Operator : Ladies and gentlemen, welcome to Roche's Half Year Results Webinar 2026. My name is Henrik, and I'm the technical operator for today's call. Kindly note, the webinar is going to be recorded. [Operator Instructions] One last remark. If you would like to follow the presented slides on your end as well, please feel free to go to roche.com/investors to download the presentation. At this time, it's my pleasure to introduce you to Thomas Schinecker, CEO Roche Group. Mr. Schinecker, the stage is yours.
Thomas Schinecker : Thank you very much, and good morning, and good afternoon, everyone. I'm very much excited to share our half year 2026 results with you. We again had a strong performance, and we truly made significant portfolio progress in the second quarter. Now let me take you through this slide. I think the headline says everything. Core operating profit growth at plus 10% ahead of sales growth at plus again, increasing our margin similar to what we have done over the last couple of years, events driven really by both divisions, both pharma and diagnostics. Diagnostics without the China impact is growing 6%, and let me just also reframe the impact of the flu season. The flu season had about a 1% or more than CHF 200 million impact on the group results. So without that, also, we will be growing at 7%. And I already mentioned the strong bottom line performance with core operating profit plus 10%; core operating margin plus 1.7 points. Core EPS plus 9%, very strong performance. We had significant milestones that we have achieved in Q2. We have 5 U.S. FDA priority reviews in for example, for Tecentriq, but also in Gazyva. We have made a number of progress in terms of filing, for example, in entering thyroid disease. So overall, extremely good regulatory progress. On the pharma readouts, we had 2 positive Phase III results as well. Overall, the Phase III success rate in this year is 80% and with that significantly above the average of the industry. So I think here, also, we are making very good progress. On the business development side, I would highlight 2 that I'm going to also mention later. One is PathAI, the other one is Nurix Therapeutics. On the diagnostics launches, we've had also significant amount of launches that I'm also going to go through and I know Matt is going to go through as well. We have significant new flow ahead, including Phase III readouts for iToF and Lunsumio and potentially a new NME sefaxersen. So in the pipeline right now, we have 3 new NMEs that we're going to launch, but with cifoxersin, could be a fourth one. And then some Phase II readouts. So overall, quite a lot of news flow in the second half of '26. But even more, if you then look at '27, '28, '29, we have really huge amounts of news flow coming with really a lot of potentially very big medicines. and also a lot of derisked assets. So we're really, really excited as we look into the next years when it comes to our pipeline. Again, let me just highlight our numbers, 6% Pharma, 3% diagnostics. I already mentioned the impact of the flu season and also the health care pricing reforms. So overall, very good track. Here, you can see the sales growth over the last quarters, and we'll continue to see good uptake in also in the rest of the year. And as we move into the end of the decade and into the next decade, as I've shown to you in previous presentations, we believe that we will continue to have a good momentum. And yes, we feel comfortable with where we are at the moment. really good growth across the different parts of our portfolio. We have a very diversified portfolio. We have in total 16 dockbusters. We're globally #1 in diagnostics. We also have very strong market position in many of the areas like hemophilia, ophthalmology, neurology, oncology, et cetera. And here, you see just some of the news, Vabysmo where we continue to see good global growth at market share gains. There is, of course, the U.S. market, which is only growing low single digit, but where we keep gaining market share also in the immunology portfolio with [indiscernible] and Gazyva, we have really good progress. And just to point that out with TL1A, of course, next year, it's a new medicine coming into this portfolio. On oncology as well, FESCO conversion ongoing, the HER2 breast cancer franchise will peak in 2026 with a strong tail. Tecentriq, we see accelerated growth driven by new indications. And Alecensa, we expect flat growth for the full year. Continuing with Polivy continued strong first-line DLBCL uptake. Columvi driven by second line plus DLBCL and also by third-line follicular lymphoma, Hemlibra very strong growth in the first half year, double-digit and also in the neurology franchise, we're growing quite well. So let me talk a little bit about portfolio progress. And portfolio progress is a combination of our own R&D and also bringing in external assets like we've done in the second quarter. We've been quite disciplined when it comes to BD activities. And at the same time, we've built an amazing pipeline in the late stage, but also early stage. So we have a very full pipeline. And I think when you look at the deals that we have done, usually, we were not the highest bidder when we won the deals. So I think this discipline is something that you can count on as we allocate our money that we do it in the right way. You can see a couple of acquisitions we've done. You see a number of those have already moved into Phase III. The latest 1 is the BTK degrader. in hematology, but potentially also in immunology and urology. Feliprutinib is BTK inhibitor with a degrader, we see even more reduction of the protein, and we believe that this could be a next-generation molecule here with a proven mechanism of action. So we feel this was a very good move for us, especially also because of our strength in hematological cancers and also in immunology and neurology. And here, usually, when I talk to the slide, you have some red boxes. We had no red box in the second quarter, which really also shows that we've had really good pipeline progress. And just to take you through here, guradestrant. We have filing acceptance by the FDA. We have FDA priority review we expect to launch towards the end of the year. NXT007 moved into Phase II. This is the next generation of Hemlibra. Feedback has been very positive so far. It's about 30x more potent but also very safe I already talked about the BTK degrader. Diverse, I know Teresa will cover that very good data. Also cevostamab has continue to progress well as well as the HER2 tyrosine kinase. This is a brain penetrant molecule for HER2 positive breast cancer, really also addressing one of the biggest unmet needs there. to tackle the brain metastases that are developed in HER2-positive breast cancer, so also very exciting. And on the obesity side, we've also had interesting data on petrolentide, specifically when it comes to tolerability, placebo-like tolerability. And we know that on current medicines, most of the patients never go to the highest dose. They actually end their dose in the midrange where you would get to the same kind of weight loss with petrelintide, but we also know [indiscernible] have a higher level of side effect. And this is really a medicine that's extremely tolerable. Now let me go to the diagnostics side and just show you some of the external activities that we've done over the last couple of years. And I would like to pick one from the last years. That one is Stratus, sequencing by expansion technology which we have acquired in 2020, which is really the basis for the AXELIOS sequencing. And I've always promised that we will deliver and we did deliver on the sequencing with really a differentiated product. And then Matt will go through that. In addition, we've done 2 additional acquisitions in more of the oncology space. One is Saga Diagnostics for ultrasensitive minimal residual disease testing. You know the market cap of some of the companies out there that are working in the space. The really interesting thing about this is not only the really ultra-high sensitivities, but you actually sequence the cancer and we have AXELIOS. And then you monitor bispecific primers and you do it on digital PCR, which is highly cost effective, and we have a digital PCR system. So we are extremely well positioned here to really scale this on a global level, much better than some of the other players. On PAT AI, this is really AI-driven diagnostics -- AI-powered diagnostics, specifically in the pathology lab, reading the slides and really improving the diagnostics. And with that, also improving the treatment. And I know Matt will talk about that as well. So really excited about the progress. And this is just a beautiful slide. 3 major launches. Each of them even for pharma terms would be a blockbuster, really differentiated when it comes to mass back for sure and sequence saying, and if you look at the industry at times, maybe you have a company having 1 of such launches, but we have had 3 in such a close period of time. It just shows you how productive our R&D is as well as adding new assays. And I just picked 2 out of here. One is the Elecsys pTau217 for Alzheimer's disease, where we have a significant head start versus our other major competitors out there. So really excited that, especially in combination with trontinemab, and you have seen some data just lately that we presented in London on trontinemab, which continues to impress. And then Elecsys interferon gamma release assay for tuberculosis. This is detecting latent tuberculosis, about 25% of the patients of people in the world who actually have latent tuberculosis. These are both really great opportunities in the scale of what you have in diagnostics when it comes to potential sales volume for a test. Now let me finish with the outlook. Mid-single-digit sales growth, currently growing 6%. Core EPS growth, high single-digit core EPS growth, growing 9% currently. And we further will increase dividends in Swiss francs. So I think we are very well on track. And with that, I hand over to my team and I want to thank them for all the great work. Alan, Teresa and Matt. Thank you very much. So over to you, Alan.
Alan Hippe : Yes. Thanks, Thomas. I can just extend that and say thanks to, if you like, the whole Roche team for the achievements that we have had with the fantastic pipeline progress and also the great financial results. So let's dig into that. And let's start with the overview. You see the 6% sales growth, 3% in die, as Thomas has said, 6% excluding China, Pharma was 6%, so really doing well. When you look at the Swiss francs, the minus 2% just for the sake of completeness. In U.S. dollars, we would have grown 8%. And Core operating profit up 10%, as Thomas has outlined as well, very good cost containment. I will explain that. Core operating profit to the core net income, we keep the momentum. That means the financial result as well as taxes were not in the way. Nevertheless, I can say stabilizing the tax rate in the first half is a little bit of an outlier and I will come to that. And then core net income to core EPS. Well, the strong momentum slows a little bit with the plus 9%, but these are just the outstanding results from Chugai. As you know, we own 60%. So we have to take 40% from the performance away. So I think that brings the core EPS to the plus 9%. IFRS net income, I will explain, plus 6%, still here a couple of impairments in there. And then the operating free cash flow, plus 21%. And plus 2% in Swiss francs. Let me outline this. So happy with that number. And then the free cash flow is plus 58% and plus 26% in Swiss francs. This is a timing effect as well. Here we had some tax payments or we didn't have the tax payments in the first half that we will have in the second half. Good, with that, let's go through the sales growth. I see really, on one hand, the 6% in CR. You see that the currency effect, which is a minus 8 percentage points, which brings us to the minus 2% in Swiss francs. Let me talk about the plus 6% at CR. On one hand, you see pharma, excluding LOE, you see the LOE with a minus CHF 244 million came in a little bit better than we all expected. So also the reason why we updated our outlook for the full year or our additional information for the year and said we expect to lose roughly CHF 600 million due to loss of exclusivity. So a lower number than we had at the beginning of the year. When you put the 2 together, you get to plus 6% in diagnostics, plus 6%, excluding China, minus 15% in China as well. And then you really put it together and you get to the plus 3% that were mentioned before. When we go through the P&L, sales is clear, other revenue. Other revenue is increasing by CHF 258 million. There are a couple of elements in it. When I start with pharma, I think on 1 hand, there's a settlement on a royalty claim. -- which is in here, roughly CHF 70 million. We have in here an expected milestone income from Sugar for Fondo. That's one element here. And then we have a cross-licensing settlement in pharma of CHF 126 million. When you put everything together, you get roughly pretty well to the CHF 258 million. When you look at the cost of sales and the cost of sales, both divisions have grown their cost by 5%, which is quite an achievement because overall, volume has grown by 8%. And pharma by 9% volume growth and diagnostics by 5% volume growth. And when you look really at the 2 divisions, the cost of sales in farm were driven by higher profit share expenses based on higher sales of solar and royalty expenses from the increased sales Ocrevus and Evrysdi. And the cost of sales in Diagnostics were driven by the increase in installed instruments, the manufacturing ramp-up of the new launches and then certainly the U.S. tariffs of roughly CHF 43 million. Look, when we look at R&D, R&D, plus 1%. I think really here, a lot of cost discipline in the game here. But certainly, I think also, let's say, quite some investment in key therapeutic areas like oncology, and neurology. SG&A has increased by 3%. And let me on one hand, say, really, in pharma, we had an increase in M&D,so we really put money behind our products in marketing and distribution. Admin was really, really flattish. There's even a small saving here. So I think, very disciplined approach here as well. And then other operating income and expenses here really lower income from product disposals compared to last year. Let me make an additional comment about other revenue. I think really, when you look really a little bit at our history and where we stand at the moment, other revenue normally represents roughly 3% of our sales. I think certainly now with the Fondeo element coming in for the next couple of years. we expect that ratio to grow to 5% until the end of that decade. Good. I think -- I hope we'll explain how we get from 6% sales growth to 10% core operating profit growth. So when you look at the margins itself, I think that looks fine. I think even in Swiss francs, I think we are able to increase the margin. So as you can see, margin has increased by 1.7 percentage points in constant currencies, and that was driven by strong performance in both divisions. Pharma increasing by 2 percentage points and Dia by 0.6 percentage points. Let me outline here that both divisions benefited from the further centralization of SG&A, especially on the legal side under corporate. That represented a benefit for pharma of CHF 105 million in the first half benefit and diagnostics for CHF 24 million, in CR less cost compared to half year 2025. And -- what does that mean? I'm certainly well aware of the fact that we have said basically it's CHF 300 million for the full year that we're going to shift. I'm not going away from that number. It could be a little bit lower, but we will see a little bit of a ramp-up of that effect in the second half. Core net financial results. Core net financial results, improvement of CHF 42 million and surprisingly in Swiss francs as well as in CER. So the numbers are equal. And you look at the equity securities, I think that's a nice improvement here. for the Roche Venture Fund. Net interest income, we had lower cash, so a little bit less compared to last year. Interest expenses, certainly, U.S. dollar helps here with plus 43%. And then in other we have the increase in losses from currency results and other effects. Core tax rate. Well, first of all, I think really it's great that it came in at 17.5%. And you see just a very slight increase compared to half year 2025. Let me say here, it's a timing effect. The timing effect that we benefited from came up late. So very clearly, there will be an increased tax rate in the second half. And just to give you additional information here, I'm pretty convinced we will get to around 20%, perhaps a little bit lower for the full year, nevertheless. Core EPS. When you look at the core EPS and at the bridge, and you see here the 9.3%, which represents around a 9% for the core EPS growth we've talked about already, you see operations is the major driver here. Then the product disposal and disposal of subsidiaries, as mentioned before, a decrease of CHF 104 million. The financial income and expense here, really positive with CHF 42 million. Then the tax rate which was pretty much stable and then all other effects, once again, sugar with an effect of minus 1.6 percentage points. So really overperformance, if you like, from sugar and when you take it out, and that's what we do in the core EPS, where we take the 40% out that we don't own, then you get to this effect. Noncore and the IFRS income. Yes, you see really core operating profit up 10%, minus 1% in Swiss francs. And then the IFRS net income, up by plus 6%, minus 6% in Swiss francs. And what are the drivers a little bit less restructuring charges compared to half year 2025. The major difference are the impairments here. Let me outline that we have an explanation for the impairments in Note 9 intangible assets in the interim consolidated financial statements on Page 65, where we really go through it. Good. When you look at operating cash flow, I think really a great result here with plus 21%, plus 2% in Swiss francs, when you really take the whole range of the bars that you have here on the slide. You see really operating profit net of cash adjustments significant increase. Net working capital is basically effect from payables. On the pharma side, I think that will wash out. So I think that looks promising. Investments in PP&E flat investments in intangible assets, a little bit less compared to last year. You remember last year, we had Zealand with CHF 1.2 billion cash out and that leads us to the plus 21%, and then you see the currency effect kicking in, bringing us to the plus 2% in Swiss francs. Good. When we look here at the margins, I think, overall, a great development, both divisions contributed to what you see really on the left-hand side of that slide and the increase of 21%. So what does that mean for the group net debt development? First of all, you see really that net debt has increased from end of the year 2025 until end of June 2026. And the increase here is CHF 5.9 billion. Having said this, when you look at gross debt, gross debt is stable, just to mention this, gross debt is stable. year-end, it was CHF 31.6 billion. This was not on the slide that number. And at half year, it was CHF 31.8 billion. So really stable gross debt, which means we have reduced our cash position. I will come to that on the next slide. When you look really what drove it, I think the operating free cash flow is clear. Then we have really taxes and the treasuries minus CHF 2.1 billion and then certainly, the dividend kicks in, as always. I think that's the driver normally for the net debt increase in the first half that we will work against in the second half. Good. Balance sheet. We keep that short. Two things to mention. As I said, cash and marketable securities, I said less cash available, we've paid the dividend. And then the other piece is really the equity. The equity goes down, which is a normal phenomenon for Roche because we deduct the dividend payment from the equity. And then as the profits come in the second half, hopefully, we will not just hope, we will wash that out and equity will increase. Good. Currency. Yes, interesting. When you really look at half year itself, I've mentioned the currency effect, I think, quite a bit. When you look at year-to-date September, keeping all the currency rates stable at the end of June, we get to minus 5 percentage points and when you look at full year for sales, core operating profit and core EPS, we get to minus 4 percentage points, minus 6 percentage points and minus 6 percentage points, which is exactly the same prediction that we had in Q1. So the situation is stabilizing a little bit. Let's see what happens, but the volatility is still huge when it comes to currencies. Good. With that, let's go to my last slide, which is the guidance slide. As said before here, Thomas has made the confirmation already. But let me mention here the LOE impact of roughly CHF 600 million now expected for 2026, which is a reduction to what we had at the beginning of the year 2026. Everything else is confirmed as we had it at the beginning of the year. And with that, happy to hand over to Teresa.
Teresa Graham : Great. Thank you, Alan. So let's jump straight into pharma. So pharma sales, as Alan and Thomas both mentioned, grew by 6% at constant exchange rates, reaching CHF 23.6 billion at half year. That's 8% in U.S. dollars and minus 1% in Swiss francs. All regions delivered growth with international and Japan growing at double digits. You'll notice that the EU also returned to growth after Q1 was impacted by a number of pricing and one-off effects for specific products. As Alan mentioned, overall pharma volumes were up by 9%. I'm not going to belabor the P&L too much because Alan made most of the comments that I would have made only to reiterate the core operating profit is up by 10% at constant exchange rates versus that 6% sales increase. with a comp margin of 53%. And just to underscore the extreme cost discipline, particularly the effect of cost management in R&D lending to that. So now let's jump right into our individual brands. So my usual comment on the graph, all absolute values and year-over-year growth rates here are presented at constant exchange rates. In the first half of the year, our top brand, Xolair, Hemlibra, Ocrevus, Phesgo, Vabysmo and Evrysdi generated roughly CHF 1.4 billion in new sales at constant exchange rates. I'm going to show the details on all growth dynamics for our key brands on following slides, so let's jump right into oncology. Oncology sales increased by 1% to CHF 7.4 billion, Phesgo continues to deliver strong growth with a global conversion rate now at 54%. And may notice that this is 1% less than we had in Q1, and this is the dynamic that we normally see. We added 2 more countries into the global conversion at metrics this quarter, we would expect that, that will correct itself over time. As those countries now come fully online. And to reiterate, we are aiming for at least 60% conversion rate to Phesgo at peak. Moving to Kadcyla. We are in line with expectations, and we continue to see competitive pressure in the U.S. and the EU. This is also a good time, I think, to reiterate our HER2 franchise outlook. We do expect the HER2 franchise to peak at around CHF 9 billion, and that's CHF 9 billion at 2024 constant exchange rates, just as a reminder, in 2026, followed by a steady decline through the end of the decade with a solid tale of around CHF 4 billion primarily Phesgo, around CHF 1 billion for Kadcyla and a bit of Herceptin plus PERJETA. We do not foresee a biosimilar for the U.S. for Perjeta before 2028 and then the EU before 2027. Let me also confirm again that we do not see -- foresee any cliff situation in the HER2 franchise. The Atopy launch is ongoing with good momentum, and we had an exciting Q2 news flow for [indiscernible] with the PDUFA date for Ladera in adjuvant ER-positive HER2-negative breast cancer set for November 30. And -- to briefly remind everyone, for Avera, the PDUFA had already been set for December 18. And -- now let's shift gears into lung cancer, starting with Alecensa. As we signaled previously, competitive pressure continues to increase, especially in the EU and the U.S. And therefore, we are, as Thomas mentioned, expecting flat growth. flat growth through the end of the year. Moving on to Tecentriq. The new indications are driving global growth, especially in Forte and small cell lung cancer. Building on this, we're adding further indications with the successful U.S. approval for IMVIGR-011 in muscle invasive bladder and have filed atomic in DMMR colon cancer with U.S. and EU regulators. I also want to confirm our full year outlook of low single-digit growth for Tecentriq. Finally, we are very happy to report the positive outcome of the KRASCENDO-1 trial, devarasib in second-line plus KRASG12C positive non-small cell and let's take a look at that in more detail on this slide. So to reiterate, we recently shared the good news of the positive Phase III KRASCENDO-1 trial of DVERaSIbin second line plus KRASG12C positive non-small cell lung cancer. Importantly, this was a head-to-head study the currently approved G12C inhibitors and the results clearly show devrasib's superiority in terms of PFS and OS improvements versus the approved G12C inhibitors. Let's also take note that, that OS statistical significance was already reached at interim, which is very impressive. The Diever asset safety profile remained consistent with previous data and was overall manageable. The data will be submitted to health authorities and will be presented in an upcoming congress. So certainly strong results that reinforce our conviction that divarasib has best-in-class potential. However, this wasn't the only good news for [indiscernible] this quarter at ASCO, we shared the results from the Phase III KRASCENDO 170 study in first-line non-small cell Here, the combination of diverse plus pembro achieved strong efficacy results across the PD-L1 positive and negative cohorts. And this bodes well for the ongoing Phase III KRASCENDO II study in the same regimen in first-line non-small cell -- as you can see on the right side of the slide, we have a broad development program for RAS-targeted molecules. This includes [indiscernible] in first line, second line and adjuvant non-small cell, but also a G12D-specific and several pan-mutation assets. So we don't only have 1 single mechanism of action, but we're bringing in potentially best-in-class molecules and different mechanisms, allowing us to think about unique combinations addressing the efficacy concerns as well as tolerability and combined ability. We're extremely excited to see the progress that [indiscernible] has already made and there is more to come. So next up, let's move into the hematology franchise. The hematology franchise delivered strong growth of 14% at constant exchange rates, achieving CHF 4.6 billion in sales. Our key growth driver for the franchise remains Hemlibra. We are seeing impressive continued global growth, driven by an increasing adoption in non-inhibitor patients and an increasing penetration amongst older adults. Based on the strong performance so far, we're updating our full year growth outlook to mid-single digit from previously low single digit. I should note that this is a conservative projection, which takes into account increasing headwinds later this year due to upcoming competitor launches. In that context, let me also tease that we're looking forward to sharing more in the in-development HEMLIBRA auto-injector at Pharma Day in September. A little bit of an aside. We did a demo device at the recent ISTH Conference in Paris, and it was so popular that we literally had to position someone at the booth to prevent people from trying it off the wall because people were so eager to get their hands on it. So we're clearly excited to be able to bring you more information on this program and ultimately to bring it to patients. So next up is malignant heme. Polivy keeps on achieving new milestones in first-line DLBCL with globally expanding market shares and now over 120,000 patients treated globally. That's up from 95,000 patients in Q1 in this setting. For Lunsumio, we achieved U.S. filing for the positive [indiscernible] Polivy and second line plus DLBCL and that PDUFA date has been set for February 9. Staying on the subject of second-line DLBCL, I wanted to briefly highlight our conviction and the potential for both Lunsumio and Columvi in the setting. Lunsumio Sumo delivers a best-in-class safety profile with significantly less CRS, making it highly preferred by U.S. clinical advisers for outpatient and community oncology settings due to its manageable profile. Columvi [indiscernible] is supported by proven survival data with mature long-term follow-up and many advisers regard it as curative. It enjoys a 2-year-plus first-mover advantage ex U.S. and post reimbursement is the standard of care. So now let's take a look at GAZYVA. As I mentioned in our last call, we do see increasing competitive pressure in CLL and follicular lymphoma, impacting Gazyva's performance in hematological indications. This is essentially masking the ongoing Gazyva launch in immunology. However, we have the first early indicators of the launch in lupus nephritis is showing a positive impact on overall Gazyva performance. And in fact, we see that because I have a quarterly growth in countries like the U.S. Germany and the U.K., where lupus nephritis is launched and reimbursed is ahead of the global average. So more on Gazyva immunology in the coming slides, but let me repeat, we will show a sales split by therapeutic area in the future as those data sources mature. Now let's take a look at the new edition to our hematology pipeline. We recently announced and have now closed our partnership with Nex Therapeutics to collaborate on the development of Bexobrutideg. Bexobrutideg is a BTK degrader with the best-in-class potential in the BTK-targeted therapy space, so including BTK inhibitors, -- as you know, BTK as a target has been validated for different hematological malignancies, but also in neurology and immunology. More on that later. Importantly, Bexobrutideg is a BTK degrader and via degradation, all functions of BTK are removed. This is unlike existing BTK inhibitors where some function may remain. Additionally, BTK degradation has been shown to overcome BTK inhibitor resistance mutations. Furthermore, Beck has strong data showing as highly selective and potent against BTK as well as has the ability to cross the blood-brain barrier. Taken altogether, we believe that Bexobrutideg has the potential to deliver best-in-class efficacy, safety and tolerability. Our belief in the best-in-class profile is demonstrated by the recently initiated Phase III and first-line CLL, which is running head-to-head versus aptiutinib. Speaking of the development program, we have a broad development program in malignant heme where we're moving at pace together with [indiscernible] and let me highlight that this includes a basket combination trial, where we will explore different combination options in CLL. Additionally, we're planning to investigate Bextag's potential in MS and CSU in upcoming Phase II trials. In short, a very exciting molecule to be added to the portfolio, and we're looking forward to updating you on the progress going forward. So now let's move to neurology. Our neurology franchise delivered 9% growth at constant exchange rates, reaching CHF 5 billion in sales. Ocrevus global growth remains strong in the subcutaneous formulation known as de novo in the U.S., is the key growth driver. We now have roughly 44,000 patients on subcut, which is a significant increase versus the roughly 24,000 patients we shared in Q1. And for the U.S., we're excited to see that Denovo is now the fastest-growing anti-CD20 MS brand, underscoring the strong differentiation of being the only anti-CD20 with every 6-month subcut dosing. Let me also quickly update the outlook. Beginning of the year, we had provided a 2026 growth outlook the Ocrevus franchise in the high single digit to low double-digit range. However, we're currently experiencing some competitive dynamics in the anti-CD20 space that are at the upper end of our previous assumptions. So therefore, we now expect to come in at the lower end of that high single digit to low double-digit range for the full year growth outlook. However, this does not change our peak sales assumptions, and we continue to be very happy on how we track towards achieving that ambition. As a reminder, our peak sales expectations for the Ocrevus franchise are CHF 9 billion by 2029, and this includes CHF 2 billion in incremental sales from Ocrevus subcut, but there will be, of course, some switching from IV to subcut on top. In the spirit of teasing format topics, we're pleased to see that the development of the on-body injector for the subcut formulation is on track, and we're excited to share more on this subject at Pharmaday. Briefly staying with our MS franchise. I'm sure you are eager to hear more on our fenebrutinib filing efforts. Let me just say that we expect to complete U.S. filing in the coming weeks. And once we have filing exceptions later in Q3, we will confirm this milestone via press release as always. And finally, we also shared positive updates on trontanumab in Alzheimer's disease at last week's AAIC in London, as Thomas mentioned. This includes long-term data from the Phase I/II study, which continues to underline the strong potential for [indiscernible] and the advantages of our brain channel technology, where specifically this long-term data confirmed the impressive amyloid clearance speed depth as well as a strong safety profile for [indiscernible]. Furthermore, we shared the study design of preventron, our Phase III study of trontenumab in preclinical AD. Preventron is enrolling cognitively unimpaired individual at high risk of progression to symptomatic AD and highlights our ambition to maximize the potential impact [indiscernible] in Alzheimer's. Next up is our immunology franchise. Immunology reached CHF 3.3 billion, growing 8% at constant exchange rates, with Xolair being our key growth driver. Staying with Xolair, we have reached yet another significant milestone in food allergy by now more than 130,000 patients have been treated with Xolair for food allergy since launch, a truly impressive number. Our 2026 outlook remains unchanged, and we expect around 20% growth for Xolair. This includes the expected impact of a first biosimilar entering the market in the second half of the year, which is currently projected for September based on our latest knowledge. Actemra sales declined by 9% at half year driven by biosimilar impact as expected. And Gazyva has had a lot of positive news flow this quarter, but we'll cover this in greater detail on the next slide. But before we get there, let me quickly just comment once again on the ongoing launches in lupus nephritis. So as I mentioned on the hematology side, despite the increased pressure on Gazyva in hematology, we do see strong uptake of the newly launched lupus nephritis indication. As I mentioned, we see live sales growing faster in those 3 markets where Alan is already reimbursed. We see patient shares approaching 10% across those same markets. underpinned by strong early adoption in the hospital setting. We see a real inflection in particular in the U.S. And in the coming quarters, we expect strong momentum to be driven by 3 New England Journal publications for SLE, lupus nephritis and the INS Phase III results. to FDA breakthrough therapy designations and growing lupus nephritis access and inclusion in clinical society guidelines. Taken together, we are confident in realizing the up to a CHF 2 billion opportunity for Gazyva across all of its immunology kidney indications. And finally, I'd like to mention the upcoming Phase III interim readout for [indiscernible], which is expected for later in the year. So now let's take a look at Gazyva in more detail. Starting with the Phase III MAGEC study in MAN, we recently shared at ERA because Gazyva clearly demonstrated superiority over tacrolimus on complete response, as you can see on the graph on the left. Based on the strong results, we believe in Gazyva's potential to become the first approved treatment for MN and therefore, the new standard of care. With that in mind, we're happy to report that we received -- we achieved U.S. and EU filing in MN and moreover, the FDA granted Breakthrough Therapy designation and priority review in the syndication with a PDUFA of the 15th of November. As you can see, we have now successfully filed all immunology indications in the U.S. and the EU, and we are looking forward to regulatory decisions in the second half of this year, starting with INS in September. The new indications will further fuel Gazyva's uptake in immunology, and we're extremely excited for the impact that it's going to have on patients. So up next, let's take a look at ophthalmology. Ophthalmology grew by 6%, achieving CHF 2.1 billion in sales. Vabysmo continues to expand its global market share and position itself as the preferred the preferred first-line treatment. This can clearly be seen for instance by the fact that more than 60% of U.S. patient starts are naive to treatment. I will spend a little bit more time discussing Vabysmo's growth outlook on the next slide. But here, I also wanted to highlight the positive Phase III Peng readout in Vabysmo and myopic choroidal neovascularization. This is the potential fourth indication for Vabysmo and while a smaller opportunity is highly relevant for patients, especially in Asia. We are looking forward to discussing next steps with health authorities and data will be shared in an upcoming medical conference. Moving on to n spring, our IL-6, where we are developed in development for TED, thyroid eye disease. We are excited to not only have achieved U.S. filing, but also to have been granted priority review. This underlines the significant remaining unmet need in TED and spring's potential to provide a much-needed additional treatment option for these patients. We're looking forward to the FDA decision by October 15. This leaves us with 1 more potential new ophthalmology medicine that we plan to file later this year, to Micky Bart and UME, and we will, of course, update you once those filings have been completed. Now as promised, let's take a closer look at Vabysmo growth. Let me start by confirming that we expect continued global market share gains and growth for Vabysmo. Furthermore, and as briefly mentioned on the previous slide, we see that Vabysmo has established itself as the preferred therapy for first-line treatment of AMD and DME. And this is in large part due to the strong and consistent clinical as well as real-world data. This data has shown time and time again that Vabysmo delivers strong anatomic outcomes like drying paired with high durability across all of its improved indications. and the survey data you see on the left supports Vabysmo's anatomic outcomes and durability are perceived. The survey comes from ASRS, that's the American Society of Retinal Specialists. It is in the 2026 addition of their preferences and trends survey amongst roughly 1,000 retinal specialists in the U.S. and ex U.S. So this obviously gives us confidence in the global market share gains and growth, but there are some regional dynamics that need to be considered. In the U.S., we do believe the branded market has now stabilized, though at a lower level than before. We do see this as the new normal and don't expect a full rebound to previous levels, but do expect strong volume growth from here. As Vabysmo is perceived as the most efficacious drug, this will drive sales growth in the low single to mid-single-digit range in the U.S. In the EU, we continue to see strong share expansion across all key markets and Vabysmo's strong volume growth is overcompensating for price effects in this region. And then the rest of the world, we see significant untapped potential and are encouraged by strong growth momentum across key markets. In summary, we are expecting low double-digit growth globally for Vabysmo, driven by ex-U.S. with U.S. growing in the low single to mid-single-digit range for the year. Let me also say that we continue to consider consensus peak sales expectations for Vabysmo around CHF 6 billion is very reasonable, and we're confident that we're on track to achieve this number. So now let's move on to CVRM. The CVRM pipeline is making good progress. And following ADA, we hosted an IR call to cover the latest pipeline developments. So let's just focus on what happened in Q2. On petrelintide, we presented positive Phase II Supreme I data at ADA and shared our Phase III go decision. The data was well received with a lot of excitement about the placebo-like tolerability profile paired with double-digit weight loss that petrelintide demonstrated. We believe in the potential of petrelintide as a monotherapy to provide meaningful weight loss at a level desired by many patients. combined with the exceptional tolerability that doesn't interrupt the daily life of patients and promotes long-term adherence, a critical factor for sustained health outcomes and chronic weight management. We continue to think this is going to be a very important option for patients. and together with Zealand, we're looking forward to initiating the Phase III in the second half of the year. On enicepatide, which is formerly known as CT388, we presented positive Phase II data at ADA which I will cover in more detail in the next slide. The Phase III trials, ENT1 and 2 for enicepatide and obesity are ongoing, and we announced plans to initiate Phase III trials in glycemic control as well as a CVOT. On CT 868, we announced at ADA that we decided to discontinue the development of CT 868 in type 1 diabetes. It's important to note that this decision was entirely unrelated to the safety or tolerability of CT 868. We did have positive Phase II results. But ultimately, we believe we have better options in our portfolio to address the unmet needs for patients with type 1 diabetes. For example, based on the latest data, we believe that enicepatide may have best-in-disease potential for glycemic control. We look forward to sharing the details of our plans in type 1 diabetes at a later stage. There is a lot of news flow for the remaining of the year, in particular, Phase II results for enicepatide in type -- obesity with type 2 Phase II CT3 -- sorry, Phase II CT996 results in obesity, our oral therapy. The Phase II supreme 2 results were petrelintide obesity with type 2. And finally, the Phase II [indiscernible] results for moves plus truzepatide in obesity. We plan to provide updates for all of these at Pharma Day, upcoming conferences or by top line releases when the data is available. And let me quickly finish this slide by commenting on further pipeline progress expected to happen in the second half. The Phase II study is synergy for enasepatide plus petrol-entitin obesity is about to be initiated -- this study is designed in a comprehensive way so that we can find the ideal combination of the 2 for the best efficacy and tolerability profile. And that is, of course, key to -- and that, of course, is key to select the best fixed-dose combination for the potential Phase III. The decision for Phase III initiation for petrolentide monotherapy and obesity has been formally taken in Q2, and that study is expected to start in the second half. And finally, the Phase III initiation for CT-996 remains scheduled for half 2 following the Phase II readout, which is soon to come. Now as I mentioned, let's take a closer look at the enicepatide Phase II data presented at ADA. I do believe it is worth in reinforcing some of the key insights from the Phase II results that were shared at ADA and in particular, highlight why we're so excited about enicepatide, which we believe has a clearly best-in-class weight loss profile. First, on the left side of the slide, you see the weight loss curves. So clearly, the 24-milligram dose did not reach a weight loss plateau at 48 weeks. Therefore, we see the potential for additional weight loss with longer treatment. That's something we hope to see in the Phase III, which includes longer treatment durations. We have also shared it at the ADA IR call that we will explore dose levels higher than 24 milligrams as we've not seen the tolerability ceiling at the highest dose tested. Secondly, the right-hand of the graph shows what percentage of patients achieved a weight loss at a certain dose. What you can see here is that the highest 24 mg dose tested, 48% of patients achieved greater than a 20% weight loss, of patients achieved greater than a 25% weight loss and 26% of patients even achieved a greater than 30% weight loss. Based on these results, we believe that enosepatide has clearly the potential to develop weight loss approaching the efficacy seen with BBG drugs in development. and with the tolerability profile in line with that of the dual GLP-1 GIP agonist -- so overall, we are very excited to further develop enosepatitis a monotherapy, but let me also highlight that upcoming Phase II combination trial of enicepatide and petrolintide. Combining these 2 molecules with their respective strong clinical profiles and the potential to address unmet needs for patients beyond just the scope of monotherapy, in particular, for patients needing greater weight loss, and roberglycemic control with better tolerability. We have strong conviction in the combined potential of these already individually strong assets, hence the name of the trial, energy. We expect to initiate that trial in the second half of the year. And now on to my last slide for the day. So as usual, let me close with the 2026 Pharma key news flow. all of the updates here, I have already covered on previous slide, but there is 1 piece that I want to highlight, so far this year, we have achieved 5 FDA priority reviews so far, which is really impressive. And that, of course, helps us speeding up regulatory processes and bringing medicines faster to patients. Just to reiterate these 5 priority reviews were granted for giradestrant in the adjuvant early breast cancer. and spring in Ted, Tecentriq Atomic and dMMR and MSH colon cancer, Gazyva in INS and most recently, Gazyva in MN. So with that, I am happy to hand it over to Matt.
Matthew Sause : Thanks a lot, Teresa. And congratulations for the strong half of the year. So with that, good morning, good afternoon, everyone. It's my pleasure to present the half year 2026 Diagnostics division results. So as you heard from Thomas and Allan, with sales of CHF 6.7 billion, the Diagnostics division grew sales at 3% or plus CHF 228 million compared to last year at constant exchange rates. Now this growth was achieved despite the ongoing impact of the health care pricing reform in China, which continued to impact sales in 2026, excluding the effect of the health care price reform in China, sales would have grown at plus 6%. And Additionally, as you heard from Alan and Thomas, we had the impact of the weak respiratory season in the Northern Hemisphere, which impacted diagnostic sales by an additional CHF 50 million. So with that, let me go through the results by customer area. So sales in our largest franchise, the Core Lab, increased at 4%. This is impacted by the previously mentioned policy impact in China. Excluding this effect, the core lab grew at 8%, Sales in the molecular lab grew at plus 3% with -- and I would call it the strong performance of our transplant business, which grew 18%. However, again, this was offset by the previously mentioned mild respiratory season, which lowered the overall testing volumes. And sales in the Near Patient Care business area -- or customer, excuse me, decreased at minus 5%. This was driven by lower Cobas Lead sales, again, due to the weak respiratory season, but offset partially by growth in our blood glucose monitoring business at plus 3% following competitive wins. Sales in our pathology lab grew strongly at plus 11%, mainly driven by advanced staining growth of plus 7% and companion diagnostics growth of plus 24. So now allow me to take you through the performance at a regional level. So we saw growth in North America at plus 8%, in EMEA, the business grew at plus 3%, Lat Am grew at plus 10%. Now in APAC, the business declined at minus 5%. As previously mentioned, sales growth was impacted by the health care pricing reform in China. As a result of this, China sales declined at minus 15. Excluding China, APAC sales grew at plus 6%. Now as you heard in our full year and Q1 earnings calls, we expect a lessened impact of the China pricing reforms in 2026. And I would call out again that our ambition this year is to grow sales at mid-single digits. Looking forward into 2027, our ambition will be to return to mid- to high single-digit sales growth. Now I'd like to take you through our P&L line by line. And Alan went through the cost of sales in some detail. And as he mentioned, cost of sales increased 5%, first, driven by the impact of the pricing reform in China. the cost of manufacturing ramp up for our new launches as well as the tariff impacts in the United States. R&D increased at 3% as a result of the increased spend on our innovative systems, including our cellulose sequencing solution and our I-601 mass spec. SG&A increased 3% due to higher distribution costs associated with increased sales volume and also commercial investment into our new launches. As a result, core operating profit on sales of CHF 6.7 billion was CHF 1.2 billion, increasing at plus 6% at constant exchange. As you heard earlier, this was also benefited by CHF 126 million in extraordinary income from patent licensing. Now I would like to reiterate our ambition from previous calls that while our consistent ambition for Diagnostics is to grow profit faster than sales. Our ambition for full year 2026 is to keep our margin broadly stable at constant exchange versus the 14.4% from full year 2025 as we absorb the impact of the health care pricing reform in China and the U.S. tariffs. I would also like to mention that in 2026, we again anticipate a negative impact -- or excuse me, we have a negative impact from currency headwinds on our comp margin. Now I would like to turn to some of the exciting developments in the diagnostics pipeline. Specifically, I'd like to start with the launch of our AXELIOS 1 sequencing solution, which I'm delighted to report that we launched on June 29. Thomas talked a little bit about our history of M&A, specifically the acquisition of Stratus and how it relates to our development here. I would also frame the discussion by saying that our next review -- the next-generation sequencing market at around USD 7.3 billion, this was assessed in 2025, and we expect to see it continue to grow especially as new clinical applications become part of routine use. I would also like to briefly highlight the performance we achieved with our AXELIOS sequencing solution. As you can see on the left-hand side of this page and why we feel the solution is so highly differentiated. We have 2 run modes utilizing our SBX sequencing by expansion chemistry and our SBX Duplex as well as our SBX Simplex workflow. Now this enables us to achieve flexibility, speed and scalability that is unprecedented and deliver what we feel is very, I'd say, differentiated cost effectiveness. Now as we previously demonstrated with the technology, we are able to achieve 1.8 terabases of SBX Duplex out pit in 4 hours of sequencing time. And this is equivalent to around 16 whole human genomes. I would mention that this is also combined with a high level of accuracy with a Q score of 38, which translates to approximately 99.98% accuracy. Additionally, the Simplex mode offers an ultra-high throughput and also longer reads of up to 1,500 bases, which can enable isoform detection and structural variance combined with our differentiated price position. And here, I would call out that in one 4-hour run, we're able to generate 40 billion reads with an average of 175 base pairs, which is an unprecedented amount of data output. I would note that the interest from the market has been consistently high since we unveiled SBX at AGBT in 2025. And our AXELIOS 1 solution is positioned to set a new standard of care and next-generation sequencing for a broad array of applications. So -- and Thomas mentioned this a bit earlier, how AXELIOS really fits in across our entire vision for oncology. Our strategy in oncology with diagnostics is to build an end-to-end portfolio that follows the entire patient journey via a combination of internal innovation and purposeful M&A. This is everything from early cancer detection, precise diagnosis of cancer, therapy selection as well as disease monitoring. So here, I'm delighted to discuss the definitive merger agreement we've signed with PathAI earlier this month, which completes our offering in primary and advanced staining for cancer diagnosis. PathAI is the leading provider of digital pathology image management systems, which enables pathologists to augment their existing IHC or primary, which is H&E staining workflows with AI-powered digital algorithms and tools to automate slide analysis and provide deeper patient insight. The combination of AI-powered digital pathology image management, combined with clinical decision support algorithms will integrate seamlessly with our Ventana solutions and augment our PHC business to increase our leadership position in companion diagnostics. This solution is wholly complementary to our Ventana business. And by putting these 2 solutions together, we're going to be even more competitive in this key area of our business. In addition, for the pharma side, this will enhance our pharma business with AI solutions that support our clinical trial work as well as enable the introduction of new biomarkers. So Theresa mentioned briefly AAIC. And now I'd like to switch to our assay pipeline, specifically the launch of our [indiscernible] -- or excuse me, the CE mark we received for our [indiscernible] test, which we received on May 12. So Alzheimer's disease is the leading cause of dementia worldwide. We anticipate that it will affect over 80 million people by 2030. However, diagnosis takes approximately 3 years after symptom onset and routine diagnostic methods are either invasive or difficult to access. They involve imaging methodologies that are not readily available and lead to this significant backlog in patient diagnosis. So with our Elecsys 217 assay, we provide a rapid, minimally invasive alternative via a simple routine blood draw. This test is the first blood-based biomarker intended to rule in or rule out Alzheimer's in primary and secondary care settings as a result of the study that we performed. Our assay demonstrated high diagnostic accuracy across health care settings and clinical stages and additionally meets the CEOI recommendations for Alzheimer's disease diagnosis. By bringing this test into health care systems worldwide, particularly primary care, we will help physicians to identify Alzheimer's disease earlier, which will facilitate timely intervention and reduce and potentially reduce health care costs. So now I'd like to transition to latent tuberculosis and continue with an update on our Elecsys IGRA TB test, which received CE Mark earlier this month. And why this test is important is around the world, approximately 25% of the world's population is estimated to be a carrier of tuberculosis infection. And as a consequence, this is one of the world's largest public health challenges. With Elecsys TB, we enable high throughput testing, automated result generation, and a 32 workflow, which is superior versus existing systems that are available, while maintaining comparable levels of data performance in the clinical setting. And in the near future, we plan to integrate our COBOs Ultra solutions to automate the pre-analytical steps further improving laboratory efficiency for tuberculosis testing and it will also help facilitate our entry into the high throughput segments of the market such as the U.S. This test has the potential to expand global access to latent tuberculosis infection testing and also help advance progress towards the WHO elimination targets. And I would call out here that we have the broadest installed base of immunoassay analyzers anywhere in the world, and we will leverage our installed base to grow and expand with this test. So to conclude, I would like to report the progress on our key launch list for the Diagnostics division. Of the 11 launches shown here, we've achieved 7 by half year 2026. We're making good progress on those that remain, and I look forward to updating you on this in future calls. And with that, I would like to hand it over to Bruno Eschli. Thank you very much.
Bruno Eschli : Thanks, Matt. And let me quickly close here with the next event, which is scheduled for our investor analyst community. We have Pharma Day coming up on the 28th of September, again, as a life event in London. Similar setup as in previous years and a couple of highlights here to call out. In the morning session, we will again cover our pharma strategy and provide an update on our commercialization efforts. We will provide an on the R&D excellence initiatives on the KPIs we have shown in recent years. and then also have a focus on our cost-saving initiatives and reallocation on the investments. And then I think a special highlight is we have Avi Regev joining on the implication of AI and early drug development. We'll take you through all the stages of early drug development and how AI there comes to life and where we stand. And then in the afternoon sessions, a bit a similar setup like last year, we will take you through the 5 therapeutic areas with the new area heads being present. And until the end of September, we also would expect a couple of additional data points to come in and as Teresa mentioned already, we have then the opportunity also to touch on some of the assets of the obesity franchise like 388 or 996 and provide updates on them. And with that, I think we are done with the presentation, and we'll open the Q&A session. First questions would go to Graham Parry from Citi.
Graham Glyn Parry : So there's a question on divarasib. You've obviously started now the Crescendo I trial, primary completion date on clinicaltrials.gov for that is October 2028. I was just wondering, though, just given the very long PFS that you saw in the Phase II of 19 months, whether you feel there could be a separation of the cores and an earlier readout on that. And then secondly, you still have this as a 1 to 2 billion peak sales opportunity in your slides. Despite the strong Phase I day down and in Phase I and hitting the primary endpoint in the second line as well. Is that now just achievable with the second line indication? And when would you provide date on whether you see that as going higher given the strong PFS, long PFS you're seeing in these studies.
Teresa Graham : Great. Thanks, Graham. Well, I think Pharma Day is going to be for you. So we will be able to provide an update on the entire [indiscernible] clinical trial program as well as the fact that we are currently now based on the strength of the [indiscernible] 1 data, we are reevaluating what we believe peak sales might be. So we're talking with thought leaders, thinking about what our ultimate clinical trial program will look like, and we'll be able to provide you an update at Pharma Day. So for right now, we are confirming CHF 1billion, CHF 2 billion, but stay tuned. .
Bruno Eschli : Graham, did we answer all your questions?
Graham Glyn Parry : Just the potential for readout in the earlier readout in 2021.
Teresa Graham : So I mean, I think we've just initiated the trial, so we'll see how we go. And as always, with an event-driven trial, the data will tell us.
Bruno Eschli : Then we move on. Next question go to Simon Baker from Redburn.
Simon Baker : Bruno, two, if I may. Firstly, I see Enzumo, it's entered Phase II. Just wonder if you could give us your thoughts on Lonsumio in that setting and also the interplay with in that space? And then secondly, on Visa Tracy, you gave us some color on the dynamics within that market. I just wondered specifically if you could give us an update on any activity you're seeing with respect to patient assistance foundations, either by yourself or others and your expectations of that for the rest of the year?
Teresa Graham : Great. So in terms of Lunsumio for SLE. SLE is a very heterogeneous and complex disease. And while we saw great results with Gazyva, we do believe there's an opportunity for more benefit for patients. And we think that based Lunsumio's mechanism of action and it's and its safety profile, we think it could actually be a really great option for patients with SLE, has very strong B-cell depletion as does Gazyva. So we are curious to see whether or not with a slightly different mechanism, we can actually achieve even greater results for these patients. So stay tuned on Lunsumio, but deeper and deeper B-cell depletion is likely what these patients need. In terms of the co-pay assistance foundation. So again, I will just reiterate that these are charitable donations and they're certainly not meant to drive sales. But I think what we are seeing is that there has not been a recovery to the overall market. We are seeing sort of that 2% to 3% growth in the overall retinal market. We do expect that this is going to be the new normal, and we don't expect to rebound to previous levels.
Bruno Eschli : Okay. Then we go on. Next questions go to Sachin Jain from Bank of America.
Sachin Jain : A few, if I may. So firstly, just another one on [indiscernible] launch. 1Q, you talked optimistically about launch and discussion by risk group. My question for this quarter is what visibility you have on a [indiscernible] of patients that could be fast adopters that specifically patients who over the quarter after or 4 years have discontinued CDK46 otoxicity and they're back on just in AI. So any sense, firstly, how big that bolus is that could be rapid adopters and would usage in that switch would be consistent with an expected label? Second question is Ocrevus. You're putting out a competition, I'm guessing that's Brian. So when you can just give us a bit more color as to why that's impacting now given it's a launch for a while and why you think it's temporary? And then just one question for Alan. It's I think the first time you called out the expected growth in other revenues midterm 3% to 5%, that kind of implies CHF 2 billion growing to about CHF 4 billion. That's all EBIT. So is that a driver of margin expansion? Or is it funding investments within your commentary of margins being stable -- you just going to dovetail that with Bruno also mentioning an entire cost poker session at the Pharma Day.
Teresa Graham : Okay. So let's start with [indiscernible]. So I think it's -- so first of all, Sachin, I think you're spot on to something here, but by sort of looking at what does the treatment of ER-positive HER2-negative early breast cancer really look like. So there's sort of risk groups of patients. There's the low-risk patient group, which is between 55% and 60% of patients. There's the intermediate risk group, which is about 10% of patients. The medium risk group, which is between 15% and 20% of patients and then the high-risk group, which is 15% of patients. We would expect that one of the first places we would gain utilization is patients who just aren't on CDK4/6 inhibitors right now. That's 90% plus of that intermediate group. It's 80% plus of the medium risk and 50% plus of the high risk, and so there's a tremendous opportunity within that group that has just never gone on a CDK4/6. But you are right, there's about 50% of patients today who can't tolerate their CDK4/6 treatment. I mean, it's part of the reason that we see such bad outcomes for people with this type of cancer is they just can't tolerate the treatment. And so for those people who either can't tolerate and maybe who have come off and are waiting, we would absolutely see this as a potential patient population, and we wouldn't see this to -- it wouldn't be in conflict with any -- likely with any kind of label the switch question or the line of therapy that is not -- the switch question is not usually something that comes up in the label. We are generating, however, switch data. So for patients who are on CDK4/6 today and want to switch will generate that data. And we are also generating data for that low-risk population, which is the majority of patients, that 55% to 60%, none of whom are currently on treatment. And then our own combination data is also forthcoming. So we do believe that when you look at the totality of the [indiscernible] data that we have in our hands already between [indiscernible] and Avera. We've already got about 80% of the market covered. We're doing trials to cover the rest. -- and sort of really looking at what is the clinical data that we need to make sure that we have the ability to answer all of the physicians questions in terms of other ways that [indiscernible] might be utilized. But we do certainly think that there is quite a bit of opportunity for [indiscernible]. And in terms of competition with [indiscernible], I mean, it's just -- normally, we don't comment on individual competitors. We generally, we're just seeing higher level of competition in the market. And we certainly believe that based on the clinical attributes of Ocrevus, we are very well positioned to compete. Ocrevus remains the leader in MS with [indiscernible] as the key growth driver. It is the growth driver in MS. It's the first and only twice yearly MS therapy that's approved in RMS and PPMS. It has over a decade worth of experience. We see that 80% of first-line RMS patients don't experience progression, 90% don't need walking implements. We're the only high-efficacy therapy that has robust family planning data in hand. And frankly, that outstanding patient convenience with 6-month dosing available as a 10-minute subcut just twice a year. I mean that's an incredible value proposition for patients. So I think in any given situation, you will see a little burst of competitive activity. But at the end of the day, these aren't driven on clinical differentiation. Ocrevus remains the most differentiated product in MS. And we strongly believe in our ability to compete and win for patients who deserve to be on the best therapy.
Alan Hippe : Yes, let me take the margin point, Sachin. I think you make a great point. I think very clear once we grow from 3% of sales to 5% of sales, that makes a difference until the end of the decade. There's no doubt about it. I think for the time being, nevertheless, I think we stick to the point to say either we stabilize the margin or we grow it. I think now things come nicely together, and you'll see how that plays out. And yes, I think that gives even more substance here to our statement.
Bruno Eschli : Sachin, did we answer your questions?
Sachin Jain : Yes.
Bruno Eschli : Then we move on. Next 1 in the row is Colin White from UBS.
Colin White : Colin White from UBS here. Just to go back to Vabysmo, you talked about being confident of the stabilization of the branded market. I was wondering if you could talk about the dynamics related to the reduced for Vabysmo growth expectations between charitable funding assistance and the increased use of biosimilars. And if biosimilar market share is shift what percentage of the market do you expect to be biosimilars going forward? And why do you have confidence that the branded market is now stabilizing? And then just a second question on firstline DLBCL, if I may. There's a big competitor to readout for [indiscernible] coming up in first-line DLBCL. So if that study reads out positively. I just wondered what you're thinking about in terms of the impact that might have on Polivy and how that fits in with your own first-line study for your anti-CD20? That's my questions.
Teresa Graham : Yes. So I mean, let's talk a little bit first about the biosimilar market in ophthalmology. I mean it's just a little bit different than in other places. But where we are seeing biosimilar impact happen, it is impacting sort of directly the molecule that it's replacing. So a biosimilar to Lucentis, took Lucentis Chair, biosimilars for other molecules are taking specifically that share and really impacting that part of the market. You don't really -- we're not really necessarily seeing the bleed over that you might see in other places. We saw 8% growth with Vabysmo in sales. this half, but we saw a 30% increase in volume globally. So we really do believe that Vabysmo has entrenched itself as the preferred therapy of choice. I think very clearly see that from the ASRS data and that where physicians are making a determination for a new patient with the majority of the time that is coming for Vabysmo's way. And again, we're not seeing new biosimilars entering the market impacting Vabysmo we're seeing them impact the originator product that they are the biosimilar of. The stabilization that comes from just sort of having watched the market over the last 6 months, talking with physicians and seeing how are they running their practice and what they're -- how they're utilizing the resources available to them and their patients. So we do think that 2% to 3% overall growth in retina will accommodate the biosimilar entry. It will accommodate other things. But clearly, Vabysmo is continuing to grow in the U.S. and it is continuing to take a disproportionate share of that branded share growth. With regards to the competitor entry. So they are about a year ahead with first-line DLBCL, but we do see Polarix being just a much better tolerated regimen in first line. So we wouldn't necessarily expect to see a terrible amount of impact there. Polarix has well established itself in first-line DLBCL. I mean Polarix not Lunsimio because that's really the first-line deal BCL drug.
Bruno Eschli : Colin just answer your questions. So we also have our own study coming up next year. As you know, [indiscernible]. Okay. Then we move on. Next one in the row is Justin Smith from Bernstein.
Justin Steven Smith : Just a very quick one on 007. Sorry, this is a bit ignorant. Just any kind of qualitative conviction you can give us as to why 360 patients means you're well powered in that sort of head-to-head versus Hemlibra in Phase III?
Teresa Graham : Yes. I mean I think we've done the statistical analysis based on what we know about the performance of Hemlibra and what we believe to be true about 007, given as Thomas mentioned, the incredibly high level of potency and we feel confident in the design.
Bruno Eschli : Maybe what I can add here in terms of the time lines. I think this study, which now has seen the first patient in, we would expect data, I think, at around year-end next year, beginning of the year after. So end '27, end '28, which I think also puts us in a very favorable situation here to bridge to the next generation. Any additional questions, Justin? . And we move on. And next question go to Sarita Kapila from Morgan Stanley.
Sarita Kapila : At ASCO, you talked about new indications, sorry, for duradestran, so the HERIDERA trial and the NIVEA trial. Could you quantify how large you think these opportunities are and whether these are upside to the is about CHF 9 billion commentary. And how, if I can squeeze in, do you see positioning specifically for douradestran in Asia positive HER2 breast following positive data for Pfizer's Ibrance in the Patina trial. If I could just squeeze in a quick follow-up on divaricib. If you're reevaluating peak sales, this is a KRAS G12 D.C. How should we think about it versus emerging [indiscernible] agents, including pipeline or programs within your own pipeline?
Teresa Graham : Yes, absolutely. So when we think -- I'll start with the second question first. and then go up to [indiscernible]. So when you think about KRAS mutations, KRAS mutations are present in about 25% of patients with lung cancer. G12C mutations are present. They represent 40% of the KRAS mutations, which means you're at about 12%, 13-ish percent of overall non-small cell patients have a KRAS G12C mutation. So the potency, the selectivity, the safety profile of [indiscernible], we believe positions it very well. in patients with those specific mutations. And I think we've seen that in the -- [indiscernible] data, we're seeing it in [indiscernible] 1, and it's something that we expect will play out in other trials as well. . So I think because of the -- the strong specificity for that mutation and the fact that mutation is so prevalent, I think if you have that mutation, you would be more apt to use use a therapy that would target that mutation directly. Certainly, there's going to be a place for pan RAS inhibitors. We have several of them in our pipeline as well, and we look forward to developing them and seeing what their results are for patients. We have a very diverse pipeline here, which is great. When you talk about the opportunities within [indiscernible], as I mentioned previously, between Ladera and Avera, we already have 80% of the ER-positive HER2-negative market covered. So the other trials that we have in place that are looking at the different aspects of first line in different combinations, those really give us the opportunity to cover pretty much 100% of this patient population. So the the peak sales that we've mentioned, they sort of encapsulate the fact that we do have pretty broad program already in place for giradestirib, but certainly, if some of these other programs came in. that could potentially be upside as well. And as I mentioned, we'll be able to give you a very good and thorough update of what our development plans look like for deradustirant at PharmaDay in just a couple of weeks.
Bruno Eschli : And I mean, the upside on diverse is also in other cancer types, right? Absolutely lung cancer. In fact, the RAS is one of the best known and most known and most muted genes in cancer in different cancer types. Absolutely. Then next questions go to Richard Vosser from JPMorgan.
Richard Vosser : A couple of questions, please. Just a follow-up on Ocrevus. There's an over uptake seems very strong and very fast. So you mentioned again the CHF 2 billion for no -- but could this actually be larger and protect more of the franchise from biosimilars? So just thinking about that. Second question, a follow-up on for Vabysmo. I don't think you mentioned pricing impacts. Just wondering about, we've seen biosimilars to other agents affect pricing in the classes. Obviously, there's a very low dose of [indiscernible] in here. But are you seeing anything in or very low price of [indiscernible] but are you seeing anything there in terms of pricing maybe in the ex U.S. markets? And then one final question just on other revenues coming back to that. I think there are probably some milestones there in this quarter for some of the new agents. You've got quite a lot of new agents from other companies launching, just should there be other milestones that we should think about in the next few years that could boost the trajectory from actually the royalties that you're getting in? Just some thoughts there as well.
Teresa Graham : Yes. Great. Thanks, Richard. So I promised you guys a hockey stick for OCREVUS de novo, and we have delivered the hockey stick. We're well on our way. We do think that as people -- as I mentioned in many other calls previously, as practices and patients get experience with [indiscernible], it fits into the practice flow very, very well, and it's intensely convenient for patients. So is there additional conversion opportunity? Quite probably. I think moment, we still feel very confident in our additional CHF 2 billion, understanding that there will be the sort of CHF 2 billion that are just brand-new patients. to de novo, but we would expect that there will be switching as well. So ultimately, that entire pie could look bigger. And certainly, that would provide some additional protection to Ocrevus over time as with the on-body injector, which we're excited to talk more about at Pharma. In terms of Vabysmo, I mean certainly, we've seen pricing impacts outside the U.S., but those have largely been related to volume because Vabysmo been doing exceptionally well in generating patient share outside of Europe -- or inside of Europe. Alan?
Alan Hippe : Yes. I think really, in general, no, that's the answer. I think there can always be stuffed, but that's why we have said we go from 3% to 5%. And I would argue that includes everything.
Thomas Schinecker : And it's mostly royalty driven, not milestones Yes, just to be very clear. But also, I mean, Richard you have to...
Alan Hippe : There were a couple of miles a couple the majority is really yes, by far...
Thomas Schinecker : But on the [indiscernible], also, you were talking about switching to Denovo also to make sure that we can protect that franchise into the next decade as well and beyond. Here, I just want to say that we have a couple of other options in play as well with ibrutinib. but a number of things that we have in the pipeline, but we believe that we can extend that as well.
Bruno Eschli : Then next question come from James Gordon from Barclays.
James Gordon : James Gordon from Barclays. A couple, please. One was guidestone and adjuvant and the launch expectations. So ASCO, there was some mixed discussion feedback on the dara and talk about need for longer-term PFS data and OS more data versus CPKs. Do you think that view is typical, -- could that blunt the initial uptake at all? Or one that's atypical? And where are you in ex-U.S. regulatory might you need longer-term data there? And I think Bloomberg consensus is about CHF 300 million next year, which doesn't look a lot versus the size of the very big motive breast cancer market. Are there any sort of roadblocks we should be aware of if we're modeling out the launch or is that plausible? The second question would be [indiscernible] regulatory. So latest confidence on U.S. approvability. I know some investors still have quite a big safety and tolerability concerns. But now you've had a bit more time to have some interactions with regulators. Anything concerning there? And where are you ex-U.S.? Any interactions there? I saw [indiscernible] approved despite its liver profile? And how are you thinking about timing for ex-U.S. And then finally, it was just obesity update. So we've got updates on your top you won't get and your [indiscernible] ADA. I think you've got your antimininand your oral GLP-1 permanently presumably at the Pharma Day or before -- so how are you thinking about differentiation? And of the 4 assets in obesity, which is the one that's most exciting because you've given similar peak sales estimate in [indiscernible], which is the 1 we should be most excited about?
Teresa Graham : James asking me to give my favorite kid, that's harsh. Wow, okay, there's a lot in there. So in terms of [indiscernible] adjuvant, I would say that we are spending a lot of time with KOLs and with potential treaters sort of asking what their confidence is in the data. And I think what we are hearing is that people are excited about having an option. The profile of giradestrant is very attractive to people. We've mentioned this a number of times before. But with CDK4/6 is 50% of patients can't stay on their therapies over time. And that necessarily means that leads to worse outcomes when you can't take the medicine that's designed to help you. The [indiscernible] tolerability and safety profile just looks much better. And so I think we are increasingly confident that physicians are excited about [indiscernible], and we'll find a place to use it in their practices fairly easily. So my writing is not great here. So ex U.S., we are currently assembling the data package that we believe will be the most robust data package to allow us to file in Europe and achieve a sustainable reimbursement value. And so that is coming, and we would expect that we fully intend to file in Europe. -- and are just waiting for that data package to mature. In terms of the consensus numbers, so we don't generally comment on -- specifically on launch projections. But what I will say is that we should remember that this is a chronic therapy. And so -- while we do expect a strong launch, clearly, the big numbers will build over time as they do with any chronic therapy. We would expect patients will stay on [indiscernible] for 5 years plus, given what we've seen in the market and what the tolerability profile is for [indiscernible]. In terms of fenebrutinib regulatory, so as I mentioned, we're well on track to file first in the U.S. We'll use that U.S. package then to springboard off of for other regulatory filings. We are collecting the additional data that we need for the EU. And again, we have every intention of filing -- and again, our focus has been on getting the U.S. package ready and then we'll go from there. While I won't comment on the specifics of any regulatory interactions, we haven't seen anything that would indicate that filing in the U.S. is going to be at all problematic. And then in terms of picking my favorite child, that's really, really unfair. I think that what we saw in -- what we saw at ADA with just the really impressive weight loss data from Enicepatide. And the very interesting and positive tolerability profile for petrolentide. I mean, if you think of that bell curve that I showed you guys at Pharma Day, last year, for the patients who need deep weight loss, we have that for the people who maybe need that tend to 15% weight loss with the placebo-like tolerability. We have that. The fixed-dose combination could be a booster for both of those products. I think what we are finding is that the nature of both of these medicines in different ways are making them differentiated and are giving them opportunities to really find a very unique space in obesity in ways that will ultimately really help patients with what they need. And I think that's actually super exciting as we head into our Phase III programs. Clearly, we'll have the data on the anti-myostatin and CT996 quickly. I mean, having an oral option is, of course, important. So we're excited to see 996. But I would have to say, I don't think I can pick a favorite because I think what I really love about the obesity portfolio that we've built is it's delivering on exactly what I talked to you all about last year at Pharma Day the ability to build a broad adaptive portfolio that regardless of what a patient's obesity -- where they are in their obesity or health journey, we have a medicine that can help them. and could help them throughout their entire weight loss journey. And so I'm just really excited about what we've seen in the data as it's come to maturity and increasingly getting excited about bringing the entire portfolio to patients.
Thomas Schinecker : Let me add 2 points, 1 on [indiscernible] and 1 on fenebrutinib, also that increases my confidence level in those molecules. You already pointed out the safety profile of [indiscernible] specifically against CDKs. I would like to point out not only the potency advantage it has versus another 1/3, but also the label and safety aspect that it has versus another 1/3. So I think from a safety perspective, it is quite differentiated as well. And then on the fenebrutinib, we mentioned that before that the FDA allowed open-label extension for fenebrutinib for initially PPMS patients. And so people that were on the [indiscernible] continued, but people who were on the control arm were switched to fenebrutinib. Now the same happened for -- so the RMS patients that were on fenebrutinib continue in the open-label extension as well as on the control patients moved to fenebrutinib. So I think these are good indicators, I would say. It gives us a certain level of confidence in that, but ultimately, we'll see.
Bruno Eschli : Then we move on to the next, James, James Quigley from Goldman Sachs.
James Quigley : I have 2 as well. So again, both -- so the BTK degrader from the data you've seen so far, where do you think the asset can be differentiated in cancer indication? Is it efficacy, safety, combinability dosing? -- interesting here there. And then also as you move into immunology, where do you hope be differentiated on the immunology side and how quickly do you think you can move there into MS and TS depending on when you see the data? And secondly, [indiscernible] immunology, I think I asked this last time as well, but when we hear you speak Teresa, you sound very excited about the opportunity. When you look at the for indications, CHF 2 billion, it looks like it might be on the low side. So what is holding you back at the moment in terms of looking at peak sales here? Is there anything in the indication size? Is anything in terms of segmentation that might be holding you back on the potential peak sales for Gazyva?
Teresa Graham : Great. Okay. A lot of immunology questions. I love it. Okay. So the beta all of those things, right? I think we're excited about the potential -- I think we're excited about the efficacy. I think we're excited about the safety, the tolerability, the combined ability. I think we really believe that a BTK degrader could be a real game changer in some of these indications, particularly in oncology. And so I think we're very excited to get this into trials and to see where it can go. Now that having been said, for all of those same reasons, having the degrader versus the inhibitor, we could see a really differentiated efficacy profile in my immunodisease are notoriously difficult to tackle. I mean there -- as I mentioned previously, they're very heterogeneous. And so having a degrader versus an inhibitor, I think we could very well see that incremental efficacy, which in immunological indications, can really be quite meaningful. So time will tell. It's a brand-new asset to us. We'll give you a little bit more insight as to what our plans are at Pharma Day, but I think we're really excited to have this partnership with Nurix to be able to bring this this molecule forward. In terms of Gazyva for immunology, a couple of those indications are quite small. So membranes and INS are quite small indications, lupus nephritis, while more sort of on the medium size, is also not huge. SLE is clearly a bigger opportunity, but there are some highly entrenched therapies there. I think it's more just about sort of thinking about where we can actually make inroads. The pricing for Gazyva is also not in the same ballpark, let's say, as some of the other immunological drugs that are out there. So I think that also lends a little bit to what we -- what our peak sales estimates would be just because we're anchored to the oncology pricing. But Gazyva and immunology is going to make a big difference for patients. And I do think it's worth watching, and we do feel quite confident in that up to CHF 2 billion peak sales.
Bruno Eschli : Then next question is going to Luisa Hector from Bernberg.
Luisa Hector : A couple, please. So I just wanted to check, are you expecting an advisory committee meeting for [indiscernible]? And then you highlighted your excellent 80% Phase III success rate year-to-date. I just wondered if you can tie that into your latest thoughts on capital allocation. So where are you targeting now any future M&A, business development and also that kind of relative external versus internal R&D spend given the intensity of your Phase III starts as well. How should we be thinking about those 2 items?
Teresa Graham : Excellent. I'll take the easy question first and then pass off the capital allocation question. So no, we -- because [indiscernible] received, as you know, priority review. We've been in close conversations with the agency, and we haven't had any indications of an ad board at this time.
Thomas Schinecker : Yes. To the second question, so we feel very good where we are at in terms of our pipeline. We've increased the value of our pipeline by 93% versus end of 2022. So we have now at an all-time high in terms of pipeline. We have medicines that we could launch until the end of the decade. So a very full late-stage pipeline. But we are really progressing well in our R&D excellence initiative across all different dimensions. If I just look at the output we have in research, has significantly increased versus 3 years ago. If we -- and we also measure, for example, also speed of trial recruitment, speed of trial closure. The white space is between the different phases of development, et cetera, et cetera. And we see a significant progress here as well. Also in terms of allocation of our resources within R&D. We've now reallocated and brought out efficiencies in our organization of about CHF 1.3 billion. And we could allocate that to all these Phase III trials into other parts of our pipeline. I mean I mentioned 1 example of that in the past. For example, we negotiated with contracts with CROs. In the past, we were quite fragmented in that. We negotiated new contracts, which gives us a couple of hundred million. Another one that I already mentioned in the past was slight iron used to make losses of close to CHF 250 million. we are now profitable with that on. These are all things that we could reallocate in terms of money. So you can see that we are really going after inefficiencies in the organization and making sure that we put money behind the project. Now that doesn't mean that we won't do any more or that we don't want it to be there, but we are very disciplined when it comes to we always make very detailed due diligence. We always have material transfer agreements where we really test the molecules in our own hands. These are all things that I would say where I've seen other companies lose a bit of discipline in this space. But we don't do that. And maybe it's also because we are not with the back against the wall and we are not in the same level of pressure as maybe some others. So you will continue to see us doing deals, but really deals that make sense and also make financial sense and where our team negotiated well. I mentioned that in my presentation, most of the time, when we won the deals, we are not the highest bidder in terms of money, but we bring other things like expertise to the table, and we are a trusted partner. And I think these are all elements that also are playing in our favor. So you will continue to see that kind of behavior from our side.
Bruno Eschli : Then we have questions coming from Eman Papadakis, Deutsche Bank.
Emmanuel Papadakis : I'll try to be brief. Maybe a follow-up on [indiscernible] pricing, given we're getting a little closer to commercialization. [indiscernible] have launched above $300,000 in metastatic. That seems a little prohibitive for broad adjuvant access. So we've seen examples in the past where you've been prepared to make concessions to ensure that. Could you just give us some latest thoughts on pricing direction should we see approval at the end of November. Then maybe a follow-up on [indiscernible], given the start the official start of the Phase III that had did. It looks like Hemlibra can be used discretion the physician in terms of frequency. And if I recall, median ABRs were pretty close to 0. So are you confident of showing superiority on the primary endpoint? Or is this more about showing improvement on secondaries, and perhaps you could also just remind us your latest thoughts on the clinical significance of anti-drug antibodies we on Phase II?
Teresa Graham : Great. So obviously, we won't comment on pricing prior to launch, we don't ever go that with any of our products. I will say that I think you can expect us to do what we have done in the past, which is to make a reasonable pricing decision based on the clinical benefit that our medicine provides. In terms of Hemlibra. So we do have multiple dosing frequency is approved in the label, so Q2 and Q4. So I mean the patients and physicians can choose what their dosing frequency is. We haven't actually commented on the head-to-head versus whether the head-to-head with Hemlibra is either superiority or inferiority at this point. But we do believe that there is an opportunity for that greater durability and convenience to be very meaningful to patients in the future. those certainly, that can't be the only thing that they bring. In terms of ADAs in the Phase II has had no impact on the Pharma Connecticut's efficacy or safety and didn't have any cross reaction. So at this point, we're not viewing them as clinically meaningful. But obviously, we do continue to monitor.
Bruno Eschli : Good, and we move on. Next questions go to Peter Verdult from BNP.
Peter Verdult : Peter Verdult, BNP Parbo. Just 2 for Teresa. Just back on [indiscernible] huge potential, but also Roche's first major launch post MFN world. Now I heard answer to the last question. So I'm not going to ask you for numbers, But could you maybe just remind us what the ballpark U.S. ex U.S. net price differences for your current on-market breast cancer franchise and how your U.S. pricing strategy might evolve for [indiscernible] in this new environment that the industry is operating in. That's question number one. I realize not you're going to go to the specifics, but I just want to understand that a little bit better. And then secondly, on obesity, we show our [indiscernible] but I'm just struggling to see how you're going to differentiate your oral GLP-1 offering given what's currently on the market. And on [indiscernible], I'm just struggling to see how you're going to position that asset given data from other [indiscernible] targeting compounds. We also have good weight loss at lower doses with lower or with good tolerability. I want to understand or do you have a better understanding as to why there was just no dose response seen in the Phase II [indiscernible]?
Teresa Graham : Yes. Great. So in terms of [indiscernible], you're right, I won't give you specifics. I can tell you that in general, our U.S. ex U.S. corridors are tighter than maybe some of our competitors have been over time, we've always been quite disciplined about that. As always, when we price a new molecule, we look at 3 things. We look at what is the clinical value that our medicine brings, what is the ability of systems and patients to pay and what is required in order to continue to return enough value to the company so that we can continue to deliver innovations for patients. And that is the the pricing philosophy that we will continue to follow. So stay tuned. But just to reiterate, it is our intention to bring [indiscernible] to patients around the world, and we look forward to to working with governments to make that happen. In terms of 996, I mean, the data will tell us. So I think we're excited to see the Phase II data to share that. But we remain confident that given the design attributes of CT 996 that we will have a competitive profile and that we'll be able to bring it to market as quickly as possible when you see the data when we are able to share the data when we have it in hand, we'll be able to have a more robust conversation about that. I mean, in terms of petrolentide, again, I just think in every conversation that I had at ADA with thought leaders, there was a real concern for the level of tolerability that patients could really reasonably tolerate over time. 50% of patients don't complete therapy as you would want them to on standard treatments. They don't get to max doses. And so this has always been the promise of the [indiscernible] class, and I think we see [indiscernible] delivering here a very reasonable profile and when that's exciting. And I think it was exciting at ADA for people to think about where this could be used, how it could be used in the different patient populations we could potentially go into. So I'm excited about Petri, I think that it actually has the potential to be a really meaningful option for patients. And I think I mentioned this already in my overall comments with the 996 data. that will be available later this year. So it will be too much longer before we can have a more robust conversation about why we think 996 might be differentiated.
Bruno Eschli : I think also to add, I think, on the missing dose response, which you were asking about [indiscernible], I think phenomenon has been seen before with [indiscernible], and I think we commented on it in the IR call. So there's probably a biology behind which we don't fully understand. That's all we can say. Okay. Then we move on. Our next question go to Rajesh Kumar from HSBC.
Rajesh Kumar : Got 2 questions for Teresa actually. I know it's very -- it's next to impossible to predict the future. But if you were to speculate the uptake curve for [indiscernible] would that be a very fast uptake in your opinion? Or would that be a more gradual one and would that differ between U.S. and Europe? That's my first question. The second question is around obesity. I totally appreciate that your portfolio has something for everyone. And that looks very interesting from a scientific perspective. As we are learning from the current generation of anti-obesity medications, these are subscription models, direct-to-consumer seems to be a much bigger part of the equation. So when you think about the commercialization strategy, are you thinking in terms of efficacy, in terms of product design, in terms of what works for reimbursement channels only? Or are you thinking it from a consumer product design as well because in reality, at the moment, about half of the patients in the U.S. seem to be paying out of pocket. And they probably don't want to understand all the scientific global group we love. They probably want to think through -- "I want to pay this much I want to lose this much weight," right? Tolerability is excellent. But what's your thought process on the commercialization strategy and how that fits within Roche's organization?
Teresa Graham : Yes. Two good questions. So in terms of the uptake curve, I think I alluded to this a little bit earlier. I mean, as with any chronic therapy, sales build over time, right? So people get on therapy, they stay on therapy and then those curves build over time. So I think there are a number of patients who are out there who are ready for guradestrin and waiting for it. But the really big sales numbers will take some time to generate as we have to build up with adherence and compliance. We have to build sales up over time. So just to kind of give that a little bit of a framing. And to answer your question, yes, I think we -- as we think about commercialization, without going into specifics, we understand that there is a reimbursable market. I mean that's certainly something that noshepatide is probably very very well suited for. But we also understand that there is a large direct-to-consumer market, and we are absolutely thinking creatively about how we can reach patients wherever they are accessing their medicines and however they are thinking about managing your health. So just know that we are we are not approaching this in a traditional Roche way.
Rajesh Kumar : Okay. So you think your competitive advantage will not only come from what the product clinical profile is but in terms of how you commercialize it as well?
Teresa Graham : I think in the obesity market, those have -- those things have to be 2 halves of a coin or 2 sides of a coin, right? You have to be able to have the clinical differentiation, and you have to be able to show the value from a clinical perspective, but you also have to create a consumer experience that is -- that meets the customer where they're at.
Rajesh Kumar : And what still do you have in the organization to do that in terms of have you hired people around that? Or is it an existing skill or muscle within the organization somewhere?
Teresa Graham : Yes. So since we have entered into the cardiovascular franchise, we have hired a hundred people from the outside, specifically with the kinds of experiences that we have not had historically. But we also have some great experience to Lena in the diagnostics organization. in CVRM that is much more consumer oriented, and we're certainly taking full advantage of everything that Matt has to offer.
Matthew Sause : Absolutely, I wanted to actually underline that point. I mean in Diagnostics, we are the leader in the space, and we have a lot of direct access to type 2 diabetics, type 1 diabetics, -- so a lot of people moving also onto our -- my sugar platform, et cetera. So we do have a lot of access and know-how in that space. And so I think we're actually quite well positioned. And the feedback that we are getting from KOLs is that they actually are quite excited about having most home diagnostics at the table.
Teresa Graham : Yes, absolutely. It's a real differentiator, actually.
Bruno Eschli : Very good. So then we have the final questions here coming from Michael Houston from Jefferies, and then we will close the call. Michael, please. Michael. It doesn't look like that he's on the call anymore. Then with that, I think we are ready to close the call. Over to you, Thomas.
Thomas Schinecker : Yes. Thank you very much, and thank you for attending the call today, and thanks to the team. We have a great momentum in terms of sales. We have even better momentum in terms of profitability. If you look at the last couple of years, we always delivered what we said. And what you can now see is a significant amount of pipeline progress. pipeline progress that gives us visibility in terms of sales growth for the next years and into the next decade. But even more exciting is then the pipeline readouts between '27 and '29 that are going to set up really well for future growth. into the next decade and beyond. And we'll continue to build on our pipeline and also with internal activities and external activities. And one thing I can say, we will deliver.
