The following is excerpted from the question-and-answer section of the transcript.
(Questions from industry analysts are provided in full, but answers are omitted - download the transcript to see the full question-and-answer session)
Question: Evan Seigerman - BMO Capital Markets - Analyst
: Guys, thank you so much for taking the question, and congrats on the progress this quarter. So one for Adam, now that you have
Cobenfy approved, can you walk us through what the next year looks like when it comes to access? I know there's a lot of puts and
takes when it comes to Medicaid and commercial. But maybe give us some color as to how we should think about it. Thank you so
much.
Question: Evan Seigerman - BMO Capital Markets - Analyst
: (multiple speakers)
Question: Chris Shibutani - Goldman Sachs - Analyst
: Great. Thank you very much. Certainly, you've been doing a lot to focus the operating expense profile here. And at the same time,
you're seeing improving top line. Where are you in that trajectory in terms of what we should expect 2025? Any early commentary
on the shape of 2025 top-line dynamics as a function of operating expense would be helpful. Thank you.
Question: Chris Schott - JPMorgan - Analyst
: Great. Thanks. Just maybe a two-parter on Cobenfy. Thank you for all the details on the reimbursement piece. Once reimbursement
is in place, can you just talk about how you're thinking about the ramp of the drug from there?
I guess, historically, I think we've seen more gradual launches in schizophrenia, but these are largely assets with similar mechanisms
to existing products. I'm just wondering in this case, are you anticipating this could be a faster ramp than we've historically seen,
given the unmet need and your unique mechanism of action?
And then just my second part on the same product is just, when you think about the additional line extensions here, what's your
confidence in the bipolar I opportunity? It's obviously a very large market and [live] data you've seen in schizophrenia. Do you view
that as a high probability of success study as you start to ramp that one? Thank you.
Question: Luisa Hector - Berenberg - Analyst
: Hello. Thank you for taking my question. On Sotyktu, you mentioned the price impact in Q4. But could you add a little more color
on the outlook for next year, and the access and pricing as we roll into next year? And then, perhaps, just a reminder of the profile
that you're looking for in the psoriatic arthritis trial. Thank you.
Question: Geoff Meacham - Citi - Analyst
: Morning, everyone. Thanks so much for the question. For Chris or Samit on the milvexian program, I know you guys did talk about
the use of -- the potential to upsize the trial previously.
But what would you say is the cause for the lower event rate? Does this change the risk profile? We know that GLP-1s have an impact,
for example, in cardiometabolic trials. You think changes there commercially could have changed the event rate in your study? Thank
you very much.
Christopher Boerner - Bristol-Myers Squibb Co - Chairman of the Board, Chief Executive Officer, Chief Operating Officer
Thanks, Geoff. I'll start, and then I'll turn it over to Samit. Let me just say at the outset, Geoff, that we're encouraged by what we're
seeing with this program. Just a reminder, we're developing milvexian because there remains high unmet need for patients in
anti-coagulation.
That's particularly true in atrial fibrillation, where as I think you know, this is an area where 40 million individuals worldwide have
atrial fibrillation and that despite the success of Factor Xa like Eliquis, about 40% of those patients remain on or undertreated due
to the risk of bleeding.
And we believe milvexian has the potential to improve the outcome for these patients. The update that we provided today is really
intended to give some context to the decision to increase the sample size given the encouraging blended event rates that we're
seeing at this point in the study.
This is a potentially important medicine. We want to do everything we can to ensure that the program continues to read out in 2027.
But before I turn it over to Samit, I want to leave you with, we're encouraged by what we're seeing here. And we look forward to
seeing this study come to its outcome in 2027. Samit?
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Question: Carter Gould - Barclays Capital Inc. - Analyst
: Great. Thanks for taking the questions in solid print this morning. Maybe I don't mean to hammer on this again, but just wanted to
follow up on the prior question for Samit there. With the increased patient enrollment, will there be any shift in the criteria or
enrichment of patients away from the (technical difficulty) our proximal segments.
I mean, I appreciate your commentary on what happened to your competitor (technical difficulty). But at the same conversation at
ESC, there was talk about the challenges in those populations given especially what seems to be going on here at the event rate.
Any color would be appreciated. Thank you.
Samit Hirawat - Bristol-Myers Squibb Co - Executive Vice President, Chief Medical Officer, Global Drug Development, Member of
the Leadership Team
Yeah. Thank you, Carter. There are no plans to change any of these criteria. We will continue to observe them, and the study will
continue as is, except for the change in the sample size.
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Question: Chun Chung - UBS - Analyst
: Morning, guys. Thanks for taking my question. Just one on the recent PRMT5 data. We saw an ORR of 21% across a bunch of solid
tumors. Can you, perhaps, talk about efficacy as regard to durability that you're seeing here with the product? And what tumor types
are you going to be prioritizing? Thank you.
Question: Steve Scala - TD Cowen - Analyst
: Thank you so much. I have two points, and there are really -- two questions. They're just really clarifications. But if 1 percentage point
of Bristol revenue growth is about $500 million, and that's the amount that Bristol is increasing its guidance, that's roughly equivalent
to what Revlimid beat by. So is the increase solely attributed to Revlimid?
And then, secondly -- and I apologize for going back to asundexian -- but the AFib trial had a lower-than-expected event rate and
failed. Why is a lower-than-expected event rate in the milvexian trial encouraging? It as easily could be a risk, I would think. I understand
the DSMB point. So any clarity would be appreciated. Thank you.
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Question: Courtney Breen - Bernstein - Analyst
: Thank you so much for the question. Another question just on the Cobenfy launch. What I wanted to make sure we were able to
understand is some of the practicalities around kind of a patient receiving a script and kind of the doctor choosing that patient to
prescribe to.
Can you share some of the context on the warnings and precautions in the label, particularly around liver, and how many patients
you practically expect to be managed through these challenges? I do note that, obviously, there isn't the box label warning. But
there are some warnings that require extra physician attention. And so can you just speak to some of those challenges?
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Question: Seamus Fernandez - Guggenheim Securities, LLC - Analyst
: Thanks very much for the question. So I wanted to just get a sense for your enthusiasm for the upcoming data at ACR for your CD19
asset and how you see the evolution of a potential market for intensive immunologic treatments like this, versus the potential for
whether it be T-cell engagers or bispecific products with a similar type target profile, but perhaps less efficacy.
And then just the second question is on the 2025 dynamics. Just hoping to get maybe a little bit of a better sense of the sort of
pushes and pulls on IRA. I know you've said that you expect it to be largely neutral, but it does seem like there are opportunities to
potentially increase volume in that context. And I just wanted to clarify whether or not any volume benefits are incorporated into
your assumptions around that neutral assumption. Thanks.
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Question: Matt Phipps - William Blair & Company, L.L.C. - Analyst
: Good morning. Thanks for taking my question. I was wondering how you all view the market opportunity for the GPRC5D CAR-CT
maybe relative to Abecma, given you've now moved the 5D program into a second-line Phase 2 trial. Do you think the profile is
strong enough to really challenge a BCMA CAR-T? Or would it be used after a BCMA CAR-T? And Chris, what type of [candy] are you
going with tonight?
Question: David Risinger - Leerink Partners - Analyst
: Yes. Thank you very much. So I'll just keep it to one high-level question, please. So Chris, I think you mentioned a few times on the
call that you see Bristol-Myers as a sustainable growth company. Could you just provide some more context on that, your sustainable
growth expectations in light of 2026 revenue pressures and the end of the diabetes royalty stream? Thanks very much.
Christopher Boerner - Bristol-Myers Squibb Co - Chairman of the Board, Chief Executive Officer, Chief Operating Officer
Thanks for the question, David. Yeah. Look, as we have said consistently, our North Star, since I took over as CEO in November, has
been that we execute in the short term and stay focused on building a company that will deliver long-term sustained growth and
shareholder value, particularly as we work our way through the middle of the decade, exiting with a very strong growth profile
towards the end of the decade.
And as I think about the way that we continue to build confidence in that, I would say, I'd highlight three things. First, we have a
young portfolio of growing assets. You've seen that in the quarterly results. And we're squarely focused on continuing to drive
performance in this growth profile. We've got products like Cobenfy, which just launched very early in its life cycle.
Clearly, schizophrenia is important. You're going to see additional indications, notably the adjunctive indication in 2025. Breyanzi
continues to show very solid and strong growth in cell therapy. And remember, that's at the tip of a pipeline of assets we've discussed
this morning, in fact, that look promising, including CD19 and GPRC5D.
We saw continued steady growth for Reblozyl and Camzyos. We would expect that to continue. Those two products have line
extensions coming up in the next 12 months. And of course, we've talked considerably about Opdualag and nivo subcu providing
a foundation for our I-O business through the end of this decade and into the next.
And then when you step back from that, the second thing that's encouraging is, we continue to see very good progress in our
late-stage pipeline. We've talked about milvexian and the encouraging progress of that program in AFib, as well as the two other
additional indications we're running in parallel.
We're excited about LPA1. And remember, we have multiple Phase 2 programs that have demonstrated efficacy and safety for that
program. So we're excited to see that play out. Iberdomide and mezigdomide give us opportunities in multiple myeloma. And these
are products that have important readouts over the next 12 to 24 months.
So we've got continued excitement in the late-stage pipeline. And then across all of our businesses, we've maintained financial
discipline. That gives us the ability to have a solid balance sheet. Our P&L looks good, and that gives us strategic flexibility to continue
to invest both in our internal program as well as source innovation externally as we did with the Karuna acquisition, for example, in
December.
So if I add it up, I think those are the core components of how we continue to build conviction in the sustainable growth that we're
looking to drive for the company.
Question: Akash Tewari - Jefferies LLC - Analyst
: Hey, thanks so much. Given that there's been reports of J&J shutting down their cardiometabolic division, is there any potential for
your team to renegotiate your partnership with them around milvexian?
And on subcu Opdivo, your team doesn't seem to be guiding for branded reps beyond the FDA regulatory protection which is a
market contract to what Merck is communicating on subcu KEYTRUDA. Any color on why your team seems to be more conservative
here? Thank you.
Christopher Boerner - Bristol-Myers Squibb Co - Chairman of the Board, Chief Executive Officer, Chief Operating Officer
So do you mind repeating the second question?
Question: James Shin - Deutsche Bank - Analyst
: Hi, guys. Thanks for taking our question. I just want to go back to milvexian real quick. I really appreciate the update on the stroke
and embolism event rates. But was there any separation between the arms? And perhaps, even more importantly, do you have any
color on bleed rates. Thank you.
Question: Olivia Brayer - Cantor Fitzgerald - Analyst
: Hi, good morning. Thank you for the question. Can you guys talk through what you're looking to see in that adjunctive schizophrenia
data set next year? And when you think about uptake in that setting, are you getting any early feedback around potential off-label
use from potential early adopters?
I mean, how big of a market do you think that could realistically be just given the focus on making monotherapy use a standard of
care? Also, I just wanted to ask a quick clarification on milvexian timelines. I know it's still 2027, but should we assume that it's later
in the year considering today's update? Thank you.
Christopher Boerner - Bristol-Myers Squibb Co - Chairman of the Board, Chief Executive Officer, Chief Operating Officer
Thanks for the questions, Olivia. Maybe we'll ask Samit and Adam to get those questions between the three of them.
Samit Hirawat - Bristol-Myers Squibb Co - Executive Vice President, Chief Medical Officer, Global Drug Development, Member of
the Leadership Team
Yeah. Thank you. Remember, Olivia, how patients are treated today with the antipsychotics that are available. Without even having
an approval in the label, patients are being treated with combinations of D2 agonist in this space. So it was important from our
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Question: Sean McCutcheon - Raymond James - Analyst
: Hi, guys. Thanks for taking the question. One more on Cobenfy. Can you speak to your view on the import of the M1 component for
Cobenfy as it relates to potentially driving cognitive improvements in schizophrenia in particular? What proportion of the population
have cognitive deficits? Do you expect these patients to be kind of parsed out in the monotherapy setting or post atypical or in the
adjunctive setting?
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Question: Kripa Devarakonda - Truist Securities - Analyst
: Hey, guys. Thank you so much for taking my question, and congrats on the quarter today. I'll switch gears and not ask a Cobenfy
question. I want to ask a question about your HFpEF program. You've recently published data from a Phase 2 with mavacamten.
Can you talk about how this translates to 224, which I think is the drug you've indicated as the HFpEF drug? And what percentage
-- like, how big of a market do you see? And can you remind us of the timelines for this program? Thank you.
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