Earnings Labs

GSK plc (GSK)

Q4 2015 Earnings Call· Wed, Feb 3, 2016

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Transcript

Operator

Operator

Welcome to the GSK Analyst and Investor Fourth Quarter For 2015. Your host for the GSK quarterly results call is, Sir Andrew Witty. [Operator Instructions]. I would like to advise all parties, this call is being recorded. I'd like to hand over to Sir Andrew. Please, go ahead.

Andrew Witty

Analyst

Great. Thank you very much. Welcome everybody to this Q4 2015 full-year update. In just a second or two, I will just take you through some of the slides which are on the my GSK.com website, under the investor side. So I'll just give you a second to pull them up if you want to and then Simon will follow-up after me. So we've announced today our Q4 results. You will see that Group sales are up 6% at CER on a reported basis and 1% up CER on a pro forma basis, obviously the difference being the impact of the transaction with Novartis. What you'll also see is at the CER EPS level earnings per share were down 15%, obviously, that driven by the diluted effect of the transaction but importantly ahead of the guidance that we sent back in May of last year. If now, we go to the slide deck, maybe if I direct you to the first data slide, slide 3. Really during the year, we continued to make, I think, very substantial progress in executing our strategy. There is still a lot to do, but I'm delighted with the progress we've made in 2015 and really building our three growth businesses. You can see the balance that we've created as a Company. Importantly, significant progression of our next generation of pipeline assets that we talked about in the New York meeting and since then, I'd say broadly speaking everything has gone pretty well on the pipeline. Then importantly, as you can see in the middle probably most critically for the short to medium run of the Company, very significant continued strong performance of new product sales in the pharma and vaccine business. If I take you then to slide 4, the left-hand side of this…

Simon Dingemans

Analyst

Thanks Andrew. I've got a few slides to help illustrate the points I'm going to make on some of the detail around the results which hopefully should come up directly behind Andrew's slides. But before we get into those, 2015 has clearly been a year of significant transformation for the Group. I'm very pleased with the progress we've made in implementing our strategy, as well as in the improved execution which has allowed us to report results today ahead of the financial guidance we gave you back in May. The most significant contributions to this performance included closing the Novartis transaction, keeping the extensive and complex integration program firmly on track and accelerating the restructuring program within our pharmaceutical business which has created additional flexibility for us to invest both behind our R&D pipeline and also our new products in HIV and respiratory. These investments are now building better momentum behind our new products, momentum that also sets us up well to return to core earnings growth in 2016. As we outlined in May, the Group in its new shape is in a much better position to drive sustainable growth. Given the significant restructuring and reshaping of our cost base, we're also now much better placed to deliver against our financial architecture and drive earnings ahead of sales while continuing to support the dividend expectations we've laid out. Our earnings release provides an extensive amount of detail about the results for both the fourth quarter and the year. So my comments today will primarily focus on the major points of those, as well as our expectations for 2016 and any comparative points you might want to take note of for your modeling. So if you turn to the first of my slides, headline results, you will see our headline results…

Andrew Witty

Analyst

Great. Thanks very much, Simon. Without further ado, let's open up the call to Q&A. Just for everybody's information, we've extended this call. So we've got plenty of time for Q&A if we need it. So please, operator, maybe you can just remind folks of the protocol.

Operator

Operator

[Operator Instructions]. Your first question is from Graham Parry from Bank of America Merrill Lynch. Please go ahead.

Graham Parry

Analyst

The first one is on international markets, particularly emerging markets down 5% pro forma in the year, China down 17% and it was actually worsening in the fourth quarter. Can you talk to the outlook and the trends for that part of the world through 2016 and maybe your midterm outlook. Second is two questions about the news that you've given up the right to withhold the consent to block the put options from Pfizer and Shionogi on ViiV. Firstly, the release in Pfizer, you did it in order that you can recognize some of the liability on the balance sheet which looks like slightly backwards logic. Are you giving up the rights because you want to book the liability or are you booking the liability because you want to signal you're basically a buyer of this asset, hence you have no need to block any put? Secondly, should we take from the GBP2 billion liability for 20% of the business that you are valuing ViiV at about GBP10 billion currently? And then a final question on consumer and potential spend there. There's been a lot of recent comments and speculation. I think Andrew, you said recently that perhaps one day this could have a life of its own. That seems somewhat at odds with GSK's previous comments that you think that pharma companies can run OTC better and there's lots of internal synergies there. To what extent is this really trying to recognize that there are some shareholders are saying you should do this versus a real shift in your own strategic thinking about that division? Thank you.

Andrew Witty

Analyst

I'll ask Simon to go into more detail on the HIV piece valuation in particular. As far as international markets and then China specifically is concerned, so international markets generally have been affected through a number of macro things like everybody else, but then specifically for us in China and specifically because of some restructuring - as part of our pharmaceutical restructuring we took quite a big set of changes during the year to reduce investment in some territories and increase in other to really focus around about 10 to 12 key markets. There is quite a bit of disruption as a consequence of that. A bit of that is self-inflicted. During the year, I fully expect that to bounce back. China and one or two other areas affected by divestments. In China, we've been focusing our business as we look to rebuild it. But that has involved some divestments. That's what's really affecting the growth rate during the year plus some price cuts that we've taken during the year which certainly the leading indicators would tell us that, that is going to put us in a much better position to go forward to grow. I think nothing super dramatic on China but there is a combination of price reductions. Let's call them one-off price reductions and some one-off divestment impacts on that top line. Other than that I think the underlying signals we're getting are encouraging. I expect to come back growth. Overall for the emerging markets, excluding the impact of divestments and Simon mentioned, for example, the Prolia effect then I would expect us to be growing again this year in the international markets, at least at the level of our branded peer group. Obviously, that's not going to be at the level we saw three, four years…

Simon Dingemans

Analyst

I think, Graham, remember and it spells out in a bit more detail in the release, that the valuation that we will bring onto the balance sheet reflects the put value estimate which is after you've taken into account the adjustments to the equity positions that reflect the preference shares that we, Shionogi and Pfizer hold. You also see it as about GBP0.2 billion, GBP200 million of value that would also accrue to Pfizer and Shionogi and that would go on to the balance sheet in Q1. We have significantly more valuable preference shares that give us a priority right over some of the earnings of [indiscernible] based income stream. So that's how you come up with the GBP2 billion number. You have got to strip out the preference shares before you land on the number that will eventually go into the Q1 balance sheet.

Operator

Operator

Next question from Richard Parkes, Deutsche Bank.

Richard Parkes

Analyst

Just got a few questions. Firstly, on the vaccines and consumer integrations, I know you talked about the pace of cost savings coming through a little bit faster than you'd expected. Could you update us on how your thoughts on the absolute [indiscernible] of potential synergy and cost savings has evolved since completion of that transaction? Secondly on established products, I think they were down 15% at CER, a little bit worse than consensus was looking for. Can you help us think about how that year-on-year decline might evolve going forward? Finally on Incruse, seems to had a good start. Just wondering whether that reflects any changes to the way you're going about contracting. Maybe you could talk about the difference between net price between Incruse and Anoro that you are retrieving. Just wondering, a bit of clarity on that?

Andrew Witty

Analyst

I'll let Simon address, obviously, some of that. As far as Incruse is concerned, I think in reality what is very interesting in the marketplace is there are two types of country and there are at least two types of doctors prescribing. There are certain countries were essentially the LAMA market is much more tied up with triple products proscriber. UK is a very good example of that. The UK tends to drive towards a steroid-based combination then adding a LAMA. You're really talking about a triple. Trying to introduce Anoro into that mix is more difficult than introducing Incruse into that mix. There are other markets which are much more interested in straight out bronchodilation. Germany might be an interesting example of that. If you then look at the U.S., what you see is not so much a simplistic, it's one way or the other, but each physician has a preference, has a habit. By introducing Incruse alongside Anoro, we're essentially everybody ends up almost on the same thing, is just how they get there. And having Incruse has created a much - it's just simply made that a much easier choice for everybody, essentially. And I think we've got positioning of that well. We've got a good claim that we were able to introduce in September therefore essentially the add-on of Incruse. That has been what's really driven this. I have to say you've got a long way to see a market-share acquisition chart like the Incruse/Anoro's chart that we showed you today. To be heading towards that kind of 30% market share is really phenomenal and well, probably helped a little bit, because I think our competitors have destabilize their own market leader and it's given us a bit of an opportunity there as well. That's that.…

Simon Dingemans

Analyst

Remember this is the second upgrade, if you like, on the synergy delivery plan across both the restructuring and the integration programs. You'll see from the chart that's in the slide deck I just walked through that a lot of the, the majority of the GBP1 billion this year of incremental savings has come out of the pharma restructuring and the smaller amounts out of vaccines and consumer. So still a lot to come from those integration programs, but I think as Andrew, said we're very pleased with the progress and the planning that we were able to do ahead of the transaction closing has stood us in very good stead. So far there's been relatively few surprises but a lot still to do in 2016 particularly. On established products, this year are kind of probably at the upper end of the range we would expect, with Lovaza particularly dropping out. A 10% to 15% decline range is probably the right sort of thing to put in your models. We're probably at the upper end of 2015, maybe a bit less than 2016, but these are older, older products with that inherent level of declined built into them. That's probably the right sort of assumption to make.

Operator

Operator

Your next question is from James Gordon, JPMorgan.

James Gordon

Analyst

A couple of respiratory questions please. One was just you previously guided to respiratory growth in 2016 and I can see some of the new launches turning the quarter in respiratory. They're doing better. Do you have confidence in the trend continuing in 2017 and maintaining growth despite the recent announcement of generic Advair filing in the U.S. or is that growth this year and that potentially shelf for next year? The second respiratory question would be on slide 8, you've got the Nucala COPD filing listed. It looks like that's, from reading the slide, like that something you've got a very high confidence in achieving. Do you have very high confidence in that working? Is that already in the 2020 restructured guidance or is there still some uncertainty how well that works? Have you seen lots of data that gives you confidence there? And then following up on Incruse, I don't see the U.S. Incruse sales split out. Are you able to give us those? Thanks.

Andrew Witty

Analyst

As far as respiratory is concerned, we certainly expect, as we've previously, to come back to growth this year. We've got some very, as you can see through all the data, some very good volume there. Price, the question mark really on the degree of growth is all about what happens to the price dynamics but certainly based on what we see today, all else equal, we expect. I'm not going to get into giving you forecast for 2017. Obviously that all really revolves whether or not if there is or isn't a generic in the U.S., as we've made clear. We read what everybody else reads. It's obviously possible there is one in 2017. It may comment 2017 it may not come in 2017. Our framework of what we've laid out over the next five years is regardless of whether it's 2017/ 2018 or not. In terms of Nucala, no new data to tell you about that. We have to wait and see when the data comes through from Phase 3 and we haven't got a particularly big COPD number locked in for 2020 in the framework we've laid out. Actually, I think the indication we already have and launched with will drive a very substantial product and I don't really - I think it would be premature to lean forward too hard in terms of confidence in COPD. We think it's a very viable indication to go after but we don't have new data to tell you to transform our view. As you also know, we're looking at the segment of products in a number of other indications. So, so far so good. Next question, please Andrew?

Operator

Operator

Your next question from Andrew Baum from Citi.

Andrew Baum

Analyst

I have three questions, please. Firstly, on your business development. [Technical Difficulty] last year you'll reconfigure that unit. Do you have capacity and/or intent to take advantage of the lower market prices for [indiscernible] right now to augment your portfolio? Second with regard to Shingrix, there's a double-digit [indiscernible] patients having a 10 centimeter injection-site grade 3 adverse event together with pyrexia [indiscernible]. How problematic do you think that's going to be from a commercial point of view? Finally, for both Simon and Andrew, you've spoken about the optionality in two years from now for separation of the consumer business. Perhaps you could outline as of today what are the barriers, their potentially near-term attempt separation, acknowledging the fact that not your intent. Thinking from an IT, accounting, manufacturing are there any impediments if that was the course of action that the Company decided to do? Thanks.

Andrew Witty

Analyst

Thanks very much Andrew. As far as the business development piece is concerned, I think the evidence of us buying the HIV portfolio from Bristol-Myers, the extension of the Adaptimmune transaction on NY-ESO yesterday, actions speak louder than words, right? So very clearly, we have got capacity and we have got a desire to look for sensible assets. What we're not going to do is we're not going to be sucker punched into buying an asset that's 20% cheaper than an extraordinarily overpriced price two months ago. We've all seen and plenty of people have talked about, even companies where perhaps we've found assets we thought have failed, they've gone to companies, that have massive valuations and six months later they have no valuations, so we're very wary of that kind of trap. We're very focused in the areas we want to go look and we will make sensible investment decisions accordingly. Against that backdrop, you got to remember we have 93 projects listed on our pipeline chart in the results we've issued today. 71% of them are new molecular entities. 63% of those 93 projects are in Phase 2 or Phase 3. So bluntly the hurdle for us to spend more capital to go after another asset is quite a high hurdle. It has to fit well within our current portfolio and it has to match well against what we see coming. We have off a lot of innovation in house coming through. We have an awful lot of collaboration assets coming through and so I'm not sat here hungry, starving or desperate, if I can put it that way, to go look for assets. But where we see things that fit really, really well, we're going to do that. As you would imagine the Bristol-Myers situation was a…

Operator

Operator

The next question is from Alexandra Hauber from UBS. Please go ahead.

Alexandra Hauber

Analyst

I've got three questions. Firstly on the ViiV [indiscernible] it looks like the minority interest is actually the share that you pay in minority interest is less than 21.7% minority shares because of the preferential dividend GSK gets dolutegravir. Can you give us some idea how sensitive the minority we see in the P&L is to that arrangement? So if dolutegravir goes from a high 50s where it is right now to something like 80%/10%, can minority share actually be something like 15%? Second question, given that you brought your guidance for the GBP6 billion pipeline sales forward to 2018, is it correct to assume that, that means better order 2020? I'm not going to ask you to update your 2020 outlook every six months. I just wanted to get directionally whether that would be the right way of looking at it rather than assuming something of it's got worse. Just one more question, when you're saying you're having your capacity bottleneck on Bexsero. Can you still ship second-half 2015 levels or have you exhausted your inventory and it's actually going to decline year on year or at least in the first half --first half this year versus second half this year?

Andrew Witty

Analyst

Thanks very much. Simon, do you want to answer on the ViiV question?

Simon Dingemans

Analyst

Clearly, directionally you are right Alexandra. It will move in our favor. It's not quite as sensitive as you laid out. Certainly for the foreseeable future the 80% number that we got in the press release today is a good guide and we'll update it as a product shifts to give you a sense so we will comment on that going forward but clearly you would expect it to move a bit in our favor as dolutegravir grows. Bexsero, probably Q1 might be a little effect as we go through the inventory and into more supply but I think it won't be a huge issue, Alexandra, but there might be a bit of an effect in Q1 and I think it's just a simple situation of we're selling a lot more than Novartis were anticipating to sell. Obviously, we have to give the supply chain revved up accordingly. In terms of your question about the new products, your interpretation is absolutely 100% correct. Thank you for not asking us to restate our guidance for 2020. We were not going to do that. We've given you a framework back in May. Absolutely stand by the framework. What we're simply signaling to you is that the new products are performing much better. We will fully anticipate do hit that GBP6 billion early. Of course that would apply the new product number in 2020 would be higher than we had previously said. There is no offsetting negative to that. That therefore it's not unreasonable for you to start to think about how you lift your 2020 numbers potentially to reflect that and the way in which that might affect your assumptions on pharma margin and all of those good things. The only precise guidance we're giving you today is for 2016 where, as you know, we're reiterating the guidance we gave you back in May of last year. We feel very good about our potential to get to an EPS growth rate at constant exchange rates this year of around 10%. I think 10% this year is exactly the kind of number we're aiming for. Obviously then we've got the 5% tailwind behind that from FX if FX stays the way it is, but who knows whether that's the case or not. That's really the specific guidance point we're giving you. We’re giving you an update on one element of the framework. I would leave it to you to work through your 2019 and 2020 numbers accordingly in terms of how you think that plays through, but you are quite right, Alexandra, there is no offsetting negative for the positive of the up lift in your products.

Operator

Operator

Next question from Jo Walton, Credit Suisse. Please go ahead.

Jo Walton

Analyst

Just to clarify on the last question, to the extent that the new products coming forward are due to strong success of Anoro and Breo, that might be coming more at the expense of Advair, just a faster switch so it's just a question of are you still happy that your overall respiratory franchise is going to be stable? And to what extent are the new products or the extra sales coming from things outside of what could just be Advair switch? My second question is just on the R&D side. You talk about your very strong pipeline, 80% being first in class. You've given us some details on how you do your internal rate of return. I wonder if you could just tell us what sort of probabilities of success are you baking into your assumptions given that you have sales forecast out to 2036. Reflecting this very high first in class, are you looking at stronger than historic probabilities of success? And finally if I could ask, it's more a request than a question, but given the cash payments out to Shionogi appear in various bits and pieces of your P&L and your cash flow. I wonder if you could - I know it would not be IFRS but in future give us something whereby we can look at these cash payments out which would otherwise be ignored as being non-core in just one simple aggregated in line?

Andrew Witty

Analyst

Simon, do you want to answer that last point?

Simon Dingemans

Analyst

Jo, just to help you and I will look at it again, in the cash flow section we do break out precisely where the cash payments related to contingent consideration fall in terms of how they are reported in the cash flow statement and there is the total number of what we paid in the quarter and what we paid in the year and I intend to give you that each quarter as we go along. If you need more than that, just let me know off-line and I can certainly have a look at it. Remember, that is contingent consideration effectively amortization and that doesn't flow through the P&L because the P&L refers only to the trading performance of the ViiV business.

Andrew Witty

Analyst

As far as the rates of return calculations are concerned, Jo and thanks for the question, we use industry average attrition rates. We don't have a special GSK rose-tinted glasses attrition rate number. We use industry average. You might be interested to know when we look back over what we've been doing, some of the drivers of this, obviously the fact we get first pass approval is very important. The beginnings of the uplift of the sales is very important. The fact that we're able to crystallize absolutely with the entire value of the oncology R&D was worth is obviously important. I also thought you might be interested to know, when we look like things like the CMR database, GSK is now running clinical studies 20% faster, so our execution time to 20% faster than our major pharma competitors. Our enrollment time for studies is 20% faster than our major competitors and we have the lowest clinical trial dropout rate compared to major pharma. Over the period since 2010, we have reduced R&D headcount by one-third and we produced our R&D footprint down to two from five global centers, all of which has taken huge amounts of fixed cost out of the organization. At the same time, we've massively increase the number of programs in the clinic and in advanced clinical development. Those are really some of the things that are driving that rate of return calculation. As far as your first question on respiratory is concerned, I think a couple of things just to say. Almost all the Anoro, Incruse and Nucalla business is coming from new patients or competitor patients. So none of that business is coming from essentially Breo or any of the established products - sorry from Advair or any of the current products. That's almost…

Operator

Operator

Your next question from [indiscernible], Goldman Sachs. Please go ahead.

Unidentified Analyst

Analyst

I've got three, please. First on the HIV portfolio, I've seen a significant increase in ramp-up on the SG&A cost across various businesses, but can you help us think about how comfortable you feel with the sales force as it stands today, especially given the January launch from Gilead and how do you feel about the need for further sales force on the ViiV side into 2016? Secondly, a clarification. I know that as you talk about getting rid of, our giving up, the put option there's a statement around the fact that you will now also recognize the balance sheet [indiscernible] for future preferential dividends. Can I just confirm if that has any implications for core earnings as you report it today, either on the minority part of it or on the preferential dividends part that may or may not quote your P&L? Thirdly Andrew, you mentioned a couple of times about this not being the right time to evaluate the potential differential structure for the business. I completely understand that, but as you think about what the right time might be, can you talk about is there a particular level of revenues that you think you might need, is there a particular level of margins? Obviously you laid out a margin guidance for 20% so when [indiscernible] reaches 20% is that the right time to think about those options? Help us think about conceptualizing the timeframe for that internal debate. Thank you.

Andrew Witty

Analyst

As far as HIV is concerned, I think we feel pretty good about our current scale. As you know, it's a relatively small sales force proposition versus, for example, the respiratory marketplace. I think at the margin we may make some changes but I certainly don't think there's anything very materially going to happen there. I would say, we continue to generate further and new data, including comparative data with other key products in the marketplace. I think you will continue to see as we go through this year some very good new data to support the profile of the product and as I said earlier on, what we're seeing in the marketplace at the moment a lot of churn within our competitors' mix of we pick up a lot of volume alongside that. No, don't really anticipate huge change there. Simon, do you want to speak to the minority point?

Simon Dingemans

Analyst

The short answer is no. The preference dividends - sorry, the deference shares are carried on the balance sheet because of they put the equity to us, they're clearly going put the preference shares as well so it's a joint liability, but makes no difference to the core P&L.

Andrew Witty

Analyst

And on your question on group structure, I don't have a particular time in mind. I think there's a window. We're just into the really heavy lifting of this transaction. We've got things off to a terrific start, very highly motivated organization. We need to execute and focus on delivery of that. I think it would be wrong to create unnecessary disruption and distraction during that period. Clearly, I think we're in the first year of what I would regard as three years of proper heavy lifting, where obviously if there are restrictions which are quite appropriate restrictions around when you create a transaction like this to try and prevent one party or the other from disrupting activities. I don't - I think that's a sensible thing. I would say though, Kia, I think we also have to slightly get which end is the nose in which end is the tale of this dog. These decisions should be made through what is an interesting transaction. These things should be done by what's right in the long run for the strategic positioning of the group and its assets in the face of the environment in which we operate. And those things change. Let's be honest, if we were sat a year and a half ago you might have a very different view of the environment than we have today. A year and a half ago, people who swearing black and blue to me that oil was worth $150 a barrel. Today they are gasping for $32. A year and a half ago, people thought U.S. pricing was an unstoppable machine. Today, I'm not sure anybody believes that. So I think the question isn't - I don't think it makes a lot of sense, Kia, to pre-dial in on a certain day, a certain question is going to be asked. Surely the right way to look at this is let's everybody should be thinking very thoughtfully about what the environment challenges are, what is it you believe the Company can achieve and can the Company demonstrate its execution at a high level versus its competitors. I think what we're beginning to show is that we can do that in pharma, vaccine and the consumer business. That's kind of the way I look at it. It's not everybody in the world is going to look at that. I'm sure a lot of perhaps people in banks and elsewhere above to the transaction point. Personally, I don't think it the way we should look at it. Next question?

Operator

Operator

Next question comes from the line of Florent Cespedes from Societe Generale. Please go ahead.

Florent Cespedes

Analyst

It's Florent Cespedes from Societe Generale. Three quick questions, the first regarding the new products. Could you tell us what has changed since last May regarding the ramp-up of these products or is the competitive environment? And maybe a follow up on ViiV regarding Nucala. How do you see the Nucala ramp-up going forward? You say U.S. pricing environments or U.S. pricing was an unstoppable machine last year or a couple of years ago. Now it's becoming more challenging so could we ask for your comments there? The last question is regarding international pharma developments. Could you come back on the comments regarding the capacity constraints there? How do you see this potentially impacting the 2016 [indiscernible] of the international pharma space? Thank you.

Andrew Witty

Analyst

In terms of what's changed on new products, Shingrix. We have Shingrix in hand and looks very substantial opportunity for us. HIV has clearly, as you've seen through the reset of our contingent liability with Shionogi, that's clearly performed at the upper end of what we would have anticipated. The performance of Anoro Incruse has really picked up. I think the overall execution of the organization has stepped up a gear in terms of our execution. I think there's a number of new products which have come really through at the upper end of our expectation and we've seen share acquisition through the last several months really accelerate as we came out of the year. You know as well as I do, when you came to the May Capital Markets Day, none of you were coming with high expectations of new products and as we came out of the year in good shape and if you look at the slide I showed you earlier in the call today, slide number 4, 2014 we did GBP600 million of products, 2015 we did GBP2 billion. That is an extraordinary degree of acceleration and of course that's what striving and if you take GBP682 million of Q4, multiply it by four, were almost at GBP3 billion annualized and clearly that gives us the confidence we can get to that very significant level. As far as the international pharma business is concerned, just to give you a couple of examples, as you know, we've done very well in developing the business. For example, for Augmen - I'll pick one example, Augmentin which has, I've said to you before, we now sell something like I think three or four times the volume of Augmentin we sold when the product was at the peak of its…

Florent Cespedes

Analyst

Excuse me, the question on Nucala, please?

Andrew Witty

Analyst

I'm not sure what your question - Florent, your question is what? Do we have a price problem with Nucala?

Florent Cespedes

Analyst

No. Maybe a better question was how do you see the ramp up and the sales going forward because some of your competitors and of course very different markets are suffering from weak patient access. If you could give us your view on this product?

Andrew Witty

Analyst

First of all, we've had an extraordinary reaction from physicians, really good resonance with what we're saying about the product, high interest. We've seen very significant number of patients come to us through our reimbursement advisory hub so we contract these patients. They're right now going through the process of getting insurance and although we don't have a J code assigned yet, we're seeing basically no rejections in terms of patients so I fully expect - listen it's early days, but this thing is going to move. I don't think we're going to be sat here having a conversation this having poor access. We've got good access. We've got very engaged physician base and we've got very engaged patient base. And so, so far, all green lights. We have time for one last question I think.

Operator

Operator

Your next question comes from Kerry Holford, Exane BNP Paribas,

Kerry Holford

Analyst

I'm afraid I do have three questions. Very quickly, firstly on the tax rate, you talk about moderate pressure building over the next several years. I wonder if you can talk about what's changed here. I don't think the geographic mix shift with the U.S. is necessarily news, so is anything else behind the scenes here that we need to be aware of? Anything related to the UK patent box tax structure and so on? If you can quantify that moderate pressure, that would be very helpful. Secondly on Incruse, here I'm interested in your focus on the growth of that put out within the franchise because as I recall from the commentary back on the Investor Day last year, Incruse is not an asset. It's being actively detailed by your respiratory sales reps and as I recall at that stage, you were looking to simplify the message and focus on Breo. Anoro and Advair. Has that situation now changed? Is Incruse in active detail and if so, how was that now positioned relative to Anoro? And then lastly on the pipeline, a question on prioritization and investment. In the press release today you highlight approximately 40 assets that you say are under active clinical development and that you discussed at the R&D day. In your full pipeline list, was we see probably another 40 in development that don't get a mentioned today. How should we interpret this difference in disclosure? Are the 40 that didn't get a mention in the press release not in active development or are they just lower priority? Lower probability of success? If that's the case, you do look to alternative routes for those products considering out licensing and so on? Thank you.

Simon Dingemans

Analyst

We've given you specific guidance around 2016 in terms of the pickup and the tax rate and it is primarily driven by the change in the mix and the acceleration of U.S. sales Andrew's been talking about and those come at a near 40% tax rate as opposed to what we can generate here in the UK or and many other jurisdictions around the world. On the basis of the prospect we've outline we expect that pressure to continue. So exactly what we see in 2017, 2018, 2019, not ready to give you specifics on that but I think if you were factoring in over the two or three years thereafter another 1% or 2%, you would probably be in broadly the right territory. Hopefully that gives you a steer.

Andrew Witty

Analyst

On the Incruse thing, actually if you go back to the May event, Kerry, you look at slide 42 you see that Incruse is one of the products which we listed there as the focus areas for respiratory. What has also changed is we were able to get a stronger claim for Incruse at the end of the summer and we're certainly promoting it, but as I explained in response to an earlier question, simplification is more around the segmentation of the doctor audience rather than necessarily the products. The point being that some physicians are more amenable to a pathway treatment beginning bluntly with an Incruse conversation versus Anoro and others are more amenable to it through an Anoro conversation. It's more the simplification through the segmentation plus improved claim. As I said, going back to May, we certainly laid that out. As far as pipeline is concerned, you ask a good question. It's very difficult to give you a simple answer. Of course each asset is different. I would say as a general rule, we have profiled the ones which have progressed beyond points of, let's say, substantial confidence building proof or substantial opportunity kind of proof. That list changes all the time. Obviously, all the time assets are moving forward or failing and part of the game is to try and get to that decision as quickly as possible. We tried to pull out for you the things that were more advanced a more interesting and had those proof points, but I'm absolutely sure that you'll see a lot more. If I had to pick one and we did talk about this one at R&D Day, but we talked about it reasonably minimally, I think the RIP kinase portfolio of assets that is coming is quite extraordinary.…

Operator

Operator

Thank you, ladies and gentlemen. That concludes the conference call for today. You may now disconnect. Thanks for joining and enjoy the rest of your day.