Murdo Gordon
Analyst · Jay Olson from Oppenheimer & Co. Jay
Thanks Peter, and good afternoon everyone. I'll take a few minutes to reflect on 2019 and then review Q4 in greater detail. In the 40 years since incorporation, Amgen's product portfolio and geographical footprint has changed dramatically. On our 40th anniversary, we reflect on the pioneering innovative spirit of our early Amgen employees that transformed the treatment of disease. Our mission to serve patients remains unchanged and it motivates us every single day. Our accomplishments on behalf of patients in 2019 give us further confidence about our future as we enter 2020. To summarize 2019, for the full year, we grew volume by 3%. The growing proportion of our portfolio posted 35% year-over-year volume increases. This portfolio is diverse and includes products such as Prolia, Evenity, Repatha, Aimovig, Otezla, Amgevita, our six hematology and oncology brands as well as MVASI and KANJINTI. Finally, our international business contributed 19% volume growth in 2019. Notably, year-over-year revenues for our businesses in China and Japan grew nearly 8 fold. These markets are long-term growth engines for Amgen and our collaboration with BeiGene along with our acquisition of Otezla will accelerate our expansions in the second and third largest pharmaceutical markets. Now moving to fourth quarter results. Volumes grew by 3% year-over-year. In Q4, net selling prices declined 4% year-over-year, resulting in reported net sales declining by 2%. As Peter mentioned, we have a stable outlook for our base business for 2020 and with the addition of Otezla, we expect revenue growth this year despite projecting continued declines in net selling price on a portfolio basis. Now getting into product details, Prolia delivered 15% growth year-over-year, driven by higher volume from increasing rates of new patient growth and strong repeat injection rates. Recall that given twice a year dosing, Prolia experiences consistent seasonal trends. Evenity posted $85 million in the fourth quarter, driven by strong uptake in both Japan and the U.S. Every year, worldwide 8.9 million fractures occur due to osteoporosis. That's one fracture every three seconds and only 20% of women who experienced a fracture are treated with a bone-building medicine. Given the under-penetrated nature of this market, we continue to focus on ensuring postmenopausal women receive appropriate screening, diagnosis, and treatment. With Prolia and Evenity, we have excellent treatment options to offer these patients. On to Repatha, Q4 sales grew by 26% year-over-year, as we continue to be the leader in the PCSK9 class worldwide unit growth was 67% year-over-year and new to brand U.S. prescriptions are steadily improving growing at 61% year-over-year, we've taken significant steps and have made major progress in improving access and affordability for Repatha. We removed the original list price offering. We simplified and improved prescription approval rates and commercial plans and we have increased the percentage of Medicare patients up to 70% that can access Repatha at a more affordable co-pay. Although the blended net price of Repatha in the U.S. declined in Q4 versus the previous year, net selling price was relatively stable sequentially. For 2020, we expect a step down in Repatha's net selling price in Q1 based on our contracting to obtain broader access with stabilization thereafter. Now onto Aimovig on Slide 16. On a year-over-year basis, volume grew 27% while net sales grew 3%. As a reminder, Q4 2018 benefited from $20 million of favorable changes in accounting estimates impacting the year-over-year comparison on a quarter-over-quarter basis. Unit volume grew 9%. To date, almost 300,000 patients have been prescribed Aimovig by more than 33,000 prescribers. Considering that there are 4 million migraine patients in the U.S. who are eligible for CGRP treatment, Aimovig has significant potential remaining to penetrate this market and we expect to drive volume growth over the course of 2020. Aimovig leads in both new to CGRP prescriptions and total prescriptions, which exited Q4 with a 48% TRx share. Aimovig has exceptional access with over 80% of prescriptions paid and over 92% of the lives covered. As a result of this broader access, we expect net price to decline slightly on a full year basis for 2020, when compared to the full year 2019. Additionally, Q1 has lower sales in subsequent quarters due to the impact of benefit plan changes, insurance re-verifications, and greater co-pay expenses as patients, work through their deductibles. We'll move to Parsabiv on Slide 17, which grew by 49% year-over-year in the fourth quarter. Independent and midsize dialysis providers already utilize Parsabiv for a majority of their calcimimetic patients while FMC and DaVita continue to increase adoption. Next onto Otezla. With the help of the dedicated professionals that have joined our team from Celgene, we will continue to drive strong sales growth and launch potential new indications for Otezla. During the period since acquisition closed, prescription momentum continued with 13% year-over-year growth. Our seamless integration efforts, combined with planned label and geographic expansion gives us confidence in our ability to grow Otezla at low double-digit compound annual growth rate over the next five years. For the approximately five weeks post closing in 2019, Otezla sales were $178 million. We expect first quarter sales to be proportionally lower than in the remaining quarters of the year. The quarterly pattern for Otezla in 2020 should approximate the historical pattern over the last number of years. Moving on to Enbrel sales increased 2% year-over-year driven by a $66 million favorable change in accounting estimates and increases in net selling prices, partially offset by unit volume declines. Volume trends in 2020 are expected to be similar to those in 2019. As for net selling price, we project limited benefit in 2020 versus 2019 due to less favorable contract terms. With two highly complementary products, targeting psoriasis and psoriatic arthritis, we see an opportunity to strengthen their positions in the market; more broadly, we're increasing our focus in inflammation through our broad portfolio, which includes our biosimilars, Amgevita, and Avsola. Our late-stage asset tezepelumab and a number of other earlier assets in the R&D pipeline. Now to our hematology and oncology business, which is highly integrated with our oncology biosimilars that I'll discuss later. Our innovative portfolio of six brands XGEVA, KYPROLIS, Nplate, Vectibix, BLINCYTO, and IMLYGIC collectively totaled $1.2 billion in the quarter, growing 10% year-over-year. As for some of the larger brands within this portfolio, XGEVA grew 7% in Q4 year-over-year driven by 4% volume growth. KYPROLIS grew 6% year-over-year driven by volume led by a 12% increase in the U.S. - in U.S. sales. Nplate grew 15% year-over-year driven by volume. Our investments in R&D for Nplate have resulted in two innovations. First, we recently launched a smaller presentation at 125 mcg in support of in Nplate's pediatric indication, as the product is administered with weight-based dosing. This new presentation will also help to minimize general product wastage for ITP patients across all indications. Second, Nplate received approval in October for the treatment of early ITP, which gives us the chance to serve patients earlier in the course of their disease and provides the opportunity for treatment free remission. Now onto our more mature brands, in Q4 Neulasta sales declined 43% year-over-year with a 42% decline in the U.S. Recall that Q4 of 2018 benefited from a $55 million BARDA order, which did not repeat in Q4 of 2019. Coinciding with the emergence of U.S. biosimilar competition, the most recent CMS published ASP for Neulasta reflects a 10% reduction. Bear in mind that ASP is calculated two quarters in arrears. On a volume basis in Q4, U.S. Neulasta retained an exit share of 74% of the long-acting segment with Onpro holding an exit share of 55%. We are encouraged by Onpro's durability demonstrating confidence that our customers have in the reliability and quality of our supply, along with our broader customer services. We now face a third biosimilar competitor in the U.S. and other potential competitors remain and development. As you model, Neulasta sales for the first quarter, recall that Q1, 2019 benefited from a $98 million BARDA order that we do not project to recur in 2020. Finally, outside the U.S., sales declined 48% in Q4 and we expect those trends to continue. Switching to Nephrology, starting on slide 25, Q4 EPOGEN sales declined 20% primarily due to lower net selling price from our contractual commitments with DaVita, which calls for a further price reduction in 2020. Meanwhile, Aranesp declined 10% year-over-year driven by lower volume due to increased competition. Regarding Sensipar, recall that in the U.S., there were several at risk generic launches in 2019 that resulted in year-over-year sales declining 76% to $107 million in the quarter. In 2020, supplemental patent protection certificates for cinacalcet expire in France, Germany, Italy, Spain, and the United Kingdom, which will likely result in a significant decline in ex-U.S. sales in 2020. I'll close the product section with our biosimilar portfolio, which is highly integrated with our innovative business throughout the company. As examples, a majority of these products were made with the same manufacturing network as our innovative brands. We also leverage the same supply chain for distribution. And on the commercial side, we continue to identify synergies in commercializing our biosimilars alongside our innovative products, making it a highly efficient selling model and allowing us to rapidly apply learnings across our portfolio. We also offer the same provider and patient services as with our innovative portfolio. These advantages are increasingly important as we now face additional biosimilar competition to KANJINTI and MVASI and expect other competitors to enter during 2020. Our Q4 biosimilar portfolio comprised of KANJINTI and MVASI in the U.S. and Amgevita, KANJINTI and MVASI outside of the U.S. recorded sales of $258 million. In the U.S., KANJINTI and MVASI each recorded $79 million of sales and we've seen very encouraging adoption rates in the clinic segment and hospital adoption is accelerating. Given the early stage of launch, there is also some inventory stocking during the quarter. Ex-U.S. sales from our biosimilars where $100 million led by Amgevita. We continue to see important differences between products and markets in terms of uptake and price erosion with some markets experiencing strong uptake at more discounted pricing levels, while other larger markets including Germany and France exhibit a more balanced and sustainable opportunity. Here again, we're able to leverage our expertise and footprint in oncology, while Amgevita efforts synergized nicely with Otezla. In summary, 2019 was a solid year given the evolution of our product portfolio. In 2020, we plan to drive volume uptake of our growth portfolio of products, now including Otezla while defending our mature brands. Let me now turn it over to Dave Reese.