Welcome to the first session of the first annual Global Healthcare Conference at Citi. We're thrilled to be here, and we're thrilled to have with us. My name is Geoff Meacham. I'm the Senior Biopharma Analyst, and we have Mary Kate Davis from my team on stage too. We're thrilled to kick it off with Bristol today. So we have CEO Chris Boerner, and we have CFO David Elkins. Welcome, guys.
Thank you. It's great to be here.
Good to be here.
We're going to just do a fireside here for about half an hour. And then, you guys, there's a QR code if you have questions. I have the audience response thing here. I already have a couple loaded, so you're welcome to add that. We can do that at the very end. So I don't know, Chris, do you want to start off with anything kind of high level, how we should think about 2025 from an event or like a strategy perspective?
Sure. Well, look, let's start with 2024. 2024, first year as CEO, and I would say we're happy with where we are. Our focus as a company is on delivering in the short term, but really importantly, setting a foundation for long-term sustainable growth. And we believe we have the substrate to deliver top-tier growth within the sector by the end of the decade. And so it's all been about this year focusing on execution, execution on the near-term drivers of our growth portfolio, but continuing to get that pipeline operating as efficiently and as productively as we would like to deliver long-term value, continuing to focus on financial discipline that David can speak to. And I think you're going to continue to see those themes play out as we get into 2025. But this is a journey.
We've made good progress in 2024 and happy with some of the things we'll talk about here. I know we'll talk about COBENFY and looking forward to 2025.
Yeah, let's start with that. So with COBENFY, you guys have talked about the launch, taking a little bit of time to secure reimbursement and access in a broad way. And I guess same idea with CAMZYOS previously and so SOTYKTU previously. So help us through that process, Chris or David. If you think about, is it possible to—what steps can you accelerate with respect to the launch? And obviously, we can talk about competition too.
Sure. Well, we're incredibly excited about the launch of this product. COBENFY is, we believe, a transformational opportunity in schizophrenia. This is an area, as you know, Geoff, where there's significant unmet need. Patients are typically getting some amount of efficacy on atypicals, but that efficacy carries with it significant side effects, fatigue, and weight gain, etc. And what we love about the profile for COBENFY is you get efficacy on par with the best of the atypicals, but you don't have that side effect profile. There was a lot of excitement around this product in the lead-up to the launch a month ago. And really, the feedback we've gotten since approval has been fantastic. Physicians are very happy with the profile that they're seeing. We've had great feedback from patients. And so as we've thought about this launch, our focus is really twofold. First, drive awareness for this product.
This is a product that, in our view, given the label is clean, if you're a schizophrenic patient, you should have the opportunity to benefit from this medicine. So driving awareness of the efficacy and safety profile is priority one. And then second, as you note, is driving access. This is a very different situation than what you would be experienced with on SOTYKTU, for example. This is a protected class, so this will have to be covered. The question is the quality of coverage. And about 80% of patients with schizophrenia have government insurance, either Medicare or Medicaid. And that's going to take some time to get that coverage locked down. We anticipate we'll have most of the Medicaid programs locked down later this year and into the first part of next year.
And then Medicare will take a bit longer, and we anticipate that by the second half of 2025. So the way to think about this launch is that we'll continue to build scripts and volume at the end of this year into next year, but this launch will really take off as we get into the second half of 2025.
Right. And just given the failure of Emraclidine and I guess the market that you're investing in, does that change your view of, okay, we should go into new indications or geographies? Or does a lack of, in theory, a competitor who's now gone away, like change the view? How do you guys see on a peak basis what the drug could be?
What I would say is in the short term, there's really no impact because remember, we had consistently said that we felt we would have a multi-year advantage over any competitor. In that time, we would continue to focus on driving physician exposure to what we thought was a best-in-class profile for COBENFY. In the short term, really no impact. Certainly, as you look longer term in schizophrenia, for sure, the loss of a competitor provides additional opportunities for COBENFY. With respect to the opportunity outside of schizophrenia, look, we took a very broad view when we acquired Karuna that we wanted to make sure we were developing this where the science made sense. We spent time with the heritage Karuna team to say, what were the programs that you wanted to fund but didn't have the resources to do?
And so we've got a very robust set of lifecycle opportunities for COBENFY. Effectively, you can think about we'll have one additional indication for COBENFY or data play out almost every year for the rest of this decade.
That's fantastic. Okay. Let's turn to the upcoming ASH meeting. So that's in a few, in about a week or so. Give us some perspective on what you think that's going to be the headliners for Bristol, what could be impactful. And maybe at a higher level, with all the launches that you have that are kind of hitting the kind of the sweet spot. I don't hear you guys talk as much about ABECMA, BREYANZI, the cell therapy business. Maybe where does that rank for you guys from a strategy perspective?
Cell therapy continues to be a very important platform for the company, and maybe we can start there as we think about ASH. While it is not a hematologic or oncology indication that we're pursuing, I'll start with CD19 NEX-T because we'll have additional data at ASH. You may remember at ACR just a few weeks ago, we presented very exciting data for that cell therapy program in autoimmune disease. We had a dozen or so patients, including SLE patients, where we saw profound efficacy with a manageable safety profile. And what's particularly exciting with CD19 is we are seeing clear signs of immune reset. We're seeing B- cell depletion, naive healthy B- cells returning, patients coming off of all of their immunosuppressive medicines, including steroids, and staying off of those therapies. So that's very exciting. And so you'll see additional follow-up data on SLE.
And for the first time, you'll see MS data at ASH. So that's very, very exciting. And then as you get into hematology and oncology, look, we've got a number of programs that we'll read out. Staying in cell therapy, GPRC5D, we'll have multiple data sets there in later lines as well as relapse and remitting patients. That data was the bell of the ball at ASH two years ago. So it's nice to see additional data on that program. You'll see data on our CELMoDs , notably mezigdomide. This will be the first PFS data, I believe, that we'll be showing at ASH for mezigdomide. So that's very exciting. And a program that's also a cell mod for us that has really not gotten a lot of attention, we've not talked a lot about it, is golcadomide. And that is in large B-cell lymphoma.
We'd previously shown data for that program, and you'll see an update not only on relapsed patients in large B-cell lymphoma, but importantly, first-line data with our R-CHOP, and so there again, you'll see efficacy and safety data, so pay attention to that one as well.
Gotcha. That's helpful. Let's talk for a second about P&L and sort of expense. David, as you look to next year, and there's a lot of investments both from a pipeline and a commercial perspective that you guys are making. Talk about how you think about the pushes and pulls for 2025 and what that could mean from a margin perspective.
Yeah, thanks for your question. I'll just build on what Chris started. We had two great quarters in 2024 with the growth portfolio growing 20% at a constant currency basis in Q3. And you really saw great growth coming out of Opdualag, REBLOZYL, BREYANZI, more than doubling, CAMZYOS close to doubling. So really good on those brands. So that gives us momentum as we go into next year. And then yet on top of that, COBENFY. We feel really good about the trajectory of that growth portfolio. Remember, that's now approaching 50% of our total business. So you're really seeing what that new company is going to wind up looking like. But we do have some headwinds the way to think about that, as everybody knows that we got more generics coming in on REVLIMID.
So as we think about REVLIMID, we have full generic entry coming in January of 2026. So we think the payer environment will be a little bit different as we go into next year. So we're thinking about that in that $2 billion-$2.5 billion range for REVLIMID. But also, as we said on the third quarter call, we're also facing that generic entry with SPRYCEL, ABRAXANE, and POMALYST. So those are the things, some of the headwinds in this, as Chris kind of indicated as well. On our immunology franchise, we continue to face those rebating pricing pressures. So continue to do that. But we feel good that we're going to get additional access. So we'll see in the first quarter of next year on SOTYKTU how that additional access plays out for it.
But if you look at the business overall, that growth portfolio is just continuing to grow to be a greater percentage of our business, which really gives you that trajectory for the second half of the decade. The flip side of that is the cash flow generation of the business is really strong. We had over $9.5 billion of cash on hand. We're committed to the dividend. But what we saw with our savings initiative, the $1.5 billion savings initiative that we announced earlier this year, we're going to have achieved the majority of that this year, the full $1.5 billion by the end of last year. But what Chris and I and the rest of our leadership have seen through that is there's additional opportunities to get even more efficient with our cost base.
Some of the things, I'll give you two quick examples of that. One of the things that we were able to do is when we did the acquisitions of Karuna, RayzeBio, we brought in an ADC as well as KRAZATI. We needed to fund those phase III programs that were there. We were able to deprioritize some phase III other programs within our portfolio, which enabled us to increase the ROI of the portfolio and shareholder value, but also strengthen the growth profile of the company in the second half of the decade. What we're learning is we find these efficiencies, we can at the same time create shareholder value by investing in higher priority programs and programs that will drive growth more.
And you mentioned the REVLIMID LOE, but when you look to 2026, you have ELIQUIS. I wanted to ask you guys from maybe a policy perspective. I know it's early and we just have several nominations, but is there anything that you guys are thinking about for next year on the policy front that could provide a new sort of wrinkle? I don't think people expect the IRA to, I mean, it's here to stay, but maybe around that, the discounting or is there anything on that front that you guys want to call out?
Our base case is that IRA continues to be here. We were one of the first to go through IRA, so there were a lot of learnings that came out of that for us. But what I would say is stepping back to your sort of more general policy question, look, first of all, it's too soon to say anything about how specific policies may change in the new administration. But what I'm incredibly proud of is the work that we have done to build a resilient company. And that's a resilient company that can thrive under a Democratic or a Republican administration in the U.S. And that's something obviously that we consider globally. And so, look, we are adept at working with either side of the aisle.
Our focus is on building an ecosystem where we can do what we do so well, which is bring first and best-in-class medicines to patients and do that as quickly as possible. And so we'll obviously stay focused on working with the administration. If I step back even one step further and say, as I look at the industry, the industry is pretty resilient. And I look at my colleagues and other companies, we've done a nice job of working collaboratively with Democrats and Republicans. And I fully expect that we'll find common ground and ways to continue to bring innovation to the market. And that's true whether it's BMS or the rest of the sector.
Understood. Let's pivot to some of the opportunities for later this year. PDUFA date coming up, 12/29 for subcutaneous OPDIVO. Maybe how are you looking at the market opportunity here? And could you walk us through the market dynamics of this product?
Yeah, we've been very focused. We have a very robust business in solid tumor oncology today that's anchored on OPDIVO, which is obviously clearly a leader in the immuno-oncology space. And so the way we think about nivo SubQ is that that's one of a couple of opportunities we have to extend that business into the next decade. So nivo SubQ, we've said that we believe we can convert about 30%-40% of that business from OPDIVO to nivo SubQ. And that's going to be our focus. And as we think about the sizing of that opportunity, look, what we've been focused on is where can this product provide meaningful value to patients and to physicians. And it's really the intersection of those two things that led to that 30%-40% of the business range.
Think about indications for OPDIVO where you have an induction phase and a maintenance phase where perhaps patients don't want to be in the office as frequently. In the adjuvant setting where a patient may not need to see a physician on every single visit. That's an opportunity. Then from a physician standpoint, remember, chair volume is at a premium in many both community and academic centers. So we've done some research to say where is chair volume an issue. Obviously having a SubQ administration, which is much faster, less chair time, allows these offices to be a bit more efficient. That's an opportunity. When you marry those two patient and physician benefits together, you get about 30%-40% of our business.
Understood. I guess what kind of feedback are you hearing from the physicians and from the patient side as well? How could this maybe impact their treatment experience?
I think it's very much aligned with what I just said in that from a patient standpoint, look, there are going to be patient visits where you're going to want to see a physician every single visit. You're a newly diagnosed patient. You're on your first few cycles of induction therapy. That's probably less of an opportunity for a SubQ product. However, for patients who are staying on therapy, they're in a maintenance phase, they're in an adjuvant setting, they're in a combination where it's with an oral product, and so you don't need to be there for the infusion of another chemotherapy, for example. Those are clear opportunities where it's in the patient's interest to potentially have a much quicker in and out of the office opportunity. And that's where nivo SubQ can play a role from a patient standpoint.
And then, physicians are very concerned, obviously, particularly in the community setting where there's high volumes about being efficient with how they run their practice. And that's, again, an opportunity on the physician side. And remember, with nivo SubQ, we're going to be ahead of a number of competitors with respect to delivering that modality. And so it's an exciting opportunity. It's an important launch for us. And we're excited with the PDUFA, which we've accelerated that PDUFA from what was originally in 2025 into this year.
Chris, can I follow up on that? So when you look at Opdualag, for example, you're combining a novel therapy with OPDIVO, and that has, I think, a long runway. Is it clear how many years of protection you may get with nivo SubQ? I know there's a lot of uncertainty what payers may do and how CMS may look at it.
Our expectation is that we'll have protection for nivo SubQ well into the 2030s, which is why we think that's an anchor for us to extend that business into the next decade. But more generally, in addition to nivo SubQ, as you point out with products like Opdualag, we're continuing to look for innovative products that we can layer on top of that. So Opdualag, we have a strong business today in melanoma. That's continued opportunity for us in the metastatic setting. And then there are a number of additional line extensions for that product we're very excited to have initiated this year with Rela and OPDIVO in first-line lung cancer. We think there's an opportunity there. And then if I step back even further and look at the oncology business, look, we continue to build out a very exciting late-stage set of assets.
We have initiated or will initiate eight registrational opportunities in solid tumor oncology across modalities, so CELMoD with AR LDD in prostate cancer. Great opportunity. You'll see additional data from that in the next 12-18 months. We are excited about the opportunity with PRMT5, which was a product that we got through the Mirati acquisition and will be initiating pivotal studies with PRMT5 next year. RayzeBio was an acquisition we did in December of last year. RYZ101 continues to progress nicely. You'll see data on that program in 2025 and then expected approval in GEP-NET in the second line setting in 2026. That's exciting, so we continue to build out either through acquisitions, our internal pipeline, or, for example, the partnership with SystImmune where we have an EGFR HER3 ADC program that's also progressing nicely.
Add it all up, that's building on a solid tumor base of business that we hope to be able to extend with OPDIVO and Opdualag well into the next decade and continue to add to it.
Makes sense. Thank you. Yeah, so let's talk about the growth portfolio. You mentioned a couple of the assets on cell therapy, but when you look at Opdualag or SOTYKTU or CAMZYOS, maybe walk us through what the fundamental drivers could be for next year that may be over and above kind of expectation?
Look, I can tell you from a growth profile standpoint, what we're really paying attention to is first and foremost, the launch of COBENFY. This is an area of significant opportunity. There are 1.6 million patients being treated with schizophrenia in the U.S. That translates to over 50 million scripts for atypicals in a given year. So this is absolutely a clear opportunity for us, and our focus is on delivering on that launch as quickly as possible through some of the things we've already talked about. We're very excited about the potential growth that we have with REBLOZYL. REBLOZYL is a product that's growing nicely, both in RS positives and RS negatives. So we continue to see opportunity in the first line. We've maintained quite a bit of the second line business there as well.
And then we'll have a line extension for that potentially in myelofibrosis next year, which is exciting. So that's one to pay attention to. CAMZYOS is another one. CAMZYOS is an incredibly important product for obstructive HCM. We've seen very nice consistent growth for that product, and that's going to continue. Next year, we'll have an additional indication in non-obstructive disease. So that's a product that will continue to be important. A fourth product I would highlight is BREYANZI. You mentioned our cell therapy platform previously, and as David said, cell therapy is going to continue to be an important modality for us. BREYANZI, clearly, has a best-in-class profile relative to competition today. We've seen very nice growth quarter-over-quarter this year, and we're going to continue to see nice healthy growth for that product.
Those would be a number of the products that I would stay focused on for 2025.
You just mentioned, from a looking external as well as in-house investments in oncology, but really across the business. Talk a little bit about the kind of capital priorities. Where would you put BD? I mean, probably I suspect more bolt-ons, but where would you put that in terms of the priorities for 2025? Is it more debt pay down versus how do you balance that?
Yeah, the first thing is we've been really focused on integrating the deals that we closed at the end of last year, and we're pretty much through those integrations now. So that was two is COBENFY. We got to make that a completely successful launch and doing everything we can to accelerate those phase III programs. But then as we think through it, paying down that debt is critically important to us to strengthen our financial position. And we're well on our way. We've done over $6 billion of the $10 billion that we plan to do by the first half of 2026. And as I said, we have a very attractive dividend and continuing to pay that dividend we know is really critical for our shareholders. But at the end of the day, business development is core to what we do, bringing in innovation.
We know not all the best innovation is going to be coming from one company. You have to constantly be looking externally, and as Chris said, we're looking to do partnerships, bolt-on acquisitions to continue to bring in really innovative scientific medicines that will address unmet needs in the therapeutic areas where we have expertise, so you should continue to expect that we'll do those types of deals.
When you step back and think about what we've tried to do over the course of this year is lay out how do we deliver in the short term, but build the company and establish the foundation to drive top-tier growth by the end of the decade, and the building blocks for that are the existing growth business that we have with the growth profile, making sure we're delivering on that.
We talked about some of the products that I think are particularly important in that business. But given the growth we've seen with that business over the course of this year, that's going to provide one leg of the stool, if you will, for what that foundation looks like at the end of the decade. We spent a lot of time this year on R&D productivity and efficiency. You don't get long-term growth unless you have a highly functioning R&D engine. And so that R&D engine is going to begin to deliver key catalysts, really starting with the launch of nivo SubQ later this year. We'll have PSA data for SOTYKTU, but the catalysts just start coming in 2025 and then particularly late in 2025 and 2026.
And as those catalysts read out, the second leg of the stool for the growth at the end of this decade becomes clear. And then we've been very focused this year on ensuring we've got a very solid financial basis for the company because that gives us strategic flexibility to continue to do what we've always done as a company, which is bring in exciting innovation into the company from either partnerships or acquisitions externally. You saw us do that in December shortly after I became CEO. And we're going to continue to focus on areas where we feel we have a right to win and bring in innovation like with COBENFY. And that's the third leg of the stool. And so as we look at it, we've made good progress along all three, and that's going to be our focus for 2025.
When you look to the ELIQUIS LOE, I know there's been some investor dialogue about potentially setting sort of trough EPS guidance and what maximum impact is there? What informs you guys thinking about that?
I'd say first, there was a lot of focus on what the IRA was. And really the worst-case scenario for IRA came off the table. So that's why we provided guidance for ELIQUIS in 2026 and 2027. And then generic entry comes in 2028. It's full generic entry in April of 2028. But still, that's two or three years out there. And in this industry, providing long-term guidance when you got changes in administration, you just have natural risks with the business that we do with clinical studies. We're just focused on providing guidance in the near term. Like we typically do on a fourth quarter call, we'll provide guidance for the following year.
Our focus is on making sure that we can provide investors guidance on things that we have clear line of sight into, where you can hold us accountable for delivering against that in much the same way we're holding ourselves accountable for delivering against that, and in this industry, I think that lends itself much more to shorter-term guidance, and that's going to continue to be our focus.
Yeah, we talked a little bit about updates expected from your growth portfolio, but maybe looking at the pipeline specifically here, what key updates over the next, say, like 12, 18 months would you highlight as impactful to your story?
Well, so this is a continually expanding list of things. And so David, you should feel free to highlight. Look, starts this year. We've got the launch of nivo SubQ that we've talked about. We've got two PSA studies for SOTYKTU that we've accelerated into this year. They were originally scheduled for 2025. So those will read out, we expect, by the end of the year. As you get into 2025, you can think about it in terms of registrational opportunities and additional data flow. Registrational opportunities, three big ones to focus on. Non-obstructive for CAMZYOS that I mentioned earlier, myelofibrosis for REBLOZYL. And then importantly, we'll get adjunctive schizophrenia data for COBENFY. That's combination use. So that's one of a string of additional indications that will be coming for that product.
And then we'll have additional data flow for GPRC5D, for CD19 NEX-T, for RYZ101 next year, just to name a few. And then we'll be initiating new studies in areas like PRMT5, as I mentioned earlier. Then as you get into late 2025 and 2026, a slew of additional key catalysts. These are registrational opportunities for Milvexian in acute coronary syndrome and secondary stroke. You'll have additional opportunities for LPA1 in IPF. We've got an opportunity for SLE for SOTYKTU. We have two studies that we'll be reading out in 2026. As you switch over to oncology, GPRC5D will have registrational opportunities there. Mezigdomide and iberdomide, both of our two CELMoD programs will read out. And then what am I forgetting?
I think you covered it.
Yeah. So it's a good thing, but if you really think about.
Oh, additional opportunities for COBENFY. We have for Alzheimer's disease psychosis. And what's exciting about that one is that data readout is important. It's a big opportunity in and of itself, but that's a leading indicator into additional Alzheimer's indications for cognition and agitation, which will come in subsequent years. And then we've got bipolar and autism coming thereafter. So it's a string of additional indications that will read out in 2025 and 2026, as well as into 2027.
Remember, four of those are new entities, right? So you think through milvexian, you think through LPA1, and then Iberdomide. These are new compounds that are going to be coming to the market. So we're really excited. And to Chris's point, that gives us a lot of depth for growth going forward. So in business development, we see it as an opportunity to layer on top of that.
Just to add on to that, so an investor question, when you look at Bristol's presence in neuroscience, COBENFY is obviously a foundational piece, but is there a desire to add more assets to neuroscience to make that a much bigger part of Bristol, or is it, let's take COBENFY, let's see where it goes with that, and then we'll sort of earn the right to do more neuro type of deal?
Well, if you go back to when we did the Karuna deal, initially our thinking was that that would be a bridge from neuropsych back into our neurodegeneration portfolio, which is a bit earlier in development. And so when you had an indication like Alzheimer's disease psychosis, that was the bridge. What I think has been very clear is that there's a real opportunity for us not only in neurodegeneration with that earlier pipeline, but also in neuropsych. The level of excitement for COBENFY in the neuropsych space has just been profound. And what's clear is there's a meaningful opportunity given the significant unmet need. And frankly, the leadership position, we have the opportunity now to carve out for ourselves in neuropsych to continue to see that as an opportunity as well. So very much so, we're interested in building out the portfolio in both neuropsych and neurodegeneration.
And just to follow up on that, Chris, when you look at the therapeutic areas at Bristol, there are some that you're not in, for example, like metabolic, et cetera. Are we at a point where let's get the integration done and let's focus on the current TAs? What's the capacity or the bar, I would say, to add a new TA?
Let me first say that our primary focus is going to continue to be on those areas where we have a very clear right to win today. Think about solid tumor oncology, clearly an area the company has a long history in. We've talked about. We've got a nice foundation of existing assets today or soon to launch assets, and then a very nice and growing pipeline of new assets. That includes, I would say, if you think more broadly in oncology, hematology as well. Oncology is one area. Clearly, we have a focus on cardiovascular disease as a company. That's, again, an area the company's been in for many, many years. We know the space well. We've got ELIQUIS and CAMZYOS today, but exciting, again, follow-up opportunities with CAMZYOS as well as milvexian. That's an area that we, of course, know well.
And then, neuroscience, we've talked about. Immunology, our focus is going to continue to be on assets that have transformational potential, which is why we like CD19 and the opportunity to fundamentally reset the immune system. So within that area, we're going to be very targeted on where can we play to win in areas where we have transformational potential. Beyond that, with respect to metabolics, what I would say is, look, the company has been in areas very much related to metabolics. We're not in that space today, but it's an area we're going to continue to watch. And obviously, we'll see how the science continues to evolve. And our focus, though, is going to be for looking for transformational opportunities where we have a right to win.
As a follow-up to that, just an investor question, when you look back at the Celgene acquisition and the integration, what would you say were some of the maybe strengths and weaknesses? And when you approach BD going forward, does that give you sort of a new analytical kind of knowledge to integrate a large deal like that looking forward for future BD? I'm going to start.
Yeah, I'd say first, from a synergy perspective, what we laid out there, we more than exceeded. If you remember, it was a little over $2.5 billion, and we went beyond $3 billion. So that gave us. We built the muscle there to integrate really well. And if you think, we learned with MyoKardia. We got really good. With Mirati, we got very good. And you think about what we've done with Karuna. So from an integration perspective, this gave us those capabilities. I think we all know that adding to your LOE profile is something that you got to really think long and hard before somebody ever does anything like that. And that was a lot of the debate around Celgene at that point in time.
But if you look at what came out of that pipeline and the products that are in our growth portfolio today, you think about the cell therapy business with BREYANZI and REBLOZYL, we got some really important assets that came out of that that are important growth drivers for us. And iber and mezi as well, with those registrational readouts coming in late 2025 and in 2026. Again, those are really important growth drivers for the company as we go forward. But I don't know if there's anything you want to add, Chris.
The only thing I would say is just if I look at the lessons that we've learned since I've been at Bristol, I've been here now 10 years, I would say our primary focus when we do business development is how can we credibly drive shareholder value.
So the way you're going to drive shareholder value is first, find those opportunities where we believe that we've got opportunities for commercial arbitrage, where we can deliver more than the street and investors think that the existing asset in our hands, we can deliver more than if an opportunity were an independent company. The other way you can do it, of course, is through R&D arbitrage. And if you look at the Karuna deal, what we did with that asset is say, you know what, the Karuna team was thinking about developing these in specific indications. We actually think the science is compelling beyond that. So we added, for example, indications for Alzheimer's cognition and agitation. We added the opportunity for autism. These were indications the Karuna team was looking at, but didn't have the resources to fully expand on.
Right after we announced that deal, we sat down with that team and said, Is there more we can do with this asset? And in that way, either through commercial arbitrage or R&D arbitrage, you can start to think about driving shareholder value. What we've learned from Celgene is if you do a deal, how you integrate that deal becomes super important. And so in the case of Karuna, we got that team integrated as quickly as we could because we had a limited amount of time in order to prepare for the launch of COBENFY from when we closed that deal in the first quarter to when we launched a month ago. So getting that integrated and integrated quickly was super important. On the flip side, we're keeping the heritage Rayze team largely together.
When we acquired that platform, that platform carried with it expertise that we needed to keep within the company. So we decided to integrate that in a very different way. So the agility to how to do these deals and how to integrate them in the company is something we picked up from Celgene.
Gotcha. And last question from an investor, just on milvexian. We mentioned that sort of in passing, but help us with kind of the bar, how you view the bar for success, maybe your assessment too of the competitive landscape, and perhaps what are line extensions even beyond what you guys have talked about through ACS, et cetera.
What we're focused on right now is we've got three parallel studies running. We've got AFib, ACS, and secondary stroke. Those studies continue to enroll very nicely. Our focus, again, is on accelerating where we can. What we like about all three is, first of all, we've got compelling data from phase II for ACS and secondary stroke, which gives us a lot of confidence in that. Coming out of ESC this year, we had a lot of conviction on the opportunity that we have in AFib. There had been some question given a competitor that had failed in that area. We had always felt that the competitor study had been underdosed. One of the advantages of being in areas you know very well is you know how to do really good drug development in that area.
We felt that was being applied to the case of milvexian and AFib. The opportunity there is now that we will be the only oral product with a Factor XIa in that space is quite significant, and so we look forward to seeing that data play out as we get into late 2026 and 2027, but that's a really significant opportunity for us. It's an area we know well and we're excited to see the data play out.
Fantastic. Thank you very much, guys. It's been our pleasure.
Thank you.
Thank you.
Thank you.