Categories Earnings Call Transcripts, Health Care

Pfizer Inc. (PFE) Q1 2022 Earnings Call Transcript

PFE Earnings Call - Final Transcript

Pfizer Inc.  (NYSE: PFE) Q1 2022 earnings call dated May. 03, 2022

Corporate Participants:

Chris Stevo — Senior Vice President and Chief of Investor Relations

Albert Bourla — Chairman and Chief Executive Officer

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Frank D’Amelio — Chief Financial Officer and Executive Vice President

William Pao — Chief Development Officer and Executive Vice President

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

Aamir Malik — Chief Business Innovation Officer, Executive Vice President

Analysts:

Louise Chen — Cantor Fitzgerald — Analyst

Evan Seigerman — BMO Capital Markets — Analyst

Mohit Bansal — Wells Fargo Securities — Analyst

Terence Flynn — Morgan Stanley — Analyst

Vamil Divan — Mizuho Securities — Analyst

Kerry Holford — Berenberg — Analyst

Steve Scala — Cowen and Company — Analyst

Colin Bristow — UBS — Analyst

Carter Gould — Barclays — Analyst

Andrew Baum — Citi — Analyst

Chris Schott — J.P. Morgan — Analyst

Tim Anderson — Wolfe Research — Analyst

Alexandra — Bank of America — Analyst

Robyn Karnauskas — Truist Securities — Analyst

Presentation:

Operator

Good day everyone and welcome to Pfizer’s First Quarter 2022 Earnings Conference Call. [Operator Instructions] At this time, I would like to turn the call over to Chris Stevo, Senior Vice President, and Chief Investor Relations Officer. Please go ahead, sir.

Chris Stevo — Senior Vice President and Chief of Investor Relations

Thank you, operator. Good morning. Welcome to Pfizer’s first quarter earnings call. I’m joined today by Dr. Albert Bourla, our Chairman and CEO; Frank D’Amelio, our CFO; Mikael Dolsten President of Worldwide Research and Development and Medical. Joining us for the Q&A session, we will also have Angela Hwang, Group President, Pfizer Biopharmaceuticals Group; Aamir Malik, our Chief Business and Innovation Officer; Doug Lankler, our General Counsel; and William Pao, our new Chief Development Officer.

Materials for this call and other earnings-related materials are on the Investor Relations section of pfizer.com. Please see our forward-looking statements disclaimer on Slide 3. And additional information regarding these statements and our non-GAAP financial measures is available in our earnings release and in our SEC Forms 10-K and 10-Q under Risk Factors and Forward-Looking Statements.

Forward-looking statements on the call are subject to substantial risks and uncertainties, speak only as of the call’s original date, and we undertake no obligation to update or revise any of the statements.

With that, I will turn the call over to Albert.

Albert Bourla — Chairman and Chief Executive Officer

Thank you, Chris, and good morning, everyone. Pfizer has had very solid start to the year. Revenues were up 82% operationally compared with the first quarter of 2021. Key growth drivers for the quarter included Comirnaty, Paxlovid, Eliquis, Vyndaqel/Vyndamax global, our Prevnar family of vaccines, and our Oncology Biosimilars portfolio in the U.S.

Overall, we reached an estimated 468 million patients around the world only in one quarter with our innovative medicines and vaccines which represent a 140% increase from the pre-year — priority year quarter and it is a testament to our purpose, breakthroughs that change patients’ lives. We continue to supply the world with the Comirnaty, which remains a critical tool in helping prevent severe illness, hospitalization, and deaths from COVID-19. To date, we have shipped nearly 3.4 billion doses of our vaccine to 179 countries. Comirnaty is the most utilized mRNA vaccine in the markets in which we operate, and the report markets to date.

Pfizer’s cumulative share of doses administered in these markets has increased from 52% that used to be on January 1st, beginning of the year 2022 to 62% on May 1, 2022. Just few months 10 points. In developed markets, our share has increased from 59% to 67% over that same period of time. We also have had a strong start to the year with regard to regulatory milestones, including the emergency use authorization from the USFDA and conditional market authorization from EMA for our 12 to 15 year old booster dose. We have an EUA from the FDA for a second booster, the fourth dose in patients 50 years of age and older and 12 years of age and older, who are immunocompromised. And we had an extension to a 12-month frozen shelf life, 12 month from both the FDA and the EMA. Our ambition is to eventually achieve 24 months shelf life, which would help alleviate concerns some governance may have evolved having expired in dose.

In addition to the U.S. and the EU, we now have authorizations for the 5 to 11 age group in 44 other markets around the world. Now, this year, we have recently released new results from our Phase 2/3 clinical trial demonstrating that the 10-microgram booster dose of our vaccine in healthy children 5 through 11 years of age, increases geometric mean neutralizing antibodies titer geometric mean, neutralizing antibody titers wild type and Omicron variant.

Based on this data, last week, we submitted an application to the FDA for an EUA of a 10 microgram booster dose for children in this age group. And we look forward to filing in other jurisdictions in the near future. We also expect to serve data on our ongoing starting children who are 6 months to under 5 years, in the next few weeks. This study is looking at the safety and efficacy of three doses of a vaccine in this age group. And we hope to submit an application for an EUA soon, pending the results of the data readout, of course.

We stand ready to support boosting authorized operations today as well in the fall ahead of its revision and flu season. Independent real-world evidence from several countries have demonstrated that our booster doses improve protection that may have waned from the primary vaccination or since the first booster. Our market research shows that greater than 96% of healthcare provider respondents in key markets like the U.S. and the EU5 largest markets continue to recommend a third dose booster to their patients. We also have seen an upward trend in updates of the third dose booster in various development. In this same market but very — for previously, 70% of people who have received the initial two-dose regimen reported that they have already received third dose booster, 74%. And the remaining 13%, the respondents said that they are very likely to receive the booster.

We believe this is encouraging leading indicator for the potential uptake for the fourth dose. We also continue to evaluate potential next-generation vaccines including variant vaccines to provide growth coverage from the fall and we look forward to evaluating and sharing these data in the coming months. We are also delivering on our commitments for Paxlovid, which is already having a profoundly positive impact on the lives of patients around the world. Through the end of March, we produced more than 6 million treatment courses, all of which have been shipped shortly after they were produced.

Because the financial calendar quarter for international markets ends in February and the majority of the 6 million treatments were produced in March, only a small portion of these shipments were recorded in our first quarter revenues. In fact, as of today, we have shipped approximately 8 million treatment courses. Our manufacturing ramp up is progressing as planned, and we are on track to produce 24 million courses in the second quarter for a total of 30 million in the first half of the year.

All of these quantities have already been allocated to existing partners. In addition, we remain on track to produce 120 million courses for the full year as previously stated. To date, Paxlovid has received regulatory approvals for temporary authorization for use with certain populations in more than 60 countries. We continue to have discussions with governments and regulatory agencies around the world about bringing this potential breakthrough treatment to additional markets. Some countries that they have experienced the recent outbreaks just come back to us to request additional treatment courses, which we are responding to with urgence. Others are taking steps to expand access. For example, Italian government recently announced an expansion of prescribing into primary care. We believe this shift from having only specialists prescribe Paxlovid will help ensure more patients get access at the right time.

In the U.K., Paxlovid will not be included in the national panoramic study, which expect we expect will increase access and collect further data regarding how the therapy works in the market where the majority of the adult population is vaccinated. This is important because today the U.K. has restricted Paxlovid use to be a very limited population and this study could lead to government to open up access to a much broader population, closer to the authorized population. In Canada, we expect increasing supply and the lifting of COVID-19 restrictions will enable greater access for patients across the country. Quebec and Ontario, which represent the two largest provinces, and are home to more than 60% of Canada’s population have expanded distribution to eligible pharmacies, allowed pharmacies to prescribe — I mean allowed pharmacists to prescribe, and started a comprehensive direct to consumer and social media campaign to ensure all eligible patients are aware on the availability of Paxlovid.

Here in the U.S., we have seen Paxlovid utilization grow nearly tenfold in recent weeks. Paxlovid was administered to more than 29,000 patients in the U.S. till week ending April 22nd, up from approximately 8,000 patients for the week ending February 25, 2022. We will continue to work with the U.S. government and healthcare providers to appropriately drive even higher utilization. And based on data from IQVIA Exponent, Paxlovid market share, relative to Molnupiravir in the retail long-term care and mail order channels, grew from 44% in that week ending January, 28th of 2022 to almost 90% in the week ending April 22, 2022. Together, these channels represent estimated 50% of Paxlovid utilization in the U.S. The number of locations in the U.S. with Paxlovid supply continues to increase with more than 33,000 sites live, as of today. This is more than a fourfold increase since late February, leading to easier patient access.

The U.S. government declared its intention to double the size again in the coming weeks and making Paxlovid available to any pharmacy for ways to stock. In addition, 77% of recent U.S. COVID-19 cases occur within 5 miles of the closest retail point of care, which is up from only 23% since February. We expect this trend to continue to increase, driven by the U.S. government’s Test to Treat initiative. For example, nearly 1,100 more Test to Treat locations have been added since the beginning of April only. To date, there are more than 2,200 locations of Test to Treat open.

Overall, we expect the recent trends to expand access as well as inquiries received from governments as the virus mutates and cause spikes in infections around the world to result in increased orders in the coming months as governments continue to help protect their citizens who are at higher risk of severe disease, hospitalization, and in response to emerging variants and continuing progress.

Now, I will turn to our business development strategy. We leverage business development opportunities to advance our business strategies, and objectives. We recently announced positive top line results from a year of Phase 3 trial of Etrasimod in moderately-to-severely active ulcerative colitis. These results underscore Pfizer’s ability to identify strong business development targets as the potentially best-in-class product candidate came to us via our recent acquisition of Arena. We look forward to presenting this data and filing for approval later this year.

First quarter, we discussed how the strength of our balance sheet and cash flows gives us the ability to pursue new business development opportunities that, if successful, would add at least $25 billion of risk-adjusted revenues to our 2030 top-line expectations. Our planned acquisition of ReViral is the first deal to be counted towards this ambition. ReViral is a privately held, clinical-stage biopharmaceutical company focused on discovering, developing, and commercializing novel antiviral therapeutics that target respiratory syncytial virus. Basically, they target RSV. We believe annual revenue from these programs, if successful, has the potential to reach or exceed $1.5 billion, which is peak revenues.

We also are excited about the prospect of adding several experienced virologists to our team. Building relationships within the growing part of the ecosystem remains a priority for Pfizer. We continue to pursue new creative ways of partnering with biotechs to increase our access to cutting-edge innovation and to bring our resources to bear — help drive recovery for patients. We believe our scientific expertise, our end-to-end development, and manufacturing capabilities, makes us an extremely attractive partner as seen, for example, through our relationship with BioNTech, and we are confident that we have the financial resources to support business development opportunities that will complement and enhance our internal R&D efforts and add capacity and flexibility to support our growing clinical portfolio.

Next, I would like to discuss some of our recent ESG highlights. First, we announced in February the results of Pfizer’s third annual pay equity study in which a recognized compensation expert confirmed equitable pay practices for employees at Pfizer. The results indicated that Pfizer compensates female colleagues at a level that is greater than 99% of what male colleagues are paid across the globe. Additionally, in the U.S., minorities are paid dollar for dollar parity of what non-minorities are paid. When you look at Pfizer’s medium pay for women globally, it is in high 102.3% for the median pay of males. However, when you look at the median pay for minorities in the U.S. workforce, it is 85.5% of the median pay for non-minorities. This median raise pay gap is an area we are actively addressing and that we expect to narrow.

Second, I want to reiterate that Pfizer stands with the unified global community in opposition to Russia’s invasion through Ukraine. While Pfizer is maintaining our humanitarian supply of medicines to Russians, as we do, we will be donating all profits of our Russian subsidiary to causes that provide direct humanitarian support to Ukraine. Additionally, we will no longer initiate new clinical trials in Russia and we’ll stop recruiting new patients in our ongoing clinical trials in the country. Pfizer will work with the FDA and other regulators to transition all ongoing clinical trials to alternative sites outside Russia. And consistent with our commitment to putting patients first, we will continue providing medicines to the patients already enrolled in clinical trials in Russia. Lastly, we are seizing all future investments with local suppliers, intended to build manufacturing capacity in Russia.

So, further demonstrating our commitment to equitable access, we have made the decision that for as long as the pandemic lasts, Pfizer will not profit from sales of our COVID-19 treatment through the world’s poorest countries. In March, Pfizer announced an agreement with UNICEF to supply up to 4 million treatment courses of Paxlovid to 95 low- and middle-income countries. Under the agreement, all low and lower-middle-income countries will be offered the treatment courses at a not-for-profit price, while upper-middle-income countries will pay a price defined in Pfizer’s tiered pricing approach.

Lastly, I’m pleased to say that Pfizer continues to be recognized as an ethical patient-focused company that calls itself and its employees and its business partners to high standards. In March, Pfizer was recognized as one of the World’s Most Ethical Companies by Ethisphere, a global leader in defining and advancing the standards of ethical business practices. And thus, last week and we are so proud about it, for the first time ever, Pfizer ranked first among big pharma companies in the Patient View global survey in 2021. This ranking is based on feedback from more than 2000 patient organizations and associations worldwide. As recently as 2018, we were ranked fifth and we have steadily climbed in the rankings ever since. But we are so proud that we are number one brand.

Now, I would like to welcome two new members of Pfizer Executive Leadership Team, Dr. William Pao joined us on March 21st as Executive Vice President and Chief Development Officer. Throughout his 25 year career as an oncologist and scientist, William has amassed extensive clinical and deep scientific expertise that make him the ideal partner to continue our pursuit in breakthrough medicines and vaccines for the benefit of patients and society. Just yesterday, David Denton joined us as Chief Financial Officer and Executive Vice President. Dave brings with him more than 25 years of finance and operational expertise, including more than 20 years in the health care sector. As a result, he brings Pfizer a unique perspective on the role of payers, the needs of patients, and the rapidly evolving healthcare landscape. We are thrilled to welcome these two highly effective and visionary leaders at this critical time for our company and global health.

And now, before I hand it off to Mikael, I want to take a moment to thank Frank D’Amelio, my best friend at Pfizer for his many contributions to Pfizer. In addition to helping ensure Pfizer’s financial strength, ambition, Frank has been an incredible member to many of Pfizer’s current leaders, helped set our long-term growth strategy, and work tirelessly to ensure Pfizer has the resources it needs to help improve the lives of patients around the world. Frank, on behalf of all Pfizer colleagues, and I’m sure all the analysts on today’s call and not only, I wish you continued good health and success.

With that, I will turn it over to Mikael to update you on the R&D efforts. After Mikael, Frank will provide financial details on the first quarter and our outlook for the remaining — the remainder of 2022. Mikael?

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Thank you, Albert. I’d like to start by highlight the two recent external acknowledgments of Pfizer’s R&D turnaround. Pfizer was ranked first innovation in the 11th Annual Pharmaceutical Innovation and Invention Index and first of what Forbes termed total R&D productivity over 20 years in our papers published in drug discovery today. This is a testament not only to the work of our scientists over the past year, bur purposeful efforts to improve our R&D engine over the past 10 years. Today, I will share updates on COVID-19 inflammation and immunology, RSV, Oncology, Lyme Disease, and Hemophilia. In some cases, I may reference publicly available data on other agents, so that you can understand our enthusiasm about what we’re seeing in our development program. Of course, head-to-head clinical trials would be necessary to support any comparative claims.

We continue to pursue a comprehensive and data-driven clinical strategy for COVID-19, focus on evaluating real-world vaccine effectiveness, demonstrating higher immunogenicity with boosters, expanding access to pediatric population, and addressing emerging variants concerned. On the left, in the Phase 2/3 trial of COVID-19 administered to children aged 5 through 11, we have shown that the third 10-microgram dose demonstrated a sixfold boost in neutralizing wild-type SARS-CoV-2 and a 36-fold boost in neutralizing the Omicron variant. Last week, we submitted an EUA request to the FDA for a third dose boost in this population.

On the right, we show that the third 30-microgram dose in adult in the landmark clinical trial effectively neutralized the Omicron sub-lineages including BA.2 one month after dose three. We have also now received EUA for a second booster in people aged 50 and older and for individuals 12 years of age and older who have certain kinds of immunocompromise. This expanded authorization was based on data from Israel, generated while the Omicron variant was dominant, and approximately 11-fold increase in geometric mean neutralizing antibody titers, again it’s wild-type virus Delta, and Omicron variants respectively were reported at two weeks after the second booster as compared to five months after the first booster.

Here, we show recently published real-world data from Israel that the fourth dose of Comirnaty lowered rates of hospitalization, severe illness, and death amidst the Omicron outbreak. The fourth dose is now recommended for certain high-risk populations in more than 15 countries. There has been a notable increase in the number of pediatric infections and hospitalizations in the last few weeks. And we recognize the has been and healthcare providers having waiting for an effective vaccine. We have been working with urgency to generate. We’ve begun the rolling submission with EUA and children aged 6 months to 4 years in February while continuing to evaluate the third 3-micrograms dose, which make it deliver high degree of protection against Omicron. We expect to analyze and submit the three-dose data by late May, early June, and anticipate both FDA and CDC advisory committee to meet soon after frequency data submission.

Turning to opex review. Following EUA in December for both high-risk standard the high-risk children 12 and older weighing at least 40 kilogram, we expect to file soon as and expect an FDA decision on the new drug application in these populations in the second half of ’22. Recently, the WHO strongly recommended Paxlovid for people with mild to moderate COVID-19, who are at the highest risk of hospitalization because they are unvaccinated, older, or immunocompromised. We expect pivotal readouts of the standard risk study in the second half of ’22 and reported top-line results from the household Prophylaxis study last week.

In March, we initiated a study in children and expect that data in the second quarter of ’23. We’re first enrolling children aged 6 to 17 years and working to develop an age-appropriate formulation for children younger than 6. A new study in immunocompromised patients is planned to start in the second half of ’22. Some immunocompromised patients were involved in the EPIC study. However, given the high unmet need, we believed EPIC IC will allow us to further evaluate Paxlovid’s features in this population, and ensure the treatment duration is optimized given our more limited natural immune response to help clear infection.

With the close of the Arena acquisition in March, I’d like to highlight the potential for Etrasimod as a best-in-class oral medicine for Ulcerative Colitis, and its strategic fit within our overall inflammation and immunology pipeline. First, Etrasimod is differentiated. It’s a once-daily pill with rapid onset, no anticipated required titration, and a promising benefit to risk profile. In the Phase 3 ELEVATE studies, Etrasimod demonstrated robust clinical remission in patients with moderate to severely active Ulcerative Colitis. In March, we reported that the ELEVATE UC 52 trial met the co-primary endpoints of clinical remission at both weeks 12 and 52 and all key secondary endpoint.

Looking at the totality of data across Phase 2 and Phase 3 studies, we see a 12 week remission rate of 25% to 30% compared to placebo at 6% to 15%. We are projecting a filing in Ulcerative Colitis in the second half of ’22. This candidate also has broad potential beyond UC. The adaptive Phase 2/3 study in Crohn’s disease is ongoing and we expect to start Phase 3 in Atopic Dermatitis in the fourth quarter. The potential expansion into Crohn’s and Eosinophilic Esophagitis strengthens our gastroenterology pipeline. Overall, given that immuno-inflammatory diseases have heterogeneous disease drivers which require multiple options for effective treatment and the continuing significant unmet need of patients in achieving long-term remission, we are excited about the portfolio of diverse and promising candidates from Arena that nicely complement our existing I&I pipeline.

Ritlecitinib is our unique cytokine modulator. It’s potent pan-TEC family inhibitor, which spares IL-10 protective cytokine, and spares dominant JAK activity of existing effective oral JAK agents. We have seen promising Phase 2 efficacy demonstrated across Alopecia, Vitiligo, and Ulcerative Colitis. The Phase 2 study in Crohn’s disease is ongoing. Ritlecitinib received FDA breakthrough designation for Alopecia, and we expect to file in the second quarter. We are finalizing potential Phase 3 study protocols for Vitiligo and exploring paths for Ulcerative Colitis.

In Phase 2b, Ritlecitinib demonstrated robust efficacy in both facial and total Vitiligo Area Severity Indexes or VASI. Here, we show the facial vast improvement. On the left, Ritlecitinib demonstrated up to 66% improvement from baseline through week 48. Efficacy was observed across light and dark skin tones. On the right, you see two visual representations of significant improvement in facial VASI at 48 weeks.

Last month, we announced our intent to acquire ReViral and its respiratory syncytial virus therapeutic candidates. RSV remains a significant unmet need globally with no approved treatment and the proposed acquisition will strengthen our capability in infectious disease R&D with a complementary strategy to help improve patient outcomes through treatment and prevent illness through vaccination.

This mirrors our COVID-19 strategy, establishing leadership across vaccines and therapeutics, RSV, to deliver potential breakthrough. All our RSV candidates elicited high RSV A and B neutralizing titers in preclinical animal models and in Phase 1/2 clinical studies, and has received FDA breakthrough designation for the material — maternal and adult program. We anticipate the total readouts of the maternal and adult study in the second half of ’22.

ReViral’s pipeline include a lead candidate Sisunatovir, which has received fast-track designation, and a second program focused on the inhibition of RSV reputation targeting the viral N-protein. Sisunatovir is an orally administered inhibitor designed to block fusion of the RSV virus to the host cell. In Phase 2 healthy adult challenge study, Sisunatovir significantly reduced viral load, the data are shown on the right. There is also an ongoing three-part adaptive Phase 2 study in hospitalized infants. Successful completion of Part A was achieved in June, ’21 with favorable safety and pharmacokinetics. Part B is ongoing.

We now turn to oncology and encouraging data from the Phase 3 trial of Lorbrena. Three year follow-up data presented at AACR confirmed prolonged progression-free survival in first-line ALK-positive non-small cell lung cancer patients. There was a 73% reduction in risk of disease progression or death versus Crizotinib. The three-year PFS rate in the Lorlatinib arm was 63.05%. Three-year rate for second-generation medicines are generally 20% points lower based on cross-trial assessments. No definitive conclusion can be drawn from cross-trial comparison. There were no new safety single and a low permanent discontinuation rate of 7.4% for patients on Lorbrena.

High central nervous system activity is important for patients with and without brain metastases. Between 25% and 40% of ALK-positive patients present with brain metastases diagnosis, and between 24% and 40% of patients developed them within two years of diagnosis. Brain metastases are one of the most common causes of death in this patient population. Leveraging our expertise in developing brain penetrant quality treatment, Lorbrena was specifically designed to meet this significant unmet need. We have seen high activity in patients with or without baseline brain metastases. Significant intracranial activity was observed will Lorbrena as evidenced not only by intracranial response rates, but also by time to intracranial progression as shown here. At three years of follow-up, 92.3% patients treated with Lorbrena were alive and free of intracranial events compared with 37.7% treated with Crizotinib. In Lorbrena-treated patients without brain metastasis, only 1 out of 112 patients had evidence of intracranial progression, suggesting potential protective effects against development of brain metastases with Lorbrena treatment.

Here, we show the first data from the pediatric cohort of the Phase 2 trial of our Lyme disease vaccine candidate, the only one of its kind in clinical development. Lyme disease affects all age groups, but children are considered a population most at risk due to their outdoor activities. We saw robust immunogenicity across all pediatric age groups and serotypes and the safety profile was similar to that previously reported in adults. The program has received FDA Fast Track designation and we plan to include pediatric participants in the Phase 3 trial, expected to start in the third quarter. As in adults, immunogenicity and safety data support a three-dose primary vaccination schedule in pediatric participants in the Phase 3 study.

Now, I’d like to highlight our robust portfolio of investigational therapies to potentially treat all people with Hemophilia. We expect a number of clinical trial for our hemophilia portfolio to readout in ’23. Marstacimab is our novel non-factor treatment candidate with the potential to address a broad patient population. As a new subcutaneous prophylactic treatment for patients with Hemophilia A or B, including those with inhibitors, we anticipate a pivotal readout in second quarter ’23. Marstacimab has FDA Fast Track designation for Heme A and B patients with inhibitors. If successful, we predict submitting for the non-inhibitor indication in both Heme A and B in the third quarter of ’23.

Turning to our gene therapy candidates. Last year at ASH, we presented updated Phase 1b/2 data from the largest cohorts of persons with Hemophilia B who have had at least three years of follow-up with AAV gene therapy. 93% of participants achieved Factor 9 activity in the mild or normal range between 3 to 5-and-half years of follow-up. We expect the pivotal readout in the first quarter of ’23. In Hem-A, we also presented updated Phase 1b data at ASH. Factor 8 activity was 25% of normal of two years in the highest-dose cohort. The FDA has lifted the clinical hold on our Phase 3 pivotal study and we anticipate study resumption in the third quarter of this year with a pivotal readout estimated in the second half of ’23.

Finally, here are the top 25 key milestones achieved and anticipated for the rest of the year, six in the regulatory space, 12 pivotal readouts, and 7 early stage readouts. I’d also note that last week we announced the planned opening of the first U.S. sites in our Phase 3 trial evaluating our investigational mini-dystrophin gene therapy for ambulatory patients with Duchenne Muscular Dystrophy. The trial also has received regulatory approvals to restart from several other pending regulatory feedback. We anticipate nearly all sites will open by the end of June. In addition, the European Medicines Agency’s Committee for Medicinal Products for Human Use granted PRIME designation for GBS 6, our maternal vaccine candidate against Group B Streptococcus infection. It’s currently being evaluated in an ongoing Phase 2 study.

Thank you for your attention and I look forward to your questions. Now let me turn it over to Frank.

Frank D’Amelio — Chief Financial Officer and Executive Vice President

Thanks, Mikael. I know you’ve seen our release. So let me provide a few brief highlights regarding the financials. Turning to the income statement. Revenue increased 82% operationally in the first quarter of 2022, driven by COVID-19 vaccine impacts COVID sales, and strong performance for a number of our other key growth drivers. And looking at the revenue excluding the COVID-19 vaccine direct sales and alliance, revenues impacts slow the contribution and increased by 2% operational. The effect of fewer selling days year-over-year decreased revenues by about 1% and losses of exclusivity negatively impacted revenues by %2. Operational growth would have been approximately 5% without these. Also, please remember that Q1 2021, operationally excluding Comirnaty versus the prior year quarter, resulting in a very different comparable.

This was broadly as expected and is embedded in our current guidance. The adjusted cost of sales increase shown here reduced this quarter’s gross margin by approximately 10 percentage points as compared to the first quarter of 2021 with 14 percentage points attributable to the impact of higher COVID-19 vaccine sales year-over-year, partially mitigated by the favorable product mix for other products, primarily driven by higher sales of Paxlovid and higher alliance records.

Adjusted SI&A expenses in the first quarter decreased primarily due to lower spending on corporate enabling functions, partially offset by increased spending on Comirnaty and Paxlovid. The increase in adjusted R&D expense this quarter was primarily driven by increased investments in multiple late-stage clinical programs as well as additional spends to prevent and treat COVID-19.

The growth rate for reported diluted EPS was 59%, while adjusted diluted EPS grew 76% operationally. Foreign exchange movements resulted in a negative 5% impact to revenue as well as a negative 4% impact or $0.04 to adjusted diluted EPS.

Now let’s move to our updated 2022 guidance. We expect total company revenue to be in a range of $98 billion and $102 billion, representing an operational growth rate 27% at the mid. The revenue range absorbs an additional $2 billion of anticipated negative impact from changes in foreign exchange rates as the U.S. dollar continued to strengthen against other currencies since we last updated our exchange rate assumptions. Regarding our COVID-19-related revenues, which continue to expect the vaccine revenue for the year to be approximately $32 billion, unchanged compared to our prior guidance provided on February 8th, despite the impact of $1 billion of incremental negative foreign exchange. With Paxlovid, we expect sales of approximately $22 billion, keeping the guidance unchanged despite an incremental $500 million headwind due to foreign exchange.

This means that excluding the COVID-19 related revenues, we expect sales to be approximately $46 billion to mid representing operational growth of 5% and absorbing the increased negative impact of about $500 million the foreign exchange. While this is slightly below the 6% CAGR and we continue to expect between 2020 and 2025, we continue to be confident in our ability to achieve that 2025 target.

Now, let me give some detail on our cost and expense cuts. We slightly improved our guidance for adjusted cost of sales, reducing the entire range by 20 basis points, the new range being 32% to 34%. We separated the former R&D line into two, R&D and a new line for acquired IPR&D isolates the IPR&D charges, which are driven by business development transactions. Our guidance includes $900 million of this expense for 2022 based on business development transactions, which have either already closed or are already signed as of mid, of which only $100 million was previously assumed in our R&D guidance for adjusted results. So we’ll not forecast to prior R&D the transactions, which are not closed or signed.

We’ve also increased our adjusted R&D expense guidance by $500 million to reflect incremental lifecycle spending for COVID-19 vaccines and antivirals, and investments in other projects. In addition, as noted with fourth quarter results, we made a decision to modify our adjusted results treatment of amortization of intangibles. Previously we only excluded amortization related to large mergers and acquisitions, but we will now exclude all intangible asset amortizations expense. This is anticipated to contribute $0.06 to our 2022, just a little earnings per share, and improved comparability with our peers. This success was previously included in our 2022 guidance.

These assumptions yield an adjusted diluted EPS range of $6.25 to $6.45, or 61% operational growth at the midpoint, compared to 2021. This updated EPS guidance includes a $0.10 operational improvement, offset by a negative $0.11 due to foreign exchange and another $0.11 due to IPR&D. Together, these impacts net out to an adjusted EPS range, which is $0.10 lower in our initial guidance.

2022 guidance once again assumes no incremental share repurchases beyond the $2 billion share repurchases we completed in March. Going forward, we will continue to be prudent in our capital allocation activities with the opportunities for deployment shown here on this slide.

So before I turn the call back to Chris to start the Q&A session, I wanted to make a personal comment. This conference call will mark my last as Pfizer’s CFO. I wish, Dave, and Pfizer, all the success in the world. It has been my immense pleasure and privilege to serve as Pfizer’s CFO for nearly 15 years. Always enjoyed my interactions with you, our investors and our analysts, and I will miss my Pfizer colleagues. I am so proud of what we have accomplished together. I look forward to your achieving a more success in the future. And as a large Pfizer shareholder, you can be sure that I’ll be watching.

With that, let me turn it over to Chris for Q&A.

Questions and Answers:

Chris Stevo — Senior Vice President and Chief of Investor Relations

Thanks, Frank. With that, let’s start the Q&A session, we will answer as many questions as time permits. And as always Investor Relations will be available after the call to answer any questions you weren’t able to ask. Operator, first question, please.

Operator

Your first question comes from the line of Louise Chen with Cantor.

Louise Chen — Cantor Fitzgerald — Analyst

Hi. Thanks for taking my questions. And Frank, thank you for all your contributions to Pfizer. And we will really miss working with you. So first question I had for you is, William, what are your initial impressions of Pfizer having come recently from the outside? And then the second question I had is what is the opportunity for a potential EU Paxlovid contracts and sales potential in China? Thank you.

Albert Bourla — Chairman and Chief Executive Officer

William, why don’t you start with your impressions.

William Pao — Chief Development Officer and Executive Vice President

Sure. Louise, thanks for the question. Yeah, I would say have been — my expectations have been exceeded. Many reasons I came to Pfizer, but one of them was the great science that’s going on, the real dedication to breakthrough innovation, but also the pace with which things have been done and Pfizer accomplished Paxlovid and the vaccine was really inspiring and I came to further build upon that and really transform how we do drug development.

Albert Bourla — Chairman and Chief Executive Officer

Thank you. Angela, you want to take a little bit the EU Paxlovid contracts?

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

Thanks for the question, Louise. So you know that in Europe, I would say that we’re really taking a sort of a two-pronged approach to our contracting. One, we have bilateral agreements that have actually either been secured or about to be secured with many of our countries. But in addition to that, we’re also looking at an EU-level contract. So I think more on that to come as the — whenever we are ready to share what the outcome of that is. But just suffice to say that we’re using both approaches in Europe.

On China, I — what I am able to share is that we are working with a local distributor called Meheco to distribute and to ensure access to Paxlovid in China and that’s all I’m able to say right now. I’m not really able to share more about the terms of the agreement or the volumes or anything related to that. So, thanks.

Chris Stevo — Senior Vice President and Chief of Investor Relations

Thank you very much, sir. Next question, please.

Operator

Your next question comes from the line of Evan Seigerman with BMO.

Evan Seigerman — BMO Capital Markets — Analyst

Hey, guys. Thank you so much for taking my questions and congrats on the quarter. So I have two on COVID. One, when we think about the evolution of the booster market, how do you see this going? We’ve seen some data suggesting that we’re kind of walking blindly into recommending boosters every so often. What’s the ultimate goal of vaccination? Is it to prevent mild symptomatic disease or is it really just to prevent the severe disease and overloading at the hospitals?

And then my second question is when we think about the evolution of the commercial model for Paxlovid, can you talk to that? When do you expect to maybe file an NDA and transition away at least in the United States from kind of government contracting to more traditional commercial models? Thank you so much.

Albert Bourla — Chairman and Chief Executive Officer

Yes. Thank you for your questions. Let me see if I can answer and then I will ask our scientists. On the evolution of booster, I think all it is — they are not moving blindly. We are moving based on data and the reason why they recommend, well they recommend it is because data are supporting according to their opinion. I believe that right now, the effort it is to be able to stay ahead of the virus and the virus repeats in the most serious mutation, which we see is the Omicron. One, because that was the one that was able to affect the new protection fast, until then I think the vaccines were offering very, very good protection against the disease and of course, an excellent protection against hospitalization and death.

With Omicron, we saw that while we keep a very good protection against hospitalizations and deaths, the protection against the disease is going down. So we have seen that with our data that the four-dose of the current vaccine protects significantly, folds, many folds the patients from either hospitalizations or death, and of course, also protects the infections, but not to the degree it used to be. And everybody is working also for new vaccines, but would be able to protect better against Omicron while maintaining the same protection, I guess the wild-types. We are very pleased with for our strategy and we are waiting to hear from FDA the what basic combinations they would recommend, what they would like to see at the end may, and we will be ready till you want with our vaccines, both in terms of filing and both in terms of manufacturing.

As regard to Paxlovid, right now we are completing the study, and I will ask Mikael to comment when we think that we can file for NDA.

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Yeah. We will file NDA this half of the year, and look forward to, as soon as possible. When review getting it approved, which would allow even more engagement with the medical and other communities. So we think that would be very helpful in order to increase education and access to the medicine.

And anything to add on the booster and how we are looking at it. You said its got very well how this has been science-driven and Pfizer is proud to have been leading, being often the first for whether it is primary series of boost or new age group. So I just wanted to add that we expect pending the work to start the fall season with the vaccination campaign, a new boost which will be critical then to redeem and as I’ll be diluted to possibly further strengthen versus new evolution that we’re seeing in Omicron and it’s likely going to be an annual procedure with this type of public recommendation about strains and for some more vulnerable patient groups, immunocompromised, older, we have learned that it may be even in between an extra dose. So we are on top of the science and we expect every year to be able to incorporate new science. We’re doing multiple learnings on how to further of all the vaccine, and see us as a natural leader as we have established such deep insights.

Albert Bourla — Chairman and Chief Executive Officer

William, anything to add? Thank you.

Chris Stevo — Senior Vice President and Chief of Investor Relations

Okay, then next question, please.

Operator

Your next question comes from the line of Mohit Bansal with Wells Fargo.

Mohit Bansal — Wells Fargo Securities — Analyst

Hey, thanks for taking my question. Maybe one question regarding Paxlovid. So it seems like you have mentioned 6 million courses, the sales is about $1.5 billion so this calculates to about $250 per course price. So, am I calculating it right?

And number two, you seem like you’re suggesting that all 20 million courses in 2Q would be shift. So, is that correct? And the pricing should be lower or higher than $250 per course? Thank you.

Albert Bourla — Chairman and Chief Executive Officer

Yeah. Thank you very much. No. there is a disconnect, let me try to explain it. We did produce 6 million doses in — by the end of March. From them only 4.2 million or 4.3 million were shipped outside. In March, the remaining were shift in the first week of February, basically. But also from the 4.2 billion that were shipped, a very small proportion, a smaller proportion was a recorded as revenues in this quarter. Why? Because most of them were shipped in March and everything was received in the U.S. in March accounts for Q1, but everything that we see internationally in Q1 counts for Q2 in the accounting calendar of the year. So of the doses that were made this $1.5 billion for sales is a way smaller than the 6 million doses that you refer.

In terms of what we expect, we expect in this quarter to have 24 million doses. So by the end June to have been able to produce 30 million doses altogether. Clearly, some of them again will be shipped in July, clearly some of that will be shipped in June in international markets. So you should [Technical Issues] operating as we have in this quarter, but everything will go into, let’s say, in the second quarter for — of all this volume. Next quarter [Phonetic], please.

Operator

Your next question comes from the line of Terence Flynn with Morgan Stanley.

Terence Flynn — Morgan Stanley — Analyst

Great. Thanks so much for taking the questions. I know it’s a little too early to give 2023 guidance, but maybe, Angela, or Frank, you could just help us think about the puts and takes for Comirnaty for next year. And if you think consensus is in the right range at $17 billion to $18 billion.

And then my second question relates to Etrasimod for Ulcerative Colitis. Mikael, based on your comments, it seems like the placebo response rate in the Phase 3 trial might have been slightly higher than Phase 2, just wondering if that’s accurate and any additional insight you could share there. Thanks so much.

Albert Bourla — Chairman and Chief Executive Officer

Thanks a lot, Terence. Look, I will ask Frank, but good luck, he will not give you guidance for a product and he will not give you guidance for ’23, but let’s see how he responds to that question. And then, Mikael, can you speak about Etrasimod?

Frank D’Amelio — Chief Financial Officer and Executive Vice President

So I’m not going to provide a year guidance, but obviously, you saw what we did in 2022 guidance. We reiterated the guidance on Paxlovid, we reiterated the guidance on Comirnaty, by the way $54 billion approximately revenue while absorbing $1.5 billion of foreign exchange. And if you listen to the commentary we’ve had so far on Paxlovid, we remain bullish on Paxlovid if you look at some of the recent trends and you look at some of the charts that Albert provided. In terms of tenfold growth from the end of February to the end of April, number of sites that we’re at, 33,000 sites now. So the rhythm of that product looks very good and we remain very bullish.

Albert Bourla — Chairman and Chief Executive Officer

And, Terence, I will say that for 2023, there are opened to be a lot of puts and takes because there will be likely new innovation which is coming that we need to see how that plays and also in the same this in the business markets. There is a chance that the U.S. will go to the private market in the next year. I think likely internationally that we’ll continue with government purchases and we do have the contracts for these purchases that goes ’23 and beyond in ’24. So there are a lot of puts and takes that will be in play here.

But let’s move to something that it’s very interesting, Etrasimod.

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Yeah, thank you for your interest, Terence, there and I think, of course, the enthusiasm I shared was base on the pivotal studies that will be filed and sure noted at one of them did have a placebo right — slightly higher. The more extensive of the Phase 3 had a traditional placebo rate and a very nice delta between treated and untreated. As you know for great drugs, you would like to see in the range or maybe a 20% delta and while we won’t give you all details as we expecting data soon to be presented this year at the proper conference, I can assure you that we saw a very nice favorable felta for Etrasimod treated. We talked about 12 week remission rate in our earnings talking point. The drug did very well in the 52 week maintenance phase and all secondary endpoints are looking very favorable. So that’s really why we think it can be both a best-in-class and in some way a best-in-disease given its convenience, its rapid onset of action, it’s well-tolerated profile. Well, thank you for your interest.

Chris Stevo — Senior Vice President and Chief of Investor Relations

Thank you. Operator, next question, please.

Operator

Your next question comes from the line of Vamil Divan with Mizuho.

Vamil Divan — Mizuho Securities — Analyst

Great, thanks for taking my questions. Maybe just shifting gears a little bit to the quarter and some of the core products here. So one, I’m curious what Ibrance especially in U.S. because we — I mean you mentioned again in the release, it was down 5% and some of this was through the patient assistance program, and I sort of thought that was more of a 2021 dynamic, kind of going through the pandemic and by this year may actually be more of a positive pricing that you could see. So maybe you can just kind of share a little bit more color on what you’re seeing in the market there.

And then the second one is on Xeljanz, obviously down quite a bit, don’t know what the safety issues and they will have to — but I’m just trying to get a better sense of how you see that product going forward. You obviously have a good immunology pipeline and a lot of other assets to leverage here, but do you see Xeljanz stabilizing here, do you think it will continue to decline? So how would you view that product roughly in the next year or two going forward? Thank you.

Albert Bourla — Chairman and Chief Executive Officer

Thank you, Vamil. Very, very good questions, both of them. So, Angela, started with Ibrance growth results.

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

So let’s talk about Ibrance first, just from a performance perspective, I just want to emphasize that Ibrance so by far in a way the undisputed leader in the CDTECH class. Actually, in ex-US, it grew 12% this quarter and as you mentioned accurately, it did have a negative 5% growth in the U.S. and this was largely due to the PAP. In fact, if you strip that out TRX volume actually grew 3% in the U.S. Ibrance. So it’s really this high proportion of unpaid RXs that led us to this revenue growth and so on. Just to give you a sense of the scale of the PAP, compared to a year ago, we have seen a 32% increase in PAP applications, and however, Q1 was similar to where we were in Q4 in terms of the number of enrollees. But maybe if we step back, it’s maybe not so surprising that Ibrance will touch a high proportion of PAP because it is the market leader. More than 75% of all the script in the CDTECH class belong to a part of Ibrance. And so as you link back to the financial hardships that are still in the economy and you link back to the fact that they are reduced alternate sourcing of financial assistance, which is driving more people to Ibrance cap. Now, also just from an annual perspective, patients enroll in January, most of them and at this stage for the year. I think what we’re seeing is approximately what we’re going to continue to see for the remainder of the year. But maybe the important message here is that this does not mean that there is no growth opportunity of Ibrance even in 2022. We know that there is tremendous growth opportunity in the CDTECH class and our ability to make this tie bigger is going to be great for patients as well. We saw just in the last year, an increase of the CDTECH class from where we were in Q1 of 2021, which is just 48% to where we are now this quarter in ’22 which is 54%. So this positive momentum on the growth of the class is something that we are very focused on. In addition to the fact that of course over the pandemic, we did see some lag in new patient start and new — and diagnosis of our metastatic breast cancer patients with delays and putting them on treatment and so that’s another area of focus for us as well as will help to drive the increased momentum around Ibrance.

So that’s Ibrance. So let’s spend a minute talking about Xeljanz and your question around sort of where are we with Xeljanz and what do we see and we definitely see 2022 as a year of transition for us. Why? Well, first, when you step back and look at Xeljanz performance, you have to look beyond Xeljanz, it’s not just about the product. It’s also about the class. And so, just to give you some numbers on what has happened in the class, over the last year, so between this quarter and same quarter last year in 2021, the new to brand prescriptions from the JAK class actually went down 40%. Now, Xeljanz went down 50%, but we also saw a product like, other product in the JAK class go down by 35%. So when we look at growth, it’s important that the cut returns to growth as well. I think that ’22 is going to be year of transition for Xeljanz because we finally have a clear label, and with this label, we’re going to be able to focus on post-TNF — that post TNF segment as our place and as the place where Xeljanz can play.

And this market is also significant because we know that many patients don’t respond to TNF and most will need options beyond TNF. And finally, we are seeing some nice signs of stabilization compared we were — compared to where we were over the last year. For the first time, our new to brand RXs are stable. [Technical Issues] declining. We’re also seeing that there are switches back into Xeljanz versus just purely away from Xeljanz. In our market research, we see a increase in the intention to prescribe by healthcare professionals.

And then finally, also in the market research, we see that the safety perceptions of Xeljanz are equivalent to that of Rinvoq, so it demonstrates the playing field in the JAK class at ground level. So we really focused on education. We have massive education efforts behind Xeljanz to reestablish where and how Xeljanz should be used and that’s what gives us confidence that we can return Xeljanz to growth.

Albert Bourla — Chairman and Chief Executive Officer

Thank you. Thank you, Angela. As always, very comprehensive answer. Operator, to the next question, please.

Operator

Your next question comes from the line of Kerry Holford with Berenberg.

Kerry Holford — Berenberg — Analyst

Hi, thank you. A couple of questions, please. Firstly on COVID vaccine. I noted in your 10-K that you expect to recognize at least $11.8 billion in revenues in 2023. Should we think about that as a floor for next year based on the contracts you’ve already signed and if so, have you signed any further contracts to delivery in 2023 and beyond since published that 10-K in February?

Secondly on the RSV vaccine. I saw in slide 36, you are not confirming the Phase 3 data readout for the older adult vaccine now in the second half of the year. And is that solely to reflect the expansion of the patient population within the study? Do you need to run into another RSV season? Or are you — we’re still evaluating annual RSV extreme vaccinations in this study?

And lastly, when do you aim to file and launch that product in the U.S.? Thank you.

Albert Bourla — Chairman and Chief Executive Officer

Thank you very much. Frank, do you want to give the answer on the —

Frank D’Amelio — Chief Financial Officer and Executive Vice President

Just in terms of 2023, we’ll talk about 2023 in detail when we provide 2023 guidance, which will be on our fourth quarter earnings call. We’ll talk about the puts and takes, we’ll explain where we are this year, where we are next year, what the growth drivers are and obviously that will include what the revenues will be for the COVID vaccine. So that’s to come.

Albert Bourla — Chairman and Chief Executive Officer

Thank you. And then, Mikael, you want to take the RSV question about the seasonal hiring —

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Yeah —

Albert Bourla — Chairman and Chief Executive Officer

I mean if you have anything to add, please —

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Yeah, as I spoke in the introduction, Pfizer is very excited about the portfolio of the RSV vaccine and RSV therapeutics. And I think we have had very strong data in the Phase 2 challenge study complete protection and also in the maternal study where we actually with small numbers had a 85% efficacy and very strong immunogenicity across the A and B strains. I believe we are the only one with such a comprehensive data set. Starting with the maternal, to the best of my knowledge, we are really the only advanced RSV vaccine there. We took the opportunity as we had sites opening up in Latin America to also capture from that region of the world and in this now 2022 season, more cases to add to our study and we expect in a couple to a few months to have the readout based on where we’re going now for the maternal. And relatively shortly thereafter this year, that also trial is expected based on comprehensive set of sites also in the Southern Hemisphere.

So it’s really a perfect composition of RSV cases from different parts of the world and I look forward very much to the readout and remain very optimistic. Its one of my favorite programs.

Albert Bourla — Chairman and Chief Executive Officer

Mine as well. William, anything to add?

William Pao — Chief Development Officer and Executive Vice President

I mean, I think, yeah, I would just add that you mentioned already Mikael that both programs got breakthrough designation. And so we’re very excited.

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Of course, everybody recognized that Israel apparently the favorite programs of everyone.

Albert Bourla — Chairman and Chief Executive Officer

Let’s move to the next question, please.

Operator

Your next question comes from the line of Steve Scala with Cowen.

Steve Scala — Cowen and Company — Analyst

Thank you very much and thank you, Frank, for everything and all the best to you in the future. I have a follow-up on the RSV vaccine in which ACIP meeting in 2023 with the Pfizer vaccine most likely be considered and I assume, of course, you have not seen premature birth in the maternal study, but do you have a theory as to why you haven’t your competitor has?

And then a question on Eliquis for Angela. To what degree has bleeding risk limited prescribing of Eliqui? And if a drug came along that was associated with less bleeding, do you think that would be a significantly preferred agent? Thank you.

Albert Bourla — Chairman and Chief Executive Officer

Great. Angela, why don’t you take the ACIP meeting and then also the question on the bleeding. And then we can go to Mikael.

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

You know ACIP, the schedule by ACIP is just closely held by the ACIP, the working group, and the CDC. So it’s a really typical thing for me to be able to predict. But typically, it’s sort of within the two to three month period from launch because you know that it only happens several times of the year. So you really need to be able to catch it right to be able to meet whatever that next meeting is. So I want to say that’s a very difficult question to answer, but suffice to say that of course, we will work as rapidly as possible to ensure they’ll get on the schedule of the very next month of the launch.

On your question around bleeding, it is not been one that has come up actually for Eliquis. In large measure I have to say our performance continues to be really strong. We’re the number one Novak in 24 markets. We are the number one oral anticoagulant in 21 other markets. So I’d say that the uptake of Eliquis outperformance, which as you can see, this quarter continues to be double-digit, I think it’s the 10th year in a row that we’ve had double-digit growth on Eliquis and we continue to see tremendous market share and utilization. So I would say that that has not been an issue that we had.

Frank D’Amelio — Chief Financial Officer and Executive Vice President

And if I could just punctuate, if you look at the revenue number this quarter for Eliquis, the revenue number is $1.8 billion, almost up 12% operationally. Continued strong performance by that product.

Albert Bourla — Chairman and Chief Executive Officer

Exactly. And also I wanted also to add to Angela’s comment from of course, can’t predict when ACIP will do whatever they think is appropriate to do, but we do know that that is risk considered by CDC as a major disease threat and [Speech Overlap] is that we’ll demonstrate the appropriate urgency as you see to deal with — if actually and if it is registered. Mikael, there was this question about pretty much sort of bears that we do not have. And if you can provide why we don’t and why others may.

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Well, we have a very deep and long experience how to design vaccines and for different patient groups. As this is for maternal, we obviously developed a very well-tolerated vaccine and we were able without the need of any harsh adjuvants to get very high immune responses that included that we use both RSV A and B and I believe we are only one that have that going. I can’t really be certain on the other vaccine you’re referring to, but certainly it’s not an advantage to use an adjuvant that was known to give a very significant local and systemic adjuvant directions for a fragile patient group like maternal. So we feel very bullish that we are their main vaccine in the maternal with only that have a bivalent, strong data behind it and look very much forward to the readout.

Chris Stevo — Senior Vice President and Chief of Investor Relations

Yes, sir. Operator, please move to the next caller, please.

Operator

Your next question comes from the line of Colin Bristow with UBS.

Colin Bristow — UBS — Analyst

Good morning and thanks for taking the questions. And I wanted to say all the best to Frank. So a couple of my side. On the business development front, could you comment on how large a deal you would be willing to consider? And is there a preference in marketed assets or pipeline or some combination of the two and then just in terms of disease spaces, I’d be curious to hear how you view the rare disease category as an area of potential of the business development from here?

And then just a quick one on Paxlovid. I understand your prior comments, but I just want to get a sense here on what is the risk that we end ’22 and obviously, these doses have been purchased but are essentially stockpiled or not utilized which could subsequently impact ’23 onwards. Thanks a lot.

Albert Bourla — Chairman and Chief Executive Officer

Thank you very much. Why don’t we start with BD questions then we’ll ask Aamir Malik to speak about it.

Frank D’Amelio — Chief Financial Officer and Executive Vice President

Colin, thanks for your question. On our BD focus, I think we’ve been very clear that compounds that have the potential to be breakthroughs is where our focus is and these can be in the form of late-stage clinical development that can be in earlier medical innovations as well, as well as early launches. We’re going to bias to the TAs where we have scientific and commercial expertise because we can add value and we’re going to be flexible on deal structures.

And on your question on size, we’ve been very clear in the past that we’re agnostic, but we’re not going to focus on deals where cost synergies are the primary source of value creation. We’re going to focus on deals where we can add value, we have a scope to have impact, and where there is going to be revenue impact in the ’25 to ’30 time period. So that is our current books.

Aamir Malik — Chief Business Innovation Officer, Executive Vice President

Thank you very much. I mean, and as we said multiple times, it is important to see Pfizer as a partner of choice. So it is important to see Pfizer as the company that can add value either by acquiring or by partnering molecules with companies to the same extent that we have proven with other biotechs that we can provide benefits to patients by putting our capabilities into work and that’s I think — it is the way we’re moving forward. And clearly, we are focusing on filling the gap between ’25 and ’30. We started this call again by making — myself making comments. We reiterate that we plan to have $25 billion of risk-adjusted revenues with expectations by the year 2030, and we feel that we are moving as per plan to achieve that goal.

Now let me turn to, speaking little bit about exploring and the question about, is there any risk but the quantities will be purchased will not be utilized.

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

So I think when we think about our contract and what has been purchased, we also think a lot about demand right, like generating demand and utilizing the products. And I think that the U.S. gives us a good example of what you can see when utilization and adoption picks up. You heard from our opening presentation that just in the last few weeks, we saw all the prescription Paxlovid grow 10 times. And I just in one week alone, it got as high as 80,000 prescriptions that were dispensed. You also heard that there are 30,000 sites that are available now in the U.S. that dispense Paxlovid and that is increasing. Deep dive to those Test to Treat sites, which were only 1,100 at the beginning of April and now has doubled to 2000, and you add upon that the U.S. government’s announcements around their focus on increasing more sites.

All of this is showing momentum around Paxlovid is real and that there are a few sort of like key levers that open up this asset. One, is the number of sites and the proximity to patients. And two, it’s the education around how to use Paxlovid and who are the patients that are eligible. And so when you think about what has happened in the U.S. You’ve now are beginning to see that have been around the world as well. We see that demand is increasing and you heard Albert speak about how countries that have purchased from us are now coming back with reorders. You’re also seeing in, across many countries, how they are changing the eligibility for criteria for Paxlovid as well as the number of sites where Paxlovid can be accessed much like what we’re seeing here in the U.S.

So I think when you add all of this up, what we are seeing is the fact that there is demand for this product. We also see that the social — that the removal of the mask mandate, the social distancing requirements that have been removed, you also know that in the EU that just in the last week, they’ve removed the emergency period of the EUA. That means that people are going to get out there. We know with all of that, infections are going to increase. And that’s the role that Paxlovid can play.

So we’re intently focused on working with national governments, state governments and in helping them to educate to take great lessons learned from around all the different countries to help them to utilize Paxlovid and importantly, what we’re also seeing is that it’s not as — we don’t have any inventory on hand. Every dose that we produce is being shipped out and is being ordered. So I think all of these give us a lot of confidence that there is a demand for Paxlovid. We know what we need to do to support the utilization and will continue to drive that throughout the year as we anticipate further surges in the COVID infection.

Albert Bourla — Chairman and Chief Executive Officer

Thank you, Angela. And also what the Angela said, I want to reiterate that. Unlike what we have seen with the partners vaccines that the governments were trying because of lack of manufacturing capacity to build stocks. Right now, the orders that are coming are orders not for the entire year. They are orders for the immediate needs of the countries and this is why we have repeated orders of countries. That’s a gross building all kinds of that we see internationally. Okay, thank you very much. Let’s move to the next question, please.

Operator

Your next question comes from the line of Carter Gould with Barclays.

Carter Gould — Barclays — Analyst

Great. Good morning, and best of luck to his post Pfizer endeavors. I appreciate all the color on Paxlovid right there. May be moving to the pipeline. In highlighting your UC franchise, the slides you focused on Etrasimod and would like — notably didn’t mentioned your TL1A program. Has your enthusiasm there shifted now that you have the induction data in-house?

And on the IRAK4 side, I saw the discontinuation in HS. Has that changed in any way? How we should think about development in RA. I believe that got removed from your early stage readout calendar. Thank you.

Albert Bourla — Chairman and Chief Executive Officer

You very much, Carter. Mikael, the floor is yours.

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Yeah. I did speak about that Etrasimod creeates a very rounded and comprehensive pipeline. I think the TL1A date that as we have in our hands and it will be I shared earlier in previous earnings calls some of it is very strong. Actually, to the best of my knowledge in the biomarker selected group it probably the strongest or among the very stronger that I have seen, I think it can be a very much complementary drug to Etrasimod and we also know that the TL1A principal not just is anti-inflammatory but also play a role in fibrosis. We didn’t have much time to speak about with Lucitanib beyond our really exciting data that we shared in Vitiligo. We also have additional inflammatory drugs that are coming to readouts with strong data behind them for potential start to pivotal such as in different beta in inflammatory muscle of diseases. So I would just say we have the advantage of a richness now of inflammatory drugs and really building a pipeline with complementary approaches and we hope to share more which are the ones that will be kicked off soonest from the menu options that we now have on our hands. But TL1A, clearly a very active drug.

Albert Bourla — Chairman and Chief Executive Officer

Thank you. Next question, please.

Operator

Your next question comes from the line of Andrew Baum with Citi.

Andrew Baum — Citi — Analyst

Thank you. Couple of questions, please. Firstly, Pfizer’s the leader in cardiology from both system Hemostasis. Four of your competitors have Factor 11 A inhibitors in clinical development. There is still significant unmet needs in Zithromax despite the Novacks. I’m curious as to why you have passed on the opportunity and what data would make you change your mind to review your decision.

And then the second question is going back to the barriers, the Paxlovid adoption that have existed historically, you’ve addressed addressing the access barriers, but in terms of physician education and holding back prescribing because of fear of supply, patient awareness, how would you delineate the percentage contribution of those to the current under-utilization of Paxlovid and what do you think of the timelines for knocking down the separate reasons? Thank you.

Albert Bourla — Chairman and Chief Executive Officer

Thank you. Mikael, why don’t you take the cardiology question?

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Yeah. First of all, we think the breakthrough with Eliquis, the Novacks was so dramatic for patients and physicians from Warfarin, which you know had many issues of significance, including a very complicated dosing and risk for bleeding. While we monitor new drug classes, including the one that you have mentioned, we really want to see a similar step up in breakthrough potential as we saw with Eliquis and we haven’t yet been convinced about that step-up, but we are carefully monitoring and internal medicine and cardiometabolic diseases, it’s an area that we think are very interesting and you, of course, heard us speak about oral GLP-1 as another very important growth area.

Albert Bourla — Chairman and Chief Executive Officer

Thank you, Mike. And then Angela, what about the education whether plan to do alone or with governments to address other barriers of Paxlovid like the perception that it is not available or other stuff that Andrew spoke about?

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

Well, education is key and it underpins the promotion of all of our products. And I think the first comment I have to make is that you all know we’re under EUA and in the EUA, we are really, we have limited by what we are allowed to talk about and also limited by the level of promotion that we would typically do, and that’s why you see that much of the education that is occurring right now is coming from the government whether that’s the CDC or at the state level, state departments health and how they’ve chosen to rollout the messages regarding antiviral treatments. Of course, we’re supplementing that by what we can do. We put public service announcements out there. We’ve utilized our field force in the appropriate way to convey what we’re able to through EUA and there is a — just a significant amount of medical education as well that we are doing, again, also in an EUA-appropriate way to support our brand. But of course, this doesn’t look anything like what we would typically do if we had a full commercial launch where we would have the ability to really deploy the entirety of our promotional engine towards education and towards support of both patients and physicians. So I would say that the education is happening and we are doing our part. And as I think that there is a lot more that can be done, but I think the second part of your question was also around how much does this contribute to the bigger issue, and I want to say that truly the ability to access this product quickly is one that even though there has been great improvement, I think that there still a long way to go, even with all the improvements that we have had recently. We’re still a fraction, I would say on behalf of all the possible retail locations where Paxlovid could be found. So tremendous that we’re seeing this uplift. But I would say that we need to continue on the path of where we’ve been and continue to do more because there is still a lot more that can be done.

Albert Bourla — Chairman and Chief Executive Officer

Thank you, Angela, of course, I want to also say that I have also not seen the government being so active if they truly believe it is that way to control hospitalizations and deaths. And we see that their own educational campaigns are working because as we have seen, there is a tenfold increase asking in a few weeks. And I think that come together with all the measures that they are taking. I think we’ll yield even more impressive results. I’m confident. Let’s go to the next question, please.

Operator

Your next question comes from the line of Chris Schott with J.P. Morgan.

Chris Schott — J.P. Morgan — Analyst

All right, great. Thanks very much. Just two additional Paxlovid ones. I think in this question of kind of contracting, it seems like we saw a lot of activity late last year, early this year, but it’s been a bit more quiet I guess more recently on the contracting front. So I know you’re expecting more contracts for Paxlovid, but just qualitatively, can you just give us a sense of how broad of a swath of the market has already entered in contracts they’re going to satisfy demand this year relative to how large of a portion of I guess a realistic global market are still in negotiations and still need to come up to some agreements? I’m just trying to get a sense of like what is the TAM look like versus what’s been contracted.

And then my second just one on Paxlovid was there seems there’s been several data points of kind of Paxlovid like COVID rebound occurring in some patients. Is that something you’re seeing in your data and just how you’re thinking about it kind of addressing that as we kind of learn more about the longer-term outcomes in some patients there? Thanks so much.

Albert Bourla — Chairman and Chief Executive Officer

Thank you very much, Chris, excellent question. Angela, what about our contracting?

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

Well, I have to say that I’m really pleased with how our contracting has gone. You heard Albert talk about the 100 countries that we are can engaging with and actually compared to where we were last quarter, we’ve made some really nice and significant progress. In terms of the number of countries. just to give you a sense, we’ve actually — and when we think about the $22 billion in guidance, by plus the $500 million that we’re absorbing from foreign exchange, when you think about that part of revenue, it really consists of countries that we have finalized contracts with as well as countries that we anticipate to close — anticipate to close shortly. So there are sort of two buckets of countries in there and what I’m happy to say is that compared to where we were in the first quarter, we are three times larger in terms of the number of countries that have actually finalized contracts. So that’s a good thing. But in addition to that, we have bilaterals, as ease of being completed or about to be completed with 60, of the 60 countries and that doesn’t count a multilateral agreements that we are also having, you heard about UNICEF earlier today from Albert. We have others as well in the work.

So I think when you think about the total addressable market, as you say, I think that we are not done, but we have combed through a large proportion of them, and that gives me great confidence in our ability to meet the guidance that we provided you.

Albert Bourla — Chairman and Chief Executive Officer

And also, I want to reemphasize that work is different. The Paxlovid contracts is that we signed a contract, with typically they start with smaller volumes and then they keep ordering and reordering, very important to have the legal framework, so that the country can order first, which we have done, but they are ordering based on their needs rather than based on emphasis to build stocks, which in fact, had also by itself shows that with signed contract you expect more because is not that they cover the whole year. For the course, all will depend on the usage in the field. We are optimistic but we need to see how big users in the field go.

William, would you want to take the COVID rebounds?

William Pao — Chief Development Officer and Executive Vice President

Sure. So, we take very seriously the case reports that have been anecdote so far in terms of potential rebound to Paxlovid. To respond to that, we’ve taken some preliminary look at our EPIC high-risk data and so we’ve seen for example that we’ve — about incidents about 2% of that viral load rebound but we also see the same or close to the same percent in the placebo arm. So it’s something that’s not particularly associated with Paxlovid, but may have something to do with the virus itself. We’ve also looked for patient characteristics and potential recurrence of severe symptoms and we haven’t seen any association with patient characteristics or severe symptoms developing in these patients who rebound.

And then finally, we haven’t seen any association with mutations in MPRO, which is the target of Paxlovid. So it’s preliminary data so far. We, again, take it very seriously, but it’s coming in a very low incidence. And we continue to learn as we go.

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

That was a very good response, Will. So I’ll just add as we do a surveillance of patients in very large databases and we have access to more than 300,000 Paxlovid treated in one of the database, we have reports of this happening in less in about 4.005% or less, which is less than one out of 3,000 treated patients. So overall, it’s quite uncommon, but as we spoke about it’s not really related to Paxlovid but more to the individuals that in dire need to clear the virus, and it is a virus that can either re-infect patients or there can be reservoirs left in the pension.

Now, what we also learn is that for some patients immunocompromised may carry these virus a very, very long time, and we see that area as a real new opportunity growth area for Paxlovid to do very well, where you may need to take multiple quarters over a year or even treat with extended duration and that’s something we now planning to study in order to expand the use of Paxlovid, where it may be the most appropriate and lifesaving.

Albert Bourla — Chairman and Chief Executive Officer

And as Mikael said, the work of Paxlovid is to reduce the viral load. And so as a result, help your body overcome the disease faster and without serious consequences. It could be that in some cases, there is bound as why the label speaks about the second treatment, but they can be given and also need to think but if by reducing and it simply in all these cases, I mean part of the — they truly did they were supposed to do, which is reduce the virus load because they became negative. So then they came back, I can only margin if without help exploring point, what would be the clean and go symptoms of the patients. But the answer is coming back. So as forget this where people, but they’re already sick and we have them go easy with disease, easier than without the Paxlovid and so far its working extremely well.

Let’s go to the next question, please.

Operator

Your next question comes from the line of Tim Anderson with Wolfe Research.

Tim Anderson — Wolfe Research — Analyst

Hi, I have a couple of questions. Prevnar 20 in pediatrics, franchise pieces 75% of current usage. It looks like the readout of your peers trials have slipped from first half to second half. I’m wondering if you can explain why. And if that impacts your confidence in the readout at all?

Second question. Your biosimilars are growing. Your press release mentions interchangeable HUMIRA. We have no real precedent with Part D biosimilars in the US, my view has been that Abbvie is going to hold on to more shares than what they’ve been guiding for. But as you’re on the other side of this, I’d love to get your perspective. I know your launch is year away, but what are your expectations for uptake in the U.S. for biosimilar HUMIRA whether it’s yours or anyone else’s. And how do you think that will compare to what we’ve seen with biosimilars with Part D drugs like Avastin.

Albert Bourla — Chairman and Chief Executive Officer

Thank you. Mikael, Prevnar 20?

Mikael Dolsten — Chief Scientific Officer and President, Worldwide Research, Development and Medical

Yeah. You know, it’s a very minor shift. We’re predicting earlier mid of the year and we now see it will come in the second half, not too far away from our original prediction is what I believe and it was just affected by COVID, and they’re easy which we could get infants vaccinated. So overall on track for readout. We had a very good readout with adult. I have no reason to believe that we won’t have also very good performance in the clinical trial or the pediatric. Thank you.

Albert Bourla — Chairman and Chief Executive Officer

About the uptake of biosimilars HUMIRA, Angela?

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

So we are optimistic about the uptake of biosimilars. I think we’ve learned a lot over the last several years. And if you look at our experience with Inflectra you look at our experience recently with our six biosimilars in oncology and they’ve just– they’ve gained tremendous market share. I think that physicians and institutions have become extremely comfortable with the use of biosimilars, you know, if I compare our experience with Inflectra when that was put onto Infliximab and I compare that to what I see now with the six biosimilars we just launched in oncology, very different experiences in terms of willingness, in terms of uptake, and comfort for physicians to use it. I think we’re very far from where we were when we first launched biosimilar here in the U.S. That coupled with the interchangeability data should mean that we would be able to gain a fair market share.

Albert Bourla — Chairman and Chief Executive Officer

Thank you. Next question, please.

Operator

Your next question comes from the line of Geoff Meacham with Bank of America.

Alexandra — Bank of America — Analyst

Hi. This is Alexandra on for Geoff Meacham. Thanks for taking our questions. Maybe to follow-up on the previous response, what’s Paxlovid capacity like? To what extent is guidance potentially constrained by any limiting factor, whether in terms of production or potentially distribution? In other words, if the contracts were there, to what extent do you think they could adjust the near term? And then, can you maybe comment on the pace of business development? As we think about some of your longer-term growth targets and where you sit now those gaps, are you still comfortable with the current trajectory? Thank you very much.

Albert Bourla — Chairman and Chief Executive Officer

On the expanding capacity, we are on the plan. So we will make 30 million treatments available this year — excuse me, this June, the first half of the year. We have already built our capacity can make 120 million by the end of the year. I don’t think, given this very high ramp up, the capacity will become a limiting factor to goverment’s in place orders, and anyway, as we see, we don’t have situations that they are placing orders that we keep in their warehouse. So they are placing orders so that they can use. So it’s always manageable reordering. And we will be able to meet this demand, particularly, we are cognizant that waves are coming. So far, not necessarily in terms of seasonality, but everybody expects when you come after mass gatherings in the summer or as we are entering into the flu season, there will be, let’s say traumatic uptake. So in not period of time, we will have really a look of exploring available, so I don’t foresee any issues on that.

And then on the — what was the second question?

Frank D’Amelio — Chief Financial Officer and Executive Vice President

Pace of business development.

Albert Bourla — Chairman and Chief Executive Officer

The pace of business development. Aamir, you want to take up?

Aamir Malik — Chief Business Innovation Officer, Executive Vice President

Sure. Alex, thanks for the question. You heard Albert very clearly reiterate our commitment to $25 billion in risk-adjusted revenue by 2030 and we fully believe that we can and will get there. We’re going to be very active in BD, and that also means being thoughtful and thorough, and disciplined. So when we see a great opportunity, we’re not going to hesitate to move fast and I think some of our recent deals are good examples of that and our ReViral acquisition is a good example of our first move towards that goal. And at the same time, we’re not going to be hurried or cavalier just for the sake of doing deals quickly. So we will move fast, we’ll be thoughtful, we’ll be disciplined, and we are very confident in the aspiration that we put out.

Albert Bourla — Chairman and Chief Executive Officer

And I wanted once more to reiterate, we totally think there is substrate to do good deals that will provide us $30 billion [Phonetic] risk-adjusted, but we are going to be disciplined. We can accomplish them. It is — we will accomplish all of that without compromising on financial returns that are expected. And we truly feel that we can accomplish both and we will accomplish of course in the next few years. We need to do to complete these activities over the — we will be able to have an impact in the trend, the client 2030 period of time. But I reiterate, there is substrate to do good deals and where do a lot of only good deals.

Aamir Malik — Chief Business Innovation Officer, Executive Vice President

$25 billion by 2030.

Albert Bourla — Chairman and Chief Executive Officer

$25 billion by 2030. What did I say?

Aamir Malik — Chief Business Innovation Officer, Executive Vice President

You said $30 billion.

Albert Bourla — Chairman and Chief Executive Officer

$25 billion by 2030, not $30 billion, by demands. So let’s go to the next question.

Operator

Your final question comes from the line of Robyn Karnauskas with Truist Securities.

Robyn Karnauskas — Truist Securities — Analyst

Hey, guys. Thanks for taking my question. So just first unpack COVID contracts. You mentioned that there is a bucket of contracts where you’re further away from signing. Can you just give a bit more color on what the rate-limiting steps are for signing in those countries or signing those contracts? Are they in areas where there is less infection, for example?

And then second on the booster, just a follow-up question, it seems like there’s a lot of debate about how long the immunity lasts with the boosters. And so how far away do you think we are scientifically from a longer asking — longer-lasting mRNA booster? Thanks.

Albert Bourla — Chairman and Chief Executive Officer

Fantastic questions. Angela, what about the contracts?

Angela Hwang — Group President, Pfizer Biopharmaceuticals Group

So they’re not infection-related, literally, its just time. We have many countries to get to and each one of them has their own internal process to — that need to go through. So there’s really nothing here other than just getting through it and time.

Albert Bourla — Chairman and Chief Executive Officer

Thank you, Angela. On the boster, let me make for some final comments before we’re out of time and also try it one [Indecipherable] clearly, COVID is the main uncertainty for the world and for as a company’s — but there are trying to really make a difference with COVID. And — but I think we don’t know the future, but there are some scenarios and they are the most likely. I believe that the most likely scenario should be seeing right now it is that the virus will be around and the virus will evade, and we know about the characteristic of this virus. In addition to mutations, it is a dozen produce long lasting immune protection, not only through vaccinations but also through natural infection. People that are getting sick, they will get secure. They can get again sick with different or with the same. We know that after some time.

The second thing that we know that the social distancing measures provide one of the main way to control the disease spreads in the first two years of the pandemic, so the pandemic will ease. It is happening because now — they too have a treatment in their hand which they can count, so they can release, let’s say, the measures, they are not as skeptic as before to see overwhelming of hospitals, but also it is happening because the societies are pushing forward. So there is a tremendous pressure across the world to get our lives back. And as a result of this, I think it’s very clear that we will have waves, that we will be more and more would be affecting people and therefore what we need to have constant vaccinations, compliance with the vaccinations, and their effective treatment. Right now people it’s clear, for the skeptical in vaccines, but it is not clear if that would be needed to take another one and then another one. It’s a particular time from the repeated booster, so it is extremely important to come through vaccine. But it could be a yearly vaccine. And [Technical Issues] is not technically easy, let’s say, it is challenging, but we are having very good scientifical edge on that. So we are working on that. So when it comes to vaccines, I think this is what needs to be the next steps to be able to stay ahead of the virus, which we are in terms of the new variants but also trying to go for the next generation that would here in the vaccine.

And of course, when it comes to the treatments, we need to make sure that we grow with the manufacturing and the availability because the usage, unfortunately, I expect the need — let me put it other way. The need, unfortunately, will increase as if we are moving through less social distancing measures and provide. So that’s how I will just wanted to answer the booster question in terms of a long-acting booster.

And I want also to thank you, everyone, for your — for today’s call. We are seeing very strong signs of increasing demand for Paxlovid. It remains one of the best tools we have. I’m proud to have been able to recruit some of the best and brightest external minds to add to our talented roster of people. I’m proud that we have been named the most patient-centric company based on feedback of more than 2000 patient organizations and associations. It’s a testament to the important and innovative work our colleagues do every day in pursuit of our purpose.

And I want close once more by thanking Frank aboout his tremendous contributions and his friendship to not only me, but many of executives at Pfizer and wish him well in his after Pfizer, although, as he said, he remains a major shareholder. So he will be attending all — everything that’s happening here. Thank you very much, everyone.

Operator

[Operator Closing Remarks]

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