Good morning, and thank you for standing by. Welcome to the AbbVie Second Quarter 2018 Earnings Conference Call. All participants will be able to listen only until the question and answer portion of this call. You may ask a question by pressing * one on your phone. I would now like to introduce Ms. Elizabeth Shea, Vice President of Investor Relations.
Good morning, and thanks for joining us. Also on the call with me today are Rick Gonzalez, Chairman of the Board and Chief Executive Officer, Mike Severino, Executive Vice President of Research and Development and Chief Scientific Officer, and Bill Chase, Executive Vice President of Finance and Chief Financial Officer. Before we get started, I'd like to remind you that some statements we make today are or may be considered forward-looking statements for purposes of the Private Securities Litigation Reform Act of 1995. AbbVie cautions that these forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those indicated in the forward-looking statements. Additional information about the factors that may affect AbbVie's operations is included in our 2017 annual report on Form 10-K and in our other SEC filings.
AbbVie undertakes no obligation to release publicly any revisions to forward-looking statements as a result of subsequent events or developments, except as required by law. On today's conference call, as in the past, non-GAAP financial measures will be used to help investors understand AbbVie's ongoing business performance. These non-GAAP financial measures are reconciled with comparable GAAP financial measures in our earnings release and our regulatory filings from today, which can be found on our website. Following our prepared remarks, we'll take your questions. With that, I'll now turn the call over to Rick.
Thank you, Liz. Good morning, everyone, and thank you for joining us today. I'll briefly discuss our second quarter performance and highlights as well as our full-year guidance, which we are increasing again this quarter. Mike will then provide an update on recent advancements across our R&D pipeline, and Bill will discuss the quarter in more detail. As always, following our remarks, we'll take your questions. AbbVie once again delivered an outstanding quarter with adjusted earnings per share of $2, representing growth of more than 40% versus last year and exceeding expectations. We also delivered strong top-line results in the quarter, with global adjusted operational sales growth of 17.1%. This outstanding performance was driven by growth from several assets across our portfolio, including significant contributions from Humira, IMBRUVICA, and MAVYRET. We're extremely pleased with our performance in the quarter and the progress year to date.
We've driven outstanding commercial, operational, and R&D execution, resulting in strong top and bottom-line results. Based on our performance in the first half of the year and the tremendous confidence we have in our business, we are raising our full-year 2018 EPS guidance by $0.10. We're now expecting adjusted earnings per share of $7.76 to $7.86, reflecting growth of 39.5% at the midpoint. It's important to recognize this is the third increase to our earnings guidance for 2018, a testament to the momentum and confidence we have in our ongoing business fundamentals and underlying performance. We're raising our guidance despite the anticipated introduction of direct biosimilar competition in certain markets outside the U.S. in the fourth quarter. Clearly, we expect our performance in the second half of the year to continue to be robust.
As I mentioned a moment ago, several products within our portfolio are driving strong growth. Starting with Humira, which delivered global operational sales growth of 8.2% in the quarter. In the U.S., Humira sales grew 10%, driven by strong prescription volume growth across all three categories. Internationally, Humira sales grew 4.4% operationally. We continue to be pleased with the underlying market trends across geographies and therapeutic segments. Global sales of IMBRUVICA were $850 million in the quarter, an increase of more than 35% over the prior year. Globally, we're seeing very strong patient uptake, including higher market share and growth across multiple indications. This includes CLL, where IMBRUVICA continues to be the clear market leader. We expect this momentum to continue based on the growing evidence illustrating IMBRUVICA's strong efficacy across a wide range of indications.
Global HCV sales were $973 million in the second quarter, again exceeding expectations with continued momentum from the MAVYRET launch. Based on its compelling clinical profile and our commercial execution, MAVYRET has achieved the market-leading position in the U.S., as well as strong leadership positions in a number of other major markets, including Japan, Germany, Spain, Italy, among others. As evident in our results, the overall business continues to deliver robust revenue and EPS growth, driven by our highly differentiated assets and our outstanding execution. Our business performance is underpinned by strong volume-driven growth. Of the more than 17% global operational revenue growth in the quarter, roughly 16% was volume-driven growth, with the remainder, approximately 1%, driven by price. In addition to the strong financial results, we continue to make excellent progress with our late-stage R&D programs.
Mike will cover the pipeline in more detail here in just a few moments, I'll mention just a few of the highlights. Earlier this week, we received FDA approval for elagolix, now known as ORILISSA, for the management of moderate to severe pain associated with endometriosis, a chronic disease which affects approximately 3 million women in the U.S. With very few treatments approved over the last 20 years, ORILISSA will be an important new therapeutic option for the many women who suffer with this painful condition. We're extremely pleased with the approved label, which provides physicians flexibility of dosing and duration of therapy. Given the compelling product profile, the disease prevalence, and the patient need, ORILISSA represents a significant long-term opportunity for AbbVie, with multi-billion dollar peak sales potential. We've also made two major advancements with VENCLEXTA, further strengthening our leadership position in hematological oncology.
We received U.S. regulatory approval for Venclexta in the broader relapsed/refractory CLL patient population, representing a significant expansion beyond the narrow indication where Venclexta was previously approved. We also submitted our U.S. regulatory application for Venclexta in AML, representing a significant acceleration of the timeline for this sizable follow-on indication. We've also made significant progress with our two next-generation immunology assets, upadacitinib and risankizumab. We recently reported results from the fifth and final pivotal trial evaluating upadacitinib as a treatment for RA. We've been very encouraged by the level of efficacy and the benefit/risk profile observed across the entire clinical program. Upadacitinib has the potential to be a best-in-class therapy in RA, offering meaningful advantages over products on the market today or those we see in development. We remain on track to submit our regulatory application later this year.
Following the completion of our four pivotal studies in psoriasis, we have submitted our regulatory applications for risankizumab both in the U.S. and Europe. Based on the data generated from our registrational programs, we believe risankizumab represents a potential best-in-category therapeutic option. We also believe that with upadacitinib and risankizumab, along with Humira, we have the most competitive and best portfolio in immunology, which should enable us to maintain our therapeutic leadership and drive continued growth. When we launched AbbVie in 2013, we had an important objective: to create a robust pipeline full of differentiated assets, enabling us to drive industry-leading growth for the long term. I can tell you that I am extremely pleased with the progress that we've made towards that objective.
As demonstrated this quarter, as well as last quarter, IMBRUVICA and MAVYRET are both playing important roles in diversifying our sources of growth, each driving strong performance along with Humira. With our recent and near-term approvals, we expect even further diversification of growth going forward. This year, we're seeing Venclexta's expansion into the broader relapsed/refractory CLL population and the launch of ORILISSA for endometriosis. These are both significant opportunities. In 2019, we anticipate the approval of Venclexta in AML and the launches of risankizumab in psoriasis and upadacitinib in RA. Each of these assets has demonstrated best-in-class clinical results, allowing us to significantly enhance our leadership position in these very sizable markets. By 2020, AbbVie will be extremely well-positioned, with multiple new assets in our portfolio driving growth, enabling us to continue to achieve our mission of delivering top-tier industry performance.
All told now, and between now and the expected entry of direct biosimilars in the U.S., we are poised to launch more than 20 new products or major indications from our late-stage pipeline. Each of these opportunities will contribute significantly to our overall growth, diversifying our sources of revenue and offsetting the impact of biosimilar competition. In summary, we're pleased with our progress, and we're confident in our ability to continue to drive strong growth. We remain committed to achieving our long-term strategic vision for the company, delivering industry-leading performance and outstanding shareholder value. With that, I'll turn the call over to Mike for additional comments on our R&D programs. Mike?
Thank you, Rick. When we launched AbbVie, our strategy was to build an industry-leading pipeline and a robust R&D engine capable of driving significant and sustainable growth. We've made tremendous progress over the past few years, and we are now entering a period where a large number of assets have either already transitioned to commercialization or are preparing to do so. Our R&D engine has been very productive over the past two years. Specifically, we've received a number of major regulatory approvals, including VENCLEXTA in relapsed or refractory CLL, IMBRUVICA in marginal zone lymphoma and graft-versus-host disease, MAVYRET in HCV, and ORILISSA in endometriosis. We've reported positive data from nearly a dozen key registration-enabling clinical programs, including upadacitinib in RA, risankizumab in psoriasis, VENCLEXTA in relapsed/refractory CLL and AML, IMBRUVICA in frontline CLL, and elagolix in endometriosis and uterine fibroids, to name a few.
We've been very pleased with the data generated across these programs, as each asset has proven to be differentiated relative to the current standard of care. We've also seen promising proof of concept data from numerous mid-stage programs, which we have advanced into registrational studies. These include upadacitinib in Crohn's disease, psoriatic arthritis, and atopic dermatitis, risankizumab in Crohn's disease, and VENCLEXTA in multiple myeloma and mantle cell lymphoma. The data we have produced and the regulatory successes we have had to date reinforce our view that the assets we're developing will achieve strong competitive positions within their respective markets. We've also continued the significant progress in the recent quarter, which I'll now spend a few moments highlighting. In immunology, we've made significant progress with upadacitinib and risankizumab, our two late-stage assets with best-in-class potential across a broad range of indications.
In the quarter, we reported top-line results from the SELECT-EARLY study, which evaluated upadacitinib, our JAK1 selective inhibitor, as a monotherapy treatment compared to methotrexate in methotrexate-naive patients. Similar to the efficacy observed in the previous four SELECT studies, in this fifth and final registrational trial, upadacitinib drove very high levels of response on all clinical endpoints, and importantly, on the more stringent endpoints such as ACR50, ACR70, low disease activity, and DAS remission. In the study, both the lower and higher doses of upadacitinib met the primary and all ranked secondary endpoints at weeks 12 and 24. Both doses also significantly inhibited radiographic progression at week 24 compared to methotrexate. These results support the potential of upadacitinib as first-line monotherapy in methotrexate-naive RA patients. We have evaluated upadacitinib in a comprehensive set of studies in patients with moderate to severe RA.
This includes a head-to-head study against HUMIRA, the current standard of care, and additional studies conducted in a broad range of clinical settings, including patients who are naive to methotrexate therapy at one end of the spectrum and very difficult to treat patients who have failed one or more biologic therapies at the other end. Based on the data generated in our program, we remain very confident in the benefit/risk profile of upadacitinib and believe that it will offer meaningful advantages over products on the market today or in development. Following the successful completion of our fifth and final study, we remain on track to submit our regulatory application in the fourth quarter of this year. Moving now to our other late-stage immunology asset, risankizumab. We recently submitted our U.S. and European regulatory applications in psoriasis.
Based on the very high and durable rates of skin clearance we saw in the registrational studies, we believe risankizumab has the potential to significantly improve upon current treatment options for both bio-naive and TNF-inadequate responder patients with moderate to severe psoriasis while offering the convenience of quarterly dosing. Moving now to oncology, where we continue to advance our programs for Venclexta and IMBRUVICA. We've seen very strong activity across a broad range of hematologic malignancies with these two therapies, demonstrating their potential to transform treatment by driving better long-term disease control and better outcomes for patients. In June, we received FDA approval for Venclexta in combination with rituximab in patients with relapsed/refractory CLL, substantially expanding the patient population for which Venclexta is approved. This approval was based on the phase III MURANO study, where combination treatment with Venclexta and Rituxan showed a profound improvement in progression-free survival.
This combination also showed high and durable rates of MRD negative response compared to BR, a measure that is predictive of improved clinical outcomes in patients with CLL. Venclexta plus Rituxan combination therapy has the potential to be a new standard chemotherapy-free treatment option. We are excited to bring this new therapy to the broader relapsed/refractory CLL population. In the quarter, we also submitted our U.S. regulatory application for Venclexta as a treatment for first-line AML patients who can't receive high-dose induction chemotherapy. AML is one of the most aggressive hematologic malignancies, with a very low survival rate and few options available for patients who can't receive intensive chemotherapy. Venclexta has demonstrated rapid, deep, and durable responses in these patients.
Based on the phase II data recently presented at EHA, we're seeing response rates in excess of 70% with Venclexta in combination with hypomethylating agents, which represents a meaningful improvement relative to the current standard of care, where response rates range from 10%-30%. We believe this could be an important new treatment option for this substantial group of patients, which represents roughly 50% of the frontline AML market. We expect to see data from several other important Venclexta studies over the next 12 months. This includes data from the phase III CLL14 study in frontline CLL later this year, and the phase III BELLINI study in multiple myeloma in the first half of 2019. Turning now to IMBRUVICA. During the quarter, we reported data from two important trials that expand and strengthen our data set in CLL, the ILLUMINATE and CAPTIVATE studies.
Results from the phase III ILLUMINATE study, which evaluated IMBRUVICA in combination with GAZYVA in frontline CLL, showed a significant improvement in progression-free survival in patients treated with IMBRUVICA plus GAZYVA, compared to patients treated with a combination of GAZYVA and chlorambucil, a regimen which is currently recommended as a category 1 treatment within the NCCN guidelines. We also recently presented data from the phase II CAPTIVATE study, evaluating IMBRUVICA in combination with Venclexta in frontline CLL. We are very encouraged by the early results of this study, where approximately 90% of patients achieved responses with no detectable minimal residual disease following 12 cycles of therapy, illustrating the potential benefit of combining these two agents to deliver deep responses in CLL.
iLLUMINATE and CAPTIVATE are just two of several ongoing studies evaluating IMBRUVICA alone and as a combination therapy versus regimens such as GC, BR, and FCR, often considered the standards of care in the treatment of CLL. Over the course of the next few years, there will be additional data readouts for IMBRUVICA in the frontline CLL setting that we believe will help drive further penetration. Finally, in the area of women's health, as previously noted, we recently announced the FDA approval of ORILISSA for the management of moderate-to-severe pain associated with endometriosis. ORILISSA is the first and only oral GnRH antagonist approved for women with this condition and the first oral treatment option for these patients in over a decade. We also continue to make good progress with our pivotal program evaluating elagolix in combination with low-dose hormone add-back therapy in women with uterine fibroids.
Detailed data from our pivotal trials in this indication will be presented at a medical meeting later this year and will support our regulatory submission in 2019. In summary, we have had several important data readouts, regulatory submissions, and approvals in the first half of the year, and we look forward to updating you on our pipeline as it continues to progress. With that, I'll turn the call over to Bill for additional comments on our second quarter performance.
Thanks, Mike. As Rick mentioned, we are very pleased with our outstanding second quarter performance. Our year-to-date underlying business fundamentals remain strong, and we've entered the second half with significant momentum. Total adjusted net revenues for the second quarter were $8.3 billion, up 17.1% operationally, excluding the impact of foreign exchange. We reported adjusted earnings per share of $2, up 40.8% compared to the second quarter of 2017 and exceeding our guidance range for the quarter. HUMIRA global sales were $5.2 billion, up 8.2% operationally. In the U.S., HUMIRA sales increased 10% compared to the prior year, with high single-digit prescription volume growth and roughly 3% favorable price. Wholesaler inventory levels remained below a half-month in the quarter. International HUMIRA sales were more than $1.6 billion, up 4.4% on an operational basis. We continue to see very good growth through the first half of 2018, despite increasing competition.
With its unique product profile, years of physician experience, and broad set of indications, HUMIRA remains the leading global frontline therapy across all approved indications. Global IMBRUVICA net revenues were $850 million, up 35.6% year-over-year, with continued strong uptake in CLL as well as other approved indications. Global HCV sales were $973 million, with MAVYRET sales of $932 million. The pace of MAVYRET's uptake continues to exceed expectations, driven by strong market share performance globally as well as higher treatment volumes from warehoused DAA failure patients in certain markets. Global sales of DUODOPA, our therapy for advanced Parkinson's disease, grew 25.1% on an operational basis in the quarter, and we also saw strong operational sales growth from CREON, which was up 11.4%. Turning to the P&L profile for the second quarter, adjusted gross margin was 80.5% of sales compared to 82.3% in the prior year.
The decrease versus prior year reflects the year-over-year dilutive impact of partnership accounting as well as exchange impacts of hedged currencies. Adjusted R&D was 15.3% of sales in the quarter, supporting our pipeline programs in oncology, immunology, as well as other areas. Adjusted SG&A was 19.9% of sales in the quarter, a decrease of 40 basis points versus the prior year, reflecting sales leverage and operational efficiencies. The adjusted operating margin was 45.3% in the second quarter, an improvement of 90 basis points versus the prior year. Net interest expense was $272 million in the quarter. The adjusted tax rate was 9%. As Rick mentioned, based on our performance year-to-date and our outlook for the remaining two quarters, we are raising our full-year adjusted earnings per share guidance range to $7.76-$7.86, representing growth of 39.5% at the midpoint.
This guidance assumes revenue approaching $32.5 billion, inclusive of recent negative currency dynamics. This forecast comprehends full-year operational performance approaching 14.5%, up 1% from prior guidance. At current rates, we now expect a foreign currency benefit of less than 1% for the full-year sales. This forecast includes the following updated assumptions for our key products. Despite less favorable exchange at current rates, we continue to expect international Humira sales to approach $6.4 billion this year. For Imbruvica, we now expect global revenues to AbbVie approaching $3.4 billion, with U.S. sales approaching $2.8 billion. Given the momentum and performance in HCV, we are raising our forecast and now expect global sales above $3.5 billion. For ORILISSA, due to the timing of the launch, we expect full-year sales of less than $50 million in 2018, as we continue to create awareness and build the market for this important new treatment option.
Turning to the P&L for 2018, we now expect an adjusted gross margin ratio of above 80.5%, which includes exchange impacts from weaker hedged currencies. We are now forecasting SG&A of approximately 20.5% of sales, reflecting investments to maximize the potential of assets launching in both 2018 and 2019. We expect full-year R&D expense approaching 16%. We now expect an adjusted operating margin above 44%, roughly 150 basis points above prior year. All other full-year guidance assumptions remain unchanged. As we look ahead to the third quarter, we expect adjusted earnings per share between $2 and $2.02. Our third quarter adjusted EPS guidance excludes roughly $0.23 of non-cash amortization and other specified items. We are forecasting operational revenue growth in the third quarter of approximately 17%.
Holding exchange rates constant at current levels, we would expect foreign exchange to have an unfavorable impact on sales growth of approximately 1% in the third quarter. For U.S. Humira, we expect sales growth in the third quarter of approximately 11%. We expect international Humira sales approaching $1.6 billion, assuming current exchange rates. For Imbruvica, we expect U.S. sales approaching $725 million. For HCV, we expect global sales of approximately $850 million. Lastly, we expect the adjusted tax rate to be approximately 9%. In summary, we are very pleased with our performance this quarter as we've driven strong revenue and EPS growth again while continuing to advance our strategic priorities. We expect this momentum to continue in the second half of 2018, putting us in a strong position to deliver top-tier industry growth once again this year. With that, I'll turn the call back over to Liz.
Thanks, Bill. We'll now open the call for questions. Operator, we'll take the first question, please.
Thank you. As a reminder, to ask a question, please press *1. Our first question today is from Jami Rubin from Goldman Sachs.
Thank you. I know there are a whole bunch of questions on this call regarding rebates, let me just ask you, Rick, sort of a bigger picture question. The gap between AbbVie's industry-leading performance, which you continue to execute on time and time again, and the stock's low valuation and lower valuation this year, and investor lack of confidence has never been wider. What do you do to close that gap? Is it deal activity? Do you feel that that's what needs to happen? Is it share buybacks? Is it committing to a 50% dividend yield or dividend payout ratio? Are there other structures that you are considering, such as spin-outs? In addition, Rick, can you clarify your comments that you made during our conference last month about doing a $20 billion-$30 billion deal?
I think investors took that as a signal that something's going to happen sooner rather than later. Maybe if you could just address those, please. Thanks very much.
All right. Thanks, Jami. This is Rick. Appreciate the question. Let me answer it first by framing how I view AbbVie. There is a lot of skepticism, concern about rebates, about biosimilars, and frankly, some of that is reasonable. Some of it is driven by people who want to elicit fear for their own personal gain. I don't think that's quite as reasonable, but it's reality. I think if you step back and you look at AbbVie in a, what I would say, is a fair and objective way, the way I would evaluate AbbVie is the following. Look, I'd start with
How will we perform? We've been in existence now five and a half years, 22 or 23 quarters we've had. We're clearly a company and a management team that lives up to the commitments that we make to investors. We take that extremely seriously. We've never once disappointed investors. In fact, in most of those quarters, much like this year, we have exceeded the expectations that we've set for investors. Every year, since I can remember, there has been fretting about Humira. Biosimilars coming in 2018, new mechanisms of action, et cetera. "You're never going to make $18 billion," et cetera. We have beat every single one of those expectations along the way. We have built two assets in addition to Humira now, that are both approaching $4 billion, IMBRUVICA and MAVYRET. Two major mega assets that are part of our portfolio and our business going forward.
If you look at VENCLEXTA, it's on the verge of becoming a major asset for us with the MURANO approval and the approval of AML next year. We have a tremendous amount of confidence in what we think VENCLEXTA can do. If you look at ORILISSA, it was approved just recently. It has an excellent label, and that is clearly a multi-billion dollar asset for us. If you look at the clinical trial data from riza and upa, it clearly supports these two are best-in-class assets, and they're going to play a very important role when biosimilars enter the marketplace in the U.S. We have a lot of confidence in what that portfolio is going to be able to do and how it's going to be able to perform.
If you look at 2019 and 2020, out in sort of the near future here, and you look at AbbVie, we're going to have seven assets, Humira, IMBRUVICA, MAVYRET, VENCLEXTA, ORILISSA, upa, and riza, which will all either be multi-billion dollar assets or on their way to being multi-billion dollar assets. For a company that started five and a half years ago with one asset, Humira, the Humira company, I will tell you, we have made impressive progress. I think the future is even brighter than what the past has been going forward. I have tremendous confidence in the growth trajectory of the company going forward. Frankly, the strategy we put in place back in 2013 is playing out pretty much exactly as we had planned.
That doesn't mean there aren't changes and things that you have to do along the way to adjust to different environmental factors. Over the long haul, investors reward long-term performance, and there's not a company that I'm aware of that's performing better than us, and there's not a company that has performed better over the past five years. If you think about it, we're delivering 40% EPS growth this year. People will say, "Oh, yeah, but you've gotten the benefit of tax." Okay, back the benefit of tax out. We're delivering 25% EPS growth this year on an operating basis. There aren't many companies that are delivering 25% EPS growth. In fact, I can't think of another one our size that's delivering that level of growth.
I'd also say that we have delivered a tremendous amount of cash back to shareholders through our dividend increase and our buyback programs. Certainly, we have shown that we're not shy about doing M&A when we think we need it and we find the appropriate kinds of assets. As it relates to the $20 billion-$30 billion comment, that certainly took on a life of its own, far greater than what I would've anticipated. My objective there was to frame how we viewed large bolt-ons, like a Pharmacyclics-like asset.
As we look at how we're going to build this business going forward, we obviously have a commitment that we have said over and over again, and that is a commitment that we're going to deliver top-tier performance and we're going to do it over the long term, and we're going to grow through the biosimilar impact that we knew we were going to face from day one. I think how we've executed around the biosimilar issue has been excellent. Outstanding, in fact, I'd say. We have built a pipeline that for the most part, with one exception, Rova-T, which was a relatively small asset and a small indication, we have delivered on every single one of the assets in our late-stage pipeline that we've talked about.
Now you're starting to see the benefit of that, and you're going to see the benefit of it in 2019 and again in 2020 as these products start to build. We look at going out and building the business around the premise of we want to continue to be able to drive top-tier growth. When we find the right kind of opportunity that we think fits strategically, that we believe we can get a good return for our investors, and it fits into what we're good at, then we've shown we're not shy. We'll act on those. Having said that, I would say the majority of what we're looking at and what we will do will be smaller kinds of product assets that fit into our portfolio.
I tell you today, there aren't a lot of assets, in our opinion, that either from a valuation standpoint, we can get the right return or they fit strategically in what we're doing. If the right thing comes along, I'm certainly not saying to you we wouldn't act. We certainly have the cash flow to be able to act. If it fits, and we thought it would enhance our long-term ability to be able to deliver on our mission, we would certainly do that. As far as the $20 billion-$30 billion, I can tell you there's nothing on the horizon right now. What I was trying to do is frame for you how we viewed it. If we found the right thing, we would. We haven't found anything that looks like that right now.
Fundamentally, if I look at our pipeline, and I look at everything that's going on in the marketplace, I still have a high level of confidence this pipeline will drive us through where we need to go.
Thanks, Jami. Operator, we'll take the next question, please.
Thank you. Our next question is from Steve Scala from Cowen.
Thank you. I have a few. As we approach the launch of Humira biosimilars in the EU, is anything shaping up differently than you would have expected, either positively or negatively? In the past, you've spoken to the fact that you're implementing defense strategies, and I'm not aware that you've amplified on them. Perhaps you could now. Secondly, has the risankizumab filing been accepted, and is there a PDUFA date? Thirdly, can you give us Venclexta sales in the second quarter? Thank you.
Okay. Steve, this is Rick. Let me take the first one. I'll have Mike take the second, Bill can take the third, and maybe I can add some color onto the third. As far as the biosimilar assumptions in the EU, I'd say there's nothing different from what we had anticipated. I've recently had a review. I'm going to have another review in a month or so with the team. I'd say everything is tracking as we had assumed it would track. If we had concerns, we certainly wouldn't be raising guidance at this point because we're already delivering tremendous levels of performance. If we had any level of uncertainty, and based on what I said a few moments ago, we take extremely seriously that we're never going to miss.
We wouldn't be raising guidance at this point unless we had a lot of confidence in what that fourth quarter was going to look like. Now, am I going to go through the defense strategies? I apologize, I'm not. Because unfortunately, it's not my objective to telegraph to all of our competitors what our defense strategies are. What I can tell you is thus far, it is playing out exactly as we had planned it to play out. Certainly as we go through the fourth quarter, all of us are going to get a lot of clarity on what that quarter looks like. I think by our actions, you can probably tell how we feel about it. We're all going to know here soon, and I have confidence in how we're going to execute against that.
Okay. This is Mike. With respect to the risa file, the file was submitted in April. It was accepted on schedule, so that would be June. We don't typically give exact PDUFA dates, but you can do the math from there. It's a standard 10 plus two review cycle. Although it's very early, what I would say is the file is going very smoothly and matching our very high expectations.
VENCLEXTA sales in the quarter were $65 million. Thank you.
Well, that's accurate. I will say that, since the MURANO approval, we have seen an inflection point in patient starts. We track patient starts on VENCLEXTA like we do on other drugs. We have seen a fairly significant uptick in patient starts. I think we're encouraged based on what we're seeing here. Now, it's obviously very early. I think if you look at that data, you look at the positioning, you look at the feedback that we're getting from KOLs about their excitement about this asset. Most importantly, if you look at the benefit that it can provide patients in this relapsed refractory setting, particularly patients who have failed a BTK inhibitor, I think it's a tremendous opportunity going forward for us. I think another big opportunity for VENCLEXTA is AML.
This is a very serious disease, has bad outcomes for patients, particularly patients that can't tolerate intensive chemotherapy, and this is an excellent new therapy for those patients, and it provides significant benefit for those patients. I think our ability to have a big impact in AML is a high probability.
Thanks, Steve. Operator, next question, please.
Thank you. Our next question is from Jason Gerberry from Bank of America.
Thanks. Good morning. Thanks for taking my questions. Appreciate the guidance on the elagolix launch for this. Can you talk a little bit more about how that launch progresses? What I mean by that is the slow early launch, is it more to do with educating the docs around the monitoring requirements that were in the label, or is it just difficult revenue recognition early on just because of presumably early access barriers? My second question, I'm not sure you're going to be able to answer this, but just can you talk a little bit about the differential gross margin profile for Humira U.S. versus ex-U.S. Just wondering because the price points are different on those, and just kind of curious, do you guys still kind of stand by the 50% operating margin target by 2020? Thanks.
Okay. Well, first on ORILISSA, there isn't any monitoring requirements in the label. Maybe let me back up a little bit and talk about what are the key attributes of this product in order for it to be successful, and then I'll talk about the ramp. If you think about this area, what you would want to get the maximum value out of an asset in this area is, one, you want a drug that gives high levels of efficacy, has a relatively clean safety profile, fast on, fast off, because many of these women are of reproductive age and if they choose to become pregnant, or try to become pregnant, you want a drug that they can stop taking and then therefore they can move forward from a pregnancy standpoint.
You want a label that allows for clinical diagnosis, not diagnosis by a lab, which is what we have. We wanted two doses because you have different levels of pain among these women. You want to be able to titrate the dose depending upon their level of pain and your ability to be able to control that pain over time. We've obviously gotten that in the label. You want the ability to be able to maintain therapy for a relatively long period of time, and we were extremely pleased with the duration of the low dose being two years. You don't want monitoring, or any kind of a black box for a drug of this size or of this nature, rather. We've gotten everything that we hoped for in the label. We've priced it in a way that it's designed to get relatively rapid uptake.
It's priced at roughly 30% lower than LUPRON, which is one of the competitive alternatives that's available. I think we priced it in a way that should enhance the ramp. Having said that, there hasn't been a new therapy in this area in, I don't know, 15 or 20 years. Because of that, physicians aren't used to prescribing medical therapy for it. Patients aren't necessarily used to seeking therapies other than pain management kinds of therapies for it. There is an education element that has to occur. We've started that disease awareness campaign already. We started it a couple of months ago. We're going to continue to run that disease awareness campaign. I think the early returns would suggest it's working well. Six months post the approval, we will launch then a branded DTC campaign for the drug.
It's more a function of just getting the patients engaged in a way that they go to their physicians and seek therapy for this condition. Number 2, then educating physicians of what are the attributes of this product and how should it be used. That drives a different ramp than an HCV as an example, where you get a very rapid uptake. It has a softer ramp on the front end because of that. I'd say if I look at every attribute of the product from a label standpoint, all the attributes of the product and where we priced it are designed to ultimately give you maximum value. We believe this is a multi-billion dollar opportunity for us.
Jason, it's Bill Chase on your two questions regarding gross margin and operating margin. We've never been specific around gross margin of Humira in certain geographies, but you've obviously noted the fact that the price point outside of the U.S. is lower and therefore there's less profit. That said, if you look at it on a percentage basis, whether it's in the U.S. or outside of the U.S., Humira is still a profound profit generator, and I don't think you want to be necessarily of the opinion that it would be massively lower based on pricing. But I can't give you a whole lot more guidance than that. And then with operating margin, yes, our intent is still to aim for that 50%. If you look at the progress year to date, we're going to be up about one and a half points versus last year.
What people don't actually realize is that is inclusive of a lot of dilution related to both partnership accounting and the Stem and BI deals. If you squared those away and did apples to apples, we'd probably be about 350 basis points higher still yet. Of course, those investments are exactly the type of investments you want to make, and we've been happy taking that near term dilution on operating margin in order to have a product like risankizumab or the ability to have the optionality of Stem. We're pleased with our progress. I think what you need to watch from here is two things. First of all, the roll-off of the rest of the Humira royalties that really kicks in in the back half of this year and then again in 2019, as well as the contribution of a more rapidly growing top line.
As products like SKYRIZI launch, for example, and RINVOQ and ORILISSA, you should definitely see some real positive leverage in the P&L.
Thanks, Jason. Operator, next question, please.
Thank you. Our next question is from Josh Schimmer from Evercore.
Great. Thanks very much for taking my questions. For ORILISSA, do you expect hormonal add-back will ultimately lift the limited duration of use recommendation on the label? If so, when do you expect that would happen? Then as the late-stage pipeline programs mature into commercial assets, what do you see as the key early- and mid-stage programs you'd emphasize as best positioned to take their places? Thanks.
This is Mike. I'll take that. We are pursuing a phase III-B program for ORILISSA, looking at the ability of low-dose hormonal add-back to mitigate some of the antiestrogenic effects that are intrinsic to this mechanism of action. We would expect that that would allow for longer duration of therapy. We already feel pretty good about the 2 years we have, but there may be some women who need even more than that, and add-back may be a route to allow that to happen. We've not given specific timing on that study or on subsequent label changes because we're still in the execution phase, but it's something that we are progressing very nicely. With respect to the pipeline, as you point out, we have a number of assets that are transitioning into commercialization.
These are the assets for which we've been delivering positive phase III data pretty consistently over the course of the last couple of years. We've paid a lot of attention to making sure that the pipeline is full behind that. What I would point to is a number of assets in our early oncology pipeline. We've invested a lot to make sure that that pipeline is robust. We have on the order of about 18 programs in the clinic in early oncology, That number changes day to day as we advance programs. That's very robust across a number of areas. We have our Stemcentrx pipeline. We have our early immuno-oncology programs, and some of those are producing very interesting early data, late pre-clinical and early clinical data. We have other programs aimed at our areas of expertise, like apoptosis as one example.
We have a very robust pipeline there that will drive future growth. We're quite confident. Outside of oncology, we've also invested a lot in our pipeline. We've invested in our early immunology pipeline with a number of assets now either in phase II or poised to enter phase II. These include things like our TNF steroid immunology ADC platform, which uses a steroid warhead, not a cytotoxic warhead, with the goal of driving very differentiated response in patients with RA and other TNF-mediated diseases. If successful, that could be a platform that we could apply to other disease states as well with other targeting antibodies. We have a number of small molecule programs like our BTK and BTK JAK inhibitor combo programs.
We have a number of very interesting programs in inflammatory bowel diseases, like our CD40 program that is moving forward there and many behind that, many earlier than that. I would say overall, we've put a lot of focus, a lot of attention into making sure that early pipeline is robust and will drive the next generation of product launches and the next generation of growth.
The only thing I'd add, Josh, this is Rick, is if you think about the strategy we had with Humira, it was a strategy where we tried to maximize the value of the asset by identifying other disease states where that mechanism could be successful and provide a good clinical benefit. As you look at things like riza and especially upadacitinib, the breadth of that mechanism, I think we are equally as excited as we were with Humira that it will allow us to be able to expand the indications fairly significantly over time. Remember, those are going to come out more in the 2020, 2021, 2022, 2023 timeframe. Going to areas like Crohn's or new areas like atopic dermatitis, which we've seen impressive data. Those are big opportunities. They're big markets.
That too is going to add to our ability to be able to continue to grow and add on significant opportunities in the pipeline over time, in addition to our earlier stage or mid-stage pipeline, as Mike mentioned in oncology and in immunology as an example.
Thanks, Josh. Operator, next question, please.
Thank you. Our next question is from Chris Schott from J.P. Morgan.
Great. Thanks very much for the questions. First one here, can you talk about the President's Blueprint for reducing drug costs and potential changes to rebate structures? I know there's a lot of uncertainty here, would just love your perspective on, A, how likely you think that we'll see changes to the current industry pricing structure, and B, how you think about that and prepare for any potential changes from an AbbVie perspective. My second question was on the outlook for HCV from here. You've obviously had a ton of success in this business this year. You're talking about north of $3.5 billion of revenue. We're seeing a step down in Q3 versus Q2. Help us understand a little bit about how you think about the trajectory for HCV as we think about the second half of the year, and we start looking out in the future.
Is this a business that you can maintain at this level, or do we start to think about this stepping down in the next few years? Thanks so much.
Okay, Chris, this is Rick. I'll take those two. I think as we think about the Blueprint that has come out from the administration, I'd say in our view, we believe it's an important step, to address probably one of the biggest challenges that we face, both as a nation as well as an industry. That is the significant burden of out-of-pocket costs for seniors, in Medicare around co-pays and the donut hole. That's a significant challenge, and I think it's something that we have to be able to wrestle to the ground. I would say we're very supportive of the idea of changing a structure where the net price would be how the co-pays were paid against. I think that's a fair and very reasonable thing to ultimately implement.
I'd also say that if you look at the Blueprint, it's probably the most comprehensive look that we've seen in a very long time at the system and looking at ways to ultimately improve the system overall. We're encouraged to continue to work with industry to provide feedback and to provide feedback directly around the Blueprint. We'd be interested in making sure that we come forward with solutions that will work. Now, it's a little early in the process, so there's not a lot of specificity yet on what some of those changes are. It's a little difficult to look at it yet and determine impacts on the business or any of those kinds of things.
I'd say generally speaking, when we looked at the framework, at least for AbbVie's business, there were probably more positives than there were negatives based on the kinds of products that we have. As it relates to rebates, I know there's a lot of debate on rebates, and I think it is important for people to understand some of the facts around rebates. We view rebates the same as you'd view a discount. Okay? From our perspective, they are one and the same. Essentially, we provide a rebate to a managed care group or a PBM, as part of a position to be able to get a formulary position. In fact, if you look at Medicare typically has a higher rebate.
In fact, I'd say it does have a higher rebate on average across the Part D plans for something like Humira than the commercial plans get, even though it only represents about 15% of our overall business for Humira. We take it very seriously how we negotiate for Medicare business. I think there's also a lot of misconception as it comes to rebating and the importance of rebating and what really drives Humira's success on these managed care contracts. Certainly, getting access in the U.S. is an important issue for any product in any category, and rebates play a role in that. If you look at Humira, I think there's four or five important points that investors need to keep in mind.
One is, if you look at our % rebate as it relates to the competitor's rebates, I would tell you that we're certainly nowhere near the highest, and in fact, we're probably in the middle or slightly below the middle from a % rebate standpoint. The second thing I'd say is if you look at the cost of therapy for Humira, for those assets that are on contract, again, we're not the highest priced product on contract, and we're not the lowest priced product on contract. We're pretty much in the middle of the pack. The third thing, I think this is a very important issue. Over the course of the last couple of years, most covered lives in the United States have moved to these open formularies. Those formularies typically have between five and seven products on contract with Humira.
Humira does extremely well in an environment where there's full choice. Physicians have total choice to prescribe any one of those drugs, and Humira has maintained its position as the number one product for capturing naive patients. It's not like we have this position where we have exclusive contracts, where physicians have to prescribe Humira. They prescribe Humira because of the attributes of the product, the experience they've had, the comfort they have with the safety profile of it, and the rest of the attributes of the product. I think what further illustrates that is, look, we compete in every socialized healthcare system in the world. None of those systems have U.S.-style rebates. Physicians have the choice to prescribe any drug that is reimbursed in that country.
If you look at our market share, if you look at our volume growth, if you look at the percent of naive patients that we capture, it's very similar in, let's say, Europe, to what it is in the United States. That tells you it's not rebates that are driving this. It is the attributes of the product and our ability to be able to execute. I think it would be disruptive to do dramatic things to the rebate system, but I'd also tell you, I don't know that there isn't a way to make those changes in a less disruptive way. What I can tell you with a pretty high degree of confidence is whether we had a rebate-based system or we had a discount-based system, it doesn't change our business model one way or another.
I think we could operate under either one of those, and I don't think anybody's contemplating getting rid of discounting altogether. We'll have to see how it plays out over time, but I can tell you we're confident in what are the fundamentals that drive Humira and what's our ability to be able to continue to drive that level of performance. HCV. Right now, we are forecasting a step down in the third quarter. It's primarily driven by two sets of assumptions. One is Japan. In Japan, as I think we indicated in the call last quarter, we had a number of patients that were DAA failure patients that were in the system getting retreated.
I can't tell you that there's perfect data in Japan on how many of those patients there are, but we had forecasted that that would go down somewhat in the second quarter and will continue to go down in third and fourth quarter. It didn't go down as much as we had assumed in the second quarter. It did go down some, but it didn't go down as much as we had assumed. We are assuming another step function down of those patients in third and fourth quarter. It's hard to tell whether that's going to happen or not. We're going to have to see how it plays out, but we normally will operate in a conservative mode in an area where we don't have good data to be able to predict it.
The second area is the U.S., and again, it's a similar phenomenon, is we're seeing patient volumes higher than we would have expected. Again, we had projected that they would come down somewhat. In second quarter, we didn't see that come down. We are projecting some reduction in patient volumes in the third and the fourth quarter. We'll have to see how that plays out. That's the basic difference. I don't know, Bill, anything that you would add?
No, I mean, market share is phenomenal.
Yeah.
It's really just a market call.
Thanks, Chris. Operator, next question, please.
Thank you. Our next question is from John Boris from SunTrust.
Thanks for taking the questions, and congratulations on the launch or the execution. Rick, if we look at the word interchangeability, FDA withdrew some guidelines there, but there continues to be a lot of saber rattling around that, such as having proprietary manufacturers tighten the specifications on their manufacturing of biologics to make it easier for companies to get into the market. There's also some saber rattling around settlements, most notably having the FTC look at settlements on a prospective basis versus a retrospective basis. Just your thoughts on those two potential risks on Humira. Then last question just has to do with the phases that you laid out at a competitor's conference. Obviously, phase I since the spin in early 2013, operational execution has been superb. Phase II, pipeline delivery.
Really where investors have been focused is phase III, your build-out in solid tumors and potentially other areas such as neurosciences. Just your thoughts over the long term on phase III and the build-out in that phase. Thanks.
All right. Thank you, John. I'll cover maybe the first two questions, and we'll have Mike cover question number three. If you look at interchangeability, I would say the FDA, certainly the discussion around this has ramped up over the last several months, I would say. If you actually go back a year and a half or so ago, the FDA had come out with some guidance around interchangeability, what you needed to do to be able to have an interchangeable biosimilar. It was switching studies. I'm sure most investors are familiar with what the requirements were. At that point, when we were doing our LRP, we made the conscious decision that we would dial in interchangeable biosimilars. Didn't mean that for sure there would be interchangeable biosimilars, but I think the prudent approach would be to dial it in.
In all of our long-range plans, we had assumed that there'd be one at the point of entry in the U.S., there'd be at least one interchangeable biosimilar in year one, and multiple interchangeable biosimilars in year two and beyond. I'd say we've dialed that into our assumptions, because we believe that that was the intent of the FDA was to move in that direction. I'd say, I think that became a prudent assumption because that clearly is, I think, the direction that they're ultimately going in. It certainly changes some of the dynamics around how we think about it, but I don't think it fundamentally changes the most significant dynamic in.
That is, we have always said, when biosimilars enter the market, when they're available to be able to enter the market, that we will compete on price, in that competitive environment to maintain the vast majority of the volume. That's certainly good for the healthcare system. I think if you look at the free market system that exists today, and you look at examples where that competition has played out, like HCV as an example, the system gets a huge benefit from it. I'd say based on our long-range plan, there's nothing in the feedback we've seen so far around the biosimilar plan that is significantly different than what we already assumed.
As it relates to settlements, I think that is unfortunately an area where, over the last few weeks or few months, there's been a lot of discussion about the Humira patent estate and our licensing agreements, whether it was direct or indirect, that's not accurate and certainly isn't complete. I think it is important to sort of set the record straight as it relates to that, because we have been very thoughtful about how we did this. I'm going to cover a couple of points that I think are important. What I would say on the front end of the system, or the front end of my comments rather, is there's nothing about our intellectual property around Humira or the licensing agreements that we've done, that we've entered into so far, that's anything close to gaming the system or operating around some set of loopholes.
Let's start with the patents first. We obviously have a robust patent portfolio that protects our investment in Humira's innovation, manufacturing, formulations, and method of use. Those are the major areas that we have IP. We've invested heavily in Humira over the course of the life of Humira. It's important to recognize it was the first FDA-approved human monoclonal antibody, and we invested a tremendous amount in research and development to expand the approved indications to the 10 different distinct disease states that Humira operates in now. We've improved and refined the manufacturing and the formulation of Humira over time, and there's nothing inappropriate about protecting that investment in innovation. In fact, I'd say it's a hallmark of our society here in the U.S. of being able to protect, through the IP system, your innovation.
Second thing I'd say is, there's a mechanism by which people can challenge patents in the U.S. If you look at our U.S. patents, they've been challenged now 20 times in IPRs at the USPTO. Despite the fact that in an IPR process there is a lower burden of proof for invalidity, and that generally you get a fairly high invalidation rate in IPR proceedings, the Humira patents have done extremely well. Of the 12 Humira patents that have reached finality in the IPR process, nine have been found to be valid. Further, the PTO has rejected eight challenges to formulation patents, and those patents expire between August of 2022 and November of 2028. This year, the PTO rejected challenges to patents covering psoriasis, UC, and Crohn's indications, all of which expire April of 2025. That brings me to our settlements.
If you look at that robust patent portfolio, our settlement agreements actually facilitate biosimilar entry in the U.S., Europe, and the rest of the world. In the U.S., we have patents with expiration dates well beyond 2030, and our earliest to expire IP is June of 2022. The first license that we granted to a biosimilar was the Amgen license. If you look at the entry date of that in the U.S., it is approximately six months later than our first to expire patent. Given the breadth of the IP that we have and the overwhelming strength of the patents that we have, the license entry date represents what I would describe as a fairly negotiated license agreement that expedites biosimilar entry into the U.S.
The other thing I'd say that's very important to recognize, under none of our settlements are there any payments or any other kind of inducement from AbbVie to the biosimilar player. Instead, what there are royalties paid to AbbVie for specified amounts for a defined period of time by the biosimilar player to be able to enter the market and use those patents. That's exactly the kinds of arrangements that promote competition in markets around the world. I can tell you, we feel confident with our position. Why don't we go to Mike?
Okay, this is Mike. I'll take the third part of your question around the phases of our strategy. Phase one, as you point out, is operational execution. Phase two is the phase that we're in right now, delivering on our late-stage pipeline, to create the next generation of marketed products that can drive our growth. The third phase looks beyond that. It is sustainable growth out into the 2020s and beyond. What I would say about that is a couple of things. One, when you look at pipeline execution, there is long-term growth out of our existing pipeline assets, as Rick pointed out. With assets like upadacitinib and risankizumab, we're really just at the starting gates, and there's a lot of work to be done in areas like Crohn's disease and atopic dermatitis for upadacitinib. Inflammatory bowel diseases for risankizumab that will drive growth.
There is more to that longer-term growth story than just our early pipeline. We have, as I mentioned a little while earlier, invested considerably in our early pipeline. We've invested in it in immunology because we are fully determined to remain a long-term leader in immunology. We have a robust set of pipeline assets behind both upadacitinib and risankizumab, and those are in the areas that I mentioned already. We're investing in our pipeline in other areas as well. In oncology, we've built a very robust early pipeline. As I mentioned, we have a large number of early clinical assets in oncology as well as late preclinical assets that are poised to move into the clinic. These are across a wide range of areas.
There's our Stemcentrx pipeline, our next generation immuno-oncology efforts, which are going very well, and other efforts aimed at our core capabilities as a company, expanding on the work that we've done in apoptosis with VENCLEXTA, for example, with mechanisms that can take us into solid tumors there. What I would say is there's a large number of programs. Very importantly, they're high-quality programs, all supported by very strong preclinical data, and for the most advanced, promising early clinical data as well. We're not dependent on any one mechanism or any one technology. We're very diverse in that early set. We're not dependent on ADCs per se or on any one technology. We have very good ADC programs, we have very good immuno-oncology programs, and we have a very strong pipeline across the board there.
That's going to start to reveal itself over the course of the next, say, 12 to 24 months. We've invested considerably in our neuro pipeline, both in terms of capabilities in our Cambridge, Massachusetts Research Center and in our pipeline. Our lead asset, ABBV-8E12, is an anti-tau antibody that's in phase II in two indications, including Alzheimer's disease. We've built a robust pipeline behind that in neural inflammation, in proteostasis, in disease-modifying agents in areas like Parkinson's disease and others. We really have invested in that early pipeline, and we're starting to see the fruits of those labors. Those programs are now moving to the clinic. They're entering phase II. Over the course of the coming years, we're poised to deliver a lot of exciting data.
Thanks, John. Operator, we have time for one final question, please.
Our final question today is from Gregg Gilbert from Deutsche Bank.
Thanks. Two quick ones. First, Rick, going back to Jami’s question, I am not sure you addressed whether you are considering anything that is different from all that you described to position AbbVie operationally and from a pipeline standpoint. Are you considering doing anything differently than you have already done going forward? For Bill, I believe your model for Humira erosion outside the U.S. due to biosimilar competition is based on some other examples that have come before. Do you think that is sufficiently conservative in light of the growing experience with biosimilars in Europe and the fact that Humira is larger as a starting point than some of those other examples? Thanks. Bye.
Yeah, Gregg. It is Rick. When you say do anything different, clearly we are still committed to be able to return significant capital to shareholders. It is clearly our intent, and we have the ability to continue to grow the dividend, and we have obviously just finished a fairly significant share repurchase. We have $2.5 billion left on the existing buyback program that we have. At the point where that gets lower, we will obviously go back to our board and gain authorization for another share repurchase. We continue to be committed in those areas. From a BD standpoint, as I said, we continue to look for various opportunities, and if we were to find the right kind of opportunity, we would obviously add to that. I think the other question that Jami mentioned was some kind of a spin, and I would not say that we are evaluating anything in that area.
From an OUS Humira perspective, look, it is the best forecast we have right now. We are going to be dealing with live ammo, obviously, pretty quick. When we look at the way we are forecasting it relative to the analogs, there are a couple of differences. First and foremost, you need to recognize that unlike the analogs that people typically compare us to, Humira is growing at a nice pace. That will make the decrease relative to peak look a little less severe than one would think had it been just a status quo marketplace where there was no growth. The other thing is, keep in mind that not all of the markets are going biosimilar at the same time. That gives us maybe a little bit of a different circumstance given certain geographies that will be going to biosimilars later.
When we back up and we look at it, and we forecast this every year, and we forecast it from the bottom up, this is the best number we have at this point in time, but it is all going to largely be irrelevant because we are going to see the real data fairly soon in the fourth quarter, and we will adjust as we see fit.
Thank you.
Thanks, Gregg. That concludes today's conference call. If you'd like to listen to a replay of the call, please visit our website at investor.abbvie.com. Thanks again for joining us.
Thank you. This does conclude today's conference. You may disconnect at this time.