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GSK plc (GSK)

Q3 2020 Earnings Call· Wed, Oct 28, 2020

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Transcript

Operator

Operator

Good afternoon, ladies and gentlemen, and welcome to the analyst call on the GSK Third Quarter 2020 Results. I will now hand over to Sarah Elton-Farr, Head of Investor Relations, who will introduce today's session. Please go ahead Sarah.

Sarah Elton-Farr

Management

Thank you. Good morning and good afternoon. Thank you for joining us for our Q3 2020 results, which were issued earlier today. You should have received our press release and can view the presentation on GSK's website. For those not able to view the webcast slides that accompany today's call are located on the Investors section of the website. Before we begin, please refer to slide 2 of our presentation for our cautionary statements. Our speakers today are Emma Walmsley, Iain Mackay, Luke Miels, David Redfern and Brian McNamara. Hal Barron and Roger Connor will join us for Q&A. We request that you ask only a maximum of two questions, so that everyone has a chance to participate. And with that, I will hand the call over to Emma.

Emma Walmsley

Management

Thank you SEF, and welcome everybody to today's call. I hope that you are all keeping well. 2020 continues to be an extraordinary year. GSK has shown resilience and agility in tackling the challenges, while maintaining focus on our strategic goals, which remain firmly on track. We continue to strengthen and advance the pipeline. In July, as mentioned at Q2, we received approval for Rukobia in HIV. And this quarter we've also had first approval and launches for BLENREP in multiple myeloma for Trelegy in asthma and new indications for Nucala. We've delivered positive data on our RSV candidate vaccines and GSK'836 in hep B. Plans to progress these programs are underway both represent major opportunities for health care impact and have the potential to be significant future growth drivers. We also initiated three major pivotal studies in meningitis vaccine second-line multiple myeloma and with our Vir antibody in COVID-19, a very exciting program you're going to hear more on later. While there have been some short-term pressures as a result of the pandemic, especially in vaccines early in the quarter our performance fundamentals continue to strengthen. And we're very confident our vaccines portfolio and pipeline will drive growth for years to come. Brian will update you in more detail, but the momentum we're building in our commercial execution is driving encouraging growth across our new products, setting the course for strong future performance. And this has also been a quarter of disciplined cost control, as we've made substantial progress on both our consumer integration and company separation programs. We continued to deliver efficiency in our support functions, further simplify our site network, and achieve an important milestone on building one development organization in R&D for Pharma and Vaccines that will improve agility decision-making and scientific collaboration as well as…

Iain Mackay

Management

Thanks, Emma. All the comments I'll make today will be on a constant currency basis except where I specify otherwise, and I'll cover both total and adjusted results. On slide 9 is a summary of the group's results for Q3 and the year-to-date. In Q3, turnover was down 3% CER. Adjusted operating profit was £2.7 billion up 4% CER. Total EPS was 25p down 9% CER and adjusted EPS was 35.6p up 1%. In the year-to-date turnover was £25.4 billion, up 4% reported down 2% pro forma. Adjusted operating profit was £7.1 billion, up 3%. Total EPS was 102p, up 55% and adjusted EPS was 92.6p, down 4%. We delivered £2.3 billion free cash flow in the year-to-date and in the quarter; there was a 5% headwind on sales and 9% in adjusted EPS from currency movements. Slide 10 summarizes the reconciliation of our total to adjusted results. The main adjusting items in the quarter I'd highlight are major restructuring which reflects continued on-track progress on the Consumer Healthcare integration and transformation and separation activities. And in transaction related within which the main contributor was a charge relating to the re-measurement of the contingent consideration relating to ViiV Healthcare. The main component within this was an increase in our forecast for cabotegravir PrEP following the very strong clinical data that we shared earlier in the year. Comments from here onwards are on adjusted results and a constant currency basis unless stated otherwise. Slide 11 summarizes the Pharmaceuticals business where overall revenues were in line with expectations, down 3% in Q3 and down 1% in the year-to-date. Excluding Established Pharma, revenue grew 12% in the quarter and was up 12% in the year-to-date reflecting our strong commercial delivery. Respiratory was up 26% with continued strong growth from Trelegy, Relvar/Breo, and Nucala.…

Luke Miels

Management

Thanks, Iain. Hi, everyone. As you know, we've been working hard on our commercial execution to ensure that we're competitively resourced with a particular focus on new product launches and our key markets. And the changes we've been made are now starting to pay off. Sales in our growth areas of respiratory, HIV, immuno-inflammation and oncology, were up 12% this quarter to £2.5 billion. Changes we've made include updated HCP engagement policies and sales force incentives to allow us to compete more effectively and responsibly in the key markets where we're driving growth. Now we're also winning share of voice with strong acceleration of our digital capabilities as well as increased face-to-face engagement where possible. And though the lockdown restrictions have as expected, impacted on some of our portfolio, especially Established Pharma we've taken the opportunity presented by the new ways of working to amplify our digital presence, complementing more traditional approaches very successfully. And with these measures in the right investment, we are seeing great momentum across our new product portfolio, which we expect to build further in the coming quarters as we bring our pipeline assets to market. Starting now with Nucala. We had another great quarter, delivering a strong competitive performance and maintaining our leadership in the IL-5 class. This remains a market with significant growth opportunities with unfortunately only 27% of eligible patients in the U.S. receiving the biologic. And we're leading share of both new and total IL-5 patients in the U.S. and remain the leader in other key markets around the world as you can see on this chart. Nucala's leading position is built on its proven efficacy derived from its precision targeting of IL-5 to reduce its intervals to normal levels, differentiating it from other biologics and we're using that benefit to rapidly…

David Redfern

Management

Thank you, Luke. Hello, everyone. As in the rest of our business, HIV is also benefiting from strong competitive execution. We have the leading share of voice in both the U.S. and Europe and the benefit is clear in the momentum, we are delivering in the two drug regimens and across our HIV business. We are now seeing U.S. dolutegravir NBRx share outstrip our TRx share. A key point of inflection which demonstrates the traction that we have achieved the two-drug regimens, which now have over a 9% share of NBRx in the U.S. Dovato in particular, is performing very strongly. We saw the inclusion of the TANGO switch data on the U.S. [Technical Difficulty]. This has helped Dovato accelerate its share of the U.S. switch market. We now see about one-third of Dovato scripts come from new patients, one-third from competitor regimens and therefore only one-third from other dolutegravir [Technical Difficulty] regimens. As such, overall, we are seeing a positive net switch to dolutegravir regimens helping to increase our overall market share in the U.S. In Europe, we are growing ahead of the market and dolutegravir is gaining market share as we continue to roll out Dovato. We've been able to launch early in all markets across Europe despite the pandemic and Dovato now has the leading share of voice in all measures of all countries. We have also seen a positive start for Rukobia, which has U.S. insurance coverage of over 70%with 250 patients already on therapy. And we are making good progress in our discussions with the FDA on CAB in the PrEP setting. We are on track to file for U.S. approval for PrEP in the first half of next year and anticipate a 2022 approval. We still expect HIV revenue growth overall to be broadly flat 2020, but anticipate a return to growth in 2021 building on the momentum we have established for Zejula and Dovato and with the expected U.S. launch of CABENUVA in the first quarter of 2021. I will now hand over to Brian to talk about Consumer.

Brian McNamara

Management

Thanks, David. I'd like to provide a quick update on our progress with integration, which is progressing well and is firmly on track. Our positive momentum has continued despite the challenges related to the pandemic. Importantly, we've delivered significant milestones to date. 96% of the Pfizer Consumer Healthcare revenue are now on our systems with 71 markets having made this transition since the start of the pandemic. 87% of co-locations are complete and 39 of the 41 warehouses identified for closure are now closed. Furthermore, all future market cutovers, employee transfers and production site integrations remain on track. At the time of the transaction, we've provided synergy and financial guidance for 2022 and this remains unchanged. We continue to expect annual synergies of £500 million by 2022 with up to 25% reinvested back into the business to drive growth. We have also delivered on our divestment commitment with transactions meeting our target of £1 billion in proceeds already signed. Through this process, we have divested more than 50 growth-dilutive brands, strengthening our existing portfolio. Our separation program is also on track with work around the future organizational structure and system separation well underway. Now it's important to remember that the end goal of all this integration work is to bring together a fantastic portfolio of category-leading brands with a strong geographic footprint positioned in a sector which is now more relevant than ever. I continue to be excited about the potential of what we have created, a 100% focused global leader in Consumer Healthcare, addressing consumer needs and driving better everyday health. I look forward to sharing more with you on this great business over the coming years and in the run-up to separation. Coming back to performance, I'd like to share some detail on the growth drivers behind today's…

Emma Walmsley

Management

So in summary, we've delivered a resilient performance this quarter with strong commercial execution of our growth drivers underpinned by disciplined control of costs. This, together with an improvement in vaccine immunization rates, we remain on track to deliver adjusted EPS for the year within our guided range. We're also pleased to have maintained progress in delivery against our long-term priorities of innovation, performance and trust. In R&D, we've had four new approvals in the quarter and generated data to support development of major pipeline assets including our portfolio of RSV vaccines. And very importantly, we've also been able to advance five possible COVID-19 solutions into clinical development, two very promising antibody therapies and three collaborations for adjuvanted vaccines. Beyond R&D. integration in Consumer Health continues at pace and we have achieved some important milestones in our program to prepare the group for separation into two new companies: a biopharma company focused on the science of the immune system and genetics and a new world-leading consumer health company dedicated to everyday health. We believe the creation of these two new companies will deliver significant new options for sustainable growth and returns to shareholders. We're now joined for Q&A by Hal and Roger and with the rest of the team. And so with that operator, we're ready to take your questions.

Operator

Operator

Thank you, Emma. Your first question comes from Keyur Parekh. You are live in the call, Keyur. Please go ahead.

Keyur Parekh

Analyst

Thank you for taking my question. Dave, Emma, first of all congratulations on your recognition of your achievement. So, [Indiscernible] on that, just linked with that, who among your senior management team has the best curtsy technique so far.

Emma Walmsley

Management

A lot of hands going up on that, it’s recognition for the company I can assure you Keyur nobody in my house takes their tails off on the floor anymore, but anyway, going to your technical question.

Keyur Parekh

Analyst

Well. You still haven't answered the question, so the two questions. One, Hal, there's some amount of confusion on the update that your partners at Merck and you put out about bintrafusp alfa. So I was just wondering if you could share your perspective on, what kind of you made out of the update. Clearly, the trial continues, but kind of the proposed expansion of the enrollment kind of isn't happening. So, I was just wondering if you could share some perspectives on that. And then secondly, as it relates to, kind of the reiteration of the guidance kind of for the full year, how much of that relies on Shingrix coming back into the fourth quarter? And what level of Shingrix revenues might be required to get there, or do you feel comfortable enough to get to the bottom end of the range irrespective of what Shingrix does, during the fourth quarter? Thank you.

Emma Walmsley

Management

Thanks Keyur. So let's come to Hal first. And then over to Iain for a bit more specifics on, the guidance on Shingrix contributions.

Hal Barron

Analyst

Okay. Well, thank you very much for the question, Keyur. Maybe backing up, I think it's important to note that, when we initiated the collaboration with Merck KGaA, we did it on a very large and robust Phase I data set of over 400 patients really demonstrating activity and a very well-tolerated safety profile and some encouraging response data in lung. As we've said many times, we think it's important to do randomized controlled trials to see, whether these observed effects are real, when compared to appropriate controls. And that is really what initiated the so-called 037 study to obtain this randomized data. As you say we updated you last week that the study is not expanding. And we'll be continuing with 300-patient sample size. And while I know, I can't really answer any of your questions more specifically. I will say that we need to await the final data, to ensure the integrity of the trial. And it's important to wait to discuss any results of the study, until we have a full data set including data on PFS and OS. So I realize that leaves you with some questions. But that's really the extent to which I can comment at this point.

Emma Walmsley

Management

Thanks Hal. Iain?

Iain Mackay

Management

Yeah. So Keyur just to be absolutely clear, it's my opinion that I do the best curtsy by a long, long way in this group, being the only guy that wears a scarf in this place anyway. Anyway moving on from that, to the more important point in Shingrix, look, we really encouraged by the progress that we've seen through September. And happily that's continued into October. That recovery in an adult -- older adult immunization rates, has been extremely important in terms of how we formed the guidance for the full year. We don't necessarily need to grow immensely beyond where we are. But we do need to sustain the recovery that we've seen. Now September was a great month. I think it was probably the best single month that we had in Shingrix. Overall growth year-to-date 6%, obviously below the number that we had guided to for Shingrix, but provided that we can sustain the recovery that we've seen through September, we're also very encouraged by the weekly prescription data and immunization days that we see so far through the month of October, then that certainly should take us to the lower end of our guidance range.

Emma Walmsley

Management

Thanks. And just to complement that, I think fundamentally we're absolutely convinced that Shingrix will be a great growth driver for the company, for years to come. And if ever we want to be reminded of the opportunities and growth prospects in the Vaccines segment, this is definitely the year to reinforce that. So next question please?

Operator

Operator

Thank you. Your next question comes from Graham Parry from Bank of America. You are live in the call Graham. Please go ahead.

Graham Parry

Analyst

Great. Thanks for taking my questions. So firstly, would it be possible to quantify the BLENREP inventory? And pension restructuring benefits on adjusted operating income and margins in the quarter? So, would you still have been coming in around the sort of consensus level, without those in there? And then secondly, your guide now assumes R&D mid- to high single-digit increase. So I think at the start of the year you were flagging similar growth to 2019 for both, 2020 and 2021. That would have been about a 13% increase in R&D. And it's obviously benefited from some of this BLENREP inventory write-back. So could you just help us understand, should we be expecting a sharp upward inflection in R&D in 2021, as the one-off benefit go away and you continue to invest in the pipeline? Thank you.

Emma Walmsley

Management

So I think both of those to Iain. But just to reiterate our number one priority is still to keep strengthening the pipeline. So we do expect to see a strong increase, but perhaps next year. But perhaps Iain you could put some, shape around that.

Iain Mackay

Management

Yeah. Absolutely, so Graham thanks for your question. BLENREP the capitalization of pre-approval inventory was just north of £60 million in that factor. When you turn more broadly to R&D expense, the main point to I think reiterating here and Hal can go into more detail is, that we've kept all our programs very much on track to the extent that we'd experienced any slight delays earlier in the year on the back of the pandemic. Those have been largely recovered. We've still got a little bit to do on gepotidacin but those are very much back on track again. And what Hal and the team have continued to do is, realize fully the efficiencies and synergies we expected from the TESARO acquisition and continue to deliver benefits and savings through the R&D just in terms of how we prioritize and manage spend within that. Reflecting on next year our guidance would remain absolutely consistent. We'd expect to see double-digit growth in R&D expenditure next year as we continue to invest in those priority programs across the R&D pipeline and made progress in that regard.

Emma Walmsley

Management

Hal I don't I wonder whether you would like to add anything in terms of the sort of overall governance and sort of progress of the pipeline because the other thing to note Graham would be that with – and you have seen it we're slightly down in both Vaccines and Consumer Healthcare R&D through integration and cost control. But Hal perhaps you could add some more color around the governance aspects of spend.

Hal Barron

Analyst

Yes Well thanks Graham. We're making a lot of great progress I think as Emma highlighted in her last comments on the last slide. And in particular highlighting that BLENREP started three pivotal studies making very nice progress on ICOS adding a second Phase II sort of head and neck study. The two COVID trials that we're doing in the Pharma side have been highlighted and they're going well three vaccine trials including moving the RSV to Phase III. We've added 10 new molecules vaccine to pharma assets into the pipeline. But importantly, we're also using a very high bar to advance things. We're using a high bar for interpreting data. And based on that we actually removed eight assets as well. We're tightening up our focus on research in areas that we think are most promising, making a lot of great progress on the human genetics functional genomics side and research, but really have reduced a little bit of spend in that in the research area. But overall, I'm very encouraged by the progress we're making on the pipeline and we'll be continuing to move aggressively to the -- to even strengthen it further.

Emma Walmsley

Management

Thanks Hal, next question please.

Operator

Operator

Thank you. Your next question comes from Tim Anderson from Wolfe Research. You are live in the call Tim. Please go ahead.

Tim Anderson

Analyst

I want to go back to bintrafusp if I can for Hal. Hal would you agree that there's two very different equal interpretations to the recent update one is that, you saw enough of a signal on the interim that you didn't feel you need to upsize the trial to hit survival; and the other would be the opposite which is that, it's not worth upsizing the trial because that interim only showed a weak signal. Just to clarify will there be a milestone paid to your partner? And then second question is another pipeline question and it's on the ICOS agonist data coming up in first half 2021. You have a second-line lung trial randomized ICOS plus docetaxel versus docetaxel alone. Just your updated thinking on the odds of success with that trial.

Emma Walmsley

Management

Okay. So just to confirm that there's been no milestone paid to date on the basis of the data to date. Doesn't mean there couldn't be one in the future. But Hal do you want to make any further comments on bintrafusp and also on ICOS please?

Hal Barron

Analyst

Yes. Tim thanks for your question. Our goal is to really be the partner of choice and be an outstanding partner when we work with another company and we've committed to Merck KGaA to have them be the lead on discussing how to interpret all this. So I sense the frustration and I would typically comment more to be honest with you, but I think it's best said that we should await the data from the trial before making any comments. So sorry for not being more transparent about that. In terms of your question about the ENTRÉE lung study the ICOS study. From memory that's about 105-patient study the design as you described. And it is a Phase II where we'll be looking at all the classic sort of end points you might expect. I think it will be important because that will be the first randomized data that really gives us a sense of the incremental activity that ICOS could engender there. And so I am cautiously optimistic that, that promotional activity and it would certainly be a huge boost to the program and drive subsequent study designs and probably thinking about where the molecule fits in the medicine.

Emma Walmsley

Management

Thanks Hal. Next question, please.

Operator

Operator

Thank you. Your next question comes from the line of James Gordon from JPMorgan. You are live in the call James. Please go ahead.

James Gordon

Analyst

Hello. It's James Gordon from JPMorgan. Thanks for taking question. Two questions please. If coming back to the same point. Just one more on TGF-beta which would be -- I noted the comment on not giving specifics about what you saw at the interim that there hasn't been a milestone paid. But can you just say more generally how is GSK thinking about investing in this mechanism in other frontline cancer trials? So could this be an area where we're going to see much more investment over the next few years and you're going to go broader, or do you still see this as just as much as a bet when you first started or entered into this partnership? So any increased confidence to go broader, would be the first question. And then, the second question is pipeline news flow specifically dostarlimab. So based on the slides, dostarlimab and dapro, again the non-COVID-19 NCEs we're going to have Phase III data in 2021. And I know you recently renegotiated the deal on dostarlimab, so it allows you to partner Zejula with other PDx agents other than dosta. So, just how much potential does dosta have? Is this something that is a big focus? Should we think this will be one of the key readouts for 2021, or is there other assets that you're much more excited about than dostarlimab?

Emma Walmsley

Management

Hal, both to you.

Hal Barron

Analyst

Okay. Let me -- so let me go with the dostarlimab first. We're excited about having dostarlimab. It obviously is part of the PD-1/PD-L1 class, which of course has transformed oncology and probably as a class will be the greatest biggest medicine maybe ever. So, we're excited to have one. We think that it's q 6-week dosing. It's actually dosed at a higher level than other PD-1s, could be an attractive attribute. I think the greatest opportunity for us with dostarlimab is to be able to combine it particularly with our pipeline reagents. We have the DREAMM-4 study with bela maf with a PD-1 inhibitor. We have of course the opportunity to combine PD-1 inhibition with aparib whether that be in lung or in ovarian with the first trial. We certainly have opportunities to combine dostarlimab with pipeline reagents that are earlier on like CD96 and STING and ICOS and other agents. So it is a nice complement to our pipeline and we're very excited about its activity. Of course, it's also active in endometrial cancer, both in the second line and we've got the frontline study going. We are hoping that we can have a tumor-agnostic approval at some point with the data beyond endometrial with colon et cetera. So, we think it has a lot of potential and that's in part why we renegotiated as you described and give us a lot of flexibility on niraparib as well. Sorry, the other question was -- I didn't write it down.

Emma Walmsley

Management

Bintrafusp, in broader studies.

Hal Barron

Analyst

Yes. So, for bintrafusp, we were very excited about the preclinical rationale for inhibiting TGF-beta the bifunctional nature of the protein to hit PD-L1 and target the protein to the tumor is attractive. The Phase I data as I comment on was very large and robust and seem to have signals of activity and a well-tolerated profile. And as we get more data, we'll make data-driven decisions about where to invest. I can't really say more than that. But since we got incremental data, we will be sharing that and sharing where that leads us to invest in subsequently.

Emma Walmsley

Management

Thank you. Next question please.

Operator

Operator

Thank you. Your next question comes from the line of Steve Scala from Cowen. You are live in the call, Steve.. Please go ahead.

Steve Scala

Analyst

Thank you. First, do you think the inflection in the two-drug regimens that you speak to is already reflected in Dovato numbers, or is that yet to come? So that's the first question. Second question is I would like to ask about the recent thinking on the dividend. I know it's a Board decision. But 25% of the Board is on this call and another 25% are former CFOs of drug companies. So, I would think that half the Board can't find appealing paying out the majority of free cash flow to cover the dividend. Emma, would you disagree that a good portion of the Board likely thinks that a change in dividend policy would be in the best interest of building the company? Thank you.

Emma Walmsley

Management

Thank you. So, we'll come to David in a moment on 2DRs and the growth prospects for our HIV business also including the upcoming pipeline. On the dividend Steve, I'm afraid I'm going to reconfirm there's absolutely no change to the Board's position on capital allocation or dividend policy. Obviously, we're working towards separation of the group. We've been clear on what the dividend is going to be for the Consumer Healthcare business in contract with Pfizer. And as we get closer to the separation and the confirming on that, we'll update with a full Board views in terms of distribution for that, but no further comment on that at this stage. David, over to you for HIV.

David Redfern

Management

Yes. Thanks Steve. It is true. I mean we're pleased with the performance of two-drug regimens across the world, and particularly Dovato, very strong in Europe, where it's now rolled out everywhere and we're seeing rapid pickup. And as I said in my remarks, in the U.S., we've seen a very clear inflection in the NBRx and particularly in the switch since we got the TANGO data included in the label in the summer. So, 2DR NBRx is running at about just over 9%. TRx is running around 5%. So some of it's in the numbers but I think still quite a lot more to come in the U.S. in particular. And then of course there's always obviously a reasonable gap time gap in NBRx coming through into the TRx. But the trend there, I think it is just symptomatic of all the data whether it's the clinical data, the real-world data, the experience that physicians now have. We are seeing very good momentum and I think that will come through more and more strongly in TRx in the numbers.

Emma Walmsley

Management

Thanks, David. Next question please?

Operator

Operator

Thank you. Your next question comes from Andrew Baum from Citi. You are live in the call, Andrew. Please go ahead.

Andrew Baum

Analyst

; : I'm surprised that we haven't seen any activity from GSK particularly in hematology given the investment that you're making in the space and the obvious synergies that could be with the late-stage products within that area. So the question is, what am I missing? There still are late-stage hematology assets right for BD some of which could be accretive immediately. Is this the valuation does it make sense for you? Is it you're looking for internal gating in order to determine the strategy? Is it concerns about the future of U.S. reimbursement? What am I missing here?

Emma Walmsley

Management

Well it's an important topic and I'm not sure that you're missing anything because we are absolutely clear in recognizing your observations that our number one priority continues to be strengthening the pipeline and it's our number one priority for capital allocation including business development. We keep -- whether it's for internal assets or external ones as Hal has alluded to we keep the bar high. We want to make sure they're obviously in line and fueling the strategy that we've laid out for biopharma and have the right kind of discipline around returns. But we certainly see it as a priority for a review and that's exactly why last quarter we built up a deal with Vir, which clearly we see as having significant potential. And we've announced this year that if it's successful with data later this year could be in market next year for something with really significant sales global demand. But we also continue to look at technology platforms as evidenced by the deal we struck with CureVac around multiple options in terms of vaccines development. So continue to watch this space and we continue to be prioritizing this as an area for team focus and energy. So I think we now have time to move to one last question.

Operator

Operator

Yes. Your last question comes from Kerry Holford from Berenberg. You are live in the call. Kerry, please go ahead.

Kerry Holford

Analyst

Thank you. Two questions please. Firstly, on the COVID antibody you spoke about the potential for an extended half life. I wonder if you could provide us with any more detail here. Are we talking weeks, months? Do you think one shot could cover a whole winter season for example? I know we haven't seen full data but any feeling around your comments there would be helpful. And then on Zejula, you talked about the progress being made in the first-line ovarian market. But did that indication contribute much to sales in the quarter and is continuing to be slow? And I guess when can we expect -- when do you think we should expect a more significant ramp in sales in that setting? Thank you.

Emma Walmsley

Management

Thanks, Kerry. So we'll come to Luke on Zejula, but then I'd like to come back to Hal please to finish up with the comments on the prospects and possibilities for the Vir antibody. But Luke, first to you on Zejula.

Luke Miels

Management

Sure. Thanks, Emma and thanks, Kerry. I just -- one thing I put in context it's really interesting when you look at the bulking surgeries in the U.S. I mean it's not interesting. I think it's fair. They dropped by about 35% in April and May and they've steadily recovered through June and July. But they're still around 10% below the levels of February. So that's obviously having an effect on patient flows. If we look and it's really in the U.S. because we don't -- well when we look in the quarter we didn't have the label of first line in Europe. But if you look at our spread of patients in the U.S. for Zejula about 1/3 of them are in first line now; a split between treatment and maintenance about 1/3 of patients on treatment and about 2/3 of maintenance. But yes around 1/3 of sales are now coming from first line. If you look at our share growth that is -- and your point is accurate. Our growth has come from taking it away from olaparib within the class. Hopefully, as we now move through and start to at some point see some stabilization in the COVID environment we can begin to see the overall class growth in first line and the number of people on watch and wait be reduced.

Emma Walmsley

Management

And that 70% on watch and wait is really the opportunity here as well as we hope in due course expanding Zejula beyond ovarian. So Hal back to you the Vir antibody.

Hal Barron

Analyst

Yes. Thanks Kerry. The Vir antibody is actually very, very special very unique for a number of reasons. As Luke mentioned in the presentation, I think it's important to highlight that this was found through exploration of antibodies from patients with SARS-CoV-1. And the argument and the rationale for choosing such an approach was that if over this period of time the SARS virus that resulted in COVID-19 has a neutralizing antibody to both that the epitope the antibody's binding tube is likely very important for its infectivity and therefore significantly reduce chances of mutating around that. So the 2DR regions we think are incredibly important and why we think there's going to be very limited resistance to a single monoclonal. And that's particularly important given some of the Lilly data where I think it was somewhere between 6% and 8% of the patients had resistant clones than the many, many clones that are emerging as through the genetic drift and even the D614G mutation that's becoming more probably due to a fitness advantage. In addition to that, it being highly neutralizing, it actually has a modified Fc receptor that not only gives it an extended half-life to your point, which we think we're not exactly sure how long that will be, but it will be most likely substantially longer somewhere probably between two, three maybe even four months of duration considerably more than what you'd expect from a typical antibody, because of this modification, which has been done on other antibodies that have been in the clinic. So we're reasonably confident it will extend half-life. But in addition, there's a modification of the effector function, so that in addition to being neutralizing the antibody through this increased effector function should be able to bind and destroy cells that are infected with the virus, and that's very unique. That's not something you would see with the other antibodies we don't think. And so this could give us greater efficacy maybe allowing us to even use lower doses, et cetera. So we think the Fc modification not only extends half-life, but the effector function may be very important. So combined with that the lower dose that's being explored compared to other monoclonal antibodies a single monoclonal nature and the ability most likely to effectively neutralize the resistant strains is unique. And lastly, I'll just mention that we do see lung accumulation of the antibody. Whether that's due to some of these modifications in the Fc or other attributes isn't clear. But the antibody also does seem to preferentially go distribution-wise into the lung, which we think will give it again another advantage. So we're very excited about this program and think it could really offer a significant solution for COVID. And hopefully, we'll have data soon to support that.

Emma Walmsley

Management

So a concluding reason for optimism, which I'd add. So the resilient performance that we've delivered and the fact that we're on track to be within our guidance range, despite particularly challenging circumstances, we're encouraged by commercial execution across multiple growth drivers and optimistic for both the near-term recovery and long-term prospects for vaccines. We're seeing strong progress on our strategic imperatives, whether that be in pipeline particularly including COVID solutions or indeed in terms of the separation preparation, which is very much firmly on track and we think gives exciting options for returns to shareholders in the coming years. So, with that, thank you all very much for joining us and we look forward to speaking and seeing you soon.

Operator

Operator

Thank you Emma, and thank you to all your speakers. And thank you everyone. That concludes your conference call for today. You may now disconnect. Thank you for joining and enjoy the rest of your day.