Good afternoon, everybody. I'm Chris Schott from JPMorgan, and it's my pleasure to be introducing Amgen today. From Amgen, we have the company's Chairman and CEO, Bob Bradway. Bob, happy New Year. Thanks for joining us, and look forward to your presentations as we think about Amgen heading into 2025.
Okay, thank you, Chris. Okay, good afternoon, everyone. Southern California has been our home at Amgen for more than 40 years, so we are obviously shocked and saddened by the devastation being caused by the wildfires in our home community.
Our thoughts, of course, are with our colleagues and our friends as they battle those fires, which continue to rage on. We're committed to being part of the solution of rebuilding our community, starting with the $10 million of support that we announced this morning to that effort.
As I begin this morning, I thought I might just take a moment for the benefit of those of you who know the company less well to remind you that we're focused on serious diseases, and we're focused in particular on serious diseases in the four areas shown here: diseases like heart attack, stroke, cancer, osteoporosis, and a number of rare diseases as well.
We're focused on these areas with an innovative portfolio of 38 medicines, each of which makes an important contribution against these serious diseases. We're confident about the outlook for growth of our business.
One of the reasons we're confident about the outlook for growth, the growth of our business, is the quality of that portfolio that I just flashed in front of you, but also the success that we've enjoyed in the past pursuing a strategy that enabled us to deliver the results you see reflected here over the past decade.
Results which I would point out we achieved in the face of biosimilar and generic competition, which aggregated about $9 billion against our portfolio over that decade. And what you see here is revenues growing consistently at a rate of about compounding at about 5% during that period, again, with the headwind of those biosimilar and generic competitors. And off the back of that revenue performance, what you see here is earnings per share, which was compounding during that period at a rate of about 8%-9%.
We expect to exit this period at the end of 2024 with 14 products achieving blockbuster status or growing at a run rate greater than $1 billion. We exit the period with a number of our key pipeline molecules having advanced to approvals, of course, during the course of the last year, one for IMDELLTRA and another for Blincyto, five successful phase III readouts, and of course, the positive readout for MariTide in phase II.
In addition, I wouldn't want you to forget that we have a very important biosimilar franchise. We have a world-leading biosimilars presence, and that business grew through the first nine months at a rate of about 7%. And we've recently added two molecules to the development pipeline for our biosimilars, and those two molecules are KEYTRUDA and OCREVUS. So we're excited about what that will represent for us.
Now, while the past inspires us for the future, when we think about the future, we expect our growth to be driven by the inline products that I'll take you through, as well as our advancing pipeline, and then to reiterate the world-leading biosimilars business that we have. With respect to our inline products, I would highlight for you Repatha, which of course is our leading molecule addressing heart disease.
EVENITY, which is a leading molecule addressing osteoporosis. Of course, we have also a rare disease portfolio, which I'd like to spend a few moments on this afternoon, and then I would like to highlight TEZSPIRE, as well as the ongoing progress in our innovative oncology portfolio.
In addition, our pipeline consists of a number of first-in-class and potentially transformative therapies, and we will have a number of exciting opportunities to see data from that pipeline during the course of 2025, and that will be across all four of our concentrated areas of activity from a therapeutic perspective, and we also expect to have more data to share with respect to the differentiated profile that we see emerging from MariTide, our lead product in the obesity area.
We talked in the past about our expectation for our biosimilars business, and I would just simply reiterate today that we are more than on track to double the sales that we had in that business in 2021, more than on track to double those sales by the end of the decade.
So when you think about the outlook for Amgen, it might be helpful for you to have in mind these four areas of activity reflected in the column headings there: general medicine, rare disease, inflammation, and oncology.
And then, of course, to think about the ways in which our inline marketed products, our innovative pipeline, and our biosimilars will contribute to the growth of the business during the coming decade. As I said, I want to start with Repatha, which is our leading medicine for heart disease.
And Repatha is annualizing now at well over $2 billion, and it's positioned for accelerated growth throughout the decade. That growth is being driven by the enormous efficacy of the product, the enormous unmet medical need, and the widespread access now for the product.
We've enjoyed great success expanding utilization in the primary care community, where the rate of adoption by new prescribers has been very rapid, and we're also encouraged by the prospect of a study in primary prevention, which we think can also further accelerate growth for this franchise during the course of the coming decade.
So from heart disease, which is the largest unmet medical need in the world, from heart disease to another large area of unmet medical need, I want to turn our attention next to EVENITY. And EVENITY, of course, is a transformational product for the treatment of women that are at high risk of fracture following menopause or while having postmenopausal osteoporosis, and this is a product which was annualizing at in excess of $1.5 billion at the run rate in the third quarter.
Like Repatha, it's a medicine that benefits from an enormous unmet medical need with many millions of patients in the United States and around the world at high risk of fracture and in need of therapies. The penetration rates for this therapy among those women at high risk of fracture remain low, and our energy will be on doing all we can to help educate payers, prescribers, and patients about the attractiveness of EVENITY as a way to prevent these unnecessary fractures.
From two of the most prevalent diseases, heart disease and osteoporosis, I want to turn now to rare disease, and that's a franchise where we've already established ourselves as a leader. In particular, I want to highlight the four medicines that we have in the rare disease area that are growing rapidly.
Those four medicines include the three biologics from left to right: TEPEZZA, KRYSTEXXA, and UPLIZNA, and then a small molecule called TAVNEOS. TEPEZZA is the first and only medicine approved for thyroid eye disease. We expect ongoing growth from TEPEZZA as we begin expanding internationally.
We're now launching in international markets, and as we broaden our coverage of the market by reaching, in particular, endocrinologists who are seeing patients with low clinical activity scores. So we believe that we will continue to see growth of our TEPEZZA franchise, again, based on the very strong profile of that molecule, based on the international expansion, and longer term, the potential for subcutaneous administration. KRYSTEXXA is also a molecule at an early stage of its life cycle.
It's a molecule that is showing to be very effective in patients that have uncontrolled gout, and we are excited about the number of ways that we think we can extend and improve this medicine for the benefit of patients over the coming decade. I want to talk next about UPLIZNA. UPLIZNA is the number one prescribed biologic that's used for the treatment of neuromyelitis optica spectrum disorder, and this is a product that's being driven by its unique profile as well as the potential for international expansion.
I'll talk in a moment about the data that we generated for this molecule and two potential new indications, those being IgG4-related disease and generalized myasthenia gravis. But finally, in terms of our inline rare disease medicines, I want to touch on TAVNEOS, and TAVNEOS is the only complement inhibitor for a form of vasculitis known as ANCA-associated vasculitis.
And we're thrilled by the rapid growth that we see in prescribers here. It was something like 50%+ growth in the number of prescribers in the last year in the nephrology and rheumatology community. So these are two communities that we know very well, two communities where we've been a leader now for several decades, and we're seeing the benefit of that established leadership in our ability to reach physicians who have patients that are suffering and can benefit from treatment with TAVNEOS.
So we're very excited about the contribution of the rare diseases at Amgen, and I want to just highlight one other particular product before moving to the pipeline, and that product is TEZSPIRE, which is also at a very early stage in its life cycle.
TEZSPIRE grew by 73% last year because of the strength that it is showing for patients that have severe asthma, of which there are more than 2.5 million such patients. And so this is a product that has a unique profile. It's the only molecule of its kind on the market, and it has demonstrated efficacy against a very broad range of patients that suffer from uncontrolled asthma.
In addition to asthma, we've generated data that are very encouraging in chronic obstructive pulmonary disease, and so we're advancing this medicine in phase III studies, again, for a broad range of patients with that disease. And finally, we also reported very interesting data in chronic rhinosinusitis with nasal polyps for this medicine, and our regulatory filings are underway for that indication.
We're very excited about what those data show and look forward to sharing them in detail during the course of the year. Now, having first talked about our inline or marketed products as a source of growth, I want to turn our attention now to what we see emerging from the pipeline, which we also think will be a source of important growth for us during the course of the decade.
Perhaps not surprisingly, I'll start with MariTide, a medicine that we believe is differentiated, unique, and has a very competitive profile for the challenges and opportunities that we see in obesity and obesity-related conditions.
We demonstrated with our phase II study that we were able to generate, with no weight loss plateau at 52 weeks, up to 20% weight loss in patients who are living with obesity and up to 17% weight loss at 52 weeks in patients who were living with obesity and type 2 diabetes.
And I think the thing that was striking to those that are familiar with the field was the shape of the weight loss curve and the fact that, as I highlighted in the slide, we didn't see any weight loss plateau implying the expectation for ongoing weight loss in these patients. And we'll look forward to continuing to share incremental data with you during the course of the coming year. Now, in addition to the weight loss, we saw significant and uniform improvement in cardiometabolic parameters.
We shared the details of this with you previously, but those improved parameters appeared in blood pressure, where we saw, for example, 11 mm of mercury reduction in blood pressure from those that were on the medicine.
We showed improvements in the levels of LDL, decreases in LDL, decreases in triglycerides, and a really profound decrease in HS-CRP, a marker for inflammation, where we demonstrated greater than 50% reduction in obese subjects and greater than 70% in those with type 2 diabetes.
In addition, in patients with type 2 diabetes, we demonstrated a 2.2 percentage point reduction in HbA1c, which had the effect of taking more than half of the patients in that study to below a level of 5.7, which would imply moving their type 2 diabetes into remission, if you will, or to below the level at which they would be considered type 2 diabetics.
We did this with a unique molecule and one that enables us to provide a unique dosing frequency, and that is monthly or less frequent. Whereas all the other therapies are short-acting and require at least weekly injections, we've demonstrated that we can achieve this with monthly or less frequent, and we demonstrated that we could achieve this with GI effects that were generally limited to the first dose, were mild and transient. With respect to weight maintenance, we obviously are intrigued about the potential for monthly or less frequent dosing, and we continue to study that in our ongoing phase II trials.
I would point out that you should expect us to move swiftly into phase III studies, and that means you should expect that we will have plenty to talk about, for example, by the middle of the year when it comes to important conferences in the field of obesity and diabetes.
Now, with respect to MariTide, we think it will address very important unmet needs in the marketplace, needs that exist today and needs that we think will exist when we have the benefit of the phase III data in hand for this medicine. Those needs include significant weight loss with the improvement in the cardiometabolic parameters that I've already highlighted.
We think this is a medicine that will be simple for patients and prescribers to use, simple for achieving a target dose, and has a regimen that will encourage patients to stay on therapy.
I've highlighted the fact that part of the attraction here is that we expect patients to be able to do this with monthly or less frequent dosing, and I would also just highlight that this is a field that has been challenged by supply, and supply is something that Amgen has demonstrated an ability to maintain across our portfolio. It's something that we feel we are ready to do in obesity as well.
Now, shifting from obesity, I want to just highlight one other molecule in our general medicine portfolio, and that's a medicine known as Olpasiran, which has the potential to extend our leadership in the treatment of heart disease. Olpasiran is a unique molecule, one that we think has the potential to be best in class for targeting lipoprotein(a), so Lp(a).
This is an issue which affects roughly 20% of the individuals in our communities, our populations, who have elevated levels of Lp(a), and Lp(a) is not something that can be treated with other approved medicines. There are no medicines that are effective in reducing cardiovascular disease attributable to Lp(a). It's not modifiable with diet or exercise, so it really is an example of an unmet medical need for which a pharmacotherapy or a biotherapy like our Olpasiran is going to be required.
In phase II, I would remind you that we demonstrated that we could reduce the concentration of Lp(a) by more than 95% in patients who had established atherosclerotic cardiovascular disease. In addition, we are running, as you know, a phase III trial which rapidly enrolled, and we will be studying this in phase III trials for primary prevention as well.
We're very excited about what we think Olpasiran represents as a novel approach to treating heart disease, which I would reiterate is the single greatest challenge that we face globally. Moving now to UPLIZNA. As promised earlier, I want to say a few words about this medicine.
Again, even those who follow us closely may not be very familiar with this, so I'll just remind you that this is a medicine that depletes cells that express CD19, and as a result, is a medicine that we think has the potential for broad utilization in autoimmune disease. This has a very convenient twice-yearly dosing schedule. It has shown an ability to enable physicians and patients to taper their steroid use, which is an attractive prospect for patients and their physicians.
It's also a medicine that has demonstrated a safety and tolerability profile that has enabled it to be a leader, as I said earlier, in leading biologic therapy in the treatment of NMOSD. Intriguingly, when we studied this disease in IgG4-related disease, a rare but serious condition for which nothing else has been approved, we demonstrated a substantial 87% reduction in the risk of IgG4-related disease flare at 52 weeks. Off the back of that, or with the benefit of those data, we were awarded breakthrough therapy, and we have an action date from the U.S. regulator of April 3rd of this year.
Also, for UPLIZNA in generalized myasthenia gravis, which is still a rare disease, though perhaps more prevalent than IgG4, we demonstrated across a broad population of generalized myasthenia gravis patients the potential benefit of this approach with efficacy and a durability of response that were intriguing. Our assessment of additional data is underway, and we expect to have that later this year.
And we've been granted orphan drug status for this medicine in the U.S., but again, I would repeat that we're very excited about what we think this represents for patients and prescribers in the area of myasthenia gravis. The prospect of B-cell depletion in a range of autoimmune diseases is something that is gaining public attention. It's something that we've been focused on for a while at Amgen.
Some of you will recognize that we have now two medicines approved for depleting cells which express CD19, and those two are, of course, Blincyto or blinatumomab and UPLIZNA or inebilizumab, and we are studying both of these molecules against a range of autoimmune disorders in a broad phase II trial, and we look forward to having those data and being able to share them with you over the course of time.
Moving to the oncology pipeline, we're very focused on what we think is a unique and differentiated approach to cancer, and of course, that starts with our leading bispecific platform. You, I hope, are now all familiar with Blincyto, which has demonstrated over and over again the benefit of a T-cell engaging approach in eliminating malignant cells that express CD19.
This has now been approved across a range of, in particular, acute lymphoblastic leukemias, and we're excited about the potential to help patients now in front line and at the earliest stages of the disease and hopeful about what we can demonstrate by interdicting the disease process at these earlier stages.
I would point out also that we have an ongoing subcutaneous development program underway for Blincyto, so that for those who wish to have perhaps a more convenient dosing alternative than what's available today in the intravenous form, that that becomes a prospect as well. And then I just briefly want to touch on two other molecules in our bispecific portfolio because they address solid tumors.
The field had wondered for some time whether it would be possible to use T-cell engaging therapies against solid tumors, and we demonstrated unequivocally last year with respect to IMDELLTRA that it is possible, and we did that against a very challenging disease, which is small cell lung cancer.
We're really encouraged by the progress that we're seeing now that this product has been approved and has been launched in the United States and now increasingly around the world. IMDELLTRA gives us confidence not just for the future of small cell lung cancer, a disease where there was precious little innovation over a period of many decades, but also gives us encouragement about what we might be able to do against other solid tumors.
And I would highlight in particular Xaluritamig, which is a medicine very similar to IMDELLTRA, bispecific against a novel target in prostate cancer that is rapidly advancing and enrolling in phase III studies. And as with IMDELLTRA and Blincyto, our objective will be to study this approach in earlier and earlier lines of therapy.
Now, we're not just focused on the immunology of cancer and therapies that harness the immune system to deliver efficacy for patients, but also focused on some novel targeted therapies. I suppose many of you may not recall that we have a molecule called Bemirtuzumab directed against gastric cancer, for which data are expected very soon, and we're excited to see those phase III data because there is a huge need to address what is a growing disease in the world, and that is gastric cancer.
It's also a disease for which significant improvements are required. We hope to be able to deliver that and look forward to sharing those data with you when we have them. In addition, we have our molecule AMG 193, which is a PRMT5 inhibitor being studied across a range of tumor types. We've already demonstrated that it has single-agent efficacy across a wide range of different solid tumors.
And then finally, I would remind you that LUMAKRAS continues to move forward in a wide range of lung and other diseases like colorectal cancer. We're excited about continuing to generate data there to inform what the appropriate way is to use that novel medicine against the G12C mutation. I've talked about our inline medicines. I've talked about our pipeline medicines. I want to just come back briefly to talk about our biosimilars business.
Again, I think it's perhaps not lost on you that this is a business that we entered in 2012 with an objective of establishing global leadership, and I think that's an objective that we have established. You see here listed the medicines that we are already commercializing. You've heard us say that we expect this to be a business that contributes in excess of $4 billion by the end of the decade.
\It's a business that has generated in excess of $10 billion of revenues for us at very attractive returns. And as I said a few moments ago, we've also added to that portfolio a biosimilar to KEYTRUDA and a biosimilar to OCREVUS. We're perhaps proud of the fact that we have a 100% success rate when we take our molecules to the FDA for approvals against biosimilarity.
We're also conscious of the fact that we've been able to supply every patient every time with a biosimilar molecule when they've come asking for one, and that's not something others in the field have been able to achieve, so biosimilars is an area where we expected our 40 years of accumulated expertise would enable us to make a difference, and I hope you would agree that that's exactly what we've shown.
I'll leave behind a slide for you that you might find useful during the course of the year. This is a slide that just simply highlights what the milestones are that we expect to be reporting on during the course of 2025, and then let me just leave you with this slide repeating that we expect to deliver strong growth in the near term through 2030 and well beyond that too.
We expect that growth to come from our inline products, products that have established efficacy, established side effect and safety profiles, and medicines for which the ongoing need remains very, very high. That includes, to reiterate, Repatha in heart disease. That includes EVENITY in osteoporosis.
That includes our four rapidly growing, recently launched molecules in the rare disease portfolio, and also TEZSPIRE for asthma and other respiratory disorders, as well as the innovative oncology portfolio, which, again, was growing at 12% through the first nine months of the year.
Our pipeline is advancing with a number of transformative therapies. I've shown you and shared with you some of the highlights of that. Again, we expect MariTide to be an important contributor to the growth from our pipeline, and then finally, our biosimilars will be a driver of growth as well.
So we look forward to having the opportunity to interact with you in 2025 and to keep you abreast of the progress that we're making, progress that we're confident will include successful, consistent long-term growth. Thank you.
Great. Thanks for those comments.
Thank you.
Just to maybe kick off the conversation here, a lot of focus on obesity and MariTide, to say the least. We'd love just, as we think about Amgen positioning as potentially the third entrant into the market, can you talk a little bit about the commercial hurdles and capabilities that will be required here and how you feel Amgen's prepared to address those?
I think the first thing I would point out is that you use the word third, I would use the word first, will be the first long-acting therapy in the treatment of obesity and obesity-related conditions. Let me just also point out that it's been an objective of the field for many years to have a long-acting treatment option for type 2 diabetics.
There's no long-acting. Weeklies , that's not long-acting. We feel the prospect of being able to offer patients a monthly or less frequent alternative is going to be very attractive. We think that'll be true in patients with type 2 diabetes. We think it'll be true for patients that are living with obesity and overweight. We think it'll be true for the various other diseases that we intend to study in the phase III clinical program for this medicine. This is still very early.
We're at a very early stage of the opportunity for these medicines. And so while we're, it's unusual for Amgen to enter a field behind others, we have built our track record over 40 years on medicines that were first in class, often only in class medicines. But we're very conscious of the fact that we have a medicine here that we think has a unique competitive profile, and we're excited to demonstrate that in phase III trials.
And we recognize that until we have the safety and efficacy data required by regulators, that we can't compete with the molecule. So we're anxious to get those data and to have an opportunity to show patients another way of managing these challenges. And again, if you look at the field today, persistency is a big problem.
And one of the reasons persistency is a big problem is the profile of the other medicines, and in particular, the pharmacokinetic profile and the tolerability issues that seem to travel with that. So again, a long way to go still, but we're excited to have the opportunity to characterize our molecule more fully and to share that with patients and prescribers.
I would just simply also state that the prescribers that we've had the benefit of talking to, that I've had the benefit of talking to, who are active in this field, are like us, really excited about what it represents as a different way to tackle this challenge.
Great. And just building on that, I know you're studying even longer dosing than monthly. What's your confidence in terms of the ability to push this even beyond the?
Let's get the data and then we'll talk. But we've been very clear in our choice of the words, monthly or less frequent, and now let us generate the data and share those data with you so you can come to your own conclusions.
Great. Maybe thinking more broadly about obesity as a portfolio, I know the company's developing 513, just started some studies. Just talk a little bit about how you envision Amgen over time with, and do you need a broad portfolio here to be successful?
I think, first of all, we're going to discover this is a heterogeneous population. I think it's a huge population. It almost boggles the mind to use the number of billion, but it is clearly hundreds of millions and maybe even a billion patients who would benefit globally from therapies that have the potential to do what we think a molecule like MariTide can do.
This is a very, very large patient population, likely to be very heterogeneous. My guess is that over time, patients will be exposed to a variety of different molecules. Again, we'll generate the data in the areas where we have reason to believe by following the biology that we can make a difference to a disease. When we have the data in hand, we look forward to being able to promote the molecules. So far, so good, very exciting.
And I would say early days and a lot of work still to do, but full speed ahead.
Great. Great. Maybe just shifting over to Repatha. We're coming off a very successful 2024. Just talk about how much more runway there is for growth of this one.
There's more than 100 million people whose LDL levels are too high, who are at risk of heart disease, who would benefit from a product like Repatha. Repatha is the market-leading agent for lowering LDL cholesterol through the PCSK9 mechanism. I think it's fewer than two in ten statin users are able to achieve their targeted LDL levels with statins and other oral products alone.
There is still a huge need for more patients to be on this medicine. The opportunity for us is several-fold. I touched on some of it earlier. We saw substantial growth in the primary care market this year with both the number of primary care physicians who are prescribing the medicine and the number of patients they're prescribing it for. We have widespread access now from a reimbursement standpoint.
Finally, we're running a really important primary prevention study, and we hope that that will add to the body of evidence to show that when it comes to LDL, lower is better, and the sooner you get it low, the better.
So again, this has been a labor of love, but it's something we're passionate about. Passionately believe that there are too many people having heart attacks and strokes that could have been prevented if their LDL levels had been maintained at a lower level, and we think we've got the best way to do it with Repatha.
Great. Just on the pricing component of this, you've mentioned the coverage really built up nicely. Can we think about pricing as a bit of less of a headwind potentially going forward for this?
Again, by saying that we have attractive coverage for the molecule now, you can infer that we think we've achieved what's necessary from a pricing perspective to gain widespread access. I think the thing to be a little bit careful about, Chris, is that as we grow internationally, there are different price points depending on where we're growing internationally. So this is a molecule that is taking off globally, and so we may see some of the effect of that over time.
Great. Maybe just pivoting over to TEPEZZA. Talk a little bit about the key priorities for 2025.
Talk about, sorry, the key.
The key priorities for that.
Well, so part of our thesis on TEPEZZA was that with the benefit of our global biologic capabilities, we would be able to take that game-changing medicine for patients with thyroid eye disease and help them out globally. And so one of the markets we were very excited about from the outset was Japan, and I think with good reason.
So the reception in Japan for TEPEZZA has been very enthusiastic. This is a disease which is prevalent, highly prevalent in Japan, and the reaction to it so far from prescribers and from patients and from the payer has been very, very encouraging. So we're expanding in other international markets. And then the other important thing is to begin reaching patients that have the chronic form of the disease.
So for example, in the U.S., that's about 80% of the opportunity, but we know that and we've demonstrated that those patients benefit as well from TEPEZZA therapy, and there's no need for them to wait until their disease gets to the point where they're having to contemplate a very serious series of eye surgeries. So we want to try to continue to educate patients and prescribers and payers about the benefit of stopping the disease before it gets to that state.
So low chronic activity score patients will be a focus for us. And that means we have to reach not just the ophthalmologists, but also endocrinologists who see this in their practice as well. So we're doing that, and we expect we'll see some of the benefit of the effort we've put behind that group of prescribers in the course of 2025.
Great. On Prolia and XGEVA, these are two, we're going to see some biosimilar competition coming in. How are you thinking about the erosion curve and how durable those brands could be post-competition?
They're two different brands, and they'll experience two different competitive dynamics in the marketplace. So XGEVA is used in the cancer setting, and so it's by a similar competitive profile, will look very different from Prolia. But I think what I would say at the highest altitude, Chris, is that we're the world leader in bone health today.
We expect to continue to be the world leader, and we think we will continue to grow in bone health throughout the course of the decade and into the next decade. So we know that we'll face competition, but we've been expecting that for some time. We have some sense for what that's going to look like. And in particular, with respect to osteoporosis, what we've seen is use of our bone-building agent, EVENITY. Now, EVENITY is unique. There's no other product like it on the market.
It both builds bone, but it also slows the resorption of bone. And patients are using that product for a year and then preserving the bone that has been built with Prolia. So we think we'll see the one-two punch continue in the treatment of osteoporosis.
Great. As you laid out in the presentation, very broad late-stage pipeline for Amgen right now. How do you think about balancing investments in those programs relative to margins? I know the company's had a great run on the margin side. How do we think about that the next few years?
Yeah, I would encourage you to think about the margin side as follows, which is what we've said very consistently for the last decade. Our focus is on building an efficient, productive organization. And we worked hard to create what is an industry-leading efficient platform for growth, and we want to maintain that. Now, our focus is not on achieving a set margin.
Our focus is on growing after-tax cash flows through the long term. So we want to invest in those programs that we think can drive the growth in after-tax cash flows. We happen to have a number of them right now. And so with respect to our research and development investment, R&D expenses grow when we have phase III studies enrolling, and especially if and when there are large phase III studies.
So we'll see some of the benefit of investing in these long-term growth opportunities in the margin. And I think we've been pretty transparent about that in all of our communications with shareholders. And I would expect that we'll continue to be.
But I think what the organization understands and what certainly our leaders in the organization understand is that we worked hard to create a leading platform for efficiency. We're not going to give that up easily.
So we don't have any free pass to spend money inside Amgen right now. In fact, the pressure that we feel to fund attractive pipeline programs makes us squeeze and work hard on all the other expenses inside the business to make sure that we're allocating dollars the most effectively, which right now we think is the innovative R&D programs.
Great. I think we're just about out of time. Thank you so much for joining today. Appreciate the comments.
Thanks. Thank you.