Bristol-Myers Squibb Company (BMY) Earnings Call Transcript & Summary

Thanks for joining us, everybody. I'm Terence Flynn, the U.S. biopharma analyst here at Morgan Stanley. Before we get started, for important disclosures, please see the Morgan Stanley research disclosure website at www.morganstanley.com/researchdisclosures. Very pleased to be hosting Bristol-Myers this afternoon. Today from the company, we have Chris Boerner, the company's CEO; and David Elkins, the company's CFO. But thank you both so much for joining us. This close to the right after summer back-to-school season, I appreciate you taking the time out of your day to join us. Chris, I think we'll turn it over to you for some opening remarks, and then we'll launch into questions.

Well, thank you, and it's great to be here with everyone. Maybe I'll just say a couple of things. First, we're obviously coming off of a pretty good second quarter. We actually saw nice growth really across the entire portfolio. Importantly, we saw good performance with our growth portfolio -- that business now is just over 45% of the total revenue for the company, and it's well on its way given the momentum we have in that portfolio to be over 50% of the business as we get into next year. So really happy with the performance of the growth business. We also saw a good performance on our legacy product. Obviously, since the second quarter, we've been able to clarify the impact that IRA has on Eliquis. It's pretty clear that that's going to be an important medicine not only for patients, but an important product for the company in the near to medium term. And of course, collectively, that legacy business is important because while the business might be declining in certain areas, that continues to spit off cash that can then be reinvested in the business. So if you add it all up, we've got good momentum coming out of Q2. We'll see some inventory dynamics play out in Q3, but we feel good about where we're going to end the year and that led us to raise our EPS guidance and clarify that we think we'll come in on the upper end of the top line range that we had previously given. And as I think about it, maybe a second thing I'd highlight is that how we performed in the second quarter I think, really starts to bridge to how we're thinking about the company as a whole. So we -- since I became CEO in November, have really been on a mission to transform BMS to be able to deliver sustained top line growth as a company, particularly as we get to the end of this decade and then importantly, continue to drive long-term shareholder value. And the way we do that is really threefold. And it starts with going back to Q2 performance, really driving the -- and delivering on the opportunity that we have with the current portfolio, and that's commercial execution on the products that are on the market. We've got a number of important launches that are coming up. It starts with the KarXT launch. We have a PDUFA for that in September. And then at the end of the year, we have nivolumab subcu coming in, and that's going to be important for the I-O business long term. And then, of course, behind that, we've got a really exciting late-stage set of assets, and we're entering this catalyst-rich period where you're going to start to see line extensions for key products like Camzyos and Reblozyl as well as important pivotal data that you'll see across a number of products, LPA1, iberdomide, mezigdomide and, of course, milvexian, just to name a few. So -- so that's going to be super important for us. In addition, we continue to look for ways to streamline and make more agile in the organization. We talked about earlier this year freeing up about $1.5 billion in resources that we could then reinvest into the company. So we're making good progress there, and we're going to continue to be focused on the efficiency and productivity of our operations. And then finally, and David, of course, can speak more to this, is we're going to continue to be very focused on how we allocate capital. We've got a very good balance sheet that gives us the ability to invest in the business. We're going to continue to prioritize business development. We have said previously that we're going to focus in the short term on paying down the debt and delevering the P&L, but we certainly have the capacity to do business development. And of course, we'll continue to look for ways to return capital to shareholders notably through a very attractive dividend. But if you add it up, we feel good about where we are. We're making good progress across all 3 of those dimensions and happy to answer any questions.

Great. No, thanks so much, Chris. Really appreciate it. I guess maybe the first place to start, just given topical here coming out of IRA is just the first big picture question is just remind us at a strategic level, how you're thinking about the portfolio in a post IRA world and then any learnings from the first round of negotiation that you can apply to that kind of strategy?

Yes. Well, I mean I think as we look at how IRA played out, we alluded to this in the second quarter and then clarified it with the guidance we provided with Eliquis, we feel good about our ability to manage Eliquis and the impact that IRA is going to have on. You see in the guidance that we provided for '26 and '27 in the lead-up to the LOE is that there's really no material impact on EPS from that product. That's going to, as I said earlier, continue to be a meaningful and important driver of growth for us in the short to medium term. So we feel really good about that. Now stepping back and looking at IRA generally, we still have very serious concerns about IRA, primarily because of the impact that, that legislation can have on innovation. So we're going to continue to factor in IRA into how we think about investment decisions that we're making. It is clear that we had to consider it when we did the deals that we did at the end of last year. So that's going to continue to play a role there. But as we look at IRA and the business that we have today, the impact on Eliquis is manageable. When you look at the impact, for example, of the Part D redesign, we think that's really sort of is neutral to our portfolio, help some products like Eliquis has a negative impact on other products like Revlimid and PAM, but I think it nets out to be a neutral impact on us. .

Okay. Great. One -- and 1 follow-up on just the Eliquis guidance that you guys gave is does that assume that PBMs are going to seek additional rebates on top of that new price? Or I know that there was some -- there was a range there, but just talk through that aspect of the Eliquis price.

Yes. We've been clear that in all likelihood, PBMs will attempt to use the MFP and the public MFP in their negotiations. What I would say on that is a few things. First, we have a long history of being able to manage multiple books of business in our negotiations with PBM's commercial business versus the government channel. And we're going to continue to leverage a very good team in doing that on a forward-looking basis to manage any potential spillover that you would see there. As it reflects the guidance that we gave, we considered multiple scenarios in the guidance that we gave both with respect to commercial scenarios that could play out over the next few years as well as the impact of various policy initiatives like IRA.

And maybe a 2-part question. So I think on the first quarter call, you talked about potentially providing earnings guidance with the Eliquis guidance that was not in the release. And again, the second part is the latest perspective on trough earnings guidance because I know that was something that you guys had kind of floated earlier this year as a possibility. So it's a kind of a related question. What's the strategy now on kind of how to think about those 2 aspects. And again, maybe it's interrelated here. Is that -- sorry about that.

No, no, no. We're good. Look, I think that as it relates to earnings related to Eliquis, as I said just a minute ago, I think the way we see it is where we netted out and the guidance reflects this is that there's really no material impact on EPS. So that explains that. As we think about just guidance more generally, I think what we've said consistently and certainly is still true post Q2 is that we're going to move more towards short-term guidance, a move away from providing longer-term guidance to focus on those things where we have clear line of sight and where we can not only hold ourselves accountable, but investors can hold ourselves -- hold us accountable for delivering. So that's going to be our focus going forward. And in terms of how we think about providing guidance, we have historically provided guidance at the beginning of the year. And so that's the process that we're going to provide going forward.

Okay. Okay. Great. Maybe, Dave, 1 for you is just, obviously, you have a lot going on in the pipeline side. You have a lot of new product launches now. How do you kind of manage that spend in the context of operating margin again, what are some of the puts and takes that you're considering here as you think about making the necessary investments, but also maintaining efficient operating margin [indiscernible].

Yes, that's a really important question. It's something we're very much focused on. As you know, we've got a 37% operating margin this year and next year, and we feel really good about that. There's a couple of components. First, if you think about gross margins. Our gross margin has been coming down and we've been guiding that down and that's primarily related to Revlimid and Pomalyst. And -- but as you know, Revlimid is pretty much through its generic cycle next year and Pomalyst in '26. . But then if you think about the growth portfolio, and now that's 46% of our total portfolio grew 21% excluding currency -- that's a high-margin business as well. As that business continues to grow and a bigger part of our business, that will be accretive to our margins. And then the third thing to really think about is with the guidance that we provided with Eliquis. Remember, Eliquis, the gross margins, we share 50% of that with Pfizer. So as Eliquis goes down and goods LOE in 2028, that actually is accretive to margins as well. So that's 1 component of it. The second component of it as Chris was talking about, from an operating expense base, our ability to move resources around, we've gotten really good at it. One, if you think about the acquisitions that we've done, really good examples we launch products freeing up Revlimid and Poma's resources for Reblozyl and Breyanzi. If you think about launching Camzyos, we're able to use the Eliquis resources. So we've been really good at reallocating resources in that. But the line of sight that you have with the $1.5 billion strategic value capture that we have, that was really to fund the deals that we closed in the fourth quarter. But we got really good at identifying savings. So we believe we got a lot of substrate there. One, we were able to prioritize the portfolio, increase the ROIC of that portfolio, but also that helps strengthen the growth trajectory in the second half of the decade. The other thing that we're able to do was our third-party spend. There's a lot of things that we're able to in-source like in clinical operations, but as well as in some of the back office. And over a year ago, we really had very few employees in India, we now have 2,000 employees there. So we were able to save money by in-sourcing some of the activities that we did with third-party providers, and we're not done there. We have a supplier summit that's coming up where we're going to be working with some of our most important suppliers, not only to help us get more efficient but also help us from a technology perspective to leverage technology more to improve productivity, both in R&D but as well as within our supply chain. And the third thing that we are doing is we continue to take layers of management out of the organization, to streamline decision-making, making us more agile. And this has been a push that Chris has been really since coming into the CEO really getting us to focus on those things that are most important, but also being more agile.

Yes. Do you feel pretty good about maintaining kind of competitive margin levels.

We Do.

Okay. Okay. Great. Want to move to KarXT just given the PDUFA date is coming up next month, obviously, an important product launch for you guys. Maybe just talk high level about some of the commercial preparation that you guys are undertaking here ahead of that PDUFA date? And then kind of the related question on just pricing reimbursement dynamics, what are some of the puts and takes that we need to think about, recognizing you're not going to guide on price yet, but just what are some of the inputs there?

Well, this has been a significant push for us since we announced the deal. We actually started a lot of the commercial prep work at risk even before the deal closed as appropriate because we wanted to get ahead of this. And I would say the focus that we've had is 3 or 4x. First, we knew coming into this launch that this is the first new innovation in 30 years, the first new mechanism to launch in neuropsych in schizophrenia specifically in 70 years. So we have a lot of market preparation to do. So we hired a very seasoned medical organization to begin prepping the market as appropriate for this launch. We also initiated as part of that, a number of medical studies that will inform the use of the product both in terms of how to use it and how to use it potentially in combination with other assets. So all of that work was done in the lead up to this month. And so that team has been in place for some time. The second thing is, remember, about 80% of this patient population is going to be either Medicare or Medicaid. And a lot of the reimbursement focused activities are going to be in the states with individual state Medicaid agencies. So we obviously had a Medicaid team prior to the acquisition of Karuna, but we bolt that team up. And as appropriate, begun to engage with these payers in the lead up to this approval. And of course, the third area is Karuna had begun to build a commercial infrastructure. We've taken virtually all of that into the company and expanded it in particular on the sales side, so that we could have a much broader base of use early in this launch. So those have been really the big areas of focus for us. In terms of how the dynamics are going to play out, I would think about this as a 2025 launch. And the reason for that is effectively, we're going to be approved in October. And as I mentioned, a lot of the activity that has to take place early on is going to be getting the state Medicaid agencies not to cover the product because it's a covered and a protected class, they have to cover the product. It's where does it sit on formulary. And so a lot of that work needs to take place toward the end of this year. They will obviously be sampling as appropriate to give physicians experience. But this is really going to be a 2025 lunch. And I would expect this to ramp over the course of this year -- that year as access and reimbursement comes online, both with Medicare and Medicaid. But if you step back, this is a product that has considerable commercial potential there, 1.6 million schizophrenic patients just in the U.S. who are treated 75% of those patients are not adequately controlled on atypicals. And what we have is a very differentiated drug. It's a drug that's delivering efficacy in line with the best of the atypicals with a better safety profile -- and we've been able to demonstrate with multiple studies, including large Phase III studies that you're seeing improvements in positive and negative symptoms as well as cognition. And so there's a lot of excitement in this community, and we're incredibly excited to bring this innovation to market.

Great. Maybe just a few follow-ups at this point, no FDA Ad Comm because they're so close. That should be our expectation.

No. And in fact, the FDA discussions have gone well, and we're on track to deliver on the PDUFA.

And how about the label, anything that we should have on our radar screen from a labeling perspective?

No. I mean, obviously, in any label, there are things that you're working through, things that you'd like to see tweaked or move. But in general, the discussions we've had with the FDA have gone quite well. We're happy where we Set and looking forward to the PDUFA date.

Okay. I was looking back, I think there was another drug that was launched for schizophrenia several years ago. And the Medicaid process, I remember, took -- seem to take like 6 to 12 months. Is that kind of a reasonable estimation? I know every state is different, but how many months does it take to kind of go through that process? I understand the coverage, it's more like you said, getting on the formulary. So what is that kind of pace look like?

Yes, I think that's a reasonable analog to use. I mean, obviously, in any launch, you're going to try to accelerate that as fast as you can. I'd mention that we already had a Medicaid team in the field to support the other parts of our business. We bolt that up -- and as appropriate, we've begun engaging with these agencies already. So I think we feel good about where we are in the launch planning here. We've got teams in the field. They're a highly experienced team. So we feel good about it, but that's a reasonable analog.

Okay. And then as you mentioned the opportunity, the 1.6 million patients, is that just as the monotherapy opportunities, does that also include adjunctive -- because I know that's the other piece where you're running trial there. So maybe just help us think about what are the adjunctive additional label data bring to the table?

Well, those are 1.6 million patients who are treated in any form, -- but you're correct to point out the importance of adjunctive. We are running an adjunctive study. We expect that to read out next year. The dynamics of this market are really interesting because given the fact that about 3/4 of treated patients are not being well controlled. What you're going to see with this approval you're going to see some patients who are going to be switched because they're not getting the right level of efficacy. You're going to see some patients who are switched because there's a novel mechanism here and they're looking to see an improved safety profile. You're going to be seeing some patients who will be used in combination with the existing therapies that they're on. And of course, there will be some de novo monotherapy use. No other product in this space has an adjunctive indication. So our view is when we get that data and are able to put it on label, it's a real competitive advantage. But one of the reasons we began running some of these medical studies at risk early on was we knew we wanted to inform physician practice however they choose to use the product. They choose to use as a monotherapy, they choose to use it in combination. And we wanted to have data early in this launch even in advance of our adjunctive label in order to inform that. So we feel good that we've got the right studies in place in the lead into that. Obviously, we'll wait and see the Phase III data in the adjunctive indication next year. One thing that's absolutely for sure is that physicians are going to want to try to use this product. And then over time, they'll figure out how to best use it in terms of the frequency of dosing and how they're going to dose and how they're going to administer mono or combo.

Okay. And 1 other question we get, obviously, is the competitive profile relative to AbbVie's emraclidine. And so we have yet to see the pivotal data. We're going to get that later this year. But as you look back at their prior data, what would you call out as some of the kind of differences between these 2 agents as we think about that market development?

Well, first, I think the way to think about this market in general is this is a very large market. And there's 1 thing we've learned from the atypicals is this is a market that can sustain multiple large players. So let's sort of level set on that. Having said that, we really like our competitive profile. And what do we like about it? First, it's an M1 M4. So that is a difference between what you see with the competitive product, which focuses only on M4. The reason we like M1 M4 is, as I said earlier, we've seen efficacy output showing clear improvement in positive symptoms, negative symptoms and cognition. Cognition is coming, we believe, from the M1 component of that, going back to early data that Lilly had presented on an asset in the Alzheimer's space showing an improvement in cognition. . And so we like the mechanism of action that we have vis-a-vis competitors. The other thing to point out is that we've got multiple studies, including multiple large Phase III studies that are going to inform this. We will see Phase II data from AbbVie, I expect later this year. And we'll have to see what that data looks like. But as I sit here and look at what we've got, we've got a drug with a really attractive mechanism of action. We have clear activity that shows efficacy equivalent with the best of the atypicals with a better safety profile. We've got a multiyear advantage in the best of circumstances over a competitor. And it's a market where you can sustain multiple large players. So if you add it all up, we feel great about where we are.

One area AbbVie's pointed a food effect, I guess, of the trospium component. Anything I mean what's your response to that, I guess, as you think about the profile? Because that's 1 area that they pointed out is like a differential, I guess, first emraclidine.

Well, I just know from prior experience, first of all, you don't get to a discussion of how you dose or food effects if you don't work your way through a continuum that starts with efficacy. So again, efficacy, safety and then you can get to dosing and administration. And the way I look at it is, yes, we're going to be twice a day. We got a great profile. As I said earlier, we've got ongoing studies to show different ways that you could potentially dose this drug over time. And the way physicians have told us they're going to think about this is take it on an empty stomach in the morning and take it before you go to bed on an empty stomach. So we think it's a manageable dosing frequency and the food criteria is not going to be a major impediment to how we launch this product. And again, multiyear head start and a lot of excitement in this space, we feel great about where we are.

Okay. Maybe the last 1 is just there's -- obviously, you talked about schizophrenia a lot, but Alzheimer's disease psychosis is the other one. And so -- how do you think about that opportunity? And when do we start to have a better handle on how that might materialize?

We anticipate the Alzheimer's disease psychosis and agitation data in 2026. And -- so that study is up and running. And one of the things that we did when we acquired Karuna is we sent our team to the heritage Karuna organization and said, look, what were the things on the development program you were most excited about? And what were the things that you wish you could have had the resources to do. So in addition to schizophrenia, which is inclusive of mono and adjunctive, as we've discussed, Alzheimer's disease agitation psychosis, which will come in '26. We have a bipolar disorder. All of those were embedded in the deal that we did. We just announced in Q2 that we've added 2 new indications 1 in Alzheimer's disease cognition that goes back to that M1 component of our mechanism of action. And then we have also added autism disease illnesses and that was -- that's another new indication for this where we're quite excited about, and those studies will be kicking off.

Okay. Great. So lots to watch for here on the forward. Maybe I thought just because again, very topical is this data just came out and as a competitor data, but it relates to 1 of your pipeline assets, milvexian, which is a Factor XIa inhibitor here, which would be a follow-on product to Eliquis, which has been a huge commercial success, the standard of care in AFib. So Bayer, as people are probably aware, had a competitor drug Phase III data in AFib, the DMC stopped the trial. I think this is November of last year that we were finally able to see the data at ESC, watched the conference over the weekend, read the New England Journal publication we had a no doubt on this, but that was my take. So I would love your guys take on the data and then the implications for milvexian where a Phase III -- broad Phase III program is in ongoing both AFib and some of the indications?

Well, we have 3 ongoing studies, Phase III in parallel, acute coronary syndrome, secondary stroke and AFib and the data that were presented at ESC or the eighth of data from asandexian, the study that was stopped. In the lead up to that, our perspective was that the BAR study was underdosed. And I would say nothing has changed in our perspective. . We remain incredibly excited about the opportunity for Factor XIa and AFib. There's a lot of continued excitement from the KOL community for Factor XIa in the space. By the way, that's evidenced by the fact that our study continues to enroll quite quickly. We obviously are continuing to have DMC reviews of our data, including relatively recently. And so the way we look at it is there's really no change in perspective coming out of ESC.

I really don't want to get through the -- is it my rating -- all right. So I agree, underdose was one of the things that the discussed in investors publication talked about. The other thing was the patient population that may be -- the system has gotten a lot more -- a lot better at managing these patients now, just given Eliquis and other treatments. And so I think there was a commentary that the control arm, the rate of events in the control arm was lower than expected. And so how do you think about that relative to the population that you guys enrolled? And obviously, you have a rich history here with Eliquis and data to drawn. So how do you think about that aspect, which was the other 1 that the discussions.

Well, obviously, there are going to be some of those kinds of nuances that come out of the data that were presented that we're going to take back and say, well, how does that affect our study -- what I will tell you on the surface of it, based on what we know about our blinded data, which remember, we see our blinded data post DMC reviews. And what we've seen there is we don't think any of those sort of more nuanced points have any negative read-through for sure into our study and could potentially have a positive effect. So -- the way we look at it is there's no real change based on some of those nuances, but we'll, of course, be taking a look at them. But if you level it up 1 step and say, what did we really learn here? A lot of the concerns coming out of the November stopping of that study was is there a read-through on Factor XIa in AFib. And what we said at the time because it was our perspective even before they stopped their study, is that they had underdosed the study. And remember, what we have, we have a study that clinically, preclinically and in modeling that we have done internally, and that has been done externally. We know we have a more potent anticoagulant in milvexian than asundexian. So that's starting point #1. The second step is to say, if you look at the dose we took into Phase III, it's 4x higher than the dose they took in. And you add those 2 points up it's pretty clear to us. And in fact, it was even referenced in the New England presentation -- or the New England publication that in all likelihood, they've underdosed the study. So we walk out of that conference saying nuances aside in things that they saw in their study. We still have a lot of confidence that Factor XIa has a role to play here. We have to wait and see the data, but nothing's changed in our excitement around milvexian coming out of that program.

And remind us the time line is '26, '27.

'26. It's a bit driven. So that's 1 -- that's the other thing that we'll be looking at as their event rate and how that relates to us.

Okay. Okay. Great. Another presentation coming up is Opdualag for lung cancer. We were talking about it before you guys are hosting an ESMO event. Again, maybe just level set us kind of the hypothesis here. Obviously, Opdualag is approved in melanoma. You guys have been studying IO-IO combinations for the last 20 years or so. And again, I think this is -- the next focal point is LAG-3 for lung cancer. And so talk to us maybe about what we hope to learn from this study and then I know you kicked off the Phase III recently as well.

Well, the reason we did the Phase II was to try to inform not necessarily would the drug work in the overarching lung cancer population, but could we identify a subset of lung cancer where we saw really good activity and what we said a few quarters ago and what we'll show at ESMO is data that gives us confidence that we've identified a subset of patients not only do we like what we're seeing with Opdualag, but we like it in comparison to the data, both the clinical data and the real-world data that we've seen with pembro chemo. . And so you will have seen in the clinicaltrials.gov that, that's a non-squamous 1% to 49%, pay attention to the above 50% when we show the data at ESMO. But we think we have a clear opportunity and at a minimum, the non-squam 1% to 49% population and potentially, as I just referenced, a broader population. So -- we're quite excited about it. And the reason Opdualag is important just to level set, is that not only do we have an opportunity that we know of in advanced melanoma -- but now we've got this opportunity in lung cancer. And when you layer on to that nivo subcu, that gives us confidence that we can extend a portion of our I-O business through the end of this decade and into the next decade.

What -- I mean I think looking back at some of these studies, I know here, you've got a nivo control arm and then you're going to have to go versus standard of care in Phase III. But I feel like every time we see 1 of these Phase II trials and again, part of our job is just the cross-trial comparisons, the handwringing in terms of how does Opdualag or how does KEYTRUDA perform versus some of the prior studies. And so anything in terms of that control arm performance that think about it. And obviously, there's like 2 different groups of patients here. So how do you think about control arm performance relative to historical studies?

Well, I mean, it's the classic pitfall of doing cross-trial comparison -- but having said that, you can look at the active arm and how it performed just in and of itself. So not just the delta between the active and the control arm, but rather just the performance of the active arm and compare that to what you saw in the active arm of these other studies. And so not only do we like the delta, but we also like just the absolute activity that you'll see at ESMO in how Opdualag performed vis-a-vis what we've seen in, for example, 189 as well as there's a plethora of real-world data that has been presented over the last number of years in first-line lung cancer, looking at the real-world performance of pembro chemo. And so we will -- in fact, I think Samit is going to show this in the ESMO presentation, sort of how it compares against that panoply of data.

Yes. So bottom line is you feel good about the absolute performance versus 189, though not just the real-world data. .

We feel that this is going to be a competitive profile. And you'll see that at ESMO.

Okay. And remind us, we're going to get PFS data that's not just ORR.

You get PFS data.

Okay. No OS because it's too early.

No OS.

Okay. Okay. Got it. anything else in terms of the Phase III trial? I know you mentioned the 149, but any other trial.

No. The only other thing Samit will talk more about it at ESMO. But the only other thing I would say is that we also like the greater than 150 data and he'll talk more about that at ESMO. .

Above 50.

Above 50. The other thing that we'll highlight there are data that we have coming up in oncology. So -- by the end of this year, we hope to be able to present some very early data with RYZ101, which again comes out of the acquisition we made of RayzeBio in December. We have a partnership with Sistema. We expect to see some data there. So it's pretty interesting the evolution of the oncology business we'll have a chance to talk about that.

Okay. Okay. So it would be broader beyond just Opdualag.

Yes.

Okay. Great. Maybe just in the last few minutes. Some of the new product cycles, newer product cycles, Camzyos, Reblozyl, Sotyktu. Maybe just high level, again, looking through your prior role as Chief Commercial Officer. What are some of the steps that you guys are taking to accelerate those launches and maybe just pick 2 out in interest.

Yes. Well, I would say just generally, that the things that we are looking at are, first, we look at the level of investment. In fact, 1 of the first conversations that David and I had after I became CEO, was do we have the right level of investment across each of these products. And so we have ramped up our investment, for example, with Sotyktu, making sure that we've got the right level of promotional resources compete in this very competitive space. We've looked at the level of rebating in order to get market access. And again, that's something we'll continue to give updates on, including in the next quarter. So that was an area that we've made up investments. We've also up invested on Camzyos and something we've been consistently doing is making sure that we've got the right investment to consistently deliver supply for products like Breyanzi. So we feel good about the level of investment, but I would say that's 1 area. The second thing we've done is we looked at level of resourcing. Obviously, that's true across a product like Sotyktu and Camzyos. But it's particularly important, for example, when we think about the next launch with KarXT where I think I referenced earlier that 1 of the things we've done is we scaled up the original plans that Karuna had to ensure we've got adequate resourcing in the field to get broad utilization of that product. So that would be the second thing that we're focused on. But rest assured, this isn't a one-and-done exercise. We review the commercial performance of our growth portfolio every Monday morning, and it's something that we're going to continue to stay focused on to ensure we've got the right resources, the right people the right level of field resources to make these products successful.

Great. Well, thank you so much Chris, Dave, I appreciate it. Sorry about the fire alarm, but I appreciate the patience and [indiscernible].

Thanks. I appreciate it.