Earnings Labs

Jazz Pharmaceuticals plc (JAZZ)

Q4 2024 Earnings Call· Tue, Feb 25, 2025

$202.85

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Transcript

Operator

Operator

Thank you for standing by. My name is Jeannie, and I will be your conference operator today. At this time, I would like to welcome everyone to the Jazz Pharmaceuticals Fourth Quarter 2024 Webcast. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question-and-answer session. [Operator Instructions] Thank you. I would now like to turn the call over to Jeff Macdonald, Executive Director, Investor Relations. You may begin.

Jeff Macdonald

Analyst

Thank you, operator. Good afternoon, everyone. Today, Jazz Pharmaceuticals reported its fourth quarter and full year 2024 financial results. The slide presentation accompanying this webcast is available on the Investors section of our website as is the press release we issued earlier today. On the call are Bruce Cozadd, Chairman and Chief Executive Officer; Renée Galá, President and Chief Operating Officer; Rob Iannone, Executive Vice President, Global Head of R&D; and Phil Johnson, Chief Financial Officer. On slide two, I'd like to remind you that today's webcast includes forward-looking statements, such as those related to our future financial and operating results, growth potential and anticipated development and commercialization milestones and goals, which involve risks and uncertainties that could cause actual events, performance and results to differ materially from those contained in these forward-looking statements. We encourage you to review the statements contained in today's press release, in our slide deck and the risks and uncertainties described under the caption Risk Factors in our annual report on Form 10-K for the fiscal year ended December 31, 2023, our quarterly report on Form 10-Q for the quarter ended September 30, 2024, and our subsequent filings with the SEC including our annual report on Form 10-K for the fiscal year ended December 31, 2024, which identifies certain risk factors that may cause the company's actual events, performance and results to differ materially from those contained in the forward-looking statements made on today's webcast. We undertake no duty or obligation to update these forward-looking statements. As noted on slide three, we will discuss non-GAAP financial measures on this webcast. Descriptions of these non-GAAP financial measures and reconciliations of GAAP to non-GAAP financial measures are included in today's press release and a slide presentation available on the Investors section of our website. I'll now turn the call over to Bruce.

Bruce Cozadd

Analyst

Thanks, Jeff. Good afternoon, everyone. Thank you for joining us today to discuss Jazz's fourth quarter and full-year 2024 results. I'll start on slide five. I'm very pleased to report that 2024 was another record year for Jazz. Our strong commercial execution resulted in more than $4 billion in total annual revenue and fourth quarter revenue of nearly $1.1 billion, our highest ever. Importantly, we helped more patients who benefit from our highly differentiated therapies in areas with limited or no therapeutic options. These achievements reflect the tenacity and dedication of our talented employees around the world. On the R&D front, we achieved several important development and regulatory milestones in 2024, headlined by the accelerated approval of Ziihera in the U.S. for the treatment of second-line HER2-positive biliary tract cancer or BTC, in November. In addition, we believe the positive results from the Phase III Zepzelca clinical trial in first-line maintenance for small cell lung cancer will support expansion into an earlier line of treatment, potentially benefiting a broader patient population. We plan to further diversify our commercial and pipeline portfolios through strategic corporate development, which remains a key focus for Jazz. As part of our ongoing search, we're evaluating neuroscience and oncology assets, while also contemplating other rare and orphan diseases. In addition, durability of revenue, efficiency of commercial call points and alignment with our expanded R&D capabilities are part of our considerations as we assess opportunities to maximize long-term shareholder value through corporate development. Turning to slide six. I'm pleased to confirm we achieved our 2024 guidance, delivering top line growth at the upper end of our range and $1.37 billion in adjusted net income on a non-GAAP basis. Phil will discuss our 2024 financial results and 2025 guidance in more detail later in the call. On the…

Robert Iannone

Analyst

Thanks, Renée. I'll begin on slide 14. We achieved an important milestone for patients and our company in 2024 with the FDA approval of zanidatamab in second-line BTC along with the initiation of our first-line BTC confirmatory trial. Beyond BTC, we significantly advanced zanidatamab development, including our ongoing first-line GEA trial and the initiation of the Phase III EmpowHER breast cancer trial and Phase II pan-tumor trial. As Bruce mentioned earlier, we are now expecting the top line PFS readout from our Phase III frontline GEA trial evaluating zanidatamab with standard of care chemotherapy with and without the addition of a PD-1 agent in the second-half of 2025. Recruitment for this trial is on track, and we expect to complete enrollment within the next few weeks. As a reminder, this is an event-driven trial, and our updated estimate is based on a more mature projection of progression events relative to the initial protocol assumptions. While we, as the sponsor remain blinded to the results of the trial, we are encouraged by the positive results from two independent Phase II trials zanidatamab in first-line GEA that have demonstrated increased median PFS, duration of response and confirmed objective response rates. If positive, we expect the PFS data from this trial will support registration. Moving to other programs. In October 2024, we reported highly encouraging results from the Phase III IMforte trial of Zepzelca in combination with atezolizumab compared to atezolizumab alone when administered as maintenance therapy in first-line extensive-stage small cell lung cancer. The combination demonstrated statistically significant and clinically meaningful improvements in the primary endpoints of overall survival and progression-free survival. The results have the potential to be practice-changing and we look forward to presenting the data at a medical meeting this year, which is an important step toward potential inclusion…

Philip Johnson

Analyst

Thanks, Rob. I'll start with our top line results on slide 18. As a reminder, our full financial results are available in today's press release and in our 10-K, which will be filed tomorrow morning. In the fourth quarter of 2024, we achieved nearly $1.1 billion in total revenues. We were pleased to deliver this top line growth, which was driven by increased Xyway of Epidiolex and oncology revenues. And for full-year 2024, we recorded approximately $4.1 billion in total revenues, representing 6% growth over 2023. This marks our 20th consecutive year of top line growth. And as you've seen in our guidance, we expect 2025 to be our 21st consecutive year. Turning to slide 19. Our full-year 2024 non-GAAP adjusted net income was approximately $1.37 billion and we reported non-GAAP adjusted EPS of $20.90. We continue to generate significant cash from our business, demonstrating the strength and diversity of our portfolio. We recorded approximately $1.4 billion of cash from operations for the full-year 2024 and ended the year with $3 billion in cash on hand. Consistent with our prior communications, in January, we made a voluntary repayment of $750 million to reduce the principal amount of our Term Loan B. During 2024, we continue to utilize our share repurchase authorization and spent approximately $311 million repurchasing shares. Going forward, if not used for corporate development investments to enhance our future growth prospects, we expect a significant portion of free cash flow to go toward debt paydown, share repurchases or some combination thereof. Finally, our overall financial position and robust operating cash flows provides significant flexibility to invest in value-driving commercial and R&D programs as well as in promising corporate development opportunities. We're pleased to share our full year financial guidance for 2025, beginning on Slide 20. Our 2025 total…

Bruce Cozadd

Analyst

I'll conclude our prepared remarks on Slide 23. 2024 was a record year for our promoted commercial products, and we expect to deliver continued strong execution in 2025. Epidiolex remains poised to reach blockbuster status in 2025 and we expect Xywav to remain the number one branded narcolepsy treatment with continued growth in IH. Ziihera represents a significant growth opportunity with an estimated $2 billion plus in peak sales potential. We look forward to submitting the sNDA for Zepzelca with the potential to help more patients for a longer duration and extend survival. Our proven strength in commercial and pipeline execution and corporate development are supported by our continued focus on operational excellence and strategic capital allocation. I'm confident Jazz is well positioned to deliver our 21st consecutive year of top line growth in 2025, drive meaningful shareholder value with data readouts such as the Phase III GEA trial and pursue strategic corporate development opportunities to deliver long-term sustainable growth. That concludes our prepared remarks. I'd now like to turn the call over to the operator to open the line for Q&A.

Operator

Operator

Thank you. We will now begin the Q&A session. [Operator Instructions] And your first question comes from the line of Marc Goodman with Leerink. Please go ahead.

Marc Goodman

Analyst

Hey Rob, can you talk about the orexin 441? Any type of comment you can make? Have you figured out the safety margin? Is your low dose kind of doing what you wanted to do? Any comments there would be helpful. And then just on the settlement with Epidiolex, is there any reason you're being so cagey? Can you actually give us the date?

Bruce Cozadd

Analyst

So Marc, this is Bruce. Maybe I'll jump in on your second question first. We actually think saying our Epidiolex settlements with all 10 ANDA filers go out to the very late 2030s is being pretty specific. I'll remind you those agreements have confidentiality provisions, which limit what else we can say. So that's all we're going to have to say at the moment is very late 2030s. Rob, I'll kick it over to you for a 441 update.

Robert Iannone

Analyst

Thanks, Bruce. So Mark, we don't have an update on the trial that we said we are initiating. This is a trial with 441 in NT1 patients, small number we thought about 10% or so. But so far, no updates on that. But we do think that even in a small number of patients that will help us define a better therapeutic index. So no updates at this time.

Operator

Operator

Your next question comes from the line of Jessica Fye with JPMorgan. Please go ahead.

Jessica Fye

Analyst · JPMorgan. Please go ahead.

Hey guys, good afternoon. Thanks for taking my question. For the HERIZON-GEA trial, I think you said you'll complete enrollment in the next few weeks. So just to confirm, is that for the upsized 918 patient target enrollment? Can you remind us when you completed enrollment of the originally planned 714 patients? And then I guess while I made on this trial, Rob, when you see the event rate maturing differently than initially projected as it seems to be here, do you take that as positive, neutral or negative for probability of success?

Bruce Cozadd

Analyst · JPMorgan. Please go ahead.

Go ahead, Rob.

Robert Iannone

Analyst · JPMorgan. Please go ahead.

Okay. Yes. So we are referring to the 918 when we say we'll be completing enrollment in the coming weeks. We haven't said when the 714 was enrolled. As you know, we are blinded to the results of the trial. And so we can't say what's driving the slower accrual of events, whether that's coming from control arm or the experimental arms. Generally speaking, it certainly could be a good thing that the experimental arms are having a significant effect and pushing that out. But we don't see the data. So we don't know for sure. I would say that the control arm certainly could be behaving differently than prior trials. However, we've seen three Phase III trials in this setting, and the control arm has been pretty consistent across those. So I don't expect a big surprise on the control arm. But again, we are blinded to that information. We have an external vendor who is tracking events and gives us periodic updates. But as we've said, we're confident in the second-half of this year, depending on how the events continue to roll in, that certainly could come in 3Q.

Operator

Operator

Your next question comes from the line of Jason Gerberry with Bank of America. Please go ahead.

Jason Gerberry

Analyst · Bank of America. Please go ahead.

Hey guys, thanks for taking my question. Mine just on M&A. You guys seem to be flagging that again this year. And I guess it's been a dominant part of the Jazz investor discussion for a while now, but you really haven't like swung the bat in a big way since GW. And so just kind of curious maybe why that is, ultimately, if you can reflect on that? And then with this Epidiolex patent settlement in place and not having a runway on a $1 billion franchise plus well into next decade. Just how does that alter how you guys think about M&A having that longevity of assets now?

Bruce Cozadd

Analyst · Bank of America. Please go ahead.

So Jason, this is Bruce. I'll jump in with a little historical perspective, and then maybe I can have Phil give you a more forward-looking view. Just as a reminder, we completed the GW acquisition in May of 2021 and levered up to some degree to do that and spend some time after that, bringing leverage back down quickly and considerably. And during that period, we were needless to say, not pursuing larger transactions as we had forecast. To say we haven't done anything, I think, would forget that we did the zanidatamab transaction, which while it had a smaller upfront certainly has been a major focus for us in terms of value creation potential for the company, and we remain excited about it. Phil, maybe you could take the part of the question that refers to what we're expecting going forward. Phil?

Philip Johnson

Analyst · Bank of America. Please go ahead.

Sorry, I have a bad connection here. So I was trying to get on to a handheld not use the speaker on to me a second. So Jason, as Bruce mentioned, we've delevered substantially from the time of the GW deal. I think we closed effectively at about 4.9 times net leverage at that point in time. As of the end of 2024 that was down to 1.8 times. So we certainly have significant financial resources bolstered by the strong cash flow that we generate as well to engage in M&A and licensing activities for the various sizes. We do have active efforts looking at each of our verticals to continue to build our growth prospects in those that would include epilepsies where the very long runway with Epidiolex has been and continues to be a strong point, I think, for the overall Jazz story, as well as making it in even more attractive area for us to be investing in. So certainly, we do look at opportunities to build out that franchise. Further, as Bruce mentioned in his prepared remarks, we do look at areas that would be either adjacencies to, and in some cases, newer areas that share characteristics with where we've been successful in the past. Often, we use our more orphan indications more focused call points, the ability to add significant value with services in addition to just product and leverage those capabilities that we've built and honed over the years. So continued very active looking. I certainly would not take the lack of announcing a large deal as lack of activity or interest in doing things and certainly, we've commented in the past, seen no expectation of those activities slowing down as we move into the coming quarters. So stay tuned. We're active and looking. I do feel there's opportunities of value to Jazz and if patients don't see valuations at this point in time being a significant impediment to be transacting in the areas where we're looking. So I hope that gives you some color.

Operator

Operator

Your next question comes from the line of Annabel Samimy with Stifel. Please go ahead.

Annabel Samimy

Analyst · Stifel. Please go ahead.

Hi. Thanks for taking my question. Just quickly on Zepzelca, just curious if there was any strange trend at the end of the year, we saw it compressing a little bit. And then what can we expect from Zepzelca this year? I know you're filing the sNDA? The approval is not expected to expect until 2026, but could we be seeing some entity and guideline -- compendia listing for this specific indication? Renée Galá: Yes. Thanks for the question. This is Renée. So in terms of what we've seen with Zepzelca, we have continued to see strong performance. I would say typically from Q3 to Q4, we do have a dynamic where there are less buying days for our distributor in Q4, compared to Q3. We had a similar dynamic in 2023, so that did have some impact. I will note, though, that as we mentioned on the call, our sales increased 11% to $320 million in 2024. That was the highest year ever for Zepzelca and that is with a competitive entrant in the market with [Imdelltra] (ph). As we look at 2025, we mentioned we plan to file in the first half of this year for our first-line extensive stage with our first-line extensive-stage data, we will not be promoting, of course, in the first line until we have that approval. We would hope to get on treatment guidelines as soon as we have the data out and available and in a peer-reviewed journal, which we're working diligently on. And then I would also say that the benefit, of course, in the first line is to be able to reach patients earlier in their overall treatment journey. We do believe there's a larger group of patients to access 27,000 in first-line versus 17,000 in the second-line and about 70% of those first-line patients are extensive stage. There's also longer duration of treatment in the first-line. So we do expect to see growth in Zepzelca, but again, we won't be promoting in the first-line until we have an actual approval. And then if I just step back and think about Zepzelca's positioning in the second-line, while we would expect to see Imdelltra as a new competitive entrant to see some gain in the second line, I'd also say we continue to receive a lot of positive feedback from physicians on Zepzelca. In terms of its clinical benefit, the ease of use, it does not require extended monitoring or an inpatient stay, which is, of course, different from Imdelltra. So we do expect to continue to see some strength in Zepzelca, and we look forward to having the ability to promote in the first line.

Operator

Operator

Your next question comes from the line of Andrea Newkirk with Goldman Sachs. Please go ahead.

Andrea Newkirk

Analyst · Goldman Sachs. Please go ahead.

Good afternoon. Thanks for taking our questions. Bruce, I was just wondering if you might be willing to provide an update on the CEO search and the background are fit that the Board is looking for? And then in the context of this ongoing transition. As a follow-up to the M&A or BD question earlier, how should we think about that strategy and the timing for a potential transaction to occur this year?

Bruce Cozadd

Analyst · Goldman Sachs. Please go ahead.

Yes. Thanks for the question. So I'm not going to give a detailed update on the CEO selection process other than to say as was true when this was announced back in December, we're going to take our time and get it right. We're not in a hurry. We want to make the right choice and the right choice is dictated by where the company is today and where we want to take it. I will say, we're just starting to reach out in the marketplace, and we're getting positive feedback that the position is an attractive one in terms of where the company is positioned today, we're obviously coming off a very strong 2024 and are excited about our prospects for 2025. On the M&A BD side, we're really well positioned right now. We've got strong operating results. Our commercial teams, our R&D teams are executing well across the board. So from an operational perspective, we feel ready to take on additional programs and more products. And as Phil mentioned, from a financial perspective, whether it's our balance sheet, our cash on hand, our cash flow, again, we feel very well positioned to really take advantage of our infrastructure, leverage it and continue to add growth opportunities to our business.

Operator

Operator

Your next question comes from the line of Troy Langford with TD Cowen. Please go ahead.

Troy Langford

Analyst · TD Cowen. Please go ahead.

Hi. Congrats on the results this quarter and thanks for taking our question. Just a really quick one on the opportunity for Ziihera and breast cancer. About how many breast cancer patients total do you think would fall into that and HER2 progression or intolerance bucket that Ziihera could potentially address? Should it succeed in the Phase III trial?

Bruce Cozadd

Analyst · TD Cowen. Please go ahead.

So Renée, I don't know if you want to make an overarching comment about the opportunity we see for zanidatamab, including in breast cancer. And then Rob, maybe you could talk a little bit more about how we see this fitting into the breast cancer treatment landscape. Renée Galá: Sure. Thanks, Bruce. So as we step back and look at the broader market opportunity, we do see this as a $2-plus billion opportunity overall when we look at the indications we're focused on right now. That includes BTC, GEA, breast cancer as well as pan-tumor. Now BTC, we've said consistently that we expect the revenues to be quite modest there given the very small patient population. But as we get into larger indications, such as GEA, we look at 63,000 patients across the U.S., Europe and Japan as compared to 12,000 for BTC. And then as we progress into breast cancer, we're looking at more than 150,000 patients across those same geographies. So while we haven't broken that up into the different elements, we do feel quite confident that there is a much broader opportunity to go after there. Rob?

Robert Iannone

Analyst · TD Cowen. Please go ahead.

Yes. I would just add that HER2-positive breast cancer patients in the metastatic setting tend to get multiple lines of therapy. Currently, that's the Cleopatra regimen followed by in HER2. There is an ongoing frontline in HER2 trial and there's optimism that, that will ultimately become the standard-of-care in frontline. So whether it be third line plus or second line plus, we think with positive results from the trial that we have ongoing that Ziihera would become the treatment of choice after patients have progressed on HER2. And we think that captures high proportion of patients given that these patients tend to be able to go on to subsequent lines of therapy.

Operator

Operator

Your next question comes from the line of Akash Tewari with Jefferies. Please go ahead.

Amy Li

Analyst · Jefferies. Please go ahead.

Hi, this is Amy on for Akash. Thanks so much for taking your question. How should we think about the pricing strategy for zani depending on whether the doublet or triplet arm hits in HERIZON-GEA, if pricing remained consistent, how would the outcome of these arms impact your peak sales estimates?

Bruce Cozadd

Analyst · Jefferies. Please go ahead.

Renée? Renée Galá: Yes, I'm happy to jump in there. So we have priced Ziihera for BTC with a 28-day cycle WAC cost of approximately $35,550. Now when we priced it for BTC, there was also a view of thinking about GEA coming shortly thereafter. We haven't given specificity around GEA. I'll say the cycle there is 21-days versus the 28-day cycle for BTC and then the weight-based dosing is slightly different for BTC. We're looking at more of an average median weight of a patient when we give the 28-day cycle price. But with respect to GEA, what we're looking at is a threshold above and below a certain weight, you would be going with a certain dosing. We're not looking specifically at the doublet and triplet arm and giving specific guidance with respect to the pricing or the peak. What we're really focused on is ensuring that we're able to capture a meaningful opportunity with GEA. And then as Rob had mentioned, also a much larger opportunity with breast cancer.

Operator

Operator

Your next question comes from the line of Mohit Bansal with Wells Fargo. Please go ahead.

Mohit Bansal

Analyst · Wells Fargo. Please go ahead.

Great. Thank you very much for taking my question and congrats on the progress. Rob, if you could help me understand the [ARM C] [ph] of GEA trial in a little bit detail. It seems like in the context of commercial aspect, it is a pretty important ARM given that majority of the patients that we believe are high patients. But again, this ARM is not power to show benefit over ARM B, so it seems like you are looking at just any benefit over Herceptin. That may be enough. So in that context, could you help us understand like how would you look at Arm C and how should investors like us look at ARM C when the data come out in the context of market opportunity? Thank you.

Robert Iannone

Analyst · Wells Fargo. Please go ahead.

Yes. So for starters, I would say that the proportion of patients for whom the standard of care remains Herceptin chemo, we think is quite high. The KEYNOTE-811 trial, we don't think represents the true epidemiology. It's likely that, that trial was enriched for PD-L1 positive, “PD-L1 positive” patients given the ubiquitous PD-L1 testing during when that trial was conducted. We also think there's a question around how to define PD-L1 positive. Are all patients with one DPS score of one or higher, truly benefiting? Or would that optimal cutoff be higher? And if it's higher, it really does drive that proportion of patients who truly benefit from a PD-1 down quite a bit. Having said that, we think Ziihera has the opportunity to be the HER2 agent of choice regardless of PD-L1 status. ARM B will demonstrate that in Ziihera combined with chemotherapy and ARM C has the opportunity to demonstrate that in combination additionally with tisielizumab. We haven't spoken to the specific power of a comparison to ARM C versus B, and we don't necessarily think of that as being required. I mean certainly for the ARM C regimen of both Ziihera and tisielizumab and combo with chemo to be approved, it has to be better than ARM A. And it also has to be, from a broad benefit/risk perspective, better than giving Ziihera alone with chemotherapy. And so we'll have an opportunity to look at all of those data as part of this trial. And again, we think Ziihera will be regardless of PD-L1 status of the HER2 of choice.

Operator

Operator

Your next question comes from the line of David Amsellem with Piper Sandler. Please go ahead.

David Amsellem

Analyst · Piper Sandler. Please go ahead.

Thanks. So how are you thinking about Zepzelca's exclusivity runway particularly with the label expansion opportunity in first-line? So that's number one. And then secondly, to the extent that your own orexin program doesn't pan out, I guess my question here is, how badly do you need to be in the orexin game, so to speak? In other words, would you continue to pursue other orexin? Or do you feel like there's other areas in terms of M&A and Biz Dev, that you would then turn your focus on? Just trying to get a better sense of how you're thinking about your Sleep franchise to the extent there isn't an orexin that moves forward in your pipeline? Thanks.

Bruce Cozadd

Analyst · Piper Sandler. Please go ahead.

Renée, do you want to start on the Zepzelca question? Renée Galá: Sure, happy to do that. So with respect to exclusivity, we have a composition of matter patent that extends to December 2029. And then we have additional patent applications that could extend that IP protection further. I don't think we have any comments beyond that to offer today, but stay tuned.

Bruce Cozadd

Analyst · Piper Sandler. Please go ahead.

And then on your specific question on the orexin space, we continue to watch as we all do data emerging from different agents in terms of what we're seeing as the benefits of orexin therapy, certainly an exciting new mechanism of action across these serious sleep disorders, particularly with the daytime benefit, a little less clear right now, whether the benefits at night are positive or whether there are, in fact, potential concerns with what it would do to nighttime sleep. We certainly believe there is a role for ongoing use of oxybate as a nighttime agent that helps consolidate sleep and produce additional daytime benefits, absolutely seen with other daytime agents that are currently available or have been studied. In terms of do we need to be in that space, we're, of course, interested in the SLEEP space where we are a leader. We're also interested in other potential areas across neuroscience, oncology, as we've talked about, a rare disease where we've got relevant capabilities. So I don't want to narrow us down to only one area, but we're looking broadly across each of these areas for opportunities that we think would be a good fit, meeting and need good fit with our capabilities on the commercial side, efficient call point, good durability and an opportunity to diversify and produce sustainable growth over the longer term.

Operator

Operator

Your next question comes from the line of Ami Fadia with Needham. Please go ahead.

Ami Fadia

Analyst · Needham. Please go ahead.

Good evening. Thanks for taking my question. Perhaps to switch gears to the oxybate franchise. Can you talk about some of the dynamics in the narcolepsy market and how you're seeing rise impact either your business or the overall market? Are you seeing switches from Xyrem or Xywav or any switch facts? And then also as the AGs have the ability to launch their own generics at the end of the year, how should we think about sort of shoring up the Xyrem revenues, switching them to Xyway or -- and maybe just sort of what type of payer dynamics you expect once additional generics come to market and how that might impact Xywav? Thank you.

Bruce Cozadd

Analyst · Needham. Please go ahead.

Yes. I mean, that was a multipart question for sure. But Renée, maybe you could talk about just what we're seeing in the oxybate space and in particular, how we think Xywav has continued to be positioned. Renée Galá: Yes, absolutely. Happy to step through that. So I'd say just looking at our full-year results and the fourth quarter results that we had, we're really pleased with what we're seeing with Xywav. We had record revenues in the fourth quarter, 19% year-over-year, with 525 patient adds, that includes, of course, narcolepsy and IH. And when you look at where our adds are coming from in narcolepsy. That's coming from both new to oxybate patients, as well as patients switching from high sodium oxybate, and that's across all the high sodium oxybates. In terms of how we think about AG. So when we look at 2026, you heard Phil earlier say that our assumptions with respect to our 2025 guidance, include the fact that we will be receiving royalty revenues from AGs throughout 2025. So if we're thinking about the market in that way, and of course, we don't know if any authorized generics will decide to launch early, that would be if Hikma were to decide specifically to launch early, that would invite or other generics into the market before early 2026. And in that case, for full generics, they would need to have their own REMS because right now, the authorized generics are distributed through our REMS. So as we look at 2026, what that then looks like is a situation where our ability to continue to drive revenues with Xywav is dependent on the continued appreciation of the differentiation of low sodium and the importance of that to long-term health. In 2026, if we see full generics on…

Bruce Cozadd

Analyst · Needham. Please go ahead.

And I'll just jump in to remind people that percentage of our revenues coming from the high sodium business, the old Xyrem branded sales and AG royalties has continued to decline over time now probably in the latest quarter, maybe dipping below 10% for the first time.

Operator

Operator

Your next question comes from the line of Gary Nachman with Raymond James. Please go ahead.

Gary Nachman

Analyst · Raymond James. Please go ahead.

Thanks. Good afternoon. On the 2025 guidance, you didn't break down the revenue components specifically this time. So can you give us more of a sense of how you expect the neuro and oncology franchises to trend relative to the overall revenue growth of 5% that you said this year? And then just the R&D, as you're scaling back in expenses relative to last year, down 8%, just talk more about the reprioritization of the pipeline? And what's the right level of spend going forward for R&D as a percentage of revenue? Thank you.

Bruce Cozadd

Analyst · Raymond James. Please go ahead.

Phil, you want to jump in on that?

Philip Johnson

Analyst · Raymond James. Please go ahead.

Yes. Gary, I'm happy to. So on revenue, what might be helpful as you think about the pushes and pulls for the year sort of step through the various products and we start with the larger ones first, working that way down. So Xywav, as Renée had mentioned, really strong momentum, growing 18% in the full year last year, 19% in the fourth quarter, really strong net patient adds 525 in the fourth quarter. So well positioned for continued growth there. Similarly, Epidiolex, really strong momentum, again, 15% growth for the full-year, 14% in the fourth quarter, and we're well positioned to reach blockbuster status in 2025. I'm very pleased with the long longevity of that franchise moving forward. Rylaze, about 4% growth for the full year, relatively flat in the fourth quarter, reflecting that negative impact that we mentioned in the second half of 2024 coming from the COG protocol change where we continue to expect revenue to normalize early this year. Zepzelca, again, 11% growth for the full year, that did dip down to 6% in the fourth quarter in part for the number of days that we had for shipping, as Renée mentioned. We feel really good about prospects for Zepzelca when we get the first line maintenance indication include the treatment guidelines and get it into the label when approved by FDA. And in the interim, we may see some weakness in Zepzelca sales of Imdelltra gained share in that second line plus setting. Defitelio really strong growth, particularly in the second-half of the year in the U.S. As we mentioned in the past, we're monitoring that situation to understand how much of that uptick you saw in the second-half is sustainable, providing a new base for the product and how much of that may be…

Operator

Operator

Your next question comes from the line of Gregory Renza with RBC Capital Markets.

Anish Nikhanj

Analyst · RBC Capital Markets.

Hi, guys. It's Anish on for Greg. Thanks for the updates this quarter and for taking our questions. As you look at Ziihera's Phase III GA top line now guided for the second half, how should we be thinking about time lines for subsequent analyses, including the second and third interim overall survival analysis? And quickly on Epidiolex, what levers can be pulled or hangups remove to enhance uptake across the treatment segments? Thanks so much.

Bruce Cozadd

Analyst · RBC Capital Markets.

Rob, why don't you start on the zanidatamab readout timing? And then Renée, you can comment on Epidiolex.

Robert Iannone

Analyst · RBC Capital Markets.

Yes. So the projected readout that we just provided is based on progression events. And at the time of that PFS analysis, we would have the first interim analysis for overall survival. So as you've seen -- as you see that time line get pushed out, of course, that also allows for greater maturity and overall survival. So we'd expect more maturity of that first interim than we might have had if the readout or sooner. Again, we're not referring specifically to the pace of overall survival events. So this new projection has no implications for the second survival analysis or the final. There are 3 in total. Renée Galá: And then I'll jump in on the Epidiolex question. So I would say we're really pleased with the growth that we're seeing. We do have quite a bit of runway now that we're really excited about. In closing the GW transaction, we were quite confident in the durability and long live nature of this asset, and we're pleased to be at a point now where we can have greater clarity on what that looks like. So as we look at what driving the increased growth right now and what we'll continue to lean into. Epidiolex is highly differentiated, and that's supported by the data that we've generated for both seizure and non-seizure benefits and that data really resonates with physicians as well as with caregivers. We have great momentum in the adult and long-term care setting, and that's an area we're making investments in the breadth and quality of our access continues to improve, and that's having a positive impact as we see pull-through -- persistency has always been a hallmark of this brand, and we're seeing great impact even additional benefit to persistency through nurse navigator programs, and we're also piloting new programs within this area where we're seeing some early success, highly targeted consumer ads and also things like we've added virtual account manager position. So this is an area where we continue to learn, and we're really thrilled with the results that we're seeing.

Operator

Operator

Your next question comes from the line of Joon Lee with Truist Securities. Please go ahead.

Unidentified Analyst

Analyst · Truist Securities. Please go ahead.

Congrats on the quarter and thanks for taking the questions. This is [indiscernible] for Joon Lee. Just a couple from us. I know you haven't updated us completely on the 441 program. But what are you thinking in terms of the amount of dose reduction? And just going off David's question earlier around how much longer could the pending patents for Zepzelca extend exclusivity beyond December 2029? Thank you.

Bruce Cozadd

Analyst · Truist Securities. Please go ahead.

I hate to do this to you on the last question, but I don't think we're going to provide additional information on either of those. Obviously, we've talked about the ability to go to a lower dose in patients than in healthy normals on 441. So that's one of the things we're exploring, even in a small number of patients. And then on Zepzelca, we don't have specific additional information on what that could mean in terms of longer exclusivity for that agent at this point.

Operator

Operator

That concludes our Q&A session. I will now turn the conference back over to Bruce Cozadd, Chairman and Chief Executive Officer, for closing remarks.

Bruce Cozadd

Analyst

Yes. Thank you, operator, and I apologize to the couple of sell-siders we didn't get to. We were given on our best shot to get through everything. And hopefully, we'll talk to you later this evening. I'd like to just close today's call by recognizing our Jazz colleagues for their efforts and thank our partners and shareholders for their continued confidence and support, and thank you all for joining us today.

Operator

Operator

This concludes today's conference call. You may now disconnect.