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GSK plc (GSK)

Q3 2014 Earnings Call· Wed, Oct 22, 2014

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Transcript

Andrew Philip Witty

Management

Thank you very much, and thank you for joining us for this afternoon's call. I'm here with Simon Dingemans, who'll pick up on the detail of the quarter in just a few minutes. We'll make a few introductory comments. You will have seen from the quarter release that in the third quarter, turnover was down 3%, earnings per share up 5%, bringing year-to-date earnings per share to minus 2 at constant exchange rates. Clearly, the quarter helped by targeted expense reductions. We're on track for full year EPS to be broadly similar to last year at CER, excluding divestments. During the quarter, strong Emerging Markets, Japan and ViiV HIV growth, offset to some degree by the continued trend in the U.S. Just turning to the U.S. The trend we're seeing is driven by the impact on pricing of Advair and access limitations becoming more common in delaying product uptake in primary care. Pricing. The pricing effect has been a bit greater than we expected earlier in the year, driven by market changes and competitive dynamics. It does feel like a new reality in U.S. primary care, and as we look across other product launches and other product categories, Breo and Anoro launches benchmark well, but all launches appear to be, in primary care, much slower. Now obviously, this has had impact for us in 2014, but we've adjusted quickly to the situation, both in terms of how we're contracting and also in management of our SG&A line. We now have very good visibility for 2015, as we have signed the majority of contracts and won substantial access for Advair, Breo and Anoro, with the substantial majority of top plans already secured. In some cases, with exclusive positions for some of our products, i.e. with the beneficiary of class lockout contracts,…

Simon Dingemans

Management

Thanks, Andrew. The group's performance in the quarter reflected many of the same factors we saw at the half year, and in particular, the transition of our Respiratory portfolio continued to impact Respiratory revenues, down 8% overall in the quarter driven primarily by the continuing shift in contracting terms for Advair in the U.S. Significant further price reductions have been required to renew or regain a number of key contracts for Advair. And while most of these contracts did not deliver improved access until the beginning of 2015, they've generally started to impact pricing immediately, driving the increase pricing pressure we've seen in the quarter. The quarter also saw continued competition for Lovaza and the ongoing impact of supply on our Consumer business, despite the significant progress we've made in remediating these issues. On the positive side, we also saw in the quarter more of the strong progress in many other parts of the business that we saw earlier in the year, reinforcing the broad base of growth drivers we're building across the group. In particular, emerging markets, Japan, ViiV, all reported significant growth in Q3. New products are also contributing and we continue to invest behind our multiple new launches as we extend their approval and access globally. And even though it's still early days for many of these, sales from new products, year-to-date, were over GBP 900 million. In ViiV, Tivicay's launch has been exceptional. And now Triumeq approved in August is already off to a good start. In Oncology, Mekinist and Tafinlar are also performing very strongly. In Respiratory, Breo and Anoro are both clearly on a slower trajectory, but coverage and access is steadily improving with Breo Part D coverage now over 70% and Anoro also building with Part D coverage expected to be over 50%…

Andrew Philip Witty

Management

Thanks, Simon. And perhaps, the operator could now open the call for questions.

Operator

Operator

[Operator Instructions] The first question is from the line of Graham Parry, Bank of America Merrill Lynch.

Graham Parry - BofA Merrill Lynch, Research Division

Analyst

I'll start off with one on margins. Obviously, an impressive looking margin in the quarter with a much lower SG&A than The Street was looking for. Could you just talk to, say, the sustainability of that level of margin? And particularly, how much of that was coming from FX versus savings? A related question, looking into 2015, if you can just talk through what [ph] you see the moving margin parts into next year and the outlook for margins into the -- into 2015. Secondly, do you have any line of sight on structural benefits into next year versus the GBP 200 million that you put through this year? And then on the ViiV IPO, could you give any kind of sense of timing and how much a minority stake would be? And do you need any consent from Pfizer and Shionogi? And then finally, on Anoro. Again, numbers are looking quite low here. Could you just give us a sense, again, of how much of your prescriptions are getting rejected at the pharmacy level and also the level of free sampling that's happening in the market here? So aside from the GBP 1 million that you reported, how much do you think it would be underlying if we stripped out wholesaler effects and promotional effects?

Andrew Philip Witty

Management

Okay. Graham, I'll touch on the ViiV and the Anoro question, and then Simon will pick up the 3 or 4 margin questions that you covered. So as far as ViiV is concerned, we haven't -- or we're not publicly declaring what we think the quantum of the flow could be. Obviously, we made it clear it's a minority. As you know, we own almost 80% of the business, so we have a reasonably large amount of room for maneuver which would leave a substantial quantum still under GSK. So we'll work on that over the next -- I would think this process is a year. I would have thought -- I'd be surprised -- I think for your modeling perspective, I would assume to keep ViiV as it is within GSK for 2015. I think this is more likely a '16 -- or subject to market conditions, it's more likely a '16 event than a '15 event because of all the work that needs to happen. We'll, obviously, work with our partners on this. They may or may not choose to participate in that, we'll see. As far as Anoro is concerned. So about 1/3 to 40% of scripts are still being rejected. Anoro access in Part D has just moved up significantly. So the end of this week, we'll be at 50%. But up until this week we're still being at the kind of 30% territory. So again we're building the access reasonably quickly by any benchmark, but it's only just coming up to those sorts of level. So reasonably punchy numbers still being rejected or reversed the first thing to say. About -- between 1/3 and 40% of scripts are being filled with free trial offers, and I think that's one of the characteristics we're seeing of…

Simon Dingemans

Management

Okay. Thanks, Graham. On the margin, currency was clearly a factor in the quarterly performance. And I think, of the 1.6 percentage point increase in margin, around 1% of that is due to currency. And clearly, we have to see how that plays out in the fourth quarter, but it benefited all 3 of the major cost lines. I think in terms of the underlying performance, as I commented earlier, SG&A, we have very -- deliberately targeted in the quarter and you would expect some of those programs to continue to roll into Q4 and are really the precursors to some of the beginnings of the benefits of the restructuring program we have announced today that will flow into 2015 and beyond. As to the margin position in 2015, I think until we get to close the Novartis transaction and we have a full view of the combined group, I think it's a bit early to give guidance specifically in that territory other than to comment, again, that you should expect a significant reset of the margin as we change the mix of the groups so substantially on the closing of that transaction. And on structural benefits, we continue to look for similar opportunities. We haven't identified any particularly that I would call out for 2015 or beyond, but we do keep searching for value opportunities like that.

Operator

Operator

Next question is from the line of Alexandra Hauber from UBS.

Alexandra Hauber - UBS Investment Bank, Research Division

Analyst

Firstly on -- when you're guiding to 2016 return to growth for the Respiratory franchise, now that, of course, depends on your 2015 decline. So I was wondering whether you can comment on where you see 2016 Respiratory relative to 2014. Is it up or down or roughly flat? Or is it just still too early to say because you don't know yourself how the trough is next year? And secondly, just coming back to SG&A this quarter and your cost cutting program, can you, Simon, maybe tell us a little bit more how on the one side, you have such a flexible cost structure, you can switch on and such off costs quite flexibly. So -- and on the other side, needing to spend GBP 1.5 billion for further cash in cash to get the extra savings. Just maybe -- essentially, I'm just trying to look where the flexibility this quarter is particularly coming from. And then third question, the changes on the management. Can we therefore assume that the new core is going to report according to a divisional structure? And if so, whether there -- what you're showing currently as unallocated costs will be the corporate costs. And also whether the materials which you will distribute ahead of the ECM will give us a first indication of those divisional structure.

Andrew Philip Witty

Management

Okay. Thanks, Alexandra. So Simon will pick up on the divisional points. As far as Respiratory in 2016, we expect to be back to growth. Obviously, exactly how '15 plays out is going to be the put and take of how quickly we can recover volume. I'll give you an idea. We've won 7 -- so far, we've run 7 of the top 10 contracts in the U.S., some of those we've got class lockouts in place that should help us drive volume. But exactly what the pace of that vis-à-vis the price is, of course, not completely clear. As a general point, we feel very confident as we move through '15 into '16, '17, your balance of what's driving the growth in the business becomes much more important, and that's why we've made the point we've made. As far as SG&A is concerned, I think in the short run, we clearly have a lot of discretionary spend decisions around non-people-driven costs in the business and we can flex those in different parts of the organization. Obviously, as soon as we started to see kind of in the middle of the year, late Q2, when we started to see things -- the price impact being greater than we anticipated. It gave us a chance to start to manage that. But when you look forward and you say, okay, now we need to adjust our cost base on a, let's call it, a more permanent basis to a newer reality in terms of price from the U.S., then you want to look at more structural things. That requires financing to release those opportunities, some markets more than others, of course. And we also want to take the opportunity not just to shrink the cost base, but to make sure we're taking the costs from parts of the organization where we believe we can. At the same time, create greater focus on where there is opportunity for growth and greater opportunity to simplify and take complexity out of the business. So again, unraveling all of that is oftentimes somewhat more expensive. So in the short run, yes, we've got a reasonable degree of cost flexibility, which we've taken advantage of. But because we want to make sure we have a cost base which is, in the long run, over it -- next year or the year after and the year after that, appropriate for where we think the price points have come to, then we need to do things a bit more significant. Simon?

Simon Dingemans

Management

And I think just on the costs of the restructuring, I mean, the costs that we've indicated today are very much in line with the costs of previous restructurings on a cost-to-benefit ratio. There will be some element of the costs we've indicated that are probably noncash. Exactly how much, we still have to work through in terms of the detail and implementation. But I think the ratio is pretty consistent. I think, going forward, when we close the transaction which, I think, is really the right point to make a shift, we will begin to report much more distinctly Vaccines, Pharma and Consumer, so that you can clearly see the different profiles of those business -- their businesses, their different characteristics and look at them on a much more end-to-end basis. But we won't do that before we get there, and that seems like the right point.

Andrew Philip Witty

Management

And we see, Alexandra, an opportunity, I think, as we now have 3 -- post-Novartis transaction, we'll have 3 businesses with real scale. It really gives us the chance to rethink and put pressure on our corporate costs and overhead costs, and to really use those 3 businesses to expose and leave only the absolute minimum of non-allocated costs. So clearly, if a business can't be allocated to cost, what's left should be at a minimum. It's much harder to do that when you've got an unbalanced group of businesses. What we're going to have here is 3 very, very clear global businesses. First order of business, beyond making them competitive in the marketplace, will be to use that structure to really shine a very acute spotlight on the costs which currently sit in the middle, if I can call it that. And I would expect that to be quite a story for us over the next 2 or 3 years as we use this shift to really ensure that we've got that level of costs really driven down. And actually, those costs are oftentimes some of the most tricky to get at, and this transaction is a very, very good opportunity to do it.

Operator

Operator

Next question is from the line of Andrew Baum from Citigroup.

Andrew S. Baum - Citigroup Inc, Research Division

Analyst

Three questions, please. Firstly, Andrew, you've said that, historically, the pipeline is the best since you've been at the company. Now obviously, there's been some approval and some failures since then, but are you happy to make that same comment today? Second, and following on the first question, should we expect the intensification of assets to bolster your mid-stage pipeline in your remaining core therapeutic areas? And then finally, can you remind us when the corporate integrity agreement in the U.S. expires and whether you would use that opportunity to review your U.S. field force compensation structure relative to your peers?

Andrew Philip Witty

Management

Thanks, Andrew. On the last, the CIA was a 5-year CIA. And I think, as of today, the short answer to your question is no. In terms of pipeline, I do stick to the view that this is the most impressive pipeline we've had. In terms of, as you say, a few approvals, we've had 11 approvals over the last 4 years. The next best company in the world has achieved 9. I think since I've taken over, we've had 17 approvals. So we've had a substantial amount of product flow. The majority of our current Oncology business has been approved in that time frame and taken a business, which had almost 0 sales or value to one that we've just sold for $16 billion. So I think that speaks for itself. And the assets, particularly dolutegravir assets are underpinning, clearly, the current growth of that business and lead us to conclude that it's appropriate to think about an IPO for that business which, again, is very direct consequence. And I think it's entirely, as a general comment, entirely consistent with what I laid out back in 2008, which is that we would deliver a wide variety of products, none of which necessarily would individually carry the company, but together as a portfolio would, over time, allow us to move forward the Pharma business. And I think we're still absolutely in that position. In addition to the 6 major products we had approved over the last 12 months, all of which were approved on first cycle review by the FDA and have now been approved in a variety of other countries, we have another 40 new molecular entities in Phase II and Phase III, and has a very substantial quantum of product. And as I indicated in the release today,…

Operator

Operator

Next question is from the line of Tim Anderson, Sanford Bernstein. Timothy Anderson - Sanford C. Bernstein & Co., LLC., Research Division: A very high-level question, Andrew. Can you talk about how you view Glaxo's future over, say, the next 5 years? The consensus here has been pretty bearish on multiple fronts given what's happened in 2014. I guess what I'm trying to get at here is what else might change radically going forward if anything? You've announced new cost cuts, you've talked about the partial IPO of ViiV, that comes on top of the recent deal with Novartis. So I'm wondering if, perhaps, you now view Glaxo as being at a new steady state that looks good and sustainable from here without the need for many additional changes. And the second question is on ViiV, just a quick question. You reported operating margins of 66%, but I think that excludes certain costs like R&D. Can you give us what the fully loaded operating margin would be for ViiV?

Andrew Philip Witty

Management

Okay. Thanks, Tim. So I'll just make a couple of comments on your first general question. If we went back a year-and-change, then actually GSK was trading its high share price since the formation of the company back in 2001. What's changed over that interim period is we've seen a reset of pricing in the U.S. on Respiratory, and we've seen a little slower launch of the 2 Respiratory products. Actually, the launch of the other products, the HIV product, the Oncology products, the Vaccine products, have all gone very well, with a slightly slower launch of the 2 Respiratory products. And that clearly has affected the way people think about the company. But that price reset now is in the system. The products are launching or launched, not just in the U.S. but around the world. And as I said earlier on the call, what really counts, which is the kind of leading-edge market share is starting to look pretty good, actually. And I remain of the view, and so does my organization, that we are going to deliver what we said we would, which is a broad portfolio of new Respiratory medicines, which are capable, in addition to whatever the legacy business of Advair and Flovent and Ventolin would be bigger than it ever was just as Advair. And the impending filing of mepolizumab will simply be another addition to that. So I -- so for me, 2014 is -- has been disappointing in terms of the impact of the U.S. pricing. But it's not been strategically -- hasn't, in my view, changed the strategic future of the company at all, first thing to say. Second thing to say, as a consequence, the decisions and the moves we've made during this year are absolutely in line with the…

Simon Dingemans

Management

Yes. On ViiV, in terms of the margin, there is some R&D to be allocated. And clearly, if you were to think about this as a totally separate company, even though it is pretty separate, within GSK today, there are probably some additional overheads and costs that you have to allocate. So probably from a working assumption point of view, I'd assume a margin of 60-odd percent of the operating level. I think the other factor to remember is that there are clearly also a number of preferred elements in the returns that the different shareholders get from the different products in the portfolio. That structure will probably have to be simplified as part of this process. Exactly how that falls out, too early to say. But I think if you model it out on a 60% margin, you'll probably be, in, broadly, right place.

Operator

Operator

Vincent Meunier from Morgan Stanley.

Vincent Meunier - Morgan Stanley, Research Division

Analyst

The first one is on ViiV Healthcare, a follow-up. Have you considered the pros and cons of selling the participation? Or maybe partnering ViiV with other companies instead of just making a partial IPO? And also can you already say what you will do with the cash from the IPO? Regarding the savings program, can you elaborate on the measures put in place in order to avoid the commercial disruption, particularly in the context of the SG&A cut in Q3? And regarding the Chinese situation, can you give an update on the DOJ investigation? What should we expect now in terms of the remaining steps?

Andrew Philip Witty

Management

Thanks, Vincent. As far as the last question, nothing to say on that. So I've got -- no update for you there at all. As far as SG&A and avoiding disruption, I think, across GSK, we've got a pretty good experience of how to manage this. We are going to be very keen to protect those parts of the organization, which are very much on the frontline, if I can put it that way, of commercializing our products. And of course, those in R&D who are really touching the key assets as they come through the system. As we'd laid out, this is going to take place over the next 2 to 3 years. It's not going to be a kind of super dramatic Big Bang phenomena because we want to absolutely target these changes at the right moment to affect the business in the right way with minimum disruption. And I think, actually, we've got reasonable amount of experience with that. We've been through lots of changes over the years, and I think I've got high degree of confidence in it. I think our senior management, so the level underneath the executive management of the group, see this as a great opportunity to reshape the business in their bits of the group in a way which they want it to be for the future, because we know marketplace is changing all the time, customers are changing all the time and our portfolios have changed. And we need to, therefore, change accordingly. So what I'm very encouraged by is the reaction of our senior management, are very embracing of this as an opportunity. And that's always the first key thing. If the management see this as an opportunity rather than a task, then it will get done in a much more constructive, positive way. And I'm very optimistic about that. As far as ViiV is concerned, listen, we -- I'm sure we will be inundated with investment bank ideas of what we should or could do. We think the partial IPO or an IPO of a minority stake is a sensible vehicle for us to assess, gives the opportunity to create and crystallize value for shareholders, it gives an opportunity to valuation to be done properly, and it also gives us the opportunity for GSK resident shareholders to remain a significant shareholder in that going forward for as long as GSK holds a residual stake. So we think that serves a number of purposes. Obviously, if there were significantly more value creating scenarios, then we'll obviously going to look at them. But we think that's the right place to start. As far as how we might spend any proceeds, we'll cross that bridge when we get to it.

Operator

Operator

Next question, Dani Saurymper from Barclays.

Dani Saurymper - Barclays Capital, Research Division

Analyst

Three questions, if I may. Just firstly on the new restructuring program that you've announced, the GBP 1 billion by 2017 time frame. Is that a net number or do you expect to reinvest some of those savings back into the business? Secondly, just -- I want you to confirm, there's some comments from the tape regarding the established products portfolio and your expectation that, more likely than not, the products will be divested. Just, in relation to it, I just wanted to understand if the cost savings program you have announced, whether there'd be any incremental savings you could anticipate from sale of the -- some of those EPP? You've alluded to in the past that there are significant scope for savings should you choose to go down that road. And then just lastly on Respiratory. I was curious to understand with regard to your 2016 return to growth comment, if you had any expectation within that of generic Advair launch. And then just very lastly, as regards to Anoro and also the commentary around a slow uptake, can you perhaps comment a, on whether you're seeing in the LAMA class in the U.S., a discounting by Boehringer Ingelheim's Spiriva in response to your launch, we've heard that? And then secondly, your experience thus far in Germany as you go up against Ultibro and how the launch is faring so far in Germany?

Andrew Philip Witty

Management

Yes. Okay. Thanks very much. So as far as the GBP 1 billion cost savings, that will drop to the bottom line over the next 3 years so that's the net number. As far as the established product portfolio, what I said on the previous call was that, I think, it's more likely than not that we will sell some element of the established product portfolio. But I guided that it's unlikely we'd sell the whole thing. And so I think that the chances that some element of that portfolio attracts sufficiently high valuation to compensate for -- to compensate the shareholder properly. I think it's -- based on what I'm seeing, has a reasonable prospect. Now I can't guarantee it, so I'm not telling you we're absolutely going to do that. But some element I think it's reasonable to expect may end up going. There will be some savings associated, but they tend to be quite long-tail savings because they're associated with manufacture. And oftentimes, these transactions bring them a contract manufacturer period. So the savings may well come in after 3 years as you go through a typical transition period, so I wouldn't guide you to get excited about that. In the short run, it's more of a medium-term opportunity. And as far as return to growth in 2016, we anticipate -- or we do not anticipate a generic Advair before the end of 2016. So that probably answers your question. Again, we remain of the view, we've always had, which is this is not a trivial proposition for anybody. We think -- we don't know when or if it might ever come or what status it might ever have, but we certainly don't anticipate it in that time frame. And as far as Anoro is concerned, yes, aggressive contracting from all of our competitors, and I think we've also been aggressive in contracting this year. And so we have been very focused on making sure that we're not disadvantaged both on Advair, but also on the entry of new products. That's taken a bit of time. It's costs us some price points, clearly, but we've been successful in securing very substantial access. And at least, the part there has been other companies trying to close out the marketplace on the way through. So it's been -- that's really what's driven the dynamic of 2014, if I'm honest. And as far as Anoro in Germany, we're just literally starting, so nothing to report yet. So literally, just beginning.

Unknown Analyst

Analyst

Two questions, if I may, please. First, Andrew, just on the dividend. If you can confirm that 2015 dividend at 80p would still be the case even if you were to go ahead and divest a part. How small or big of the established products portfolio? And secondly, that in the context of your long-term progressive dividend policy, 2015 is an exception i.e. post-2016, the progressive dividend policy still holds? Secondly, on the cost savings of GBP 1 billion, if you just help us think about kind of some details around that, where does it comes from in terms of SG&A? What is R&D? What is manufacturing over the next 3 years? And to your earlier comments on trying to take a final look at the central cost post the transaction, if you would care to kind of just give us some more color on the opportunity there.

Andrew Philip Witty

Management

Thanks. So in the first point, yes, I wouldn't anticipate any decision on the EPP effect and the commitment we've made on the dividend for 2015. We do have a long-term commitment to increasing dividends for our shareholders. Obviously, we'll update you on 2016 and beyond when we get there, but we've very clearly restated our long-term commitment to increase the dividend. We're not going into detail today on the cost savings, but suffice it to say, it will be blended across different parts of the organization. But as always, you should expect SG&A savings, and to some degree R&D savings, to come at the front and the manufacturing savings to come at the back end. So in terms of phasing, you might see them in a slightly different way. But they'll be blended across the piece and central costs will certainly be a focus for us, particularly as we go through the transaction, as I've said already. I think the transaction gives us a very, very new lens to go after that over the next couple of years.

Operator

Operator

Next question is from the line of James Gordon, JPMorgan. James D. Gordon - JP Morgan Chase & Co, Research Division: Two questions, please. First question is about the Novartis transaction and the 2015 outlook. My question was should we still anticipate accretion to 2015 EPS in the transaction, despite the margin dilution? And is there any prospect for EPS growth in 2015 which consensus currently models? Or should we take a flat dividend in 2015 as a reflection of where our earnings might be for 2015? And then the second question was just in terms of IPOs. If this makes sense as a way to monetize ViiV, could it also make sense to IPO part of the Consumer that you're going to have, as presumably you also think that's undervalued at the current level?

Andrew Philip Witty

Management

Thanks so much, James. So the exact impact of Novartis on -- so as you remember, when we announced Novartis, it was that in the first full year, it would be marginally accretive. Of course, the real question is when is the first full year? So when exactly do we close? That's important because it determines how much of the Oncology business we have, for how long in the year. How much of the Vaccine Consumer business we have, for how long in the year. And also, it determines when the B-share scheme gets executed which, of course, has an effect on the EPS accretion in the short run. If you remember, when we introduced this transaction to you all, the initial accretion was helped a lot by the B-share scheme. It's then helped by the synergies. And then in the long term, the deal becomes hyper-accretive because you're essentially contrasting to retain Vaccine and Consumer terminal value against what would in years 7, 8, 9, 10 be a decline in Oncology business. So you've got these 3 phases of synergies. So that first phase in the first 12 months, even with the margin dilution that Simon talked about, as we described to you at the time we launched, it would be marginally accretive. But the exact effect on 2015 depends on exactly when it closes. And today, I'm only able to give you guidance that we're on track for the first half. Obviously, if it closed on December 31, then the marginally accretive statement would stand. If it closed later, it might be different and we'd give you guidance at that point. In terms of -- we're not giving you guidance today for next year. I think, though, it's pretty clear from what we've said that we expect the…

Operator

Operator

Next question is from the line of James Weston, Crédit Suisse. Matthew Weston - Crédit Suisse AG, Research Division: It's Matthew Weston at Credit Suisse. Three questions, if I can. If we just contrast the first 2 quarters of Anoro in the U.S., they seem to be tracking the experience of Breo very closely with some pipeline filling and then some incremental discounts impacting the second quarter. As we work through the next few quarters of Anoro, are you confident that the revenue will exceed the performance of Breo in terms of following the same launch trajectory? And if not, how comfortable are you with the GBP 250 million consensus expectations for Anoro for next year? Secondly, on China. Now that the legal issues certainly in the domestic market are behind you, can you just give us an update of your experience in terms of physician reaction to GSK and what you're doing in that market to regroup and refocus growth? Andrew, you were very clear to point out how much you've implemented the strategy as you set it out when you took over the role of CEO, as I recall, strong Emerging Markets growth was a key element to that. And then finally, just on the difference between non-core and core earnings. Historically, GSK core versus non-core represented about 70% -- or there was a 30% difference between those 2 metrics. For this quarter, there's now a 70% difference between those 2 metrics. And even if we exclude the China fine, one is still half of the other. Can you just walk us through some of the key elements that have been excluded from core in Q3, particularly in that acquisition and accounting column which is, by far and away, the single largest adjustment what your putting through the P&L?

Andrew Philip Witty

Management

Okay. Thanks, Matthew. And thanks in particular for the last question because I think that's a really good thing for people to hear and understand, and Simon is going to touch on it. So in China, obviously, we've just gone through the end of the case. And as you would expect, we are making sure we learn the lessons from that. We're very focused on ensuring that we do indeed learn those lessons. We have a new management team in place in China. But it's very early days, and I'm not going to go into more detail. Suffice it to say, you've seen the annualization of the effects of China no longer has the same negative drag that we've seen on the business. As far as my commitment to Emerging Markets, I think that's reflected, actually, in the very strong performance in the quarter, double-digit growth rates from the Emerging Markets. We continue to be very robust about that. And when you look at where EMs are now, more or less the same size as Europe. Whereas 5 or 6 years ago, they were under 1/3 of the size of Europe. You can see the change. Now of course, that brings with it -- nothing is easy in this world, Matthew, right. So that brings with it currency volatility, which you see some of this year. It also means you're operating in very difficult markets, and those markets can throw you curveballs from time to time. But I reiterate the fundamental reason why we're focused on Emerging Markets, of the 6 billion people who live in the world today, only about 600 million live in Europe -- Western Europe and America. And we have to be focused on building the business for the long term. But we also need to…

Simon Dingemans

Management

Yes. Thanks for the question on that. And the first point is just to remember that a lot of these charges are noncash. And in particular, obviously, amortization and impairment charges. And quite a lot of the charges that you often see in the acquisition column are noncash, and that indeed is the case this quarter. So in particular, we have 2 significant adjustments going through. The first is GBP 350 million, which is a revaluation of the contingent consideration we owe to Shionogi on dolutegravir containing products, which is a reevaluation given the outperformance that we've seen of Tivicay in the last couple of quarters. So we've reassessed that this quarter and that takes the total provision there up to GBP 1.3 billion. And then the other is a change in the treatment dictated by the IRS in relation to the U.S. industry pharma fee which led to a forward-looking treatment rather than a backward looking treatment. And so we have adjusted our current year for the IRS's required treatment. And in that adjustment column, in non-core you'll see the previous adjustment which, again, is noncash. It doesn't affect how we actually pay for the fee going forward and just really correcting the treatment for the latest guidance that we've been given. So that's obviously creating the main distortions that you've seen. There are also a number of other Novartis costs in anticipation of closing the transaction, including some hedging that we have in place to protect the cash returns that we're going to get out of that transaction. And that will fund the GBP 4 billion which we, obviously, need to make sure that we still get GBP 4 billion at the end of the transaction. So those are the main drivers and why it's jumped up this quarter. But that's the principal reason.

Andrew Philip Witty

Management

Thanks, Simon and thanks, Matthew for asking the question because I do think it's important people do understand what's between those 2 numbers. It's particularly ironic that you end up having bad news in the cash to noncash -- sorry, core to non-core because we've increased our forecast for Tivicay. And as a result, we have to take a bigger provision. So make of that what you will, but I'm sure that's triggered off all sorts of calculations about what our real forecast is for Tivicay and therefore, what the impeded value of the ViiV business really is. That should keep everybody up all night, I would have thought.

Operator

Operator

Last question is from the line of Kerry Holford, Exane. Kerry Holford - Crédit Suisse AG, Research Division: Two questions, please. I wonder if you can just talk a little more firstly about the targeted expense reductions you mentioned in SG&A and R&D. I'm interested to know whether there's been any change in the size of the Respiratory sales force, in particular? Just to understand what those reductions might mean for Anoro and Breo, given they're still in a very critical stage of their rollout. And then secondly, I'd be interested in your view as to why U.S. primary care drug launches are becoming so much more difficult. Do you think this is a reflection of the quality or the lack of differentiation of some of the new products being launched? Or is it pure price pressure and access? Do you actually need to be having formulary positioning discussions of payers in the U.S. much earlier than you have been in order to secure that access that you're now confident you will have in 2015? But does that mean you just need to have those conversation much earlier? Or is it simply that you're now willing to be more flexible on the rebates you can offer on some of your existing products?

Andrew Philip Witty

Management

Thanks very much, Kerry. So as far as the expense reductions, yes, I can absolutely reassure you no change to the size of the Respiratory sales forces. In fact, no change to the size of any sales forces during this period. So I don't think you don't need to worry about that. This is -- we've identified things we believe are not going to affect the performance of the product and the cost opportunities we've taken. As far as the U.S. market is concerned, again, we've looked at the last primary care dominated launches, 2012, 2013, 2014. And we see Breo, which is the one where we have the most data of course, performs very much in the upper quartile of those launches, and these are products from all categories. So obviously, you're looking at different markets. But whether you're in diabetes, in Respiratory, cardiovascular, wherever you are, I had a very -- some of you should maybe -- it might be instructive just to look at one chart. If you look at NRx performance for Breo versus Benlysta versus the JAK inhibitor from Pfizer. And I pick those because you've got 3 products which are priority products for the 3 big companies. 2 of the 3 companies use a traditional selling model. One uses the GSK selling model. When you look at the performance of those 3, you'll see straightaway how Breo stands out from those other 2 product launches in a very positive way. So I don't see anything from that which really says there's something very special going on just vis-à-vis GSK. So what might be going on in the market? I think the first thing you've got to focus on is that if you look at the U.S. market now, the top 10 commercial plans control…