AbbVie Inc. (ABBV) Earnings Call Transcript & Summary

Good morning, everybody. I'm Chris Schott at JPMorgan, and it's my pleasure to be hosting this fireside chat today with AbbVie. From the company, we have Scott Reents, CFO; Jeff Stewart, Chief Commercial Officer; and Roopal Thakkar, Chief Medical Officer. So happy New Year guys, and thanks for joining today.

I thought just to kick off the conversation, Scott. As we enter 2026, can you just run through top priorities for AbbVie and how you're thinking about the business?

Sure. Great. Thanks for having us, Chris. We're very excited to be here today and to talk about AbbVie. So when we look at 2026, I would say it's really a continuation of the strategy that we've been articulating. One is just to operate and execute operationally in a way that delivers strong financial results. And then secondly, to advance our pipeline. I think when we think about the momentum of the business and the financial results, certainly, '25 we'll announce in a couple of weeks. But if you take it -- if you'll indulge me and look back a couple of years, when we were going into the HUMIRA LOE. Certainly, there was a lot of uncertainty as to how that would play out. And we've been very proud of how the organization has worked through that. When we look at the 2025 guidance that we have out there, that's reaching a peak sales in the second full year following the LOE. And even if you rewind back to 2023, I mean, we've grown in '25 versus '23 sales, $7 billion in the aggregate, and that includes absorbing $10 billion of HUMIRA erosion, $2 billion from the IRA. And we've done that by our growth platform, our ex-HUMIRA business. Skyrizi and Rinvoq over that period have grown $15 billion roughly and the neuroscience portfolio has contributed another $3 billion. So we've been very happy with that. And then when you look at the '25 results, the business as a whole growing roughly 8% on the top line, but our growth platform growing approximately 19%. So very strong momentum of the business. And I think that continuing that momentum, continue that execution as we drive towards our long-term guidance for high single digits through the decade. That's an important piece. And then, of course, the second part of our strategy is just to develop the growth drivers for the next decade. So we have to advance that pipeline. In the next 2 years, we will have -- we anticipate approvals for PIVOT as well as tavapadon. We have indication expansion coming for Rinvoq, Ubrelvy, Qulipta. And certainly, Roopal can talk a little bit more about all these as we go through the conversation. And then we have pivotal data coming out for lutikizumab and [indiscernible]. So looking at that overall portfolio and the pipeline that we have in addition to what we brought in over the past year, 2 years, we're just going to continue to advance that pipeline. And that's really the 2 priorities that we have for '26.

Great. Maybe just you alluded to it a little bit, but longer-term growth. Can you just -- how are you thinking about top and bottom line growth for AbbVie from here?

Yes. No, we're excited. As I said, we have long-term guidance for high single-digit CAGR through the decade. We also have a clear line of sight with the assets in place today to growth well into the 2030s into the 2030s. So that's where we see from a revenue perspective. We also then when we think about -- from an earnings perspective, we will see EPS expand at a rate faster than sales as we expand our operating margin. So we'll continue to invest in R&D. '25, we'll spend $9 billion in R&D, just about almost 15% of sales. And you can anticipate that profile will stay roughly the same over that same period. So we're going to have that expansion coming from the SG&A line and finding efficiencies as we leverage the P&L. So that's how I would think about revenue and earnings.

And as we think about the business, are there aspects of the business that you think are underappreciated still by the Street as you think about that longer-term profile?

Yes. I would think about -- so I do think that the Street has come to appreciate the strength of our franchise is certainly in immunology and Skyrizi and Rinvoq, they've kind of -- they probably don't see the durability and maybe in the outer years, what we'll see and the confidence that we have, especially with the second wave of Rinvoq indications that we're -- that we've just started and embarked upon. So I think that's one piece. But probably neuroscience is one that we focused on significantly, helping everyone understand that neuroscience, our second largest franchise. It's our fastest-growing franchise, and we anticipate being the largest neuroscience player in the industry soon. So I think that's one that we continue to emphasize to make sure folks understand. And then the oncology pipeline is something we're also very excited about that, that probably isn't as appreciated as we'd like it to be.

Great. And we'll jump into those later on. I guess the question I have is about longer-term guidance, especially as the company transitions past HUMIRA. Is that something we should expect that AbbVie continues to update and extend over time? Or is that a practice you maybe shift away from now that you've maybe had a little bit better line of sight on -- or the Street has a better line of sight on the growth profile?

Yes. I think based upon where we are now, we're not going to have that emphasis on long-term guidance that we had. We put in place our long-term guidance as we were heading into the 2023 event for the U.S. loss of exclusivity for HUMIRA. And it was important for us to frame up for people to understand what we saw on the other side of that LOE event and what that business would be. So we went through and put together some pretty granular long-term guidance, more robust than we've ever done in the past, but I would say even more than others do. And so that had a specific purpose at a specific point in time. And certainly, we've updated it since the initial time that we issued that. But that's not going to be something we're going to emphasize. I mean there might be situations where we would want to do pieces of it, but you're not going to see a robust comprehensive program for that long-term guidance, absent some rationale. And it was just the HUMIRA LOE rationale that we had at that point in time.

And maybe a similar question on Rinvoq and Skyrizi. I know you've -- for a while, like this target for you to be aggressive now to view as conservative. But would we expect that you keep updating those kind of 2027 or 2030 Skyrizi, Rinvoq numbers? Or is that a similar approach that think of less of that?

No, it's a fair question. So right now, our guidance sits at a combined $31 billion in 2027 is the long-term guidance I've given, $20 billion for Skyrizi, $11 billion for Rinvoq. I think that what -- we'll issue our results. And as I said, in a couple of weeks, we'll give our '26 guidance. I think it will be clear when we give -- provide that '26 guidance, how we're tracking towards that. And so that's our emphasis is really to provide that '26 guidance. And I do think that there is a great recognition by consensus and the Street and investors as a whole as to the strength and the potential and the growth of those 2 franchises.

Great. Maybe one more bigger picture one. As we approach 2026, I know you're not giving formal guidance, but just pushes and pulls we should think about for AbbVie this year?

Yes. We'll give formal guidance. I think the things I would think about are, one, the strong momentum of the business that I mentioned. Two, we do have that critical piece of long-term guidance for the high single-digit CAGR revenue growth through the decade. And I would expect to see us -- we feel very confident in that. So this will be another step towards that. And I think from a pushes and pull, obviously, HUMIRA will continue to erode. Certainly, there'll be some erosion from Imbruvica as has been eroding from a competitive perspective, but also because of the price negotiations. But that is all well within what we had planned and certainly contemplated by the guidance that we've given.

Great. Maybe shifting into immunology. Start the conversation here. Skyrizi and Rinvoq clearly exceeded expectations in 2025. How do you see the continued growth opportunities for these products? And I guess what's the remaining runway for growth for these?

Yes. Thanks, Chris. I mean Skyrizi and Rinvoq have been exceptional products, and we expect that they will continue to be very important products, and I'll walk through why. So the runway is really significant still through the end of the decade and even into the 2030s as we go forward. And that's based on the certain way these immunology markets are structured and the breadth and depth that we have with both of those assets. So the first thing we look at is like, are we set up for significant incremental share capture, and we really are. We've highlighted before that we have 10 head-to-head trials against all major mechanisms across basically most of the major indications. So what that allows our teams to do is really represent the strength of changing the standard of care versus the older biologics or even orals with our customers, and that works really, really well. So we can look at things like, for example, our new patient starts and our capture rate. And our TRx share is still well under what we're capturing. So you know that you can see that big momentum still to come in that runway with the share capture. I think the other thing we look at is these are great markets. They cascade on top of one another. So they're significant. I mean you're looking at markets like psoriatic arthritis and IBD, they grow in the high single digits every year. So that's a significant compounding effect. We see the slowest market might be rheumatoid arthritis. It's still growing in the mid-single digits. And then atopic dermatitis, highly underpenetrated in the mid-teens. So you get this market tailwind on top of your ability to capture. And then we see another dynamic, which is basically line of therapy expansion. And this is important because we see in many of the large markets now, the second-line plus market as people go through their journey with these chronic diseases are bigger than the naive markets. And that's important when you have a portfolio where you can basically manage with customers, Skyrizi and Rinvoq, for example, both in Crohn's disease. So that -- those are all very significant elements of -- as we look at the market structure, why we're very confident in that runway. And I think lastly, one of the key pieces that Scott discussed just now is the next wave of Rinvoq indications. And that's important because we've looked at GCA and lupus and things that we'll start to see next year and very close to that alopecia areata, vitiligo, HS, these are right in the framework of our target customers, whether they're rheumatologists or dermatologists, and we think that we'll have more than $2 billion of incremental momentum as we move towards the end of the decade. So that, in a nutshell, is why I think, as Scott mentioned, you'll see as we report in the fourth quarter, we're well on track to exceed that '27 guidance that you've highlighted.

Yes. On Skyrizi, can you talk to us a little bit about maybe penetration rates for IL-23s, particularly in this IBD setting. I think that's kind of surprised us all a little bit of how much growth we've seen there. But where are we now? And where could that go over time?

Yes. I think if you look at IBD, certainly, we have 2 -- let's say, 2 very large animals in that forest with both Rinvoq and Skyrizi. But to answer your IL-23 question, they're relatively new entrants here. I mean, even in ulcerative colitis, both of the major IL-23s just entered about 15 months ago. So we studied these markets very carefully. And what we're seeing in the market based on Skyrizi's profile is very high and very consistent new patient starts despite a competitor that's coming in. So you have to ask yourself a question, well, why is that? And exactly what you highlighted, which is the IL-23 market is expanding very, very rapidly. And I'll give some metrics on that. So if you look at ulcerative colitis and Crohn's, we can see that the new patient capture just for the class, the IL-23 class is now somewhere between 40% and 50%. It's actually 50% for Crohn's and around 40% for ulcerative colitis. And you can imagine a few years ago, it was essentially 0. So when you look at that capture rate, what it tells you is that the IL-23 category and Skyrizi in particular, is really has shown tremendous clinical advantages to the older medications. So then we take a step back and say, well, where might that end up? That's just the current capture rate. So we look at the psoriasis market or the psoriatic disease market, and we can see that over 6 years, greater than 60% of all patients today are on IL-23. The majority of that is SKYRIZI. So if you sort of fast forward and you say, what sort of headroom do you have or runway, as you said, you can clearly see that right now today, only 12% are in IL-23s. And so we could see that market develop in a very similar fashion where you could have the majority of patients in 4, 5 years that are established on an IL-23. And I think what's also critical to note is that there's also another very large moon in that space, which is our own Rinvoq, which is actually typically sequenced after in sort of the second line plus, which is a very robust market, as I highlighted previously. So that's how we see the market develop. These are very attractive markets. And currently, of course, our positioning of our brands is extremely high.

Excellent. Can you just talk a little bit on the competitive front? Certainly, we've been getting more questions in IBD with TREMFYA launching in UC and Crohn's. What are you seeing there in terms of new patient starts? And how do you think about how these 2 brands kind of compete against each other going forward?

Yes. I mean the launch of the competitor is largely -- it's really in line with what we thought. And we did predict that we'd see with that level of share of voice that's coming in from J&J and also what we bring to the market with Skyrizi, we would see that market lift. So as I mentioned, we have exceptionally strong new patient capture rates. So we're not seeing any degradation in terms of what starts we're seeing in the marketplace. And of course, they're well above any of the sort of the TRxs that will follow. So TREMFYA is a good competitor. It's a strong drug. We've competed with them in psoriasis for many years. So really much on track. I think the important part as we've been highlighting, it's certainly not a zero-sum game. So it's not like one versus the other particularly. And then, of course, with our full portfolio, we have an exceptional position in the market. So that's what we're seeing. Competitive, but also basically the boats are lifting very nicely across the board.

Great. And maybe another one on the competitive front. We're going to have an oral IL-23 entering the market this year in psoriasis. How are you thinking about that from a competitive standpoint?

Yes. I think if you take a step back, you first have to understand like the size and the position of Skyrizi in the psoriasis market or the psoriatic market because we've had 5 years of psoriatic arthritis, too, which is a very important part. We capture right now over 60% of all of the psoriasis frontline patients. And this is -- it's just an exceptional brand. I mean we talk a lot about IBD. It's even bigger in psoriasis. That's our single largest indication. And why is that? Again, we've done head-to-head trials against all major mechanisms and have gross superiority against an IL-17, 2 different orals, STELARA, an old IL-12 and certainly HUMIRA back in the day. So the physicians can just see the pure performance of exceptional skin clearance. And not only is it the skin clearance, it's actually the durability of that clearance. So it just continues to grow in terms of the control of the disease and certainly have amazingly simple dosing. So basically every quarter, it's quarterly dosing. So when we look at an oral IL-23, the first thing is that it's important, I think the community will understand that. It isn't an oral Skyrizi. It's got a different sort of efficacy profile. And certainly, you do have to take it every day. We often see and we have the data that we see the compliance impact of that. So the way that we look at this, and we've studied the oral interaction with the biologics over time because we've had other orals. And typically, what we see it's a little bit of a sort of a market expansion type of dynamic because we still probably have only about 35% overall bio or even oral penetration in the psoriasis market. So that's kind of what we saw, and that's probably more likely. We've not seen orals enter the market that would materially move the ongoing penetration of a super high efficacy and well-known product. So we'll see how that goes, but we're incredibly confident in the profile of Skyrizi.

Great. Regarding the next-generation therapies in IBD, I know you've got a Crohn's platform study that's looking at combinations with Skyrizi. Can you just update us on what we should expect there in the next year or 2 and the combinations you're most excited about?

Sure. Thanks, Chris. As Jeff was stating, Rinvoq and Skyrizi have set standards in IBD treatment in Crohn's and ulcerative colitis. And we've seen other mechanisms read out over the last couple of years, but yet none of them have exceeded the efficacy thresholds that have already been set. So we think the way to break that efficacy barrier is through combination therapy. And when you have an anchor asset like Skyrizi, that's the one that we've considered to combine with. So we have that platform study that you referenced that has a Skyrizi control arm. And currently, we have lutikizumab being combined with that. And as was stated, that's in Phase III for HS right now will read out later this year. We also have our own alpha-4 beta-7 in that platform. And that data set will read out this year, and then we'll get an idea of the behavior of those assets together and then consider next steps if we want to further optimize the dose before moving into Phase III. Also in the clinic is our TL1A extended half-life and a TREM-1 asset, both of these that we've obtained. And those have -- would be the next wave that we would then combine with Skyrizi. Again, the desire here is to break that efficacy signal, a ceiling, I should say, that, again, we've seen set by Skyrizi and Rinvoq. So I'd anticipate data readouts this year and some phase transitions.

And you're seeing it sounds like the path forward in IBD may be more combination versus displacing an IL-23?

I think so. I mean, as Jeff stated, there is expansion of lines of therapy. So there is room. These markets continue to be underpenetrated I think IBD and RA are probably the highest penetrated, but they're lurking around 50%, maybe under 60%. So you still have room to go on penetration of these markets. And then as Jeff was stating, lines of therapy are expanding. So your patients that you can treat post naive is a larger set. But to capture a large proportion of that market at a high level of efficacy, particularly on the mucosal healing side of things, I think you're going to need combination therapy. So that's going to be our focus here.

Great. Maybe one last one on immunology pricing. I think you've guided to kind of low single-digit pricing headwinds for these brands. I think in 2025, we saw more pushes and pulls there. Just level set us of how we should think about 2026 and beyond on the pricing front.

Jeff?

Yes. I think it's very consistent. I mean I think we see that low single-digit guidance that's very true. I mean we have good visibility certainly in this year into '26. And so that's generally what we've seen in this marketplace. We do see overall in terms of access that the macro movement of access is that the large payers are actually putting more and more mechanisms and brands at a parity level. And so there's no real -- when you look at all the big brands, certainly our big brands in immunology, there's not really material payer shifts once you're on a preferred status across these PBMs or these health plans. And so it's largely a competitive market in front of the physician on your brand profile. So those are the dynamics we see. This is a volume-driven business. The markets are exceptionally strong as we just highlighted. And so that low single-digit concessions is a good guide.

Yes. And I think, Chris, you mentioned the pushes and pulls in '25, but embedded in there from a payer rate perspective was the low single digits that Jeff spoke about.

Perfect. Maybe shifting over to neuroscience, a segment that's been outperforming, I think one that received a little bit less attention. And just how do you think about the growth profile for your neuroscience portfolio over time?

Yes. I think it's a great question because as Scott mentioned that when we look at the total global sales, we believe we'll be the largest neuroscience business in the world. So this is a significant opportunity and a significant profit driver today. And I do think it's a little underappreciated. We look at neuroscience in sort of 4, let's say, subsegments as we sort of drive that business. We certainly have psychiatry. We have a migraine portfolio. We have a very dynamic and emerging Parkinson's business. And then a little bit later, we have sort of neurodegeneration. So if you think about how we look at the growth, and certainly, it's the fastest growing of our segments right now, and that's going to continue based on how we're investing. Certainly, Vraylar, we've highlighted a very unique product that we've guided towards approaching a $5 billion asset, and we continue to see strong growth potential there. We have our -- I call it the triple play in migraine. I mean right now today, as we sit here, we have the 3 leading migraine products in the world. We have Ubrelvy for acute migraine. If you get a migraine, maybe at JPMorgan and need to do that. We have Qulipta, which is an oral product for both episodic and chronic migraine. And then we have BOTOX, which is a multibillion-dollar product that grows wonderfully every year. So -- and what we see is ongoing momentum, very significant growth, and we're really globalizing in particular, Qulipta [ or EQIPTA ] with new indications. So that's an exceptional franchise. And I think Parkinson's is probably the most underappreciated segment of our neuroscience business. I mean our product, VYALEV has really captured the imagination of the movement disorder experts. We're roughly -- we roughly guided towards really the first full year, maybe a little bit longer than a year, $450 million of sales this year, I mean, 2025. And the momentum is exceptionally strong, highly underpenetrated product that we think will significantly exceed expectations. And then through the Cerevel acquisition, we plan on launching an oral drug, very novel oral drug called tavapadon towards the end of the year, which has basically exceeded all of our clinical expectations. So very unique. So again, a little bit like Skyrizi and Rinvoq, where we can have our representatives and our medical experts really establish sort of best-in-class therapeutic care in Parkinson's. Roopal can talk about some of the other exciting pipeline assets, but it's a great question, Chris. We have a really strong momentum in neuroscience and some special assets.

Great. And Roopal, you want to talk about what's next to neuroscience?

Sure. Well, in addition to the us being excited about VYALEV ramping and then launching tavapadon this year in the movement space, we will be moving into hopefully a rapid Phase II dose assessment of a new toxin [indiscernible], which is a follow-on to BOTOX, which we saw very strong data in essential tremor, 10 million individuals will have that in the U.S., and it's underreported and not well managed today. So that's a very, very large opportunity. And we see the strength of that data from BOTOX and this novel toxin we have appears to have less spread within the muscle, so it may be even better suited for essential tremor. So that will get kicked off. And then we -- turning to psychiatry [ 9 3 2 ] follow-on to Vraylar that leans more towards the D3 receptor than D2. That data will read out this year in bipolar depression. And we're also in generalized anxiety disorder will probably read out in the early part of 2027. Our [indiscernible] opioid receptor antagonist, 2 Phase IIs will start this year. This was brought in through the Cerevel deal. And then I should also mention emraclidine, we are moving through a multi-ascending dose study that dose originally in those pivotals that failed was 30 milligrams. We have moved past 50 milligrams cleared that dose and now working on 75 milligrams, and we'll continue up as that asset is tolerated. And the one that I'll mention, which is quite exciting is our psychedelic asset, bretisilocin. This is a short-acting agent from a hallucination standpoint and seems to have a long tail of efficacy, which was very strong in the Phase II data that we saw. We'll get 2 more derisking events this year, 2 more Phased II cohorts will read out as we plan the Phase III approach for this asset with regulators. So we're looking forward to all of those data in psychiatry and movement disorder along with Parkinson's that we're all very excited about.

Great. Maybe shifting over to oncology. I know, Scott, you had mentioned that's one of the areas that maybe a bit underappreciated the pipeline. Roopal, I don't know if you just want to talk about some of the -- where you are in that portfolio and maybe what the key data readouts from your perspective, we should be watching from here?

Yes, for oncology?

Oncology, yes.

I'll start in solid tumor. We have already launched EMRELIS. This is a c-Met ADC. It's in a c-Met higher expression population, smaller subset of lung cancer. And our follow-on to that asset actually targets c-Met as well, but has a topoisomerase inhibitor warhead. That one is performing better than EMRELIS, and we've seen very strong data in colorectal cancer. In fact, in combination with bevacizumab in later lines of therapy, we've seen very strong data in all comers, against conventional chemotherapy. So that will be a Phase III that we're going to kick off. And then we've seen strong data in lung. So we're in dose optimization in different populations there, EGFR wild-type and EGFR mutant. We just read out strong data in pancreatic cancer. So combinations with different sets of chemo will be kicked off in pancreatic. And then this year, we will also see data readouts in head and neck and ovarian on the CME side. And recently, announced a deal for a PD-1 VEGF. We feel that can be a very nice complement to our c-Met franchise, [indiscernible] in CRC and lung, in particular, and potentially other indications. And then in the small cell lung cancer, we'll be kicking off a Phase III with our 706 asset that targets SEZ6 similar ADC concept with the topo warhead. So very strong data there. That Phase III will be initiated. And then on the heme side for [indiscernible] the Phase III as a monotherapy will complete enrollment, and we could see an ORR readout this year. And we'll see combination data and potentially start a Phase III in second line in combination with Palm. So quite a bit of excitement there. And to follow on, on myeloma, we've done we have access to BCMA-GPRC5D as part of that as an option deal and then a partnership with IGI for a unique BCMA CD38 asset, all in myeloma.

So just a bigger picture on that oncology pipeline. Just talk about the approach from here and it seems to get a lot of different shots on goal. Should we think about development mostly kind of living within the portfolio you have? Or I guess how much of a priority is this segment from a business development standpoint?

I think we have a very strong pipeline internally and a very active discovery research groups. So we get assets out of that a fairly consistent stream. However, we do continue to look externally to complement and bolster that further. So you just heard the recent example for a PD-1 VEGF. And I think you could anticipate from us looking externally for ways to complement the ADC franchise and on the heme side as well.

Perfect. Just switching to aesthetics. I know it's been a bit more volatile, I guess, uncertain in terms of the outlook. Just your latest thinking about positioning of that, both U.S. and internationally as we head into '26.

Yes. We -- it has been disappointed largely the macro issues on the markets, particularly, I would say the [ HA ] filler market where we have a very strong position around the world, but particularly in the U.S. and China. So that's been challenging. I think what's important is we really like the aesthetics business. It's an important part of the AbbVie story. And largely because we like the cash pay approach, and we also like the idea that it's highly still underpenetrated. So we can see in our market research and our consumer work that many of the patients because of the pressure, particularly the more middle-income patients, they're on the sidelines because of some wallet constraints, but they're still highly active to -- in the consideration phase. And so one of the decisions that we've looked, particularly because we're the leader in the space. I mean we have low 60 share in the BOTOX or the toxin market. We have the leading share in the filler space in the U.S. and around the world. we're investing into some of the softness. I think that's important. AbbVie, we have the capacity to continue to sort of move these markets, and that's the decision that we've taken. So in the back half of last year, and we have consistent spend this year, we're really putting forward significant consumer investments to revitalize the toxin market. And we call that the one and only BOTOX for the one and only consumer. So that's an important part. We've realized that in the filler market, which is the second largest market in the facial injectable business, that there is some pressure from social media on an overdone or an overfilled look. So we're working with a global campaign called Naturally You with all of our big clinics to make sure that the consumer can understand you can just get spectacular looks with these fillers. You don't have to have a funny look or an unnatural look. I think that's another key component as we move to sort of revitalize and stimulate this market as the leader. And I would say the third thing, Chris, is on the innovation front. We continue to drive innovation from an R&D standpoint. And certainly in 2026 and probably in the back half of the year, we'll start to see the launch globally of TrenibotE, which is our short-acting toxin. And the concept of a short-acting toxin is we know some of those considerers who are not quite ready for BOTOX, when you ask them, they say, well, I'm concerned on 2 fundamental issues: One, I might have an unnatural look; and number two, maybe there's a cost barrier. So TrenibotE, as we introduce that into the market, we'll be able to address both of those barriers because basically, you get almost a full effect within about 8 hours, and it wears off in 2.5 weeks. So it's essentially been designed as a trial toxin so that the consumers can get comfortable with a great look that they'll have. So that's kind of how we see our movement as we move into 2026.

Excellent. Competitively, anything changing from your perspective?

Not materially. We continue to have stable share in the toxin markets and also in the filler markets. But one of the things that we see is we've been afflicted a little bit in '25 by a global mix issue. So we have -- we're underexposed in Latin America relative to the competitors, and that's the area that's growing the fastest. And we're significantly exposed to China, which has been suppressed. So that's actually a geographical mix is where we see a little bit of the share pressure, but overall, the markets are pretty stable.

Maybe taking a step back, I think one of the controversies in the AbbVie story, I think, has been still around the pipeline. We've got this great momentum in the commercial portfolio. I think we've got a portfolio in the pipeline is like building out. But I think relative maybe to some peers, there seems to be fewer kind of like large like anchor type of R&D programs. How do you respond to that type of pushback on the story?

Well, I think it somewhat relates to our overall business development approach. And so when we look at our setup where we are today, as I said, we've got top-tier growth in our guidance and that we are working towards and certainly will hit through the decade. We have a line of sight of growth into the next decade. And so with that, we look at it as strategic and say, okay, we need to build out for the future for the next decade and beyond that. And so what you've seen us do is look at over the past -- since the beginning of '24, almost 40 transactions as we build out. And these are a number of the things that Roopal mentioned as he went through. And even if you just think of immunology is a great example, Roopal will talk about the combination studies and you guys had a discussion around that. But we've also done an acquisition called Capstan around B-cell depletion, which we think may maybe be a functional cure, it's very early. But so we're building out all of our therapeutic areas, and there's examples throughout. So that is really fits within our overall strategy, and that's the approach that we've been taking. Now we'll see how the data reads out. Certainly, those things have to occur. But I think we have the time, we have the financial capacity to do what we want in those 40 transactions, we've deployed roughly $8 billion over the past 2 years. So we'll continue to do that. But we're going to make sure that we're looking in the right way. And if we see something that is compelling, even if that's something is compelling a little bit more near term than we necessarily need, then we have the ability and then we certainly wouldn't shy away from things like that. But it's just not the primary focus of our strategy at this point in time. But certainly, look, we're tracking things. We're mindful. We're looking at the revenue base that we have, the growth that we have, and we're watching very, very closely. This development of the pipeline and all the various readouts that Roopal mentioned and the excitement that we have, we're going to track and monitor those extremely close.

Can you talk about obesity as a potential area for portfolio expansion? I know you've done a deal there. What do you view as AbbVie's role in the space just given how large of an end market it is?

Yes. I think we're continue to be interested in the space. We have the longer-acting amylin. We like the tolerability profile of that mechanism. But we are interested in building that out further. And the key for us is around tolerability and durability of that weight loss for these patients that tend to cycle off of these first-gen therapies, if you will, quite rapidly. Some of our data shows that only 30% or so patients are still taking these therapies after a year. So that's still, I would say, a critical aspect of our business development and licensing strategy. But I think we're still a very good company to be in this space for a variety of reasons. We're good at research and development. But on the commercialization side, maybe Jeff can comment how this could be a very nice fit with how that market is evolving.

Yes. Basically, we looked at this market, certainly, we know the scale that this market will [indiscernible] will achieve. We believe that there's likely to be 8 or 10 really meaningful segments that declare themselves over time. And so having a portfolio of assets, particularly think about the maintenance, the profiles, the bone, the weight loss, I mean this is going to be a super dynamic market, and we certainly want to play in that. The aesthetics business was a consideration of that because we actually understand the cash pay business very well. We also understand basically how our customers on the aesthetic side will program around weight loss aspects with their own clients that sort of seek that element of care. And we didn't watch. It was quite striking in the aesthetics business when the compounding was really, really moving. It became over a matter of a few quarters, the second largest segment in the aesthetic space. So we like that both on the therapeutic side and the aesthetic side, the way that we're structured. And to Roopal's point, we've made the strategic decision that, yes, we're in with this very unique and we think quite differentiated amylin. We'll see how that data plays out. But we need to do more as we come in there, and that's our stated strategy.

Great. We have one last question here. It's around PBM reform, and there's been more discussions about rebates going away. How do you think about that type of change and potential change for AbbVie's business?

Yes. This is something that we've -- that we would study obviously very carefully. And certainly, from my perspective, and our teams work very closely with all these major PBMs. I would say that this, if and as it moves is going to be more of an evolution versus like sort of an immediate sort of shock or shift. I even mentioned, Chris, to one of your comments that in the immunology space is there's more and more drugs on the preferred formulary. Some of that is because the -- there's still rebate seeking that's going on. So if you actually have more preferred drugs, you actually accrue more rebates. Now the PBMs pass through those rebates, but it's still important part of basically how net prices work in our system today. I think the key thing for us is that we're a sophisticated company, and we operate in all sorts of systems around the world. So we work in HTA systems. We work in systems that are hybrid systems like Germany, where there's rebates and there's net prices and there's different stakeholders. I mean even the U.S. is depending on the channel is not necessarily always rebate driven. So we're very comfortable because of the way that we think about differentiating our assets or how we basically apply our communication plans or our investment plans that we believe that we can win in any model with our businesses and our brands. Certainly, rebates are not driving the performance of really any of our brands right now. It's largely open access. And the more distinctive your brand is, the more that it's going to do very, very well with value across any type of ecosystem. So it's something that I think will be more of an evolution, and we'll basically participate that and understand it. And certainly, we're confident that we can operate in any sort of system that's thrown at us.

Great. Well, I think we're out of time. Thanks so much for the comments. Appreciate it.

Thank you, Chris.