GSK. I'm also pleased with the confirmed development and strengthening of our mid and early stage pipeline. With positive clinical progress and the addition of several promising new assets in the areas of oncology and respiratory immunology and inflammation. Or RINI. Next slide, please. So with all this progress to date, R and D is now heavily focused on the clinical development of 14 scale opportunities. With peak year sales potential above £2,000,000,000 and expected launches before 02/1931. And the majority in Specialty Medicines. In our INI, we're prioritizing depimokumab, Nucala COPD, Kamlipix and long acting IL-thirty three, IL-five and TSLIP medicines. The aim here being to leverage GSK's deep expertise in inflammatory mechanisms. To lead in COPD and to target new In oncology, we're prioritizing resources to Blendrep, and to the acceleration of our very promising ADCs, targeting B7H3 and B7H4 antigens, as well as continuing life cycle innovation for JEMPERLY. In HIV, our plans for long acting and ultra long acting treatment and press options for four and six months are all progressing very well. And infectious disease, are prioritizing development of bepareversen, a potential functional cure for hep B, and of course, our high potential new mRNA and mAbs vaccines.

Alongside these, and as Tony starts to outline, in December, we're also prosecuting the early stage pipeline with a further 40 assets or so in Phase one and two. Lastly, we continue to add new opportunities through targeted business development, the recent agreement to acquire IDRx being a great example of what we want to do here. Next slide, please. Looking at GSK's launch portfolio over the next five years, we expect it to offer scale opportunity for growth. Together with an attractive risk profile. By 02/1931, we're increasing our outlook again. And now expect risk adjusted sales to be more than £40,000,000,000 This increase reflects the inclusion of Blendrep, our significant Phase three progress since last year, and multiple launch opportunities in the twenty six to thirty one period. Almost 90% of our 02/1931 sales ambition coming from products already approved or planned for launch in the next three years, we're confident that our Port In terms of contribution, we now expect 50% of sales by 02/1931, with this area being the key growth driver for GSK over the next few years too. Reflecting the high number of opportunities we have in the maturing late stage pipeline for specialty products, particularly in our I and I and oncology.

For Vaccines, while we've adjusted expectations to accommodate for new sales growth trajectories of Varexvi and Shingrix over this period, as you can see here, continue to expect this part of GSK's business to remain a key source of future growth. General medicines will also remain an important and relatively stable contributor to sales over the period. As before, we have further upside from our early stage pipeline, including notably Q6 month HIV, and prospective BD. Where we will continue to pursue smart opportunities at the same kind of scale and pace seen in recent years. And as you can see, from the two bars here, there is significant potential for up upside with successful clinical outcomes. Next slide, please. Overall then, we continue to set out positive outlooks for growth in the short, medium and long term. And we are all strongly committed to maintaining our track record of delivering this [indiscernible] expect 2025 will be another year of profitable growth led by Specialty Medicines. And with our recent progress we're now even more confident in our ability to deliver not only our '26 but also our new 02/1931 outlooks. All of this, while retaining the flexibility we need to invest competitively in growth and to deliver improving returns to share.

Next slide, please. We remain extremely focused on disciplined, allocation of capital. Our first priority for capital remains to invest in growth and in R and D. With the pipeline opportunities we now have, we are deliberate [indiscernible] HIV medicines and existing core vaccines opportunities. In addition to growth, we also remain focused on delivering improving returns for shareholders. Our primary mechanism for this remains via delivery of a progressive dividend, For 2024, we've declared 61p and we expect to pay 64p in 2025. And as we've previously said, we also look to deliver returns using other And today, we are announcing our intention to buy back up to £2,000,000,000 of shares over the next eighteen months, We believe this offers a very attractive return for shareholders at current share price levels. Very importantly, and to reconfirm we will maintain planned increased levels of investment in R and D new launches and targeted business development alongside these share buybacks. So let me now hand over to Luke to start to take you through more detail on our 2024 performance and the prospects we see for some of our near term growth drivers.

Thanks, Emma. Please turn to the next slide. As Emma highlighted, overall sales for the year were up 8% with strong growth from Specialty and General Medicines, more than offsetting short term headwinds primarily in The U. S. To our vaccines business. Next slide please. Specialty medicines continues to show excellent momentum and pipeline progress. And as Emma said, it's now expected to be over half our business 02/1931. In 2024, specialty grew 19% with strong performances across all therapy areas. Respiratory Immunology products were up 13% in the year Nucala, our anti aisle five biologic treatment grew 12%, driven by strong performances in Europe, international. Ben Lister, our treatment for lupus was up fourteen percent in the year, with strong demand across all regions. In oncology, sales almost doubled in the year. So JUULA grew 17% with strong growth across all regions driven by sustained increases in patient demand, Gympurli sales more than triple in 2024, benefiting from increased patient uptake in The U. S. Following FDA or COMMA's approval for primary advance or recurrent endometrial cancer and we received EMA Allcomers approval in January. [indiscernible] Ojara sales increased more than 10 times in the year largely driven by continued strong uptake in The U. S. Contributions from Europe and international are also increasing, following launches in The UK, Germany and Japan.

We expect further launches in 2025. David will cover HIV shortly.

We expect the excellent momentum in our specialty medicines portfolio to continue in five with sales growth of low double digit percent while absorbing the IRA impact. Next slide, please. Looking at what's next in Specialty, in R, I and I, we are targeting a major new indication for Nucala, to treat COPD following positive headline results from our Phase three MACNA trial. COPD affects more than three hundred million people globally and is the third leading cause of death worldwide, excluding COVID, An FDA decision is expected ahead of the May 7 PDUFA date and launch preparations are fully underway. We plan to publish the full matine results at this year's ATS meeting. Depamocumab, our new long acting anti IL medicine has now been filed in all major markets for dual approval in severe asthma and chronic rhinosinusitis with nasal polyps. Depamocumab has the potential to be the first approved ultra long acting biologic with six month dosing offering physicians and patients the reassurance of prolonged efficacy through sustained suppression of inflammation and could improve compliance and adherence for patients with severe asthma. Expect more Phase three readouts over the next eighteen months for eosinophil driven indications and also plan to start a Phase three trial in COPD this year.

And we have Kamlopixin, a highly selective P2X3 antagonist with the potential to be a best in class medicine for treatment of refractory chronic cough, a disease with significant unmet need. First data from the Phase three CALM development program are expected this year, with more early next year. In oncology, we're working to realize the full potential of our existing medicines as well as to expand our portfolio in areas of high unmet need. We have significant potential assets to drive growth for GSK and I am very optimistic about what we as GSK can deliver here. We're building a portfolio of novel pipeline ADCs with the ability to target tumor cells while sparing healthy ones. GSK-two twenty seven targets B7H3 an antigen which is overexpressed in a wide range solid tumors. Early data show promising clinical activity and we expect to share updated small cell lung osteosarcoma and additional data from our clinical development programs at the ASCO and ESMO conferences this year. Pivotal studies for two twenty seven are expected to start before the end of the year. GSK-five 84 targets B7H4, which is also overexpressed across a number of solid tumors. And our initial focus here is for the treatment of ovarian and endometrial cancers.

Again, we expect to share more data on five eighty four at the conferences of this year. [indiscernible] As you may have seen, we started 2025 with the announcement to acquire IDRx GSK.

This gives us access to IDRx42, a very promising and highly selective kit tyrosine kinase inhibitor designed to treat gastrointestinal stromal tumors. This adds to our GI cancer portfolio and we plan to accelerate development of this exciting asset. Lastly, as a reminder, we also expect initial results from our ZuoraOne and ZUO2 trials exploring JEMPERLY in rectal and colon cancer in 2026 and 2027 respectively. And the Phase three JADE study to read out in 2028. All this highlights the very strong progress GSK is making in oncology. 2025 will be another key year with the launch of Blendrep. Next slide, please. Blendrep is at the forefront of our ADC portfolio. In December, we presented overall survival data from the Green seven second line multiple myeloma study at ASH and the data demonstrated a statistically significant and clinically meaningful forty two percent reduction in the risk of death, comparing Blendwrap to the daratumumab based standard of care.

Median overall survival has not yet been reached in Dream seven.

But the projected difference is thirty three months. For context, that's almost an additional three years of survival versus the current standard of care. If approved, unlike a number of alternative second line treatments, Blendrep would be an off the shelf treatment option delivered by a thirty minute infusion in a community setting with no requirements for pre infusion protocols, hospital admission or posted fusion monitoring. This could be important for the seventy percent of patients created in the community. In the newly diagnosed or first line setting, we're encouraged by the second line trial readouts. But also by the BELLA RD trial, which demonstrated one hundred percent response rate. Our pivotal trial for Blenrep in the first line, Dream 10, started recruitment at the end of twenty twenty four and we anticipate headline results towards the end of twenty twenty seven. Next slide, please. I remain very ambitious for Blendrip. Which I believe will become an important new growth driver for GSK. We have gained extensive experience of treating patients with Blenrep and have a better understanding of how to mitigate eye related side effects. Around a third of patients in Blendrep studies have reported blurred vision, as an adverse event But for the vast majority of these patients, this was manageable, transient and reversible.

And data suggest did not impact patients quality of life. Eye related side effects in Dream seven were generally managed by dose by extending the interval between doses. Data recently presented at ASH showed that when dosing intervals were extended from eight to twelve weeks, the incidence of ocular events declined and critically the efficacy of BlendRit was maintained. We've completed a number of regulatory filings and have an FDA PDUFA date of July 23. As we prepare for BlendRev's launch, market research tells us intent to prescribe has significantly improved. With the overall survival data a strong motivator. However, ACPs are mindful of eye related side effects and therefore educating them in the appropriate dosing will be key. As a result, in the initial phase, we expect a staged ramp up as we build physician experience for the medium to longer term. I'll now hand over to David to talk through HIV, Thank you, Luke. HIV sales continued to deliver strong growth up 13% for the full year, with Q4 delivering our ninth consecutive quarter of double digit growth. Growth in 2024 was driven by strong patient demand for our oral two drug regimen, DEVATO, up 27% and long acting injectables, cabonova and Apertuse, which reach £1,300,000,000 of sales and contributed more than 50% of total growth.

This resulted in a two percentage point increase in global market share compared to the prior period. Cabanuba the first and only approved complete long acting inject [indiscernible] to over £1,000,000,000 of sales in 2024. Growth was driven by strong patient demand across The U. S. And Europe, with seventy thousand people living with HIV.

Now benefiting from this transformative medicine globally, In January, announced European Commission approval for use in adolescents. This marks an important step in bringing this medicine to younger people in line with our commitment to leave no person living with HIV behind. [indiscernible] the first and only approved long acting option for HIV prevention, delivered sales of nearly £300,000,000 in 2024 continuing its strong growth trajectory at 93%. With ninety nine percent effectiveness we are confident in its strong efficacy safety and overall tolerability. In 2024, of the thirteen percent growth, ten percent was volume, with the remainder favorable in year pricing dynamics. In 2025, we anticipate sales growing by mid single digit percentage supported by ongoing growth in volume, partly offset by pricing headwinds with the introduction of the Inflation Reduction Act which we expect to be a £150,000,000 to £200,000,000 impact. The potential for the long acting market remains significant. With the market today for treatment and prep together worth more than £22,000,000,000 with treatment accounting for around 90% of this and we believe treatment will continue to be the much larger market going forward. Next slide, please. Our pipeline is founded on integrase inhibitors or INSTIES, the gold standard of HIV treatment and prevention.

Due to their potency, long term tolerability and high barrier to resistance. We have a clear roadmap to deliver more long acting innovation, with three new instis in development, and five planned launches by the end of the decade. In December, our registrational study for cabotegravir four monthly long acting injectable prep Again, and we are on track to start our registrational study for every four month long acting injectable treatment this year. Early data on assets with the potential for six monthly dosing will be available in 2025. Including selective presentations at the Croy Congress in San Francisco in March. [indiscernible] We are on track to confirm in 2026 the assets that will deliver six monthly dosing. For PrEP, this will be one of three long acting entities and for treatment, One of those instis in combination with [indiscernible] or our capsid inhibitor. As pioneers in long acting injectables, we are confident we have a strong and innovative pipeline to secure and deliver future competitive performance. With that, I will hand back to Luke. Thanks, David.

Turning to vaccines. Total sales were £9,000,000,000 down 3% in the year largely due to lower sales of Oraxi in The U. S. Overall, Oraxsee continues to be the market leader in The U. S. With around 10,000,000 adults now protected. However, demand for the vaccine was lower in 2024 following new ACIP recommendations a late RSV season and an unfavorable comparison to launch stocking in 2023. Going forward, we continue to assume no revacc [indiscernible] or expansion of age cohorts in 2025, but we do expect both in time. Given the protection RSV can offer against RSV. Outside of The U. S, 36 markets and we are seeing good momentum in up uptake with national recommendations in 17 markets and national reimbursement programs in six.

We expect more this year. Moving to Shingrix. Sales grew 1% in the year with growth in Europe and international offsetting lower sales in The U. S. Whereas anticipated, the pace of penetration is slowing. The U. S. Immunization rate at the end of the third quarter was 40% up five percentage points in line with our expectations for around three percentage points to five percentage points per year. Ex U. S, growth was driven by higher uptake across European countries and a national immunization program in Australia. Shingrix has now launched in 52 countries and the average immunization rate across the top 10 markets outside The U. S. Is now around seven percent. In meningitis, our portfolio achieved another year of double digit growth with sales up 18%. Pexero reached blockbuster status with sales up 23% aided by CDC purchasing and positive recommendation in Germany. Menvaya grew 5% impacted by comparison to stockpile replenishments in 2023 And in February, we anticipate U. S. FDA approval of our new pentavalent MINABCWY vaccine combining the antigenic components of BXERO and Menvayo. In time, we expect this to simplify immunization schedules, increasing coverage and protection against a serious life threatening illness. Medium and long term.

We expect vaccines to remain a key source of future growth. In the short term, given the challenging China macro environment, and the potential for changes to U. S. Vaccination policies, and uptake in the next twelve to eighteen months, we're expecting vaccine sales to decrease low single digit percent twenty twenty five. Next slide, please.

General medicine sales grew 6% in the year.

And this was largely driven by TRELEGY, up 27% with strong demand across all regions strengthening its position as the top selling brand in asthma and COPD. In 2024, increased use of authorized generic versions of Advair and Flowvent fully offset the headwind from the removal of the AmpCap on Medicaid drug prices. This year, we are excited to launch Jeopardycin, the first completely new antibiotic to treat uncomplicated urinary tract infections in more than twenty years.

And we expect to see demand increase from twenty twenty six once payers have completed their review process and put Jeopardasen on formally. Overall, looking across the General Medicines portfolio, while we expect volume growth across key brands to continue, we expect that to be broadly offset by pricing and generalization pressures and so anticipate sales to be broadly flat in 2025.

I'll now hand over to Julie.

Thank you, Luke, and good morning, everyone. Next slide, please. Building on the comments made by Luke and David, this slide shows the significant growth contribution from 80% of the growth this year by building scale and momentum in our respiratory immunology, and oncology business as well as ongoing growth in our HIV Next slide, please. Moving to the income statement for the full year. With growth rates stated at CER and ex COVID. Sales increased 8% and core operating profit 13%. Despite a 6% headwind from the loss of Gardasil royalties. Within this, gross margin grew 80 basis points benefiting from the positive mix from Specialty Medicines, and the supply chain efficiencies.

Despite incorporating a £150,000,000 charge to drive future supply chain productivity. SG and A increased 2% year on year benefiting from our returns focused disciplined approach to investments supporting global market expansion for key assets including JEMPERLYNUKOLA, long acting HIV, Erexvi and Shingrix. As well as a one off credit from the Zajulla royalty dispute in quarter one. R and D grew 7%, broadly in line with sales, as we invested in Phase three trials, particularly in RINI and on Core EPS grew 12%, slightly below operating profit as anticipated due to an expected increase in the core tax rate. And turning to the total results, operating profit decreased materially year on year to £4,000,000,000 The reduction reflected a £1,800,000,000 charge relating to the resolution of the Zantac litigation, and the higher CCL charge driven by the improved long term outlook for our HIV business. Next slide, please. Core operating margin improved to 29.2% up 130 basis points year on year at CER and ex COVID, notwithstanding the absorption 140 basis points due to the loss of Gardasil royalties. This marked improvement demonstrates productivity, efficiency and optimized resource allocation to the key commercial and R and assets in the business.

The gross margin benefited from the outperformance of Specialty Medicines, positive channel mix and supply chain productivity. Next slide, please. Turning to cash. Cash generated from operations was £7,900,000,000 impacted by settlement payments relating to the resolution of Zantac. Excluding this impact, we continued our track record of improving cash every year with CGFO up £400,000,000 totaling 8,500,000,000.0 This improvement primarily reflected the increase in core operating profit together with favorable working capital largely due to lower receivables and lower pension contributions. These benefits were partly offset by lower other payables due to the reduced rebates and returns from AMCAP. Free cash flow improved to £3,500,000,000 ex [indiscernible] of 0.4 of a billion in BD intangibles. Next slide, please. This slide demonstrates how we have deployed our cash in line with [indiscernible] Free cash generation, pre capital expenditure and excluding Zantac was strong, at over $6,000,000,000 Our first priority is to invest for growth And in 2024, we deployed €3,600,000,000 on CapEx and BD. Our second priority is returns to shareholders. And today, we have declared a dividend of 61p an increase of 5% year on year and ahead of guidance. Reflecting the strong outperformance of our 2024 results compared with our original position.

In 2025, we anticipate paying a dividend of 64p a further 5% increase year on year. And finally, we had two one off factors. The monetization of Halyon, which generated $2,300,000,000 and the resolution of the Zantac litigation. At December 2024, net debt reduced to 30,000,000,000. Driven by strong free cash generation and the Halion proceeds. As we've previously said, we will look to deliver incremental returns when business needs have been fulfilled and the balance sheet allows. And given the significant transformation since the demerger, we now have a strong balance sheet, which gives us a high level of flexibility for the acceleration of organic investments and further business development. Whilst also enabling a step up in shareholder returns.

As Emma said, we will augment our dividend with the €2,000,000,000 share buyback program to be completed over the next eighteen months. So to summarize, our focus is on investing for growth. And there is no change to our capital allocation priorities. And we remain fully committed to maintaining a balance sheet with a strong investment grade credit rating. Next slide, please. Now turning to guidance at constant rates. I'll cover 2025 and phasing and then move to the outlook for 2021 to 2026. So first, for 2025, we expect another year of good profitable growth GSK. Sales are expected to increase between 35% core operating profit and EPS to increase between 68% With EPS impacted by higher interest charges, and the tax rate rising to around 17.5%, offset by up to a 1% benefit from the share buyback. Some points to note for modeling purposes. Firstly, we expect our sales growth to be driven by special Medicines in 2025, which also benefits gross margin. Secondly, in terms of OpEx, we expect SG and A to grow at a low single digit percentage. With strong investments behind product launches, whilst focusing on competitive precision analytics, and an AI enabled approach driving increased ROI.

R and D is expected to grow broadly in line with sales as we prioritize investment in key pipeline assets including RINI, oncology and next generation vaccines. And finally, we expect royalty income to be in the range of £650,000,000 to £700,000,000 As previously stated at Q3, our guidance incorporates a $400,000,000 to $500,000,000 revenue headwind from the introduction of the IRA. Next slide, please.

In terms of phasing, we anticipate growth in 2025 to be second half weighted largely due to a significant sales comp base effect particularly in vaccines. As well as benefits last year that will not repeat. Namely ZEJULA in Q1, and return and rebate adjustments in Q2. Next slide, please. Emma has covered the overall outlooks. And therefore, I would just like to give more color on the change in the product mix outlook from 2021 to 2026. The contribution from Specialty Medicines has increased significantly. With growth accelerating due to strong RINI oncology and HIV performances. This performance momentum means we now expect a low to mid teens 2026 CAGR ahead of the previous guidance. And for HIV specifically, to grow high single digits, across this period. For vaccines, the recent performance has been volatile. And whilst we continue to expect material contributions from vaccines, in the medium and long term, In the near term, we have reduced our expectations for the twenty twenty six six CAGR to a mid to high single digits. Where we ultimately land in the range will depend on a number of factors, most notably the overall U. S. Environment for vaccination, ASIP recommendations, disease incidents, and the China macro backdrop and its implications for Shingrix uptake.

General Medicines has also outperformed, which means we expect a low single digit contribution to our 26 CAGR. [indiscernible] Alongside sales, we continue to focus on margin improvement, with no change to our guidance of more than 31% margin by 2026 and more than 500 basis point improvement over the five years. And we continue to expect a broadly stable operating margin through the Dolategravir patent expiry. Next slide, please. Turning to our IR roadmap. We have made significant progress this year in our pipeline and execution and the deployment of capital to support growth. And turning to '25, twenty six as mentioned. We expect five major approvals this year including Blendrep and Depimocumab. Over the coming twenty four months, we also anticipate Phase three readouts for chamblipixent for refractory chronic cough and bepraverzin for hepatitis B as well as pivotal Phase 2s for our four monthly HIV, PrEP, and Gemperli, Brexmal Cancer. Next slide, please. Before I finish, I just wanted to take a minute to reflect on progress we've delivered over the last few years, which demonstrates a marked improvement in capital management, operational efficiency and our commitment to improving outlooks. Firstly, operating margin improved three sixty basis points.

And we have moderated the growth of SG and A as we leverage investments and take a disciplined returns based approach together with supply chain efficiencies and mix benefits. Importantly, over the period, our investment into R and D is increased at a 10% CAGR. And going forward, R and D growth is expected to be broadly in line or ahead of sales. Secondly, cash generated from operations has been growing to about GBP 8,000,000,000 per year since 2021. With 2024 being a record year adjusting for the one off impact [indiscernible] We anticipate this rising further to more than 10,000,000,000 by 2026. This strong cash generation has allowed us to commit to a progressive dividend policy. With more than 5% growth over the last three years alone. And it has allowed us to announce the $2,000,000,000 share buyback program today, Including this, we will have returned in excess of €8,000,000,000 of cash. To shareholders over the three year period to 2025. Our balance sheet is now very strong with net debt to EBITDA at just 1.2 times.

Allowing us significant firepower for future BD and shareholder returns. We will continue to benchmark all future deals against stringent criteria to ensure capital is deployed optimally, And ultimately, you will only see us investing in opportunities that are strategically aligned to our main therapeutic areas. And with that, I'd now like to hand back to Emma for her closing remarks.

Thanks, Julie. So in summary, GSK is powering forward. This comes on the back of a strong track record of operational delivery and accelerating progress in innovation and pipeline development, where of course, there is always more to do. Our portfolio is demonstrating both growth and resilience. Built around high quality specialty medicines and vaccines, with more to come in key areas of therapeutic strength. [indiscernible] As we head into 2025, we expect another year of profitable growth, we have further improved our long term outlook. To sales of now more than £40,000,000,000 by 02/1931. Our outperformance and stronger balance sheet support our future as well as providing us with the opportunity to deliver enhanced shareholder returns.

All of this underscores GSK's opportunity to deliver scale health impact to patients, through this decade and beyond. Combining science, technology and the talent of our people to get ahead of disease [indiscernible] Thank you very much, and I will now open up the call for Q and A. Okay. Thank you for the Q and A portion of our call. Please use the hand raise feature in the Zoom webcast that we may accommodate as many participants as possible. For our first question, we will go to Emily Field, from Barclays.

Emily, Can you please ask her question?

Hi. Thanks for taking my questions. I'll ask two hopefully quick ones. Firstly, I know you mentioned impact from sort of the China macro on Shingrix. Obviously, with the Merck announcement yesterday on Gardasil, a lot of concern that this has the deterioration in this outlook has accelerated. I was just wondering if you could provide a little bit more granularity on your expectations for Shingrix in China in 2025? And then secondly, 2025, are you assuming much of a competitive impact from the launch of Linnek Thanks. We'll come to David in a minute on HIV. And I'll [indiscernible] China. I just would flag this is something that we addressed last year with the repositioning of our deal with our trusted partner, Jaffee, and I think still remain ambitious, although the short term pressures were acknowledged both through 2024 and of course in the [indiscernible] from our longer term ambition. Luke, do you want to comment on China? Thanks, Emily. I mean, as Emma said, look, there's not much more to add than what I covered on the Q3 call.

I mean, our market share is around 70% and that's our target population there. We're very happy with the partnership with Chef A. But the intent to extend it out to 02/1934 is to was to address exactly what we're seeing right now, which is just to navigate these short term headwinds Our focus operationally is partnering on the ground with Chipang. To expand in those high tier cities. And initial signs are encouraging. But again, I wouldn't expect too much in 2025. This is a bit to longer term play here.

Thanks. Michel, Vikram? Yes. Thanks, Emily. So firstly, very pleased, obviously, with the continued strong growth momentum in HIV in Q4.

Contributing almost £2,000,000,000 of sales, I think on your specific question, look, we certainly expect HAPRITUDE to continue to grow this year. First and foremost, the prep market in U. S. Is actually significantly underdeveloped. The CDC estimates, I think, about one point two million Americans could benefit from PrEP and stay only about a third of those are getting any form of PrEP treatment.

And we also know that the prep market is very well suited to long acting options. And I think Apertoon and now the competitive product have very similar strong efficacy probably will definitely better than the orals mainly due to compliance. So I think with a second long acting entrant coming into the market, this year, it should help grow the market for all of us. And then secondly, the competitive product definitely won't be for everyone. We now know that there's quite a high frequency of nodules people experience in their abdomen. Where the two injections are given. I think in the pivotal studies, about sixty three percent of participants experienced nodules with a mean duration of about six months. And seven cases of ulceration I expect we'll learn a lot more as the year goes on. Through more data and more real world evidence of exactly what type of patients and the size of these nodules and so forth, But for potential prep users who are body image conscious which will be quite a proportion of them, I think, That potentially is an issue. And then I'd also flag that the competitor product has quite a high number of drug drug interactions, made 14 classes of commonly prescribed prescription medicines corticosteroids, dysfunction meds and so forth, And also DDIs are recreational and MSX drugs, opiates, spentanols and so forth.

And these DDIs can be serious and in very extreme cases potentially cause fatal respiratory depression. So again, for PrEP users or potential PrEP users, who are taking these meds, it may not be for them. So we'll see how this unfolds, but I think we expect to grow in a growing market.

Thanks, David. And just to underpin, we welcome the opportunities to grow the market, but even if this market triples in size and we get to the 100% participation to the part of the market that the CDC said could could be treatment is still where most of the business is and here we obviously lead the way. So next question please.

Great. The next question will be from Richard Parks at BNPP Exane. Richard?

Hi. Thanks for taking my questions. So I've got a couple of questions on vaccines and the targets. So in on RxV, Obviously, You You Saw Rapid Penetration Of The U. S. Market, but there's still a large international opportunity. Can you discuss how prepared you are to access that in 2025 and what the key factors are in in driving that or limiting your ability to access the opportunity. And then again on vaccines, obviously, you talked about moderating expectations for RxE Shingrix Can you talk about what's assumed for peak sales of both those products now? Because I think the market is quite skeptical about your prior peak sales target given the current headwinds and just wondering what the offsets are to raising your twenty, thirty one targets. I know BlendRep's obviously been included, but it sounds like there's some other offsets that where you're more optimistic. So helping understand those moving parts would be helpful. [indiscernible] Thanks, Richard. And I'll come to Lou to add a bit more color on how we see The opportunities for growth over time on OREX because we really are in the foothills of this vaccine, which as you know, we really thrilled with the data that's come through on its efficacy and a high burden of disease.

Area. Explicitly, there's no change to our ambitions for our assets, be that our existing ones or some exciting pipeline that's coming through later in the decade. The real question is actually the area under the curve. And obviously, last year, you saw us recalibrate our [indiscernible] those or sorry to maintain that the and acknowledge the short term pressures on that [indiscernible] expected the mix to change, she's been more explicit today We've been more explicit today on how that mix changes. And obviously, that has flowed through to our updated 02/1931 Outlooks. Alongside as you suggest, Richard, the impact of 13 positive Phase 3s The momentum in our Specialty business more broadly. And as Judy said, we've upgraded whilst acknowledging the pressures on vaccines, we've upgraded our 26 outlooks for total specialty, for HIV, also for Genmed, these have rolled through and we've added in BlendRev. And as I have my introduction, doesn't yet include our intent to invest in progressing the early stage pipeline or our intent to pursue further BD like the kind of assets that you've [indiscernible] Right at the January, IDRX isn't yet in there. So I think the key takeaway on this is the strength of our broader portfolio, the progress we're making in the broader pipeline means we can digest these what we think are short term pressures of both The U. S. And China, and we remain optimistic about our broader vaccines pipeline.

And lots more to come, particularly in oncology and RNIR be it Glen Rep or ADCs or the other pipeline that's coming through. So with that, I think let's come back. It's explicitly to OREXVI Luke, and how you see the international opportunity, whatever the weather in The US is at the moment?

Thanks, Emma, and thanks, Richard. I mean, last year, we had about 15% of revenue was ex U. S. I'm very encouraged what we're seeing. It's early days, but we know what we're doing in this context. I think with these national immunization programs, which I said earlier, we've got six that's in The UK, Greece. They want to check Saudi strong tender there as well as critical success with Stico in Germany, in addition to The U. S. Think it's an encouraging start. I think what also is important is the systems will differentiate based on clinical data. And the market research that we have in these key markets is certainly very encouraging in terms of the perception of OREXI. The efficacy of high risk groups as well as the durability and cost effectiveness of the vaccine. So look forward to updating you more this year. But so far, it's a good start.

Thanks, Sue. Next question, please.

Great. The next question, we will go to Steve Scala from TD. Cowen Steve.

Steve. Thanks for joining us early.

Just asking Steve to unmute himself. All right, Steve, we'll come back to you. And instead, let's go to Peter Welford, at Jefferies.

Hi, thanks. Two questions.

Firstly, just sticking with the Rex deal, but this time in The U. S, I wonder if you could just talk a little bit about the commercial environment there if you can, because I guess in the last part of the season that we can see the prescription data for, it looks as though Pfizer is beginning to claw back quite a bit of share compared to what we've seen in the past. Can you just talk a little bit about contracting that you're seeing, I guess, for this year and perhaps also reluctance, I guess, on that from pharma from pharmacies and buyers, I guess, to engage given what I imagine from their part must be pretty uncertain demand going into the next season, which I appreciate is still months and months away. And then secondly, just on the buyback, I mean clearly reflect your confidence in the longer term pipeline that you already have on internally relative to how the market perceives the R and D and what you have for new launches So I guess could you talk a little bit about how I guess how much of when we look at that chart, how much of it do you think is reflecting also things like long acting HIV?

And maybe you could put a number on your how big do you think the HIV long acting business could be beyond the sort of LOE expiras that we're seeing? And I guess trying to sort of build some confidence in what is it that the market's missing? Do you think in terms of the sort of resilience perhaps in the base business that gives you the confidence to do, you know, to allocate capital to a buyback there.

Yes, lots of questions in that, Peter. I'll come back in a minute to Luke on the U. S. Commercial environment in vaccines. Obviously, lots of external commentary and speculation on that for 2025 which also depends where we see the sort of pressured external environment, but Luke can add further comment on the commercial side. Look, buyback is completely consistent with the capital allocation framework that we've laid out. And the first priority continues to be, as both Julia and I said, to invest in the future growth of the company, to invest in the pipeline to invest it competitively in these exciting new launches that we've got coming through be that the five approvals we hope to have this year or hopefully as they progress the 14 key assets that R and D with commercial partners working together on on bringing forward. We also want to continue to supplement that. And Span, to continue to supplement that with further business development. The point is that alongside that, priority, we also continue to demonstrate our focus on improving shareholder returns. And obviously, considering the momentum in the business, the progress in the business, the strengthening of the balance sheet, we are very confident that we have both the circumstance and the opportunity to deliver really compelling returns to shareholders that we've made today.

Now I am not going to guide by individual product forecast in terms of what we will deliver in 2030. We've given a, I think, a reasonable schematic that we've presented you that shows most importantly, and this is really the key thing I think people should take away from today, is our biggest business 19% in 2024 with every single therapy area growing at double digits. It's still a nascent business, but progress we're making in oncology is very exciting and we have a a really material contribution to make even if the launch is staged and it's really about the contribution to '26 to '31, certainly not to '25, but we're very excited about Blenheim coming through. And remember, that doesn't yet include First Live, but we were pleased to start the study let's see. But the data we have on overall survival is, we think, game changing as well as life changing. And so very excited to see what comes there and what could be added with ADCs.

And further progress we want to make.

Explicitly on HIV, the six monthly drugs, it are not yet included in this outlook. So that's also worth bearing in mind. So I think that's where people should focus. No one should doubt for one second our commitment into our vaccines portfolio, but really, it's this shift in the mix, which, as Julie also said, secures the profitability of the business and the gross margin to So with that, maybe Luke, you can comment specifically on the commercial world in Southeast of Remodelius. Yes. And thanks, Peter.

Look, I mean, I think when I said came out with its surprising decision in June, I mean, we called it a spade a spade and we said it was going to be tough. And I think the evidence has indicated that that was correct. If you look at penetration rates in The U. S, the most recent data we have is in November. If you contrast that with December of twenty twenty three, [indiscernible] ASIP. If you look at penetration, there's 75 plus population at the end of twenty twenty three, it was about 17%. That only increased up to 26% over 2024.

And if you look at high risk individuals in the sixty to seventy four population, it went from 11% to 18%.

And in the generally healthy population where ACIP was steering people away, it just increased from nine point four percent to around 14%. So there is a shift here in terms of demand. If we look at market research and profile physicians still prefer Auryxia. And I've said this a couple of times. For me, the key element here is to navigate what we think is going to be a transition from three vaccine market to a two vaccine market. There's a huge amount of pressure competitive pressure in the market through the contracting cycle last year. I think we've navigated that quite well. Our focus remains on retail. What I would strongly stress is we need to compare apples with apples when we're talking market shares. So you need to adjust the market shares for maternal volumes where we don't have the label. So if you do that, the end of twenty twenty four, we had about a 58% market share. So about 4.1 doses out of seven million were with Auryxia. I think we're happy with that. The key thing is to preserve value and position us ourselves for the future when we do think ACIP ultimately will move to expand this Based on the evidence, there will be a revacs at some point and we want to be positioned to compete with Pfizer very actively at that point.

And David, I think you want to add something on the six monthly? Just on six monthly, Peter.

As Emma said, it's not in our forecast, but I'd certainly agree with you that it could be a potential upside year will actually be an important year for six months. We will have Concept data on 184 and also the two options that we could put with either 184 or one of the other entities. So N6LS, the EMBRATE study at six months, think we'll have a CROID and also our Capsiv So the aim is to look at that data this year and then make a reg [indiscernible] choose our insti for prep. Next year and potentially run start running the pivotal studies in 2027. So as we go into next year in 2027, that's probably the time when we think about formalizing the forecasts And let's remember, it was only four years ago that we said we were expecting more than £33,000,000,000 in 02/1931.

Today, it's more than 40 you can see we're already close to that number. In the near term. So yes, we are confident in our prospects. And yes, we know we've always got more to do. Next question please. Great. So let's go back to Steve Scala from TD Cowen. And Steve, see if you can ask a question now.

Thank you. That was my mistake.

Two questions. For NUCCALA, is the exacerbation data competitive with DUPIXENT? And have you shown an FEV benefit?

I mean, if not, your statements that you will lead in COPD might seem less And secondly, you noted that GSK expects changes to U. S. Vaccine policy This contrasts with what another major vaccine company said just last week when they reported that company expects no changes So in practical, on the ground, everyday terms, what exactly do you expect to happen and to which vaccines Or is this more of kind of a vague concern?

Well, thanks, Steve. I'll come to Tony in a second on New Carla.

The only point I would make is our ambition in COPD is across a portfolio of pipeline that Tony did share in December. So as well as New Carla, I'm sure he'll want to comment on that. Newkala is just the first foray into biologics for us there. And then in terms of changes to U. S, I think our point was We note the significant speculation Let's face it, there's been a lot of it over the last few months. Around what kind of changes there might be to U. S. Vaccine policy. And that is definitely one of the contributors to our view around the short term pressure [indiscernible] We also, as Luke reemphasized, are still living with the decisions that were made by ACIP last year. And the key assumption is from us in that context is that there will be No further indications or cohort expansion assumed on RSV. This year. Although we do over time expect them to be added in, as Lou said, rebacs as well. I think the only point I would add without wishing to predict exactly what's going to happen is it was good to hear through the nomination process RFK reiterate his recognition of the value of vaccines, his own children have been vaccinated and also over the weekend to hear in the discussions with Senator Cassidy, the CDC vaccine guidance is and the NASIP should remain unchanged.

So let's see how this plays out We'll know we'll all know a lot more through 2025. And look forward to some of the speculation being settled. [indiscernible] Tony, do you want to Yes.

Let me start with Steve the first thing I'd say is we're looking forward to being able to share the the total new color data set with you soon. I'm obviously not going to get into the details as that. I've ahead of publication, but perhaps I might just stress a few aspects of this and in particular in the context of patient population. So if approved, Yukawa is going to be the first monthly biologic proven to reduce exacerbations across the full spectrum of CO COPDIC disease. And in particular, that includes individuals with emphysema, who are the most difficult to treat. You'll recall from the data that we've previously published around the two prior phase three studies across that population and exacerbation reduction rates in the order of around about twenty percent is typical in the in the broader population. I'd also stress that we went to great lengths to ensure that we removed co morbid asthma patients from that study as well. And so I don't think it's it's difficult to compare side by side. However, we have a broader population, about a third of the COPD population, have ensoscema. And I'd like to ask Luke just to comment on that.

But one final thing, again, if you look back in our data at similar populations and we've published similar sorts of headline efficacy on exacerbations, but it's important not to compare across MEDLINE data because it's a very different patient characteristics in the two studies.

Yes. Thanks, Steve. I mean, Tony and I spent a lot of time talking about this. I think you just need to look at it practically on the ground. And Tanya mentioned about a third of those patients have an emphysema alone. About a third of them have bronchitis. Also a third of them have mixed and can be difficult to separate those. So just practically, also when you look at the Dupixent population and we're not sick, they have a goal of two to three. So moderate to severe. Whereas we were two to four, which included very severe. And I think if you look at what the gold report, which just came out last year said, it's pretty much positioning Dupixent in that bronchitis subset, So again, I don't want to preempt that data, but think we have a broader argument here also the important thing is to focus on hospitalizations because when people go into hospital, obviously, many of them don't come out. And it sets off a cascade here. So in summary, we've got efficacy and tougher to treat patients, a broader population.

And, yes, let's see what the publication and the reception from the community says. But we intend to compete There was a request from DUPIXENT for more competition and we intend to provide it.

I mean this is what's great is the opportunity to grow biologics. On the back of by the way, [indiscernible] Trilogy business in COPD. And I am really excited to see what long acting drugs are going to bring here. So good to see that we're we're going to be going into COPD study for Depi. We've also got the ILs and and TSLIP as well that Tony laid out. So I think this is the beginning of some exciting prospects in biologics. That will get much stronger through the end of the decade too in a disease that is the third leading cause of death. And so when you're talking about scale opportunities to address health in a field that we really know what we're talking about, this is a good one. Next question, please. Excellent. Next question is from Rajan Sharma from Goldman Sachs.

Rajan, you're up.

Hi. Thanks for taking my question. Just first one was on HIV. Could you just discuss the dynamics driving that positive impact from channel mix? Is that implying that there's a low proportion of Medicaid patients? And do you expect that to continue into 2025 and 2026? And then the second question is just on the 02/1931 guidance update. So you've taken up guidance by €2,000,000,000 in revenue, which includes Blenwrap, which you've previously talked to as a £3,000,000,000 peak sales opportunity. So just to be clear, should we read that as kind of a 1,000,000,000 reduction in the guidance excluding Blenrec or are you not expecting Blenrec to reach its peak until after that?

And then just related, there's obviously quite a bit of a difference between work and is right now. Is there anything particularly that you'd call out as where that delta is?

Yes.

I mean, Julie, you might want to comment in a minute on the consensus as much as you wish to. And I'll come to David on HIV. But first of all, to be clear, the outlook for 31 is a more than 40,000,000,000 pounds and we're pleased to have moved that up as I've said, which is a combination of rolling forward the mix shift in 2026, progress in our Phase three, results and across the portfolio, and the inclusion of a BlendREP second line launch as well. There is no change to our ambition for BlendREP to be more than £3,000,000,000 peak year sales. There was no time put on that. And we're looking forward to the contribution of the five approvals that we flagged and more to come, really contributing to that 26% to 31% outlook. So David, do you want to come on on HIV?

Rajan, I think the main channel mix evolution we expect this year is just the ongoing rise of three forty which is somewhat sort of a headwind, but not huge. Other than that, I think it's going to be more of the same. And Medicaid and the related programs like Ryan White ADAP and so forth are about forty percent of The U. S. HIV book of business. Medicare is about twenty percent. That is steadily increasing over time, obviously, as patients and the rest is private insurance. So So very much apart from 340B, I think pretty much the same trend is continuing. Thanks. So Julia, So in terms of the difference with consensus in terms of our outlook, which is more than €40,000,000,000 The two main therapeutic areas where we've got a difference are oncology and respiratory, immunology and inflammation. And within the oncology category, the two biggest ones are Glenrep And obviously, people are probably waiting for the launch. And then also Jen Purley, so we've got lifecycle indication And you've seen the track record we've got on JEMPERLY already with some important readouts. Coming up. So those are two big differences. And then with the within the respiratory, immunology and inflammation area, We've got Calvaryxent, where obviously people are waiting for the readout that's coming in about a year.

And then also, depamercumab interestingly, even though we've now got a successful filing, clearly, we've got the approval expected the end of the year and the launch at the beginning of 'twenty six. So those are the main areas of difference which we have got with consensus.

Thanks, Julie. And let's remember, I think it's seventy two percent of reductions in exacerbations that cause hospitalization on Depi. So even if that's really a twenty six launch, hopefully with an approval at the end of this year, Just considering the burden of disease, the cost of hospitalization, the enthusiasm and loose presented this research before from HCPs as well as patients for this, that's definitely one to watch.

Next question will be from Justin Smith at Bernstein. Justin?

Yes, many thanks indeed. It's just one on 10 Phase three first line, and the MRD endpoint. Just could you share a few thoughts how that endpoint resonates with payers and community docs, particularly those outside The U. S?

Let me just start with the dynamics and data plan associated with MRD and remind you of what we've already seen with molecular measure in Dream seven and Dream eight. And then Luke, perhaps I can hand over to you in terms of the the resonance with key docs. So we were expecting and again a reminder that ODAC approval of the use of MRT as an endpoint was only just last year.

A recommendation for use of MRD as an endpoint, We started the study, as Emma mentioned, in December, we're expecting the first readout on MRD data in 2027. What needs to occur over the intervening period and others will be driving this based on their own first line studies is a relationship between an understanding of MRD and a more established regulatory endpoint like PFS. What we know from our own analysis in Dream seven, Dream eight and indeed other first line studies for brain rep is when we look at the characteristic details of MRD readouts and we see a similarly improved outcome for Blaine rep relative to competitive assets. But Luke, you might want to comment on. Yes.

Yes. I mean, thanks, Justin. And just to build on Tony's point, I mean, the market research we get is exactly what the FDA is signaling, which is MRD is a practical response to very long durations and clinical trial feasibility in first line. What it is not is a replacement for survival in second line. I think that's absolutely critical and we see that. So and as we've covered earlier, we've got very strong data in second line and look forward to talking more about it over the year.

Thanks. Next question, please. Great. Next question will be from Grant Parry of Bank of America. [indiscernible] Thanks for taking the questions. So first question is just on the guidance for 2025. So relative to consensus, it looks like the guide is a little bit worse than is looking on vaccines, but Genmed is better.

At stable, I think, most looking for a decline there. So could you give us some little bit more color behind the outlook on Genmed, especially as I think there were some rebate adjustment benefits to TRELEGY in 2Q last year. So you're actually looking for underlying growth. So what gives the confidence in that holding flat in the year and maybe the durability of that beyond 2025 And then secondly, on the buyback and free cash flow allocation, just perhaps give us a little bit of a sense of where you see free cash flow in 2025 If you're generating around £3,000,000,000 in 2024, you'd moving to a €2,000,000,000 share buyback.

And you highlighted low leverage. Are you now assuming you're going to increase leverage through the year as you see opportunistic to fund opportunistic BDL to make sure you're still funding the pipeline? Thank you. Hi, Graham. Well, two great questions for Julie.

So Okay. Thanks, Greg. So in terms of the RAR adjustment we had last year in the second quarter, It was largely there was there's a high level, obviously, Trelegy was performing extremely well and that attracts high levels of RAR. We had a true up in the second quarter simply because when the claims were coming in, they were at a lower level than expected. Whether people were moving into the catastrophic coverage quicker and that was causing that. Obviously, we don't know. But it was a benefit in the second quarter of last year. In terms of the leverage point, obviously, we've ended the year really well. We've got leverage of 1.2 1.2x net debt to EBITDA. We'd expect to run the buyback as we've mentioned, over a period of within eighteen months. Obviously, the weighting will be more towards 2025. So the leverage will move up during the course of the year. In terms of cash flow expectations, for '25 obviously, slightly below 2024. We've got the Zantac settlement going through. Which is expected in the second quarter. And then we will have an upside from, obviously, operating profit growth. RAR likely and trade payables. Great. Next question, please.

That is the last question. Yes. So let's go with one final question from James Gordon.

James?

You're up.

Hello, thanks for taking the questions. Two quick ones, please. One was just capital allocation building on one of the earlier questions.

So where is the ceiling in terms of how levered the [indiscernible] Could you go much above that? And so you could still do multi billion pipeline deals? Or is that optionality off the table really? That's the first question.

And the second question, just Camlopixum was mentioned. So I think we're going to get one of the Phase three at the end of this year and one early next year. But Merck's Gefu, which is also P2x3 that had similar efficacy to you in Phase II and also didn't come to market. So what is the latest thinking and what you actually need to show in Camaropixin?

And how confident are you, Saul?

This a blockbuster product with GSK?

Thanks. Well, look, I'll come to Tony to answer on that and the two studies that we've got coming. And Luke, you might want to add also a reminder on why we wanted to do this deal and what the patient opportunity is. In terms of capital allocation and business development, I'm just going to repeat what we've said, which is Our number one priority is to invest in growth. We do want to do more BD I'm really pleased with the discipline that has gone into the kind of business development that we've been doing, the bolt ons in our core areas, some with that might be high risk, but very high return.

And really nice tuck ins, including the IDRx one that we just announced, you should expect James the kind of BD we've been doing, the kind of scale and pace and with the focus and with the discipline that we've been doing. Obviously, we want to underpin all of that. Capital allocation with a strong balance sheet. And, Jude, I don't know if there's a sense of what you want to say on leverage, but No, I think in terms of the ceiling, your question about the ceiling. Obviously, we want to retain the strong investment grade rating. Clearly, liberating [indiscernible] because it's not a scientific number. We're basically very comfortable with where the balance sheet is. As Emma mentioned, very clear priorities about capital allocation. They haven't changed. It's just the robustness of the balance sheet that allows us to do the buyback. Complemented with what we're already doing in BD.

Yes. And all supported by the strong momentum in the delivery of the business. Which we're planning to maintain. So Cabinetsum.

Yes, Cabinetsum.

Just quickly then, James, I think it's really important when you look at this area in P2X3 not just to think about efficacy, but in particular to think about therapeutic index. And if you remember, camlopixent has a far improved therapeutic index, but disturbance. We have less than six point five percent adverse events in our studies so far Compare that with jeffepiXin, which had a nearly seventy percent taste disturbance. So it makes it hard to run the study when you're unblinding your your treatment group. I think we have just to keep it short, a superior asset a clinical trial program which has been designed to take account of the aspects of frequency of cough. And as I mentioned, we will not be unblinded functionally by the taste disturbance in the way that Jeff Opixson was. Luc, anything to add? Yes. I mean, just to build on Chinese point, I mean, the smooth Phase 2b, we saw around 34% cost reduction. I think Tony's team is doing an excellent job in terms of execution of that study. Merck's molecule was basically a pro rata validated the target GSK had flaws in its selectivity and there were some challenges and study design around cough counter These have all been incorporated into our program.

When we talk to pulmonologists, they still express high enthusiasm. The numbers are quite big if we model out 02/1930. We expect around just under three million patients in The U. S. Will have had chronic cough for more than a year. Actually over that number in Europe. So we're talking large numbers patients sitting in primary care and also pulmonologists respiratory physicians, offices, and there are unlimited options for those people at this point.

A really high dissatisfaction with current standard of care options. So thanks everybody. Again, after a strong 24, we really are looking forward to another year of profitable growth and pipeline progress.

And we're really pleased to be upgrading together our 02/1931 outlooks again with prospects of 50% of our business by then more 50% being in specialty medicines. And this continued performance and the stronger balance sheet are really underpinning underpinning our plans to continue to increase investment in the 14 key assets that we're focused on in the pipeline, in BD and in the success of launches ahead. And of course, staying focused on improving our direct returns to shareholders. With thanks to everyone, we'll look forward to catching up with you in coming days.