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J.P. Morgan 42nd Annual Healthcare Conference 2024

Jan 9, 2024

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Welcome to the Bayer session at the 42nd J.P. Morgan Healthcare Conference. I'm Richard Vosser, European Pharma Analyst with JP Morgan. It's my great pleasure to welcome the CEO of the pharma business at Bayer, Stefan Oelrich, who's going to present to us. We'll take questions after his presentation, so just please put your hand up, and we'll get a mic to you. Stefan, welcome to the conference.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Well, thank you, Richard, and thank you for your interest in our business here. Glad to see that the room is filling up fast. So, I'm gonna give you a little overview on how we're proceeding well with the implementation of our strategy. But before I get to that, we're really excited this week because we've had tremendous news flow with our latest phase three trial giving positive primary and secondary endpoints in two parallel trials, an approval for EYLEA in Europe, which was sort of like the icing on the cake, and some really fast transitioning new medicines in our pipeline that...

So this has been really a good week so far, so I hope you're enjoying the conference as much as I do for the time being. So let me get right into it, and I'll try to give you an update based on three dimensions, where we are currently and how we're progressing with our strategy. You know that for the last five years, we've really been transitioning our resourcing to a much more global approach with a stronger focus on the U.S. and with a lot of launches happening, lots of moving parts and moving past an impending LOE for Xarelto for the most part, while at the same time rebuilding our pipeline. So I'll get into all of these topics.

To get started, we're really on track this year to deliver against our guidance. You see a slightly negative sales in the first nine months. So this looks that we're gonna confirm guidance to come in around the zero mark for the end of the year. So this has been accompanied by gradually improving quarterly results, both in top and bottom line, where we started really against a huge backwind that you're seeing here on the China business, and that has pretty much subsisted throughout the year. So China has been really slumping for us, and you know that we're over-indexed in China compared to many of our peers.

Also on the margin side, we're fully—we expect to be fully in line with guidance. We have a lot of moving parts because while we get the backwinds from Xarelto, which will be coming in negative, not double digit yet, but we're now seeing the first really impact from LOE in a number of regions. We're seeing really good momentum on our launches. I'll speak to that in more detail. Also maybe noteworthy, our radiology business, which is a really solid base, where we're seeing, from a market-leading position, our continued strong growth. Also, on some of the backwinds that we've been facing, obviously, is the discontinuation of the OCEANIC-AF study that was not expected.

And, some of the things that I think the entire industry is grappling with, inflationary pressures, the China situation I mentioned, and also, in the mix as, Xarelto goes to become less important, we're having somewhat of an unfavorable mix, but counterbalanced by a lot of positives that I'll go into, in a second. Before I do so, I always get asked: "So, where are you headed in the coming years in terms of your top-line dynamics, given that that Xarelto is going out?" You can see here, a major decline that we expect over the next three years. Just as a reminder, the compound will expire in the first half of this year.

We still have solid IP use patents, and that, we believe, can get us some exclusivity in most of the territories until 2026. Against the Xarelto situation, we have a strongly growing launch platform with Nubeqa, Kerendia, and now elinzanetant, and not to forget asundexian and Stroke. And of course, EYLEA with the 8-mg approval that we got this week, we have now a best-in-class label, and I invite you to look very closely at our label. We have up to 5-month dosing intervals on the label.

That is really a step change from where we've been at with the current dosing, and that should give us an anchor for years to come, despite LOE of the substance. Let's also not forget, we continue to enjoy a very stable base business that we also see stability for the coming years. I think sometimes we don't get credit for some of the base that's there in their very strongly growing radiology business, which is actually quite nice. Now, let me dive in a little bit into our launch successes. Nubeqa has been, I think, a great track so far.

We're well on our way to blockbuster status this year. So last year, we barely missed it, but we're gonna be clearly above EUR 1.024 billion. We're expanding our label, hopefully, with the last readout data that's gonna be ARANOTE. That's gonna basically place us across the entire continuum of the prostate cancer market, and we're really seeing that Nubeqa is becoming the standard in the continuum here in prostate cancer, and we couldn't be more pleased with the development of this great medicine. That also confirms our peak sales assumptions of more than EUR 3 billion moving forward.

Then Kerendia, our product to treat diabetics with renal disease, is showing a continued good uptake, strong new prescriptions, and leading in the renal category. This is, as a cardiovascular product, something that has a little bit of a slower uptake. So, we had told you about this, that this would take time, and we're seeing just that. I think one of the important catalysts for this year, a part of the fact that we expect more than EUR 500 million in sales in 2024, is gonna be that we're gonna expand from the renal indication into the heart failure area.

We've decided, because we feel really strong about the prospects in heart failure, to actually expand on the data collection in this area so that we cover a broad range of heart failure patients moving forward. You know, the mechanism of action behind Kerendia is well known to, in principle, work in heart failure patients, but has not been approved for that use because of side effects. We see now after two years of broad use of in renal patients, that the side effect profile of this product can be perfectly managed in the clinic and is not clinically meaningful. Here, again, we continue to see more than EUR 3 billion in peak potential, so strong, a strong launch platform.

Then I spoke to EYLEA briefly, so I'm not gonna repeat myself, but we clearly see this to become the new standard of care based on already what we define as standard of care. EYLEA has been exceeding our expectations, and we've been exceeding the peak sales that we've been putting behind EYLEA. And we now see continued life behind this really important medicine in coming years. So not only does Europe typically behave differently a little bit in the face of biosimilar exposure, but now we have a clear anchor to also retain pricing at current levels, and we expect that there will be rapid switching, or better said, new patients' enrollment onto this dose, and possibly also some switching.

So, which gets me to elinzanetant. And I hope you join me in the excitement that we see. It doesn't happen every day that you have 2 parallel phase III trials that confirm all secondaries and primaries at the same time. This is an area where not only the need is so high in women that have a high frequency of hot flashes and with a high severity, and also sleep disturbances that typically come with that, we feel like we have a class-defining and potentially class-leading new medicine that's coming up. In order to complete our submission package, we need to finalize the OASIS- 3 trial.

That is a, a safety trial, a 52-week safety trial. We haven't seen any, safety signals in the 26- weeks trials, but, this is an area where you want to be rather s- be safe than sorry. So, so we expect this, at the end of the quarter, to have results, and then we're gonna go straight from that to, to submission. You will always-- also have seen that, we're expanding, data collection and potential use of elinzanetant to women with induced vasomotor symptoms. Those are breast cancer patients, that, because of their medication, have induced, symptoms. So, so this will expand, the, the use and will further confirm, the mechanism of action, in, in the safe and effective, medicine. And then what is new, what we...

We've seen this in our phase II data, and now we've confirmed it also in OASIS 1 and 2 that this compound seems to have positive effect on sleep disturbances. So we're going to add a specific trial with the NIRVANA trial, where we're going to look at sleep disturbances that are associated with with menopause. And you can see we feel really confident about this new medicine to potentially redefine this class. Why are we so excited about this? Because this is such a prevalent condition in women. 80% of women will experience hot flashes. 60% of women will experience sleep disturbances, disturbances with vasomotor symptoms. And who am I to say this as a male?

But the opportunity in the U.S. alone is enormous. We have 64 million women impacted by menopause. We have a constant inflow of new women into this category, and most of them choose not to use hormones as a potential solution to treat symptoms. This couldn't come at a better time for us because there is awareness being created for this condition. We believe we're coming in with a really strong opportunity for women. Be mindful of the fact that we continue to enjoy one of the most long-standing tenures in women's healthcare. We've been leaders in the area of contraception for decades.

We've been redefining many of those markets, including hormone replacement therapy in the past, and we feel this is right down where we're strong. So we're getting ready to launch this, hopefully in 2025, once the package gets concluded. So really strong momentum here behind our historically strong women's healthcare business. Let me shift gears for a second, because one of the things that I've been and faced with since I joined in my current capacity was what are you gonna do to replenish the pipeline? How are you going to stabilize the ship once Xarelto goes away?

I couldn't be prouder to report to you that we've really turned around our R&D, and I think in many ways also an industry-leading fashion. We've pruned many of the things that we thought were not making the cut. We've shifted to a much more breakthrough-oriented innovation with first-in-class, best-in-class. But it's not just in the words. We've acquired platforms that people were saying, "Oh, you're acquiring a lot of early stuff." Well, we're seeing all of these platforms deliver constant on a very convincing way now clinical-stage assets.

And we've had last year alone, and I'll speak to that in a second, for us, one of the most productive years in recent history with eight new INDs, six of them went into the clinic. We've replenished our phase I with 18 molecules over the last two years. So it's been a real pleasure to see, and all of this focused on four areas: oncology, where we have two very strong platforms. One, Vividion, it's a proteomics company we acquired out of San Diego, which is really a one-of-a-kind, I think, platform. And also, let's not forget the radiopharmaceutical platform with Algeta that we acquired prior to my time. I actually see the gentleman who did that in the back of the audience.

So it's good to see you over there. Of course, our cardiovascular heritage remains strong. We've ventured into neurology and rare disease with our cell and gene platform. Two very exciting Parkinson assets that are starting to mature with some intriguing data coming out of phase I. And then, because of the strong position that we have also with Vividion, we think that we can also make a difference in immunology going forward. So you can see an R&D organization that has broadened its reach in terms of modalities, but most importantly, in terms of depth. And when you think about the depth that we're seeing, we're advancing really best-in-class assets into the clinic. The Vividion KEAP1 activator is one of these highly sought-after targets in oncology.

We have it, and we're adding, adding to that. I could give you more examples from the Vividion platform, but I don't want to be exclusive to that one. They alone delivered three new clinical-stage assets into our pipeline last year. Another great example is our PSMA PET for cancer. So this is radio alpha emitter in an actinium conjugate platform. This is something that right now runs really hot in the industry. Other people have been paying double-digit billion amounts for this. We have it in store, and we're looking forward to see and share with you clinical results as we move this forward.

But what is more important is we now not just have more phase I, we're shifting them through, and we're accelerating things into later stage in our pipeline. Bemdaneprocel, our cell therapy by our platform company, BlueRock, has some really intriguing phase I data. We're starting to enroll phase II, first half of this year, and we hope that the quality of the data will allow us to even accelerate the clinical stage process, and hopefully also approval to get this drug and this new treatment of cells into people's brains to regenerate and enable to produce dopamine into Parkinson's patients that are advanced, where the need is so high.

Another great example for our delivery in pipeline is from our cardiovascular pipeline. The anti-alpha-2-antiplasmin monoclonal is something where we believe that we can redefine how to treat ischemic acute stroke with an effective thrombolytic with no increase in bleeding. So something where the standard of care is extremely low. So you can see we're really making good progress on the pipeline, and for a company of our size, with five potential blockbuster-sized launches in the next five years and a steady inflow of new compounds coming through our pipeline and through our platforms that we've invested in, we feel very strong about the future of Bayer Pharma.

So some of the key catalysts for this year, and I don't wanna repeat myself, but obviously the launch of EYLEA 8 mg is gonna give us a lot of boost, especially in our European operations and in Japan. Then, of course, Nubeqa will continue its path, as well as Kerendia, and we talked at length about elinzanetant. What I also want to share with you that we're really making great progress in what we like to call the reallocation of our resources. We have created a highly performing launch platform for all of these launches in the U.S. You know that Bayer traditionally has not enjoyed the rights for some of its major product in the U.S.

That has changed, and we're seeing that we're having really strong launch performance in our U.S. organization, be it with Kerendia or with Nubeqa, and we expect the same with elinzanetant going forward and later, hopefully with asundexian in stroke. Same on the R&D side. The fact that we acquired these platforms has led to a shift. We were traditionally very Germany-centric in terms of our expenditures on R&D. This has brutally changed, if I may say so. We are now much more balanced and not just a one-trick pony, and much more present, especially in the U.S.

In terms of rebuilding the pipeline, I spoke to the data readouts that we expect for this year: Nubeqa in metastatic hormone-sensitive prostate cancer, finerenone in heart failure with preserved ejection fraction, and, of course, the replenishment of our pipeline. Add to that, our efforts that we're making in order to make our organization much more dynamic and much less bureaucratic and much faster, which we like to call internally DSO, which gives us more efficiency and higher productivity. And if you take the whole mix, that gives you the new and improved Bayer Pharma that we feel very strong about. And with that, Richard, I propose we move to question.

I would like to invite my colleagues, Christian Rommel, Head of R&D, and Olivier Mauroy Bressier, Head of Finance, up to the stage. Thank you.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Thanks very much, Stefan. We're moving to the Q&A session, so does anyone have any questions? There's a question at the back. I hope... I'll repeat the question if you don't get a microphone. Go for it.

Speaker 6

Just a question about elinzanetant. Curious, there's one.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Actually, there's a microphone on its way, so it might be worth waiting.

Speaker 6

Thank you. Just on elinzanetant, the EUR 1 billion guidance, curious if you could share a bit more on, on, how you're getting to that number, and then also, on, on the elinzanetant launch, that's been going slower than the other companies' expectations. Curious if you have any commentary on that and why, elinzanetant, might be different. Thanks.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Should I go directly?

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Yeah, yeah, yeah.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Thanks for the question. First of all, January is not normally the time of the year when I would re-guide sales, so bear with us. We'll have a capital markets day in March, so I would address the question then. But what I can tell you is that we feel very strong about this, and this- I'm not gonna say a number, but I'm gonna tell you this has definitely blockbuster potential. I'm not gonna comment too much about to what our competitors are doing. What I can tell you, though, is nothing comes easy in any of these categories, so there needs to be awareness that needs to be created.

And I think if you have more medicines in the same category that actually work on creating awareness, that's gonna be positive. And you have to ask others about their performance than me, so that's not up to me to comment. I feel that we have, based on the dataset that we're gonna present at an upcoming conference that you've seen the top-line data of, we have every reason to believe that we have class-leading evidence, potentially. We're waiting to complete our set. You've seen that we're adding to it, even on top, and we have every reason to be optimistic.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Another question here. Oh, two questions here. I think this gentleman was first, and then, lady there.

Ebrahim Delpassand
CEO, RadioMedix

Well, thank you, Dr. Delpassand. I'm from RadioMedix in Houston. With being pioneer in first alpha therapy, bringing to market Xofigo, has Bayer decided on acquisition and increasing the menu in this, in your portfolio for radioligand therapy? We know the space is growing so rapidly, and it's very promising field at this point in oncology. Any plan for expanding your portfolio?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

So I'll let Christian comment in a second because I know that he's a big enthusiast, and I remember when he joined the company, he said, "Do you actually know what you have there?" So we're very grateful to see that some of the things that we've been pioneering, as you say, are being sort of like confirmed by some of the recent deal flow. But I'll let Christian speak to what you think of our platform and if you need more than that from the outside because we've been doing some deals in that context.

Christian Rommel
EVP and Head of Research & Development Pharmaceuticals Division, Bayer

Yeah, so one, it has become a priority, and thank you for the question and highlighting the potential of this therapeutics. It has become a priority for the oncology portfolio and strategy. We are not considering right now to further invest in terms of technology or platform in that space because I really think we have the capability available to us. But I do think when you think about the indication, the target, the modality, the conjugation to the actinium radionuclide, there we have entered in a partnership with Bicycle, for instance, to make sure that we line up the right modality with this approach.

On those things, we will continue to do, and we're building a pipeline, and we will soon, you know, proudly share that this is filling up quickly because of the experience that we have and the capabilities are there. I mean, it has become a resource priority for us, and we had to make sure we can also secure the sourcing of actinium, as you might know, and I think we have that all under the belt.

Ebrahim Delpassand
CEO, RadioMedix

You know that actinium is not the only alpha emitter?

Christian Rommel
EVP and Head of Research & Development Pharmaceuticals Division, Bayer

Yes.

Ebrahim Delpassand
CEO, RadioMedix

Lead-212 is another one. There are others. But overall, I was asking more about maybe acquisition of some more mature drugs already, you know, in the pipelines, in different areas of oncology, and especially one in the neuroendocrine cancer.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

... I'm happy to follow up with you, but it's not currently a priority.

Speaker 7

Thank you. First, congrats on the top-line data for elinzanetant. Very, important and unmet medical need for sure. And Bayer has a lot of history, legacy. I'm just curious, as you get ready for launch in 2025, are you? Can you talk a little bit about your commercial organization? Do you need to build? Do you have enough? Maybe talk about how, how your capacity looks.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Yeah. So thank you for the question. This is something that we're looking at. Obviously, we do have a class-leading contraception organization for long-acting contraceptives in America, so there is some overlap between those that will most likely not suffice. So we will have to supplement our existing footprint in the U.S. U.S. is gonna be our first go-to market, and in Europe, it's slightly different, that we probably have the capabilities that we need, and then also in the countries in Asia or Latin America, where we would be introducing, or in China. But yeah, in the U.S., it's likely that we will have to expand on the existing footprint because the overlap is not perfect.

But, this is, for us, something pretty natural because we've been there, for a long time and very successfully. So, these OB-GYNs know who Bayer is, because we've been there, for, as we learned today, for over nine decades, that we've been pioneering the women's healthcare space.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Question there in the middle.

Speaker 8

Thank you. Thank you for the presentation. Just a question on Kerendia. Can you talk a little bit about the dynamics, and the market dynamics might be a bit slower in terms of uptake. Sounds like in the U.S., you've got quite a bit of traction. Can you talk about non-U.S.? Where do you stand? How is that looking?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Yeah. So we have a very good uptake also in China. Japan, very promising. Brazil, Mexico, very strong. Where we are maybe not as strong as we would like to be is in Europe, and Europe is an access question and a pricing question. So typically, you get the comparators that serve as a pricing anchor in Europe are extremely low-priced diabetic products. So we feel like the value of our product is not always recognized as it should be in Europe, which really creates a negative, but that's something that we had expected from the get-go. Because we knew that even with the evidence that we were generating, it would be close to impossible to get over certain thresholds.

So the jury is out on some of the countries in Europe. Some of them are good. Germany is an opportunity. But we're still negotiating price there as we speak, but it's not easy. France is definitely difficult, and U.K. is difficult, so it's not an easy one in Europe.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

In the US, I mean, Kerendia had a very fast start, but the prescriptions sort of slow off, or plateau maybe slightly, or at least the cadence is not so great. You know, is that competition from the other diabetics, or is it fully penetrated? What's going on?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

No, I think it's rather that the dynamics vary a little bit, depending on part of the year, and we've seen also decreased promotional activities from the other diabetic products. So it's not that our share in the renal space is going down, quite to the contrary. It's that we also benefit when the tide lifts all ships, we benefit from that. So we think that adding and completing our evidence set around also heart failure is going to add to the credibility of the overall asset, and I think that that's gonna boost us across the board.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

You mentioned during the presentation the high-dose EYLEA, and obviously a good product. European market's different to the U.S. in terms of adopting sort of longer-acting products. What's the thought, especially with biosimilars coming?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Yeah, I think the data will make the difference because this is, we're basically injecting the same level of volume that was injected before with the opportunity to enjoy much longer dosing intervals. So I think physicians are going to like this. We're solving, in a way, two problems. We're solving one, the problem of decreasing the frequency of dosing of something that you inject into the eye, and at the same time, we create space in the ophthalmology office to treat more patients. We know that today there is a huge backlog of patients that don't get injections because there is just no time in those offices to do that.

And so we feel like this is really solving two issues at the same time. What we will need to see and monitor with time is how this, once biosimilars step in, how the dynamics are going to change? From experience, Europe obviously has a slightly different response to biosimilars than you would see maybe in other regions. Our business is mostly Europe, Japan, and Canada. So we'll see. But what we think will happen, that this has the opportunity to really stabilize our EYLEA sales.

Let's not forget that we've largely exceeded the guided peak potential for EYLEA as we speak, and even this year, as we're facing major competition, we're seeing very solid volume growth with EYLEA, so almost double digit. We've been experiencing pricing setbacks in some European countries, like any competitor right now. So U.K. has been a difficult place, Richard, not because you're from there.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

It's my fault.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Yeah, well, lots of things are Richard's fault, but that's a different story.

Speaker 6

You invited him.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

I did. This is my fault.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

No, but we're not saying that this is going to add another EUR 1 billion to what we already have, but we think that this is definitely gonna be a stabilizer of in the coming years.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

And that biosimilar competition, yeah, you've held up the... Are they getting more aggressive, the competition, or?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Again, this changes from country to country. There's some price aggressiveness in some countries. And obviously, they want their share of the market. What we're seeing is that they have gotten to a certain threshold, and it's also not easy for them to go further than that. And again, I'm saying all of this, excluding the United States market.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Yeah. A question at the back?

Speaker 9

Can you just talk a little bit about how you expect the margin profile for Bayer Pharma to evolve over the next few years as you, you know, have these high-margin assets coming off patent, and you're trying to invest more in R&D and more into these launches? So, you know, how should we think about that over the next few years?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

I'll let Olivier speak to that.

Olivier Mauroy Bressier
CFO of Pharmaceutical Division, Bayer

Thanks for the question. Yes, we need to see a bit like our strategic roadmap is that definitely on the short term, we will have the loss of exclusivity of a product which is above EUR 4 billion and which has enjoyed high margins, very low cost of goods. We don't spend on sales and marketing on Xarelto. So definitely, our strategic roadmap does include the fact that on the coming 3, 4 years, 2, 3 years, we will have to face this product mix situation while EYLEA and other products will be ramping up. We are also in a moment where we want to invest and continuously invest on our launch products, namely Nubeqa, Kerendia, and coming with elinzanetant.

We want to also invest in our innovation so that we can fulfill also our commitment for the midterm. Innovation, our platform companies as well, will benefit from a higher rate of investments in the coming months and in the coming years. Facing inflation as well is just an industry trend that we are also facing, so we are under some challenges in terms of margins. For the post-LOE phase, which is the coming 2-3 years, you will see that the margins will be still under challenges while we pave the way for sales growth momentum and margins better momentum as well, post-LOE phase of Xarelto.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Maybe to add to your question, which is a really good one and pertinent one, I think it's noteworthy to see that we're able to really keep our overall top line pretty much stable, so you don't really see that patent gap that you would normally expect when a product of the size of Xarelto goes off patent. But when you replenish with products that have potentially a slightly lower gross margin and higher SG&A, then you get margin pressures. We are diligently looking at our cost constantly to spend as little as needed and as much as needed in a way to balance this out, but we will be facing margin pressures in the next three years.

Please accept that today we will not be reguiding or guiding in that sense, but that's sort of like an obvious one.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

You talked about the stable business. As you reallocate costs, does that put pressure on the stability of the business or with those products? You know, is there a point in time where reallocation leads to the stability being affected?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

I think when you look at how our profile has evolved over the last few years, we've been driving up R&D, which at the beginning of my tenure was around 14% of sales, and it's closer now to 18%, and we've been taking that same amount out of SG&A, and we've still been able to manage our launches, I think, competitively. So, no, I think at that point there was enough flexibility to still shift things around. We've seen in R&D, we've been fueling the three platforms that we've acquired in a significant way, and without necessarily completely taking out all that cost from our base, but some of that.

So, I think that there's always opportunity in a business of our size to find efficiencies. You heard me speak on the last slide here about what we call DSO, so this organizational efficiency and productivity. So to give you just an idea of what we're doing, we just recently introduced at the beginning of this month, so January 1st, a realignment of our U.S. commercial organization, and we've really taken out a lot of the hierarchical staff from sales and marketing, and are really focusing in on maintaining our customer relationships, but with much less hierarchies. So where we used to have a manager for this and a manager for that, and a third manager...

If I think back 30 years when I was a rep, I was all by myself. Today, you get supported by all kinds of things, and when you ask the reps, "how do you feel about the support?" they often tell you, "Well, they keep me away from the customer." We've tried to address that, and those things still exist. They have accumulated over the years, and sometimes it's worthwhile. It's like moving your house. It's sometimes worthwhile checking out how much has accumulated in the basement. We're doing a little bit of that, and it's actually very energizing to do that, and we'll look at the same in manufacturing and R&D like we're doing in our commercial footprint.

Commercial, we've said we want to radically center around the customer. In, in our other activities, we've said we want to radically center around our products and not necessarily around our functions, and I think that gives us a lot of energy and potentially also productivity reserves that we can activate.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

A question over there.

Speaker 10

Hey, thank you so much for the presentation. A quick question: I guess, as you look at the pipeline rebuild you've done, as well as the reallocation of resources, and the increased R&D you just alluded to, do you feel like the organic internal engine is enough to kinda satisfy the growth here? Or do you believe that, there might need to be some incremental inorganic actions to help, you know, particularly as opposed to the OCEANIC study?

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Independent from OCEANIC-AF, the right answer is a pharma business can never function without external innovation, so you will always be open to deal making. Last year, maybe not so noticed by you, we didn't participate in the large transactions that we did participate in in prior years, but we still did 20-plus deals. So it's not that we're inactive. We're supplementing to where we've built very strong platforms. We will continue to do so. I mean, if I think about... We're talking about radiopharmaceuticals, we did an interesting deals with Bicycle last year that's going to make us stronger in this case, and more differentiated.

So we sort of like use the strength of what we've built organically, or what we've acquired and now is becoming organic in a way, and supplement it. But I would never exclude that we would not be out hunting for deals, but they need to make sense. And when I look at some of the recent price tags, I sometimes wonder how this is gonna create value. So it's really hard to hunt for good late-stage stuff that creates value. With elinzanetant, that was one of those examples where we went after a late-stage target. It was a phase II asset that was ready to go into phase III .

There were very few bidders because there was very little expertise in the area of women's healthcare, of people that could do this, so we went after it. So if something like that shows up, we will be looking at that for sure.

Richard Vosser
Head of European Pharma & Biotech, JPMorgan

Thanks, Stefan. I think we're at time, so thank you very much.

Stefan Oelrich
Head of the Pharmaceuticals Division, Bayer

Thank you.

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