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J.P. Morgan 42nd Annual Healthcare Conference 2024

Jan 8, 2024

Chris Schott
Managing Director, JPMorgan

Good afternoon, everybody. I'm Chris Schott at JP Morgan, and it's my pleasure to be hosting a fireside chat today with Albert Bourla, Chairman and CEO of Pfizer. So Albert, happy New Year. Thanks for joining us.

Albert Bourla
Chairman and CEO, Pfizer

Happy New Year.

Chris Schott
Managing Director, JPMorgan

I know you want to make some quick opening remarks, and then we'll jump right into the conversation from there.

Albert Bourla
Chairman and CEO, Pfizer

That would be fantastic. First of all, I was instructed that you should all read very carefully this statement here. Legal insists on that. But, I wanted to make a few comments before we go into the questions.

Chris Schott
Managing Director, JPMorgan

Perfect.

Albert Bourla
Chairman and CEO, Pfizer

So clearly, 2023 was not a good year for us. We missed our internal projections, and also we missed the expectations of the Street. And the miss was predominantly in COVID, but also we didn't impress very much with the commercial performance of the other products. We were a little bit behind. And clearly that was shown in our stock price performance, that was very, very bad. That hurt a lot. You can imagine, first of all, it's not coming to this position from a position of mediocrity. We used to be the stars of the industry for a few years, so that drop really hurts. Also, we're not used to it. I'm five-year CEO. We have 19 earnings releases under my watch.

17 of them, we have beat Bloomberg estimates in EPS. 17 of the 19. And actually 13 of the 17, we also beat revenues, so it was a high quality beat. So for us, comes as a very big surprise, and actually came also as a year that, I don't say we want to forget, but, a year I want to remember that will never repeat again. However, I want to emphasize that because of all this, bad taste that the drop of the stock created, there were a few good things that happened in year 2023 that, maybe were lost in translation. Number one, it is Pfizer affected the lives of 600 million people in the world.

I don't think in our estimations that there is any other company that has this broad reach of consumers and patients as Pfizer, and particularly if you multiply that with the brand equity and the awareness of Pfizer, I think that creates a very unique connection with the consumers that can be a very strong asset in our hands. The second is, despite the fact that we had to take write-offs and returns and all the things that you all know with COVID, we will end up the year probably the number one pharmaceutical company in terms of revenues in only pharma business. Clearly, we were the top one year to date, period nine, which is not given. We used to be number four before COVID, and we jumped to number one position.

Third, and even more important, I would say, it is that 2023 was a record year for FDA approvals for Pfizer. We had nine approvals of nine new molecular entities. We had numerous more approvals because we had a lot of new claims in already approved products, but nine new molecular entities, which is three times the size of the second one, and that's a very productive research year for Pfizer. Last but not least, we closed Seagen acquisition. In the political environment that we are all living, I think being able to close the Seagen acquisition with very minimal commitments

demonstrates our ability to navigate a very complex legal and political system in an effective way. Now, in addition to all of these things that were good things, clearly, we realized that things are not doing well with our stock price already in the middle of the year, and we clearly tried to understand what is the driver of the stock price so that we can take some corrective actions. And, we did a lot of things to fix what we thought was the problem so that we can come in year 2024 with a clean slate. We realized that one of big overhang of the stock performance is the COVID uncertainty. For many people, COVID uncertainty means how many people will use the vaccine, or how many people will use the treatment. For us, it was way more complex and actually scariest, if you think about it.

We had multi-billion-dollar contracts with multiple governments in the world, but suddenly, although they were signed, they had second thoughts if they want to honor them or not, because they are governments. So one of the most famous of that was in EU. So we were able to negotiate and resolve each one of them.

So now we have a clean slate, and we have constant, very predictable supply over three, four years that gives us basically the lion market share in these countries for the years to come. A second uncertainty that was not maybe in the eyes of many people was that COVID needed to go to many countries from a government business into commercial business. That meant significant different pricing, and you all know the price differences. That requires significant access discussions and requires significant, careful moves so that you will not create the public center. We're able to do both in Paxlovid and in Comirnaty.

We launched with the new prices in the U.S. in Comirnaty, and we launched with a new price of Paxlovid in the U.S., and not only launched, but we have secured more than 95% of lives, commercial lives, access next year for Paxlovid with a small co-pays.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

The third thing that was overhanging in stock uncertainties was a lot of stocks that existed already, particularly in the U.S. with Paxlovid, that could take maybe two years for to be exhausted, that could lock us out of the market for many years. So again, that was resolved with very careful negotiations with the U.S. government in a deal that was very favorable for them and for us, and for the taxpayers, and for the public health, and that issue is now behind us. And the fourth, of course, we had a lot of stocks ourselves because we had built stocks to save the world, and the world didn't need them.

So we made sure that within the year 2023, we took all the right adjustments so that we can write off everything that is not going to be needed, so that we can come in the COVID business with a clean slate. So all of that was COVID-related. So it's not simple how many people will use the vaccine, but there were a lot of things that we had to remove. Right now with COVID, every person that is using the vaccine, we know the price and we know the market share that we are getting. Now, in addition to COVID, we understand that a big overhang on the stock price was that our cost base, if COVID is not as we thought it would be, and probably it was not, as you can see, obviously, it's very high.

So we came to also address that with very high sense of urgency, and to announce the cost adjustment plan that had $3.5 billion reductions. We upgraded those projections to $4 billion reductions in the beginning of the year. Already, we started implementing in next year, and right now everybody knows what is in Pfizer, if he's in or out, based on this new cut program. Last, but not least, I think what we had to do was to enhance the commercial structure.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

Seagen acquisition gave us an opportunity to create a new business model. And we were not very happy with the performance of our commercial operation, particularly outside the U.S., where we had a decline compared to double-digit growth in the U.S., in international developed markets. So by splitting the business, which is very big, we think we have now way better conditions to start the year. So all of that was done in year 2023. So on January first, we start executing. And if you can go to the next slide, please. I just want very briefly to say what investors should expect from Pfizer as priorities for the year to come, 2024. Number 1 is the obvious for all. We just completed a major acquisition of Seagen. Will it give us the opportunity to achieve world-class oncology leadership?

Our research in oncology overnight with the acquisition of Seagen is doubled right now. We have exactly double the resources. The commercial presence is 1/3 larger, for Seagen, three times means in the commercial. The very important thing for Seagen was the way that we did the integration. Right now, 50% of the people of the new Pfizer oncology research group are coming from Pfizer. 50% of the people in the new Pfizer oncology group come from Seagen. We have a leadership team that is driving the new oncology business unit. nine members are reporting to Chris Boshoff. five of the nine are coming from Seagen, four are coming from Pfizer.

We believe that because the integration was done in a way that we're able to inspire people from Seagen to join us in a common vision, how to run the new Pfizer oncology, that will deliver on the promise of becoming a world-class oncology leader. Second priority, Pfizer launched more products than any other company has ever done in the history, and what is also first thing for Pfizer, we never launched as many products. It's extremely important to get it right. So priority to maximize the performance of the new products is paramount for us, and we have set all the right commercial structures in place and many other things that you can't see, but we are doing underneath, so that we'll be successful. Deliver in the next wave of pipeline innovation. I'm sure you ask a lot of questions about it.

We need to expand our margins, and the first thing in our effort to expand our margins comes by adjusting our cost, our cost base. We have announced a $4 billion cost base program in a guidance, that everybody recognizes that it's a guidance, that it is reliable and conservative. So which means that we feel comfortable we will achieve the cost reductions that we have promised. And last but not least, I want to emphasize that a lot of investors were penalized this year with Pfizer. We were not happy. I want to make sure that they all understand, first of all, that we are very sensitive to that. Secondly, that our capital allocation will continue being a investor-friendly capital allocation going forward. Number one priority for capital allocation, it is growing dividend. Sacred cow, that will not change. Number two priority, it is to deliver.

We are going to pay back a lot of this debt in the next one and two years. Number three priority, it is to allocate, after we do those two things, the business between growing the business and buying back shares. And of course, the first periods of my tenure was always we didn't buy back shares, was investing in the business. This is what needed to be done so that we can cover the gap of the LOEs. Now, we have done it and we are moving. So in essence, you should expect 2024, after all the changes and the setup that we did in year 2023, to be a year of execution. We think we did the right steps to execute, but the proof is in the pudding. So quarter after quarter, we need to deliver, and we will be here hopefully next year.

Chris Schott
Managing Director, JPMorgan

Excellent. Well, appreciate those opening comments.

Albert Bourla
Chairman and CEO, Pfizer

Thank you.

Chris Schott
Managing Director, JPMorgan

Would love. So we're fresh off the 2024 guidance call, and I just want to talk a little bit about the company's approach towards setting expectations for this year. In particular, it seems like you guided to a lower COVID number than maybe what the company is expecting internally. So maybe just talk a little bit about how you thought about approaching guidance this year, and maybe how the guidance stacks up against maybe an internal base case for the business?

Albert Bourla
Chairman and CEO, Pfizer

Clearly, I cannot say how it stacks in terms of internal or external expectations, but it is a guidance that we think is very reliable very achievable, and clearly will be the base case. We did speak about COVID, and we spoke that we don't think that the utilization of COVID products should be different this year, in 2024, than last year. Those people that they did get the vaccine in year 2023, were people that despite the fact that there was COVID fatigue, or there was anti-vax rhetoric, et cetera, they feel that there is a need, the value to vaccination. So those people will do it also, again, if not more, right? Next year. Our guidance doesn't assume that all of them will do it.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

It's more conservative. That's true.

Chris Schott
Managing Director, JPMorgan

I guess to the extent that you see a COVID franchise that outperforms this base case in 2024, should we think about that revenue largely flowing to the bottom line once we adjust for, you know, the profit split, et cetera? Or would you look to reinvest that upside back into-

Albert Bourla
Chairman and CEO, Pfizer

Particularly for COVID, but for any other product-

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

If we exceed expectations, the entire thing should fall into the bottom line.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

The only exception is the cost of goods.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

All, everything else should fall into the bottom line. We are not going to. Our cost base is not going to be higher in terms of R&D or SI&A, because we do better in COVID.

Chris Schott
Managing Director, JPMorgan

Okay, great. And the other, I think, gross margins were the kind of big question we've all been grappling with as we kind of digested the guidance. Can you just elaborate what's contributing to maybe a lower gross margin than I think the street would have anticipated based on the components of your business this year? And, you know, beyond even this year, then, how do we think about gross margins progressing once we look beyond 2024?

Albert Bourla
Chairman and CEO, Pfizer

There are several items, but I would say the most impactful. Last year, we had an infrastructure that delivered way higher revenues, right?

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

Particularly on COVID, more than double. Right? In terms of revenues. Right now, those revenues are not there, so the same cost base is allocated in way less revenues. That improve. That, let's say, improves the cost of goods and reduces the margin. It's not that because we are anticipating, and we forecasted less revenue, that we kill the infrastructure that can produce more-

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

in case that the demand is there. So this is there. Even if we wanted to do, it takes time to do that. Couple of years, right? But right now, we keep it intact so that we can deliver demand, even upside, so some. The second thing it is that, we have a lot of new launches, and typically, the new product that are disproportionate amount compared to normal, right? The new products that are coming always with lower, let's say, margin, because the yields to manufacture them are improving over time. And also, you set the infrastructure to manufacture them, but then you start with lower volumes. So also that will improve. But also, let's underestimate that there is inflationary pressures that improves a lot of the cost, let's say, entries-

in our business. We are going to take care of a lot of these things, and of course, we will try to make sure that we optimize our manufacturing network. We are using our purchasing power to reduce cost, but right now it's a guidance that it is, I think, reliable and okay.

Chris Schott
Managing Director, JPMorgan

As I think about those components of the, maybe the COVID franchise and the underutilized capacity versus the new product launches, is the gross margin dynamic? Is it skewed more towards COVID, or is it skewed more towards the, the new product piece of it?

Albert Bourla
Chairman and CEO, Pfizer

I think COVID is a bigger component of that.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

But I wouldn't underestimate also the new. Also, some of the new products, keep in mind that for Nurtec, for example-

Chris Schott
Managing Director, JPMorgan

Yeah

Albert Bourla
Chairman and CEO, Pfizer

It's a lot gross to net. There are a lot of rebates in the categories. So also that affects a little bit.

Chris Schott
Senior Analyst, J.P. Morgan

Okay. And then off of the. I guess maybe one last question on that. To the extent the COVID business, I guess, doesn't normalize to some degree, is that infrastructure that over a couple year time, you could start to normalize, or is it too early to talk about that?

Albert Bourla
Chairman and CEO, Pfizer

No, this is, first of all, in a hypothetical-

Chris Schott
Managing Director, JPMorgan

Yeah

Albert Bourla
Chairman and CEO, Pfizer

question, and you know, COVID could go lower. COVID could go higher. And the same is with other products as well, right? So clearly, we should be able to adjust based on whatever happens, and that's what a dynamic business should be doing. But I don't anticipate right now something other than being able to gradually consolidate the infrastructure on COVID, because you had built billions of doses, and now it is a smaller number. All the changes that needed to be done to go into year 2024 has been done.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

It's purely a year of execution for manufacturing, research, and commercial.

Chris Schott
Managing Director, JPMorgan

Great. And then bigger picture, as I kind of just think about the growth algorithm for Pfizer looking beyond 2024. So it seems like you set a, what seems like a very conservative, very achievable kind of baseline this year. But can you just talk about how we should think about top-line growth and margin progression over time as we kind of think about the longer term, model at Pfizer?

Albert Bourla
Chairman and CEO, Pfizer

Let's say, on the top line, which is so important in pharmaceutical industry, right? There is one thing that it is certain, some products will lose a LOE. Those products, when we measure them, they are coming to approximately $16 billion-$17 billion of revenues that they're going to lose from 2026, 2027, 2028, 2029, all the way to year 2030, right? This is why we try to deploy a lot of capital to acquire projects or products that will deliver revenues in year 2030 to cover this gap. We deployed $72 billion of capital, and we bought what we estimated, $20 billion of 2030 revenue right now. The street is very close to that.

Right now, the street, when I count the business development that we have accomplished, they are $19 billion, and they haven't adjusted yet the reason for the new successes of Padcev, et cetera, but we'll bring it 20 and plus, I think. So that there's a strong consensus that Pfizer will lose 26, and through the new business development that has accomplished, will deliver minus small growth.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

into that. Now, we are launch- we launched, not we are launching, we launched, basically, all 18 new products already within the first months of this year. We estimated that these 18 new products will provide $20 billion of revenues. The Street is very different. The Street estimates that instead of 20, it's almost $13 billion of revenues that we will make with those 20 products. And the truth is that we didn't impress with all of them in our new launches. So we have work to do to be able to bring this number, if not at, very close to what we estimated at $20 billion, which is, again, the corrective actions that we are taking right now to be able to accomplish that. But even if we do the $13 billion plus the differentiation between LOE 16 and Seagen and business development

Chris Schott
Managing Director, JPMorgan

Yeah, yeah.

Albert Bourla
Chairman and CEO, Pfizer

20, I think we have just with the products that we are launching and we have acquired a healthy opportunity to have top-line growth. Of course, to that, you need to add anything from pipeline that is coming out.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

Of course, it's not only about growing the top line, it is also growing the bottom line. I think in our business, growing the top line is a very good predictor of growing the bottom line, because you need really to mess it up, not to have a leverage down the road. But there are a lot of levers that we plan also to do, and that's why Dave Denton, our CFO said that we plan to bring, over time, the margins to pre-COVID. margins of Pfizer, and we think we have a path to do it.

Chris Schott
Managing Director, JPMorgan

Okay. And then the timeline on that, is that kind of later part of the decade? Is. How many, how many years until we kind of think about those type of margins?

Albert Bourla
Chairman and CEO, Pfizer

I have been burned giving predictions

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

In previous years. So allow me if I will be

Chris Schott
Managing Director, JPMorgan

Fair enough, fair enough.

Albert Bourla
Chairman and CEO, Pfizer

a little bit less, talkative.

Chris Schott
Managing Director, JPMorgan

Okay, perfect. Maybe moving over to the pipeline. Maybe just first on the cost kind of cut piece before I get into the specific products. I guess, how much of the $4 billion came from R&D? And I guess, how did you go about prioritizing what within the R&D portfolio stuck around and what was maybe impacted by that?

Albert Bourla
Chairman and CEO, Pfizer

I will be very transparent into that.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

From the $4 billion, that is all Pfizer, nothing Seagen, 70% comes from R&D.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

So $2.8 billion is approximately from R&D, $1.2 billion from SI&A. However, following the acquisition of Seagen, we didn't take any cuts in the Seagen R&D, so that added $1.5 billion. So right now, Pfizer, I will give you two numbers just to assess our ability, why I feel very comfortable that R&D will have enough resources to thrive, not to do well, to thrive. Our guidance for this year, after we take out the $4 billion, is $11 billion-$12 billion of R&D. The absolute number of R&D is one of the highest in the industry. So just to make sure that we are not starving anyone. Also, to give a comparative to Pfizer, in 2019, when I took over, Pfizer's R&D was $7 billion. Now it's $12 billion, so I don't think anyone is suffering in R&D.

right now with Pfizer. The fact that we are reducing and still maintain that high makes me feel more comfortable that we'll be more productive on R&D, because the way that you are reducing, it is by taking out the least productive parts of R&D, including projects or divisions that are not very productive. So I think we will have very sizable and more productive R&D machine going forward.

Chris Schott
Managing Director, JPMorgan

Great. Danuglipron and the obesity category in general has been at top of mind, I think, in terms of the R&D discussion. Maybe just put some context around the data that you, released in December in terms of, the profile you have with Danuglipron and just your expectations from here on that, on that opportunity.

Albert Bourla
Chairman and CEO, Pfizer

Yes. I will be a little bit careful, particularly with the obesity, because it became very material event for Pfizer-

Chris Schott
Managing Director, JPMorgan

Yeah, yeah

Albert Bourla
Chairman and CEO, Pfizer

without knowing that it could be. Let me start by the obesity opportunity in general.

Chris Schott
Managing Director, JPMorgan

Great.

Albert Bourla
Chairman and CEO, Pfizer

I think it's a great opportunity. Obesity, the science has matured enough. GLP-1s are fantastic molecules, and they are not the only ones. I think they are unlocking a very big opportunity, so there is craziness right now in the market with that. I don't think it's without merit. Maybe it's a little bit over... Well, but there is opportunity there. Obesity is going to be a big market, period.

Pfizer will play in the market. Why? Not because it's big, but because it's big, and I think we have the capabilities and the right to play and win. Metabolic diseases was always a big strength of Pfizer. We are having very strong groups. Let's not forget that Pfizer had the first GLP-1 orals. They didn't do well, but we had them, and we had them because we had people that developed them, and they worked on them. So I think the capabilities, we have them. Now, in terms of assets, our leading asset was lotiglipron. If that would be successful, we would be in a very different place with the stock price right now-

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

Because that would be the first oral, very strong, once-a-day molecule that would appear in a world that obesity sells a lot. Unfortunately, liver enzymes were elevated. We had to kill it. With Danu, we presented the data. Tolerability was not good, and I think we also didn't design well the study.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

Frankly, because we had the, we didn't allow step down in a dose. If you see the studies, for example, of Lilly. When you go to a higher dose and you don't tolerate it, the protocol allows you to go back to the previous dose. In our study, the protocol didn't allow you to do that, so it was very, very high, the criteria, right? So as a result, if you couldn't tolerate it, either you had to suck it up or to exit the study, and that didn't work well. So that's one. But the efficacy was competitive.

We are very careful with that because at twice a day is not viable, so we are not planning to go into a phase III before we see the totality of the data. And the totality of the data means we want to see particularly how we are doing with extended release. So for that, remains to be seen. Data will be seen the first half of the year.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

We have in the clinic right now, two other molecules with humans. The first one we announced that it is a GLP-1 follow on, and the second one, we didn't announce the mechanism of action, for competitive reasons, because it's getting very competitive right now. But we do have one in the clinic, and we have a lot preclinical.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

It's an area that we are watching, and we are looking around like everyone else, and we have our own assets that we are progressing.

Chris Schott
Managing Director, JPMorgan

So this is an area you're still very much focused on as a company?

Albert Bourla
Chairman and CEO, Pfizer

It's an area that we will continue to focus.

Chris Schott
Managing Director, JPMorgan

Yeah. Excellent. Outside of Danu, can you just, you know, pipeline new assets, what, what are you most excited about, and maybe where do you see the biggest disconnect between Pfizer's expectations and where The Street is?

Albert Bourla
Chairman and CEO, Pfizer

On the disconnect with. First of all, I said that the biggest disconnect it is in the products that we are launching-

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

not those that we bought. Within those products, when I see one after the other, I think The Street is severely underestimating the Elrexfio, which is the elranatamab, the multiple myeloma product.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

We have way higher, let's say, projections for that, what The Street is having. I believe, on The Street, probably, and you know, you, you are The Street. You know about it, right?

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

One, it is, it's allocating right now the potential only to the current existing indication, which of course is a small one, is a triple refractory. But I think they are missing two things. One, it is that, the data that we have presented, that demonstrates better significant efficacy advantages compared to competition. And also significant convenience. The twice a month. Right now for chronic disease, rather once, is a very big competitive advantage. The Street is not understanding that we have right now thousands, literally, of patients in phase III studies with this molecule. We are going all the way. We have four phase III studies that are going all the way to first line of treatment. We plan for success. We are optimistic that. Of course, the data need to read out, but if those things go well, this product will be way higher-

Chris Schott
Managing Director, JPMorgan

Okay

Albert Bourla
Chairman and CEO, Pfizer

than what the Street. But let me speak about some other-

Chris Schott
Managing Director, JPMorgan

Yeah

Albert Bourla
Chairman and CEO, Pfizer

opportunities. Let's take oncology. Let's go one from, Pfizer. CDK4 is going to clinic this year. Will go to clinic as a follow-on on Ibrance, but of course we have plans to take it into second line, but also have plans to take it in first line. I think it's highly promising molecule, but we should all watch it. I think on the Seagen, of course, the B6A is going to the clinic. Not to the clinic, phase III.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

Excuse me, not the clinic. All of that is going to phase III. CDK4 and the B6A is going to the clinic for lung cancer this year. Again, very, very significant opportunity. For vaccines, we already went to the clinic with a new generation pneumococcal. We haven't disclosed how many, how big, how valent it is-

Chris Schott
Managing Director, JPMorgan

Yep

Albert Bourla
Chairman and CEO, Pfizer

For competitive reasons, but it is the best we hope that will be in the market, and more is best in this case. We are in the clinic with a combination of COVID and flu, particularly the young generation, where it represents, I think, the biggest opportunity. Why I say that? Because COVID vaccinations in below 65 is really unpenetrated. Very few people, very few young people are doing COVID vaccinations. The 70% of Americans did, but all of them are very old ages, right? So it's predominantly in the older ages. In the younger, no. The flu is way higher. It's almost 50%.

When you have a combination program, product, that people go to the pharmacy to take their vaccine, and they will be offered, if you want, only flu or if you want with the same injection and with zero copay, to get also COVID, a lot will choose the option to get also COVID.

I think it's a significant one, and that is going on in this reading. We all know that we bought Global Blood Therapeutics and we have already their product in the market. But the good news was that, the follow-on molecule- Had transformational data, I think.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

Right? Phenomenal data. So this one also is in the clinic in the next phase right now, and I think will deliver significantly. So I just mentioned-

Chris Schott
Managing Director, JPMorgan

Yeah, yeah.

Albert Bourla
Chairman and CEO, Pfizer

Some of them.

Chris Schott
Managing Director, JPMorgan

Absolutely, yeah.

Albert Bourla
Chairman and CEO, Pfizer

I don't want to go to more because-

Chris Schott
Managing Director, JPMorgan

Yeah

Albert Bourla
Chairman and CEO, Pfizer

Less is more.

Chris Schott
Managing Director, JPMorgan

No, that's great. On BCMA, can you just talk a little bit about how you see the bispecifics playing out versus the CAR-Ts as we think about the-

Albert Bourla
Chairman and CEO, Pfizer

I think it's way more convenient and way more scaling up.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

Everything will be eventually decided based on the strength of the data. I think that Elrexfio will be the best in class in bispecifics.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

I think the bispecifics will get significant share into the market.

Chris Schott
Managing Director, JPMorgan

Timing on when we can think about those earlier line studies, is that the next few years or is that?

Albert Bourla
Chairman and CEO, Pfizer

No, no, no, they are now. They are, most of them are enrolled, of course, it's, there, there is, let's say, time, but it's not something that will happen in many years. It's happening now. The studies are all running as we speak.

Chris Schott
Managing Director, JPMorgan

Yeah. Now that... I guess maybe pivoting over to Seagen. Now that that deal is closed, can you just provide more specifics of how you think about reaching that $10 billion plus target by 2030, and how your expectations have changed at all since, you know, the time of the deal was announced to when the deal closed?

Albert Bourla
Chairman and CEO, Pfizer

Look, the expectations for me changed.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

My level of comfort increased significantly.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

I will tell you why. First of all, a $43 billion acquisition was a significant bet in a technology, what is called ADC. Significant bet, right? Since we announced the acquisition, I think there is a broad and broad consensus that this technology is going to be transformational. ADCs has become the hottest thing on Earth right now.

Chris Schott
Managing Director, JPMorgan

Yeah

Albert Bourla
Chairman and CEO, Pfizer

-in oncology. Every day someone is trying-

Chris Schott
Managing Director, JPMorgan

Every day there's an announcement.

Albert Bourla
Chairman and CEO, Pfizer

Yeah. But of course, there is not many assets that you can get ADCs to the level that you can get it. There were two.

I think we selected the best of the two, Seagen. Why I say I think we selected the two? Because since I announced the acquisition, and today, Seagen had significant readouts of data that demonstrated the strength of their technology. Significant. Transformational. So I think we hit the lotto in technology, and we hit the lotto in the company. Now, we have seen multiple times that big companies like us, buying smaller companies like Seagen, and killing the innovation in the first one year. Because they bring them into their own bureaucracy, and they try to Pfizerize them, and they try to do all the things that, we do. Our. And we have done this mistake ourselves, but also have done it right in certain cases. This time, I was meticulously focused from day one to get it right.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

That's why I announced. I said in the beginning that all the Seagen people are coming, that we have them basically Seagen-izing Pfizer, rather Pfizer, Pfizerizing Seagen. We believe that this momentum... Also, the cultural differences that, in many times, when a small comes to a big, that we see are way less severe when we speak about oncology. Because the oncology people, no matter where they are, they think and they feel oncology. If you ask someone in vaccines. What job are you doing in Pfizer? If he's marketing, he will tell you marketing, and if he is research, he will tell you research.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

If you ask an oncology person in Pfizer, "What is your job in Pfizer?" He will tell you oncology.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

As the Seagen people, they are very oncology-minded. So I think we did everything we can to bring the two together in the best way. So all of that was not known when I did the integration, that we will maintain the talent, that we go after it, and now are known. So I'm very optimistic.

Chris Schott
Managing Director, JPMorgan

Yeah. Is that kind of why when you created that separate structure was to-

Albert Bourla
Chairman and CEO, Pfizer

It's absolutely why I created a separate structure. It was the first thing that we discussed with all the Seagen leaders, "What is your secret of success? I realized that the handoff in oncology between early and late is way more fast as with obesity, for example.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

Where there are very distinct phases between phase I, phase II, phase III. In oncology, it's all blended, so it was extremely important to bring early and late together. That was the first phase. Everybody was pretty telling me how big advantage they see that commercial is part of one organization, because oncology, again, is very technical, the sale. You are not selling on consumer conviction. You are selling on data and your ability to explain those data to the people. So it was always decided that that would become one. Of course, we announced it when Seagen closed.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

We didn't want to disturb our own commercial operations by early announcements, so that was a very big part of it.

Chris Schott
Managing Director, JPMorgan

Yeah. Is there other, I guess, therapeutic areas within Pfizer where that would make sense to also carve out, or is, is oncology unique?

Albert Bourla
Chairman and CEO, Pfizer

There is a different therapeutic area, which is vaccines which already we had early and late together.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

Again, for the same reasons.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

But over there, commercial Is very different.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

The research is all about getting the immunogenicity and the technology right. Commercial in vaccines is all about consumer conviction.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

Very different animals.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

They are performing way better within the commercial organization.

Chris Schott
Managing Director, JPMorgan

While we're talking about vaccines, RSV, it was, you know, really nice launch that we saw last year. Can you just talk us-

Albert Bourla
Chairman and CEO, Pfizer

You think so?

Chris Schott
Managing Director, JPMorgan

It wa So, so far, so good.

Albert Bourla
Chairman and CEO, Pfizer

From my perspective-

Chris Schott
Managing Director, JPMorgan

Well ahead of expectations.

Albert Bourla
Chairman and CEO, Pfizer

it was a better launch of Pfizer.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

It, uh-

Chris Schott
Managing Director, JPMorgan

Oh, really?

Albert Bourla
Chairman and CEO, Pfizer

I will explain.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

I will be, again, very transparent.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

We did in RSV way more than what we had in our budget. We did in RSV way more than the street was thinking that we will do. But we did it because the market was proven to be way, way bigger than what we thought. People were worried about it. By the way, I think this year will be even better year for RSV, because the sensitivity with all this wave of respiratory diseases is increasing. We have 35% market share. That's not Pfizer.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

We shouldn't.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

So we should have-

Chris Schott
Managing Director, JPMorgan

Yeah

Albert Bourla
Chairman and CEO, Pfizer

higher market share, so we need to fix it.

Chris Schott
Managing Director, JPMorgan

That's goal for the company this year?

Albert Bourla
Chairman and CEO, Pfizer

Yes.

Chris Schott
Managing Director, JPMorgan

Yeah. Any updates in terms of. You mentioned the market size was, I think, surprised a lot of us. How big do you think this market can become over time?

Albert Bourla
Chairman and CEO, Pfizer

You know, I don't want again to-

Chris Schott
Managing Director, JPMorgan

Yeah

Albert Bourla
Chairman and CEO, Pfizer

-risk projections-

Chris Schott
Managing Director, JPMorgan

Sure

Albert Bourla
Chairman and CEO, Pfizer

because we have been burned, but clearly bigger than what we thought.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

It's going to be multi-billion-dollar products.

Chris Schott
Managing Director, JPMorgan

And what do you think-

Albert Bourla
Chairman and CEO, Pfizer

By the way, there are two markets. That one is the adult respiratory that we are playing with, GSK, and maybe Moderna will come. But we have the maternal, which is basically, which we are alone.

Chris Schott
Managing Director, JPMorgan

Yep.

Albert Bourla
Chairman and CEO, Pfizer

I think that, first of all, provides an additional market opportunity, but also provides an opportunity to gain market share in the adult.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

Because it is the same product that is doing adults and maternal. And one, if he wants to cover both cases, needs to stock only one product. If you want to cover with this case, for example, product, you need to stock also Pfizer's maternal. So it's more complicated. So I think it's an opportunity for us.

Chris Schott
Managing Director, JPMorgan

And maybe just last question is, what do you think it will take to kind of regain that market share or to claw back that share?

Albert Bourla
Chairman and CEO, Pfizer

No, you need to see what drove these markets there.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

I think, there is the RSV market has a component, but it is on physicians' offices and has a component that it is on retail. The physicians' offices was, as we predicted, the size.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

What surprised us was the retail.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

In the physicians' offices, our market share is dominant. It's not 60, way higher. So we have the physician, but it's a small part. In the retail, this is where we lost.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

Why we lost market share in the retail? We came later GSK had already signed contracts, and we missed the opportunity to sign the contracts that we should have. So every year it's clean slate. So now we'll see how the contracting will go this year.

Chris Schott
Managing Director, JPMorgan

Right. Maybe last question here for the last minute or so. On business development, I know you've got some priorities to delever a bit post-Seagen. What is Pfizer looking at in terms of, you know, in this intermediate period? Is the company still active in terms of looking for transactions or partnerships or?

Albert Bourla
Chairman and CEO, Pfizer

Again, I want to be very clear and very transparent. 2024 will be a year that we will try to consolidate what we already acquired.

Chris Schott
Managing Director, JPMorgan

Okay.

Albert Bourla
Chairman and CEO, Pfizer

It's a year of execution for Pfizer. It's a year, but I don't think we will see any major, acquisition or any major, let's say, capital going into licensing, et cetera. We will still see licensing deals in early stages-

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

which is smaller dollars, because that's what is needed for your R&D engine to move. But this is not the year that you will see a big acquisition. Going forward, as we start deleveraging, of course, we are looking. What we are looking to, to do it is areas that are playing to our strength so that we can maximize the opportunity as always.

Chris Schott
Managing Director, JPMorgan

Yeah. Excellent. Well, I think we're just about out of time. Really appreciate the comments, Albert. Thanks for joining us.

Albert Bourla
Chairman and CEO, Pfizer

Thank you very much.

Chris Schott
Managing Director, JPMorgan

Yeah.

Albert Bourla
Chairman and CEO, Pfizer

Thank you very much, everyone.

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