GSK plc (GSK) Earnings Call Transcript & Summary

Good afternoon, and welcome to this GSK Q2 Results and Accelerate Growth event. Today, we look forward to having a good event. And if we could have the agenda slide on the screen, please. Just a few words on logistics before I hand over to Luke. The first thing is that we have a Q&A session for you planned at 2:45 and another one then at 4:20. After the first Q&A, you will have a short break, and the event is planned to end around 5:00 p.m. Next slide, please. Also note the legal disclaimer on our cautionary statement regarding forward-looking statements. And I would like to add that any definitions in terms of our reporting as well as assumptions on accelerated growth can be found at the end of this deck. Lastly, if we comment on performance, any of these comments will be made at constant currency or CER, unless otherwise stated. And with this, I'm delighted to hand over to Luke.

Thank you. Welcome, everyone, and thanks for investing your time here to join us in person at the London Stock Exchange and on the webcast. If anyone wants photos of the South Cambridge Railway Station, which is a lovely orange color, Mick Readey has them, so we can send them to you after. Seriously, today is in 2 parts. The first, we'll give you an overview of our Q2 results. Then we'll move to what is the primary focus of today, which is GSK products and our plan to grow the business and how we'll create value for both patients and shareholders. So first, I'll cover the results we announced today quickly. So Q2 performance was strong. We've got continued operational momentum with sales up 5% to more than GBP 8.4 billion. Core operating profit grew 7% and core earnings per share were up 9%. Our cash generation remains very positive at GBP 4.3 billion, and our Q2 dividend is 17p. And we're on track in terms of our responsible business rating. In July, we also closed the acquisition of Nuvalent. Nuvalent is a precision oncology company closely aligned to our approach to Vd. And I'm delighted to say that this acquisition has already contributed to our portfolio with the approval of Jideytro, an pretreated ROS1 positive non-small lung cancer just last week. Looking forward, we are updating our full year 2026 guidance with sales and operating profit now towards the upper half of the range with EPS now expected in the lower half of the range following the acquisition of Nuvalent. I'll now hand over to Nina, who is going to summarize how we're delivering this growth and she'll also take you through some color on Nucala and COPD, Exdensur and Blenrep.

Thank you, Luke. Hi, everyone. So commercial momentum continued in the second quarter, driven by key products across our specialty and vaccines portfolio. Growth was driven by Specialty Medicines, which grew 14% and vaccines, which grew 8%. Vaccines growth benefited from the global expansion of Arexvy, our RSV vaccine, strong performance from our meningitis vaccines and Shingrix in Europe. Specifically, Arexvy benefited from a tender win for a 2-year supply in Australia. Specialty growth was driven by Nucala's continued COPD launch and our long-acting HIV treatment, Cabenuva as well as Dovato. General Medicines was down 9% in the quarter with declining sales of the older established portfolio. Also, there was a challenging pricing comparator for Trelegy in the U.S. due to a positive true-up that took place in the second quarter last year, also softer inhaled respiratory market demand, both of which we expect to improve in the second half of this year. As Luke mentioned, we are focused on the products that drive the most value, including new launches and growth contributors. Next slide, please. Here, we have pulled out the 3 major launches of 2026. Starting with Nucala. We once again had strong global growth driven by the COPD launch and its halo effect on the other indications. In the U.S., new-to-brand prescriptions were up 69%, with COPD driving more than 70% of the growth. Internationally, sales were up 18%, primarily driven by our success in China, where Nucala gained majority share of bio-naive patients in COPD and already has NRDL listing in severe asthma and nasal polyps. We are also continuing with the launch of Exdensur, our twice yearly IL-5 for severe asthma. The J-code went live on July 1, reducing the logistical burden on prescribers and providing certainty on reimbursement. We are continuing to build access and coverage with more than 50% of insured patients now being covered. The majority of new patients are coming from the bio-naive population, which we expect will continue as around 70% of patients who could be on a biologic for severe asthma still are not. And finally, Blenrep, our community-ready antibody drug conjugate for multiple myeloma is building in line with our expectations. We now have approval in 49 countries. And recently, we have gained reimbursement for Germany and Spain. In the U.K., that's the country where Blenrep launched first, we are seeing a shift in second-line treatment, as shown in this very nice chart provided directly by NICE, with Blenrep now leading in new patient starts. In the U.S., we are receiving positive feedback from physicians with strong intent to continue use. As we've said before, our approach is to go slow to ensure positive experience, helped by the J-code, which is now in effect for Blenrep as well. As we enter the second half of the year, we will continue to focus on unlocking the community opportunity where the majority of the patients are. And with that, I will hand over to Deborah.

Thanks, Nina. I'm delighted to report another quarter of double-digit sales growth at 10%, reflecting continued execution of our strategy and sustained market growth for our long-acting injectable portfolio, which in Q2 represented 80% of our total HIV growth. In the U.S., we accelerated our market share growth, continuing to outpace the competition with sales growing 14%. Long-acting injectables contributed 35% of sales, underscoring strong execution in a competitive market and increased demand for our HIV medicines. Cabenuva continued to convert patient preference into sustained growth with sales plus 33%. This performance was fueled by patient demand. And in the U.S., 77% of new prescriptions came from competitor products, reflecting increasing confidence among both health care providers and people living with HIV and the benefits of long-acting treatment. Apretude sales increased 39%, supported by more than 4 years of real-world evidence and tolerability data. At AIDS 2026, 6-month follow-up clarity data further reinforced a more favorable injection experience versus lenacapavir after a single dose of each drug with 70% of participants rating CAB as very or totally acceptable compared with 37% for LEN. In addition, fewer HCPs reported challenges with administration and patient management. Given our continued growth momentum, we are raising our 2026 sales growth guidance to high single-digit growth from mid- to high single-digit growth. I'll now hand over to Julie.

Thank you, Deborah. And I will now cover financial performance. So turning to the next slide. Starting with the core income statement for the quarter with all commentary at CER. Sales grew 5% and gross margin improved 250 basis points due to product mix benefits driven by the growth of specialty and vaccines, together with supply chain optimization charges that we took in Q2 last year. SG&A grew 5%, driven by launch investments and phasing compared with the prior period, partially offset by continued productivity gains. R&D growth in double digits continues to be driven by accelerated investment in the pipeline with 3 Phase IIIs initiated across specialty in half 1. And the royalties decline simply reflects the RSV IP settlement that we received last year. Operating profit grew 7% and EPS 9%, benefiting from a lower tax rate of 17.9% and the benefits of the share buyback. And then turning to the total P&L. Results were impacted by the impairment of Camlipixant following the recent CALM-2 readout. Now turning to the first half cash flow. CGFO was GBP 4.3 billion, up GBP 0.5 billion versus last year, driven by operating profit, receivables and the CureVac settlement income. Free cash flow improved by GBP 1 billion with around half driven by the business and around half driven by one-off cash receipts relating to linerixibat and ViiV. On the 15th of July, we completed the acquisition of Nuvalent at a net cost of GBP 7.1 billion, increasing net debt to GBP 22 billion, just under 2x net debt to 2025 core EBITDA. And the share buyback is now complete with an average price of GBP 16.13 over the 18 months. Now turning to guidance. I will now cover 2026. And at the end of the event, I will cover the longer-term outlooks. So following the strong start to the year, we are pleased to be updating our sales and operating profit guidance towards the upper half of the range. Sales by product area has been modified with HIV and vaccines expectations improving to reflect the strong performance of Cabenuva and also Shingrix, respectively. GenMed is downgraded to reflect the tough environment together with generic competition. Operating profit reflects the underlying strong business performance and is now expected to be in the upper half of the range with reduced SG&A and improved royalties, partially offset by increased R&D investments. EPS is now expected to be in the lower half of the range, and this is predominantly due to the additional interest of around GBP 160 million following the acquisition of Nuvalent. Now to support your modeling with respect to phasing, we expect operating profit growth to be significantly Q4 weighted. And a number of factors lead to this, including productivity charges taken in Q4 last year, whilst Q3 is impacted by the consolidation and phasing of Nuvalent costs and the acquisition-related interest together with a tough tax comparator. Thanks. And with that, I will hand back to Luke.

Thanks, Julie. Right. So coming back to the agenda, we'll now move to the accelerate portion of our event. As a reminder, we have allocated time for your questions halfway through and then again at the end of the presentations. Now at the start, I mentioned before that the focus of today is about products and growth. And we'd now like to take -- like to take you through our plan to do this. So first, we'll give you more details on our products and why we're confident in our ability to grow the business. And then second, we're going to update you on how our late-stage pipeline is evolving. We're also going to talk about what we're doing to accelerate and expand our key late-stage assets as well as working hard to improve our ability to find and develop new competitive products and then finally, we'll update you on how we are funding all of this. And essentially, we will be reallocating capital and resources in a disciplined way to focus on what creates value. And hopefully, at the end, you'll have the same confidence that the team and I have in our plan and our ability to execute it. Next slide, please. So what do we think our business is going to look like over time. Over the last few years, we have delivered considerable strong growth with commercial execution, and we will work very hard to maintain that growth in the near term, while we invest in the late-stage pipeline. In the midterm, we've identified key growth drivers. We think those growth drivers will compensate for the loss of dolutegravir exclusivity and allow us to push through this transition period that I'm talking about. In the longer term, the changes we're making now to how we operate will accelerate the next wave of products to continue delivering top line growth. And finally, we remain very, very active in terms of BD. And here, we're looking for increment growth opportunities that make strategic sense for GSK. Next slide, please. So the biopharma business, our biopharma business has changed over the last 10 years. Here you can see that operational execution has driven a move from being a company that was highly reliant on a genericizing business of largely primary care products and commoditized vaccines to a growth-orientated company with a broad mix of innovative products. And if we look at where we aim to be in 2021 and beyond on the right-hand side of this slide, GSK will continue to evolve to be more specialty focused -- and that means a much larger proportion of our sales coming from oncology, respiratory and hepatology, supported by a differentiated long-acting HIV portfolio. Now right now, our portfolio is built around 5 core therapy areas. So today, our team will engage with you about the promising potential we see in each of these areas. And these are the 5 areas we're investing in. This is where we are focused. And whether they're walking into a lab, a manufacturing site, one of our offices or meeting our customers, every single one of our people needs to know how their role helps us deliver on these 5 priority areas. Because in our business, and certainly with this audience, you'll understand this, a company's valuation is based on products and the core ability of management to recognize and deliver competitive innovation. And to do that, senior managers have got to be close to the products and the people leading the project teams. So we've taken material steps with the late-stage portfolio, BD and advancing our early stage to ensure that we are evolving to do just that. Now I'll cover the mid and early parts of this slide shortly, but starting with the late stage on the top left-hand side. Every 2 weeks, a subset of the Executive Committee. So Tony and Nina as well as Regis. Regis you're there. I don't think many people know you, Regis, so that's Regis there. And Mondher, who everyone knows, Mondher Mahjoubi, who everyone knows, who's on holidays right now. So we meet to look at the progress of our late-stage portfolio and selected assets every 2 weeks. These meetings are led by the product teams, the people running the projects. And this allows us to delayer the organization and it promotes accountability. And the aim is to keep us all on top of the internal, but also critically the external factors that influence our success. Now since these reviews were started in January, we have identified acceleration opportunities across 7 assets, 18 indications and 25 studies. And you'll learn more about all of this today. Now as a result of these efforts by our team, we have over 20 Phase III starts this year. And that is more than double the expectations that we set out at the start of the year when we committed to 10. You can see on the right-hand side of this slide that there is a good spread across our therapy areas. And you can also see the increasing importance of oncology. These Phase III trials are based on validated data with strong medicine profiles. And each opportunity has been thoroughly interrogated as part of the strategic portfolio reviewing process and in order to give us the confidence to invest right now. This is a busy slide, but I love it. I think this slide does a good job of showing you how these elements come together in terms of the late-stage portfolio, the momentum that we have and the bolus that we've built up in Phase III starts. There will be attrition after we are talking about drug development, but that's why we have a broad portfolio. And our portfolio really is a set of assets that we are confident that is competitive and that can drive growth. For the mid-stage portfolio, we will continue to supplement our pipeline with business development, and we'll focus on products that address a validated target and where there is an efficacy or tolerability gap. So far this year, we have executed 3 deals. Looking at this list, we missed with Bellus and Camlipixant in cough, but we've just got approval with Jideytro in lung. And overall, the majority of assets we've acquired with these deals have progressed to Phase III. Next slide, please. In the early stage, we need to improve our output. And we've got to keep evolving how we work and who we work with. And I mean this slide shows we're putting our money where our mouth is. This is why we're closing Stevenage and moving our people up to Cambridge. I mean, having lived in Cambridge and worked at one of the places listed up there, I know the power of relocating to this environment, and it is designed to help Tony and his team drive change and to make us fundamentally better at discovering and developing new drugs. And Tony is going to take you through this in depth shortly. So how are we making all of this happen and how are we paying for it? To realize the opportunities in the late-stage portfolio and R&D, we have announced today an accelerate growth program. This program is about reallocation within our existing P&L to fund these studies and labs. This is a 3-year program that will enable us to increase investment in R&D by targeting annual cost savings of GBP 1.9 billion by 2029. To do that, we will incur an expected onetime cost of GBP 2.4 billion, which will be GBP 2.1 billion in cash. The majority of these savings we were making will be reallocated to the late-stage pipeline and some of that money will also go towards strengthening the margin through the dolutegravir loss of exclusivity period between 2028 and '30. Now this is fundamental to our strategy. We plan to evolve the company's cost base in line with its shifting product portfolio and to accelerate -- to deliver accelerated long-term growth and value to both patients and our shareholders. Next slide, thanks. Finally, this is how we see the late-stage portfolio. As you can see, the portfolio will evolve over time, accelerating growth to drive long-term value for patients and shareholders. Now with that, let's get into the nuts and bolts of how we're going to make this happen as a team. And to get that started, it gives me enormous pleasure to hand over to Tony. Tony?

Hi, everyone. Delighted to be here with you, and thanks, Luke. As Luke highlighted earlier, accelerating R&D is a key priority for us, and this means focusing on 3 important areas: maximizing the value of the late-stage portfolio, supplementing that portfolio through business development and of course, accelerating the progress we've been making in changing the way we work in R&D. I'm pleased with the progress we've already made. Starting on the left-hand side of this slide, you can see the value of our pipeline is increasing. In fact, we've more than doubled the number of Phase II and Phase III assets with blockbuster potential since 2022. Our pipeline is also moving 25% faster, meaning we're now in the upper quartile of our peers based on recent CMR benchmarks. We expect this trend to continue to improve. Together, this means we can do more. And as you can see, we significantly increased the number of Phase III starts this year compared to the past. 2026 will be a bolus year for Phase III starts based on our acceleration decisions, which I'll cover in more detail in a moment. Much of this has been achieved through our use of data and technology. It enables faster decision-making with greater confidence, something we continue to embed in all aspects of R&D. As Luke mentioned, we're taking a new approach to reviewing the portfolio. And this means experts from project teams present directly to myself, Luke and Nina, so we can make quick decisions, resolve issues promptly and provide support to advance exciting programs. The approach ensures we have the right alignment across R&D, commercial and medical to make the most informed decisions possible. It's fully cross-functional, data-driven and has already allowed us to confidently make a number of acceleration decisions, which you can see on the right-hand side of this slide. These are the assets and programs you'll be hearing more about today, so you can understand why we're excited about them based on their differentiation and potential benefit to patients. In oncology, our ADC portfolio has been significantly accelerated. This is supported by data from our partner, Hansoh as well as our own global clinical program. Our decision to accelerate 5 Phase III studies for Mo-rez in gynecological tumors and 4 for Ris-rez in lung and prostate cancer demonstrates our confidence in these assets. In respiratory, we'll start 6 Phase III -- sorry, Phase III trials across indications for our ultra-long-acting TSLP GSK'283. This is a significant acceleration of its development path. Kaivan will describe emerging data, which support the use of the 6-monthly regimen for treatment of diseases like COPD. For efimosfermin data suggests a best-in-class profile for the treatment of MASH. The program has recently been accelerated against our original time lines and now includes F4 in addition to F2 and F3 patients. And I'm pleased to announce that the F4 program recruited its first patient only last week. As you can see on this slide, the changes we've been making in R&D, particularly in development have led to a transformation in our late-stage portfolio, which is now much more focused in areas with greater patient benefit and value. Overall, we're significantly increasing the number of Phase III starts significantly this year. We expect this trend to continue to be above that as a past, although not at the level we're seeing at this year. Importantly, these are in high-value areas with a major driver of this being a significant increase in the number of oncology Phase III studies. 2026 will see the start of pivotal trials for Mo-rez in gynecological cancers, Ris-rez in genitourinary cancers, Velzatinib in first-line GIST, efimosfermin in F4 MASH and our 3x yearly treatment for HIV. External innovation and business development have been and will continue to be an important part of accelerating R&D. Luke's highlighted the deals we've added important assets to our late-stage pipeline, most recently, of course, Nuvalent. We'll continue our approach of bringing in assets with validated targets that address efficacy or tolerability gaps to complement our mid-stage pipeline. We use the same data-driven scientifically courageous approach I just described for our BD decisions as well. It's true for both clinical and earlier platform deals. And in the latter case, means R&D is increasingly externally focused. You'll hear more from me on the early-stage R&D later in the year. Now as we become more externally focused, we're also making sure we co-locate our key laboratories with major external innovation hubs containing leading academic institutes. We have 4 key locations, the East Coast of the U.S., U.K., Europe and China, each with important academic partnerships, and I've highlighted the major ones on this slide. The partnerships span a portfolio of interests aligned to our core therapeutic areas and forge deep connections with leading researchers that expose us to groundbreaking innovation. The majority of these projects focus on human health data, giving us unique insights that derisk our target identification and translational efforts and allow us to advance faster with greater confidence. We continue to actively look to expand our partnerships on the East Coast of America and in China, and I look forward to sharing updates with you in the future. In Europe, we already have a significant presence with very strong partnerships like the one we have with Oxford University. The announcement today that we're establishing a hub in Cambridge, U.K. shows our commitment to ensuring our people are in the right places with the right partners to accelerate innovation. Our new Cambridge site will accelerate the changes we're making within R&D, reflecting the new way of working we've built to discover and develop medicines. CBC is one of the leading integrated biomedical campuses in the world and as such is a perfect location for us. We'll be beside one of our key academic partners, Cambridge University as well as with internationally recognized research hospitals and clinical infrastructure. Our scientists will be able to work in state-of-the-art technology-enabled labs with an ecosystem of innovative AI and biotech companies. This move is part of a broader transformation of R&D, which I'll continue to update you on. Finally, I want to reiterate the strength of our late-stage portfolio, which has been delivered from the momentum we've been building over the past years through business development and most recently, our acceleration decisions. We have a number of exciting milestones ahead of us, and I look forward to updating you on these in the future. With that in mind, I'm now going to hand over to the team to take you through these programs in more detail, and we're starting with Hesham and our oncology portfolio.

Thank you, Tony, and good afternoon, everyone. I'm Hesham Abdullah, Global Head of Oncology R&D at GSK. Today, I'll highlight the significant progress we've made in oncology, building on our strength in gynecological and hematological cancers and expanding into new tumor types. Given the additional R&D investment we're announcing today, I'll also discuss how we'll focus this investment to accelerate development and bring our pipeline of clinically meaningful medicines to patients faster. Let's start with why oncology matters. Oncology is a large market opportunity, defined by significant and persistent unmet need. Cancer incidence continues to rise with many tumor types projected to see double-digit growth in incidents through 2030 and beyond. Despite meaningful advances over the past decade, driven by precision medicine and new modalities, many cancer diagnoses continue to have very low 5-year survival rates. There remains a substantial opportunity to improve patient outcomes. Our pipeline and team are well positioned to address this growing unmet need. We've built a portfolio of competitive, high-potential assets and critically, we have a talented team with a proven track record of execution in oncology. This combination of high unmet need, a high potential portfolio and a proven team will make oncology a key growth driver for GSK. We've been deliberate with how we've rebuilt the oncology pipeline at GSK, starting with strong franchises in hematology and gynecologic malignancies and now expanding into lung cancer, propelled by the recent Nuvalent acquisition as well as gastrointestinal, prostate cancer and other solid tumors. Building on our marketed anchor assets, we're advancing a deep clinical stage pipeline across multiple modalities, including ADCs, next-generation targeted small molecules, immune cell engagers and novel precision oncology medicines. We're focusing on developing a better understanding of cancer biology, generating unique insights from deep phenotyping, novel nonclinical model systems and foundational models for patient identification and stratification. These differentiated oncology technologies enable sustained growth and innovation with a quality portfolio of assets in our research pipeline. End-to-end, our GSK oncology portfolio is designed for scale and sustained leadership. Turning first to our 2 lead antibody drug conjugates, Mo-rez and Ris-rez. Both ADCs utilize a proprietary TOPO1 payload with a proven linker technology designed to deliver enhanced stability and tumor penetration with a potentially differentiated safety profile. For example, in our BEHOLD interim study results presented at SGO, we observed a 3% incidence of ILD pneumonitis, and we'll share further evidence of these potentially differentiated outcomes at ESMO with Ris-rez. We've already advanced both ADCs into pivotal programs based on an extensive range of clinical data spanning across ovarian, endometrial, small cell and prostate cancer with data generation ongoing across other solid tumors. Early access to extensive Hansoh clinical data sets in large patient populations, combined with competitor insights and our own data in global populations allows us to rapidly incorporate learnings, design competitive Phase III trials and optimize our strategic positioning. At the same time, we're evaluating novel biomarkers to potentially further enhance activity with a multipronged translational strategy. Across both programs, we're delivering at pace, striving for flawless execution while making smart, disciplined choices along the way. Mse mocertatug rezetecan, or as we call it Mo-rez builds on the strong foundation of ZEJULA and Jemperli to drive GSK's next wave of innovation in gynecologic cancers. Strong clinical data in both ovarian and endometrial cancer position Mo-rez in the top tier of a competitive and emerging class of antibody drug conjugates in gynecologic malignancies. Mo-rez delivered numerically higher antitumor activity, combined with manageable safety with a 62% response rate in platinum-resistant ovarian cancer and a 67% response rate in second-line plus endometrial cancer. Importantly, this activity is independent of B7-H4 expression level with no unique toxicities. For example, none of the TROP-2-specific stomatitis. Supported by an extensive data set, we've moved at pace to initiate a scaled Phase III development program, initiating 5 Phase III studies during 2026, including 3 ovarian and 2 endometrial cancer studies. Driven by a strong signal observed with Mo-rez in early clinical trials, the BEHOLD clinical program has recruited over 600 patients, and it has taken just 15 months to move from Phase Ib to initiating Phase III. Expect further safety and efficacy data updates from Mo-rez at ESMO. The second asset from this class-leading ADC platform is Ris-rez, our B7-H3 ADC, which is effectively an oncology pipeline in a single asset. B7-H3 is widely expressed across a large number of solid tumors. Across these potential indications, we're prioritizing early entry into small cell lung cancer and prostate cancer, where proof of concept has already been established. In parallel, signal confirmation in a global population is underway in non-small cell lung cancer and sarcoma, now that PoC has been established in China. And we're also exploring additional opportunities across multiple other solid tumors. With already more than 930 patients dosed across in both trials globally, we have established a strong foundation to further accelerate Ris-rez development and maximize its potential. Similar to Mo-rez, robust early clinical data provides conviction to move our Ris-rez program with pace and at scale. In the second-line small cell lung cancer setting, FDA granted Ris-rez breakthrough therapy designation based on the initial data presented by Hansoh at the World Conference on Lung Cancer in 2024. The updated data published in cancer cell this year showed an objective response rate of 60% with a 6.3-month median progression-free survival and a 14.9-month median overall survival in the TOPO-1 naive cohort. Earlier in July, our partner, Hansoh, announced that Artemis-008, a Phase III China study, met its primary endpoint, demonstrating a clinically meaningful and statistically significant improvement in overall survival for patients with second-line small cell lung cancer. This marks a significant milestone as the first positive Phase III overall survival data for a B73-directed ADC in any tumor type. Our global GSK Phase III study in second-line plus EMBOLD Small Cell Lung Cancer 301 is actively recruiting, and we plan to initiate a first-line study later this year. And at China non-squamous non-small cell lung cancer, second-line plus population, Ris-rez has demonstrated meaningful activity, both as a monotherapy and in combination with a PD-L1 inhibitor. Our ongoing Phase II combo study EMBOLD PanTumor-101 will aim to confirm the signal in PD-1 exposed patients in a global population. Prostate cancer is a key growth opportunity for Ris-rez, and we will initiate a number of Phase III studies in prostate cancer before the end of the year. The EMBOLD program includes 2 Phase III monotherapy studies in late-line and chemo-naive metastatic castrate-resistant prostate cancer as well as a Phase III combination study in metastatic hormone-sensitive prostate cancer. These accelerated investments are supported by the response data shown here on the left, a 37% confirmed objective response rate in metastatic castrate-resistant prostate cancer patients, supported by 9 months landmark PFS rate of 56%. Ris-rez is complemented by a growing pipeline of early-stage prostate assets that position us for future expansion with different modalities. Highlights for the remainder of 2026 include the Artemis-008 data set, which look like Ris-rez in second-line treatment of small cell lung cancer. This trial met the overall survival primary endpoint and data will be published before the end of the year. These data are significant because this is the first pivotal trial to show a survival benefit for any B7-H3-directed ADC in any indication. In addition, our partner, Hansoh, has just announced positive results from a second China Phase III study, evaluating Ris-rez in osteosarcoma patients that have received at least 2 prior lines of therapy. The trial demonstrated a clinically meaningful and statistically significant improvement in its primary endpoint, IRC-assessed PFS with consistent benefit observed in key secondary endpoints. Osteosarcoma is an area of high unmet need, and Ris-rez has secured breakthrough therapy designation from FDA in this tumor type. Data from the Phase III study will be presented at a scientific congress later this year. Additionally, at ESMO, we'll share the first Ris-rez data from a global population alongside ILD analyses that will further characterize the asset's potential differentiated monotherapy safety profile. This momentum is expected to continue into 2027 with Ris-rez data being presented at major medical congresses throughout the year. Together, this represents a rich multiyear data cadence across one of the broadest B7-H3 development programs. Turning to our recent Nuvalent acquisition, which provides assets in precision oncology lung cancer. Neladalkib and Jideytro have the potential to transform treatment in ALK-positive and ROS1-positive non-small cell lung cancer. The potential to improve efficacy and tolerability in ALK-positive and ROS1 positive patient segments will support extended treatment duration and in turn, drive market growth. The ALK and ROS segments of the non-small cell lung cancer market represent around 2% to 4% of the overall population. But these segments are typically younger. They are more frequently women and fitter than the broader lung cancer population. Patients are usually diagnosed with metastatic disease and typically have a higher rate of CNS involvement at diagnosis. For patients with ALK ROS non-small cell lung cancer, next-generation agents like Jideytro and Neladalkib may extend median PFS beyond 46 months in ROS1-positive patients and over 84 months in ALK-positive non-small cell lung cancer patients. While the majority of first-line lung cancer patients will be treated for around 9 to 10 months, the duration of therapy for a first-line -- the duration of therapy for a first-line ALK patient may be greater than 7 years. Jideytro was recently approved by FDA for the second-line treatment of ROS1-positive non-small cell lung cancer patients. We're also working with FDA to support Neladalkib approval with an FDA decision for second-line ALK-positive non-small cell lung cancer expected by November 27. First-line studies for both Jideytro and Neladalkib are still ongoing and enrollment in Neladalkib's first-line ALKAZAR Phase III trial is already more than 30% complete. In the cross-trial comparison shown here for ALK-positive non-small cell lung cancer post second-generation TKI, neladalkib shows 14.5 months median PFS compared with 6.6 months achieved with lorlatinib, with 91% of patients maintaining a response for more than 12 months versus 70% with lorlatinib in a TKI-naive population. In ROS1-positive non-small cell lung cancer post TKI, Jideytro shows 23.8 months median PFS compared with 9.7 months for taletrectinib with 96% of patients maintaining a response for more than 12 months versus 74% for taletrectinib in a TKI-naive population. Acknowledging the caveats that exist with these cross-study comparisons, these data appear to suggest the potential to meaningfully prolong median PFS with Nela and Jideytro. These are best-in-class efficacy profiles, and I will review safety and tolerability data on the next slide. Data from the neladalkib clinical program indicate Nela is well tolerated with the lowest rates of dose reductions and discontinuation when compared with other assets in the class. Nela is a highly selective ALK inhibitor, which is reflected in the adverse event profile observed in clinical studies. Nela does not appear to be associated with the long-term metabolic and neurological adverse events seen with other TKIs in the class. While Neladalkib does show higher liver enzyme elevations, physicians' feedback indicates these are largely clinically asymptomatic and manageable with routine monitoring. In short, a tolerability profile designed for long-term first-line use. Velzatinib is another asset in our precision targeted therapy portfolio. It's in Phase III development for the treatment of GIST or gastrointestinal stromal tumors, a rare type of cancer, which develops in the digestive tract, most commonly in the stomach or small intestine. The first-line standard of care for GIST patients has not changed since the introduction of imatinib over 20 years ago. While this first-line therapy has improved the outlook for patients over time, GIST tumors will ultimately become resistant to imatinib and patients typically progress to a second-line treatment strategy. The standard of care in second-line treatment is not well tolerated with variable efficacy. Velzatinib is the only agent in the TKI landscape, which targets all primary and key secondary KIT mutations with a lower rate of adverse events when compared to other available treatment options or standard of care. At ASCO this year, we presented velzatinib data, which showed a 61% confirmed response rate and a 65% unconfirmed response rate for velzatinib in the first-line setting with every patient on the trial demonstrating a reduction in tumor volume. These data were used to inform the StrateGIST frontline study, which recently started recruitment. We now have 2 Phase III studies underway, StrateGIST-3 in second-line GIST and StrateGIST frontline and first-line GIST, both exploring velzatinib as monotherapy. Recruitment for both studies is progressing strongly ahead of schedule. This momentum underscores the pace at which we're advancing this asset and velzatinib's potential to redefine the standard of care in GIST. Finally, I'd like to provide a short update on Blenrep, our ADC for the treatment of multiple myeloma. Blenrep's clinical development program is targeting all patient segments of newly diagnosed multiple myeloma. The DREAMM-10 study is designed to investigate a Blenrep combination, which is appropriate for the majority of first-line or newly diagnosed patients. These patients are described as either standard risk fit or high-risk frail patients. DREAMM-10 investigates a Blenrep triplet versus a daratumumab triplet, and we anticipate preliminary MRD negativity data in the first half of 2028. For high-risk non-frail newly diagnosed patients, the Phase III PRECOX study will investigate a quad regimen of Blenrep plus VRd versus a CD38 combination of daratumumab plus VRd in a high-risk enriched population, addressing the need for deeper myeloma control through higher treatment intensity. Together, these 2 pivotal studies should support blenrep use in a large proportion of the first-line multiple myeloma patients. Blenrep's projected median progression-free survival of 101.8 months from the TERPOS data presented at EMN is competitive versus 100 months for a CD38 quadruplet regimen and 62 months from a CD38 triplet. Next, real-life burden of care. BRd offers a meaningfully lower burden of care with dramatically fewer infusion days. This has real-world implications for patients. And then finally, the Grade 3/4 ocular event rate is significantly improved and matches first-line expectations. This is achieved with 1.9 mg per kg dosing on a once every 12-week dosing schedule in the maintenance setting. This is a regimen designed to optimize benefit risk in this newly diagnosed patient population. Now let me close with the big picture. Our GSK pipeline and team are well positioned to address the growing unmet needs in oncology. We have a highly competitive oncology pipeline, and we're continuing to apply various acceleration levers. Starting in lung, we have a near-term acceleration opportunity into second line with Jideytro now approved and Nela on its heels with first-line expansion for Jideytro planned in first half 2027. Both address clear efficacy and tolerability gaps. With our 2 ADCs, extensive clinical data sets provide conviction to progress multiple pivotal programs at pace with Mo-rez in Gyn-onc and Ris-rez pipeline in a single asset. Ris-rez brings the first positive Phase III OS data for any B7-H3 directed ADC with 2 positive Phase III trials to be presented in the second half of '26. Continuing with our pipeline of differentiated precision oncology medicines in areas of unmet need, Velzatinib has the potential to redefine a 2-decade-old standard of care for GIST patients as a well-tolerated monotherapy with potential superior activity and tolerability profile. Finally, we will continue to see upside with Blenrep. The ongoing clinical development and evidence generation program aims to ensure success in newly diagnosed patients while creating broad access for community-based BCMA therapy. Taken together, this is a high potential competitive oncology pipeline and one we're advancing with real pace and conviction. I'll now hand it back to Luke to commence the Q&A session. If I can also ask Julie, Nina, Deborah and Tony to join me on the stage as well, too.

Great. Thanks, Hesham. And as you said, we'll open the floor -- open the floor. [Operator Instructions] So Matthew, I think you were the first. I think you get a job as a Formula 1 driver with those reflexes. So Matthew.

It's Matthew Weston from UBS. One question really about -- and it's about the financials before we get into all the detail because there's more time to dig into the detail later. Slide 24, you gave the illustrative picture of the impact of the new GBP 1.9 billion savings program. And it showed the cost base today and then it showed a smaller cost base in the future. And I think you're on track to deliver about 31% margin based on guidance in '26. So one of the most significant questions I've received today over and over is, does the new cost saving take that margin target higher? So am I right in interpreting Slide 24 that, yes, you are now aiming for margins up at the end of the 2031 period relative to where we are today.

The reservation in the slide that we shared was basically saying it was the cost base as a percentage of sales, first of all, as a result of accelerate growth. We are guiding to more than 31% margin in '26. And what we've said previously before today was that the margin will be stable through dolutegravir LOE, which is 28% to 30%. And we feel confident of that because the portfolio is pivoting more and more towards specialty, #1. And as you've seen over a number of years now and with this program, we are driving productivity and improvement in the business. So that brings us to date. Now what we've said is as a result of accelerate growth, we will also drop some of those savings through to the margin in the period of dolutegravir. So it builds in the dolutegravir LOE period, 28% to 30%. We've not given a specific percentage, but what we have done is changed the margin guidance through dolutegravir now to say it will be stable to improving. So we're giving a range and recognizing the drop-through from the Accelerate growth program.

I think, Luisa, you are next, right?

Luisa Hector from Berenberg. I wanted to check on the asset accelerations. So you've highlighted 7. What are the criteria for accelerating? Is there some new decision-making in that mix? And then I don't think Nelo is an accelerated asset. Is there a reason for that? Maybe it's in flight too recent? And if I can also ask on probabilities of success and linking that to the validated targets. So you have this awesome selection now of pipeline. Is there a reason for probability of success being higher with the '25 Phase III starts? You talked about the validated targets. I don't know how much of those -- what percentage of those are with validated targets and what that really means validated target.

Thanks, Luisa. I'll start, and then I think this is very much going to be a bit of a tag team answer. So maybe a little bit of heritage, a little bit of background. I mean, Nuvalent wasn't in there because it was running on a similar track with the deal and the programs are more advanced. But if we can go faster, we'll certainly look to do that. But essentially, we wanted to sit down and look at the portfolio, benchmark it versus external parameters, not just marking your own homework, but if you look at a classical program in lung, what are the appropriate time frames, what's a typical white space that's a fair comparator? And then what can we do to compress that obviously applying common sense that we didn't want to go so fast that you increase risk. The other thing is, of course, as this portfolio is evolving, if you do have a validated target, you are removing elements of the risk, and therefore, you've got more confidence. I think just fundamentally, we want to look at ways that what were the things that were stopping us from making the decision to go faster. Was there any biological risk? Was it a resource risk? Was it our own process? And really compressing all of those, and each program had different combinations. And then we ended up -- we ran up against Julie, who said, that's lovely. And she's doing her job, she said, this needs to be paid for. And that's what then triggered the second round of the process, which is to say, okay, well, then how do we effectively use our shareholders' money appropriately to try and unlock that. And clearly, moving it from historical areas of the business or areas where, frankly, we could partner or we could do things more simply and moving those monies to Phase III programs and to BD, we felt it's a better return and a better use of our shareholders' money. So that's the high-level answer. I don't know, Tony, if you want to give a bit of color, Nina and then Julie, just sort of how that flows through. But clearly, at the end of the day, it's a benefit of -- a combination of benefit risk that we're looking at with these programs, classic portfolio management. Tony?

Why don't I just start a little bit with what data underpins confidence here. And you're going to hear a lot more about that from Kaivan, for example, and you already did from Hesham. And so I think you start with the fact that our portfolio now has a significant number of assets that have broad potential associated with them. And what we've been doing -- and by that, I mean, a number of potential indications that carry significant value as well. And we've been integrating data from one end human causal data from genetics all the way through clinical characterization of patients to individually detailed molecular data. And what that allows us to do is, if you like, draw lines of confidence in underlying biology across different indications. So that's one aspect of it. You'll hear some nice examples from Kaivan after the break on that. Couple that then with the opportunity to be able to execute a clinical study in both an effective and shall we say, appropriately gated way when we're going with relatively strong data, as I've just described, but perhaps the absence of a Phase II. And what you have is a set of ingredients that allow us to then put confidence behind the 7 assets that we described. And that's why we've described it as 7 assets with 18 indications and I think 25 studies. All of that, coupled with having my friend here sat beside me telling me whether or not she thinks it's worth anything, really helps us to pull together a very different approach that we have now to accelerating the portfolio. I'll hand over to you.

Yes. Thank you, Tony. Not much to add, but Luisa, to your point about the confidence, I'll use some examples. Velzatinib, we have seen -- we have ongoing second-line study, right? When you see a study recruiting at 200% rate, that gives you a bit of confidence that there is actually genuine interest and desire to use the program, to use the asset. And then we try to accelerate, obviously, starting first line and support to make it possible to hopefully repeat the same. I'm not promising it, but there is high confidence that, that is -- that study will recruit. Other examples are the 2 ADCs. We have this massive benefit of having a Chinese partner who generate a huge amount of data very quickly. We are all aware that sometimes data generated in specific Asian population might not be repeated. So the question here is which level of confidence we need to have in the global Western population to then embark very quickly into a Phase III study. And some of these, we -- for some of these, we feel very confident already. So I think it's based to what Tony said, it's underpinned by data, definitely. And also, you can imagine that we have -- we ask the teams to come bottom up with proposals. If you have a blue sky scenario, what would you bring as acceleration? We had more than 100 opportunities that were brought by various teams. And we obviously looked at how big are certain opportunities and what does it mean for our 2030, what does it mean for post-2030 growth. And I think we are very confident that at this point, we are -- our kind of cutoff is blockbuster indication. So that plays a role as well, together with how much does it cost, operational execution? Is it feasible to do it and so on.

And we -- just to stress something Luke said right at the beginning, we keep a very close eye on what's going on competitively. Particularly, for example, Kaivan, I'm sorry if I get ahead of you, but the TSLP's a nice example. We got a hint that our friends at Generate Bio are getting ahead of us, which we didn't like the idea of. So that was something that then went very quickly through this process, and you'll hear more about that program later.

And I think, again, we want to build a culture that's obsessed with products. Graham?

It's Graham Parry from Citi. On the accelerating growth post 2031, can you just help us understand what you're assuming for cabotegravir IP protection there? So you've talked about protecting through dolutegravir, but the cabotegravir LOE is 2031. It would be pretty major if you actually lost it there. So you can detail how you're expecting to protect that. And then secondly, on zidesamtinib, what's your confidence in the ability to get approval on the first-line data given I think it's only a 35-patient cohort and you've already got Taletrectinib approved from TRuST12, which actually had more patients. And have you had any discussions with regulators regarding the filing yet?

Great. Thanks, Graham. Deborah, do you want to give some color on that? And then Regis, if you could just step through the process of making cabotegravir because I think that's -- it's quite interesting is what I would say. And then we'll come back to zidesamtinib first-line Hesham.

Sure. So thanks for the question, Graham. So we've got a robust approach to intellectual property. You'll see on Charlotte's slides later, a little more detail on this, but I can talk about the additional intellectual property that we have in our hand today and potentially we will have in the future on cabotegravir. So let's look at 6x yearly treatment for Cabenuva that's in the market today. We've got additional protection now granted through to 2040 for that asset. We've then got 3x the yearly treatment. Again, we've got additional protection pending through to 2047. And then when we come into 60 early prevention, we actually have the patent granted to 2031. We don't have an additional coverage for that asset. And then 3x the early prevention, we've now got secondary patents pending, which takes us out to 2045. So it is an incredibly difficult medicine to make and to bring rilpivirine and cabotegravir together in the treatment space. Enables us to have quite a moat of intellectual property either available today or patents that are pending, which are broad and cover both the combination of the 2, how you make it and obviously, the original composition of matter patents. So we feel really confident in the future of our IP to protect the assets that we have in our hands and in our pipeline. Just so we don't leave because we're on the topic of IP, VH184 and 499 out, the base patents there run until hopefully, when they're granted 2040, but we have additional patents that will again take us out to 2047. Regis, do you want to just talk a little bit about how challenging it is to make these medicines?

Yes. I had no idea. I would be describing the process this afternoon, but fasten your seat belt. We make the API in Singapore, quite a standard process, long chemistry, synthetic chemistry. Then after you bring it in U.K. where you do nanomilling. When you have finished a nanomilling, you will do gamma irradiation. When you have finished the gamma irradiation, you bring it back, you're going to feed it as a sterile product. You're going to gamma irradiate again and you're going to inspect it and then you're going to inject it. So if we do it, we are not the only one to be -- someone else can do it, but not everyone.

Thanks, Hesham, first line. And maybe just build on some insights we've got as part of the due diligence process talking to physicians. And again, we had insight into the regulatory exchanges as well. So over to you, Hesham.

Yes. Thank you, Luke. Yes, I'll start off first by saying, of course, that the Phase I study has actually been recruiting additional patients in that first-line cohort as well, too. I think the key really when we think about first line is the fact that we need the additional follow-up to be able to show that duration of response and that durability of response, which I think is really critical for regulators as well, too. With that in mind, I think probably what I would probably focus on and point to is really when we look at the comparisons of the efficacy, especially in this TKI-naive patient population, you look at the duration of response more than 12 months, it's really at about maybe 96% for zidesamtinib versus 74%, of course, for taletrectinib. And then, of course, to Luke's point, really had a lot of insight into physician experience with the drug, especially from a tolerability profile perspective as well, too. When we look at, for example, the GI side effects, including the diarrhea, the nausea, the vomiting. And then even, I would say, when we look at some of the CNS side effects as well, too, just given how selective and TrkB sparing the drug is, including on dizziness, where we see, of course, with taletrectinib about the 22% incidence versus 12% only with zidesamtinib as well, too. So I think we feel pretty confident about the first-line approach from a regulatory standpoint. We're expecting a filing probably before the end of the year and then hopefully, a regulatory decision in 2027.

Great. Konstantin, I think we'll take one online and then we'll go back to the room.

Our next question comes from Steve Scala at TD Cowen.

Relative to the General Medicines guidance decrease, it was in part attributed to the soft environment. I'm curious what emerged in the last 3 months that led to this softness. Specifically, the company signed the agreement with CMS on June 15. So were there any details of that agreement, which were negative surprises?

Nina, could you hear that?

I think...

A little bit of an echo.

Yes. Okay. So I think -- so look, this is a portfolio of mature, older assets that continue to be in many regions under pressure, under pricing pressure and generic medicines coming on board. That's one element. The other element is Trelegy. And I think you have seen -- we spoke about this in the first quarter already. We do see increased abandonment rates in the U.S. for Trelegy and Trelegy is not the only one. It happens to actually all the assets in the SIT (sic) [ sitagliptin ] class. That is easing definitely. But overall, that level of abandonment, the trajectory is going down, but it's at a higher level than what we have seen in the previous years. And to some extent, that is contributing, we mentioned that we expect this to now be removed in the second half. We expect the growth to come back, but it influences the whole year. And I would just ask Julie if she wants to add anything.

I think that's a perfect summary. We've obviously seen Gen Med under some pressure in Q1 and the pressure increased slightly in Q2. So the full year view reflects that. I think very importantly, we knew Trelegy would be under pressure in the first half and Trelegy has been the asset that's been growing double digits. So it's taken away some of the strength in Gen Med that we had before. So in the second half, we're anticipating there'll be less abandonment going on, and we haven't got a tough comp like we had in Q2 because of the rebate and return adjustment. So I think that's the summary.

Yes. And there's a little bit of mix, of course, as the COPD component becomes more. Peter.

Pete Verdult, BNP. Just a few for Tony. Just what time lines are you working to ballpark to get your people into Cambridge? When it comes to this new accelerated R&D strategy, have there been -- and I don't mind if it's not, the answer is no, but have been any notable leadership changes to your team in the last 12 months? And then just specifically, when it comes to your B7 targeting ADCs, they are competitive, we agree with you. But there are a lot of others out there. And in many cases, they're ahead of you. So as part of this accelerated change in late-stage development and the 9 studies you're doing, are there any indications you'd call out where you think you could be first to market as a B7-H3 or 4 targeting ADC?

Okay. Let me start and Hesham, I'll give you a chance to have a think about where the B7-H3 and 4 question might go. First of all, in terms of Cambridge, remind me, there was 3 questions in there. The first question was...

Yes, time frame became...

Time frame, early '29. We want to move the whole group and the first building is up. There are 2 more to go up, but early '29 is the plan for that. No immediate changes to my team. I've elevated one person. Our Head of Clin Ops now reports directly to me, and that's all consistent with the way we're operating the business in R&D. She is an experienced leader and somebody we acquired actually from AstraZeneca. So she knows how to find the Cambridge Biomedical Campus. And in terms of what you -- where you will see changes, and we will probably introduce you to some of these folks in the second half of the year when we do some of the earlier updates on research are the folks who report through to my colleagues who are here with us today. We continue to hire really exciting new leaders in MD PhDs who are still clinically practicing individuals. These are the folks who are helping us, for example, to integrate across different data layers. So I'm delighted with the progress we're making in really bringing the patient right to the center of our thinking in early research. In terms then of the ADCs and with regards to acceleration, look, before I give Hesham the opportunity to talk about which of the programs we see as coming first, I think it's worthwhile underscoring what we see as an emerging picture for both molecules, both in terms of their overall quality for response rate and now the first OS data, as you heard from Hesham for Mo-rez, together with an emerging, not yet fully qualified, but I think advantageous selectivity profile. And since Regis is in the room, I'll also mention the fact that our experience with Blenrep has set us up very well with regards to ensuring manufacture of these molecules, which is not the most straightforward proposition. But Hesham, you might talk about some more specifics on where we see acceleration.

Yes, I'm happy to, Tony. And I think probably starting off first to say -- it's not always about being first. I think there are a number of different variables when we think about these ADCs that we have to take into account. I think the first one really is the type of technology platform that you have. I think we're pretty confident about the fact that we have a well-validated linker payload technology. We're seeing that in the data sets that we're generating. I think the second is, you heard me talk a little bit about the fact that we've got -- and Nina touched on this as well, too. We've got different sources of data that not everyone has access to. We've got large amounts of data that have been generated in China with both H3 and H4. And then we're complementing that with the data that we're generating across our own development programs, more than 600 patients for H4, more than 930 for H3. And that gives us unique insight in terms of not only which indications to pursue, which ones not to pursue. And I think the third really is more around how we're thinking about translational strategy. To me, at least, probably, it feels like the most differentiated ADCs across different patient segments or tumors are going to be the ones that could better enhance the treatment effect relative to the ITT, and that comes through a really good understanding of the biology, but also how the drug actually works in the context of not only target expression, but also the linker and the payload and their importance in terms of how sensitive the tumor is to them. And so we've got a multipronged strategy where we're actually looking at a number of different technologies and platforms for biomarkers that we think will certainly be important in that regard. And then, of course, the execution is clear in terms of the pace and the scale, which is important. But I would say probably maybe for B7-H3, the one maybe tumor type that I'd highlight that could be of potential interest and could be differentiated is actually non-small cell lung cancer. We're seeing the data, of course, that was presented at AACR, 47% response rate in combination with PD-L1 in a PD-1 pretreated patient population. Again, it's data from China. We have to validate it. We've got ongoing Phase II to do that and help confirm it, but it could certainly be an interesting opportunity that maybe is more unique at least in the short term.

And that's probably worthwhile just quickly, particularly for Mo-rez where the data is more advanced. I think it serves to take a look across the various patient characteristics and dose use for our molecule relative to our competitors there to get a sense of what Hesham was talking about in terms of the emerging properties of Mo-rez relative to others.

Yes. And I'd also add, we've got a team, the layers below that has a fantastic track record across a number of companies in terms of navigating programs. All right. We've got time for one more question. Simon, then we'll go for a break.

Simon Baker from Rothschild & Co Redburn. I'll try and be quick. A big picture one on R&D. It's clear that R&D at GSK in 5 years' time will be in a very different place in every sense of the phrase. But I just wonder if you could give us an idea of the moving parts between the additional resources that's going in, productivity changes. And really, the key question is, how are you going to measure that change in improvement? And how will we see that measure improvement beyond simply looking back in 8 years and thinking GSK accomplished more than it did in the previous decade. Where sort of where are we now? Or where were we? Where are we now? And where could we be by the end of the decade?

Tony?

Well, that's certainly another 1-minute answer, Simon. So look, I mean, where were we was a very distributed portfolio pointing to opportunities of little value. And you saw that we've transformed that substantially in the past 4 years. Also that we have a portfolio in which there are a number of meaningful life cycle innovation opportunities so that I'm getting more out of each asset. They're moving quicker. We're 25% quicker than we were. We're in upper quartile as far as that's concerned. The decisions that we make about that portfolio and in terms of BD as well are made by exactly the same people who make the decisions on the early-stage portfolio. So you should expect to see the same discernment in terms of highlighting and accelerating assets to that as well. I will share with you at some point in time, if you want, the scorecard on how we evaluate individual areas of the business. I don't have time to go through that in detail right now. What you will see, hopefully, is continued momentum towards the areas of significant opportunity and competitiveness in terms of either pace and for first-in-class or careful decisions for best-in-class agents. And the best way I can illustrate that is through the portfolio that we'll be sharing today. In early stages, I could pick different examples across all of the parts of our business, looking, for example, at how we execute our clinical programs. A case in point might be as we apply more data there, for example, we're expecting to be able to half our study start-up time by the time we get to 2028. So it would take me the next half an hour, Simon, to go through each one of the segments and give you the simple KPIs that we're using to judge progress there. But I can assure you they are in every single group. They're a relatively small number because I don't like to give people the opportunity to hide behind long lists, and it's extremely data enabled.

So the good news, Tony, is you've got 20 minutes at the coffee break to do exactly that. That concludes our first Q&A. If we didn't get your question, please obviously know the people to find, and we'll make sure that we get to your questions in the second round. And of course, we've got time at the end as well. I just want to get -- make sure we capture and get your questions. So with that, we'll have a break. Thanks, guys. We'll see you back in 20 minutes, at 3:35. It's a less than 20. [Break]

So welcome back, and I now get to introduce Kaivan, over to you.

Thanks, Luke. Good afternoon, everyone. My name is Kaivan Khavandi. I'm the Head of R&D at GSK for Respiratory, immunology and Inflammation. GSK is well recognized as the leader in respiratory medicine, having pioneered multiple products across indications, notably asthma and most recently with the launch of Exdensur, the first ultra-long-acting biologic to be launched in airways disease. However, when we think about the largest remaining unmet need and the sheer scale of opportunity, this is undoubtedly in COPD, which is an area of enduring growth and represents a core focus of our future portfolio. Similarly, in hepatology, we have an important product launch planned with bepirovirsen for chronic hepatitis B, a rare opportunity to impact population health and where, of course, we're committed to realizing the full breadth and value of that product through its life cycle, including potential combinations, but it's steatotic liver disease, secondary to MASH and alcohol, where we see GSK continuing to innovate with efimesfermin and beyond. What's underappreciated, though, is that these 2 areas are much more connected than at first apparent, serious chronic diseases with shared underlying inflammatory and fibrotic as well as vascular risk, which frequently coexist. Patients with primary disease of the liver, heart and lung are also at risk of developing secondary pulmonary hypertension, a serious and much more expansive area than idiopathic PAH, for which there is largely no approved treatments. Together, these 3 areas form an unaddressed comorbid access that carries a very high risk of mortality and for which GSK is strongly positioned to lead. So with that background, when we look at recent product developments at GSK, success has been demonstrated really as a consequence of mechanisms that stop the core inflammatory risk relevant to each disease. In areas like asthma and nasal polyps, these are primarily driven by T2 pathways identified by eosinophils and very well served with products like Nucala. Future innovation in these diseases will not come from marginal gains with new mechanisms, but from practical real-world innovation from modalities that can help patients comply and persist on their medicines, enter our ultra-long-acting portfolio with Exdensur and ultra-long-acting TSLP. There is one overlooked T2-driven disease, and that's food allergy, where IgE targeting has only recently been shown to be effective and where we rapidly build on that observation and early commercial success with an improved long-acting and potentially best-in-class approach with Ozareprevast. And that takes us to COPD and non-CF bronchiectasis. Whilst an important subset of COPD is T2-driven, most of it is not and a different set of risk factors with distinct inflammatory metabolic and vascular drivers are responsible for disease progression. Here, we do need mechanistic innovation, and we apply our deep translational insights directly to late-stage product developments, notably with IL-33. This bridges us to pulmonary hypertension that can, of course, result directly as a consequence of COPD, but is a pulmonary vascular disease by definition with mechanisms of risk overlapping with COPD on the left and MASH on the right. So with COPD really at the center in terms of the greatest burden of disease, GSK's competitive advantage and bridging these 2 worlds of inflammatory risk, let's take a moment to consider the scale of the problem. And it's substantial. You might have heard these stats before, but when you see them contrasted versus enormous established markets like rheumatology, it becomes evident that we're only scratching the surface with only 2 advanced therapies in one subtype of COPD reserved for late-stage disease. But with 400 million patients affected globally, over 20x more patients than RA and 100x more deaths annually, it becomes very clear that multiple product solutions are needed. So what do things look like for a patient with asthma or COPD today? The orange line in the top figure shows exacerbations and with them, the step changes in lung dysfunction, which in asthma leads to disease progression and in COPD brings irreversible loss of lung. And as seen in the red line below, these are associated with surges in mortality. Short-acting biologics today are started late with poor persistence leading to disease progression in asthma and unfortunately, hospitalizations and premature mortality in COPD. So what's the solution? Well, start biologics sooner and stay on them for longer. If we were able to move from 24 injections a year to just 2 and provide sustained coverage and protection, that would surely be the way to achieve this. And that's precisely what our portfolio is designed to do with Exdensur launched in asthma and shown in the graph, how we're approaching COPD, a development program that seeks to sustain persistence, but not just at the conventional point of treatment, but with these unique characteristics of the medicine, we have the confidence to start a third Phase III study, VIGILANCE, enrolling patients after just 1 exacerbations. That's unprecedented for a biologic. So the prior slide showed how Exdensur achieves greater coverage and clinical benefit in patients with T2 inflammation through earlier management, and that's illustrated in the rubric here by extending across the grid horizontally. But I mentioned that in COPD, we do need more mechanistic innovation to achieve greater coverage across different populations who have different types of inflammation, and that's illustrated by extending vertically up the grid. Nucala was the first biologic to achieve a broader label owing to metrics, which studied lower eosinophil levels, while MATINEE came in and showed efficacy for the most clinically impactful events, emergency department visits. TSLP is a mechanism that by design is able to extend into intermediate T2 inflammation and where data indicates efficacy in those with eosinophils as low as 150 but not lower. And that takes us to IL-33, where we probably need to ignore eosinophils altogether as this mechanism cuts COPD in a fundamentally different way, and that's easier to visualize. All patients with COPD have innate immune dysfunction and a propensity to T1 and T17 inflammation. These patients are older than those with asthma, they're sicker and they have a high burden of vascular and metabolic disease represented on the right-hand side of the slide. A proportion of these patients have truly high T2 risk and a further group have mixed intermediate levels. This is the orange and middle overlap segments of the slide. And this risk is well addressed with IL-5 and TSLP biologics, respectively. But how do we get to the backbone of pathobiology in COPD, the blue plane in the slide? Well, a single, dual or even triple cytokine approach won't be the answer if they're targeting the wrong biology. This is where we need to get to the tissue, vascular and structural damage that results from repeat injury at the root of COPD. IL-33 is expressed primarily on lung epithelial and vascular endothelial cells, the dynamic barrier lining the airways and blood vessels. These are the first tissues to be exposed to and then attempt to respond to inflammatory injury and our translational insights reveal how and when IL-33 governs this therapeutically untapped space. And so we're very excited to have a potentially best-in-class long-acting and Phase III-ready products, which will be deployed with the benefits of this deeper understanding. We predicted the early success now shown clinically for anti-IL-33 when stratifying based on mucus score. With the luxury of what we believe to be the most complete set of respiratory data anywhere in the world, over 1,000 randomized controlled trials, several million patients with deep genetic and cellular profiling and of course, clinical interventional data in COPD with our product, we've designed pivotal studies based on patient profiles most likely to respond to IL-33. These will include factors related to stage of disease by which I mean lung function, distinct from disease severity defined by exacerbation history and other traits and tested against new clinically important outcomes that can differentiate the product. Without disclosing too much, what I can share is that one of these pivotal study starts includes a cardiorespiratory outcome study, which we will start next year in partnership with a major cardiovascular academic research organization. In parallel, we will complete our Phase II study in non-CF bronchiectasis, an enormous market with no approved biologics and where we're positioned to be best-in-class with IL-33 as well as testing combinations with TSLP, which our AI-enhanced models predict could provide synergistic efficacy. So we're looking forward to coming out of IL-33 stealth with conviction and material differentiation. Our ultra-long-acting TSLP program has been significantly accelerated by 9 months across 3 indications, now positioning this asset to start 6 pivotal Phase III studies, the PERSIST program integrating data from a GSK-sponsored Phase II study in asthma, the NASER study, alongside data from our partner, Hengrui, who studied nasal polyps. This gives us dosing and pharmacodynamic data to confidently advance the first ultra-long-acting TSLP across all major indications, asthma, nasal polyps and COPD. Our BD strategy to access derisked mechanisms with a high likelihood of success allows us to jump directly to testing for product differentiation rather than mechanistic relevance. And this is reflected in our deal since January. Ozarepubart builds on the proven efficacy of IgE in food allergy and CSU, but provides materially broader eligibility for those 25% of patients contraindicated for Xolair because of their weight or high IgE levels and an optimized solution for all with 3 monthly dosing. This will be transformative for the prevalent adolescent population and children. This class has had a remarkable first launch within the first 2 years with Xolair, now Roche's fastest-growing product and ozure is positioned to provide an objectively improved profile whilst benefiting from that momentum. This overlooked space has understandably garnered interest and activity since our deal, but Ozure is the most advanced next-generation product with clinical efficacy data in CSU, which importantly included an active arm with Xolair, which didn't perform as well as Ozure. The program is rapidly enrolled in Phase II and has now recruited the sample size necessary to progress to an interim analysis, which will enable Phase III start in both food allergy and CSU by the end of 2027. For HS235, we build on a new and transformative class of activin traps in pulmonary arterial hypertension, but with an improved molecule that can both remove the liabilities of the incumbents in group 1 PH, namely bleeding, but what's equally exciting is the potential to unlock the full value of the mechanism, which extends to reducing inflammation, insulin resistance and reducing visceral fat, all of which are substantial drivers of risk in Group II and Group III pulmonary hypertension secondary to chronic heart and lung disease. Whilst this program is relatively earlier than other products being presented, we've seen evidence to support both the safety and efficacy profile described in the Phase Ib study. And I can share today that we've rapidly converted this post deal to Phase IIb starts that have now been initiated for both Group 1 and Group 2 pulmonary hypertension. And that takes us to our hepatology portfolio. Put succinctly, our portfolio is pointed to the 3 major causes of liver-related cirrhosis and mortality, chronic hepatitis B, metabolic dysfunction-associated steatohepatitis and alcohol-related liver disease. All of these diseases have poor outcomes and inadequate standard of care. There's no approved treatments for alcohol-related liver disease, one liver-directed treatment for MASH and no therapies that can drive cure in hepatitis B. Let's start with bepirovirsen, our first-in-class ASO for hepatitis B. Our program was ambitious, designed with the primary endpoint of functional cure, the very highest bar. This is best illustrated in the comparator arm in B-well, where what's labeled as placebo actually represents the standard of care, 48 weeks of treatment with a nucleoside or nucleotide analog. And in that group, we saw 0 patients achieved the primary endpoint, functional cure in the ITT population. 0 patients achieved functional cure in those with baseline surface antigen levels less than 1,000 and 0 patients achieved an effect with surface antigen levels under 100, which will be consistent with the definition of partial cure. In comparison, bepi achieved 19% cure in the ITT population, 26% in those with surf antigen at baseline less than 1,000. And importantly, when you include partial cure, a response that's been reported in population studies to improve long-term outcomes, almost 1 in 2 patients studied in the ITT population received a response that would predict clinical benefits. And that increases to 62% in those with surface antigen levels less than 1,000 at baseline. Of note, this opportunity consolidates in 3 key markets: China, U.S. and Japan. You can see the epi and scale of the opportunity on the slide in the bottom left, which is vast. So a very exciting opportunity reflected in a suite of expedited regulatory designations setting up near-term expected marketing authorizations and product launches. And then efimosfermin, our potentially best-in-class FGF21 analog in an area of major unmet need in steatotic liver disease. Let's start with the class. On the left, in F2-F3 MASH, you can see greater benefit on improvements in fibrosis with FGF21 analogs when compared indirectly across studies with GLP-1 agonists, such as semaglutide and thyroid hormone agonist, resmetirom. Moving to the right in cirrhotic MASH, where currently there's no approved treatments, you can see placebo adjusted changes that are unprecedented with this class, showing the ability to reverse histological fibrosis and move the patient from cirrhotic to non-cirrhotic disease. In contrast, semaglutide showed directionally worse effects versus placebo. And then within the class, we selected efimosfermin over other products, all available at the time of acquisition based on its best-in-class credentials with monthly versus weekly or biweekly dosing regimens. And since the deal, efimosfermin has reported the fastest observed signal for an antifibrotic benefit of any in the class with fibrosis biomarkers improving as soon as 4 weeks after treatment and for which we've designed our pivotal program to substantiate as a potential additional differentiator. For all these reasons, we're committed to realizing the full value of this potentially transformative product, seeing us initiate the ZENITH studies to F2/F3 MASH, both recruiting since earlier this year. And we have now initiated the F4 cirrhotic MASH program, the NEBULA studies only in the last 2 weeks. And our Phase II study in alcohol-related liver disease, ALL-STAR has just had IND approved and will start this year. So a portfolio of specialty products pointed to serious and prevalent diseases with renewed discipline to truly focus on areas of greatest commercial value and in turn, prioritize and accelerate those programs. Unprecedented data for bepirovirsen, which resets the bar of efficacy in chronic hepatitis B with functional and partial cure where the standard of care fails to achieve either. A portfolio in COPD that will provide modality and mechanistic innovation providing greater coverage and protection for a disease that's the third leading cause of death globally and with material acceleration of programs like ultra-long-acting TSLP and with both molecule and potential evidence and claims differentiation for our best-in-class long-acting IL-33. Efimosfermin advancing at speed across a comprehensive Phase III program, which will capture the unique breadth and potential for this mechanism across all stages and etiologies of steatotic liver disease, F2 and F3 MASH, cirrhotic F4 MASH, alcohol-related liver disease and actually potentially beyond with a molecule that has best-in-class properties. And a portfolio enhanced by BD deals that bring best-in-class products, derisked mechanisms and which all fits within an axis of disease that physicians recognize that has yet to be applied to drug development. And that's a gap that GSK is uniquely positioned to address. With that, I will hand over to my colleague, Sanjay, to cover vaccines.

Thank you, Kaivan. Good afternoon, everyone. My name is Sanjay Gurunathan. I head the Global Vaccines and Infectious Disease Unit in R&D. Vaccines have a massive impact on public health. That's not new. We've known that for decades that preventing disease takes real pressure of health systems. But here's the thing. The science and economics around vaccines are shifting. They are pointing to something much bigger than we give them credit for. So let's dig into why this is the case. Here's a stat that always surprises people. Vaccines make up a tiny slice of our health care spending, less than 1% of the health care budget in high-income countries. And yet that investment -- return on investment is roughly 19x of what you put in. We already know how valuable it is to prevent an infection. What's missing in the economics is the big picture. The benefits that go beyond preventing the disease a vaccine was designed to stop. And let's think about that. That could be worth a lot. But if it's not on the label, it doesn't count towards how a vaccine gets assessed or reimbursed. The science is starting to catch up. We used to think of an infection as something that happens and then passes. It turns out that's not the whole story. A lot of infections go dormant in the body, and some of them seem to be tied to long-term health effects, even chronic disease down the road. So preventing that initial infection might do a lot more than we thought. It could lower your risk of things like heart disease and dementia later in life. So the opportunity here is simple. We need to build the evidence that turns this potential into something that's recognized and reimbursed. And GSK is in a great spot to lead on this. We have already a broad, well-established vaccine portfolio, Shingrix, RSV, flu vaccines, a strong meningitis franchise and a deep lineup of pediatric and travel vaccines. But more importantly, there's real room to expand beyond what these vaccines can already achieve. Shingrix is our best example of this. We have a huge amount of real-world experience. Over 116 million adults have been vaccinated with Shingrix since it was launched nearly a decade ago. This growing body of evidence that herpes viruses, including herpes zoster, the virus that causes shingles can influence cognitive decline. So why would that be the case? Well, the shingles virus doesn't actually go away after a chickenpox infection. It just goes dormant hiding out in the brain neurons. When it wakes back up, it can start local inflammation, and that inflammation seems to play a role in cognitive decline over time. So by keeping the virus from reactivating in the first place, Shingrix may end up slowing down that decline. But there's likely more to the story. We think Shingrix's adjuvant AS01 might be doing some extra work behind the scenes beyond just blocking viral activation. it could possibly be dialing down inflammation more broadly, including the kind of age-related inflammation that builds up in the brain. If that's right, it could mean Shingrix is nudging the whole trajectory of neuroinflammation in a healthier direction. We've now seen through several observational studies, risk reductions of dementia symptoms up to 50%. This signal is now being put to test in 2 big pragmatic studies in Finland and Denmark, covering around 200,000 people with results expected from 2029. We're not only seeing this as how Shingrix affects neuroinflammation, but as we go to the next slide, when we look at cardiovascular risk, it gets even more interesting on Shingrix's broader protective effects. real-world data from several independent sources, Veterans Affairs, Kaiser, Optum, TrNIDEXX, all point the same way. Older adults who got Shingrix saw about a 25% drop in major adverse cardiovascular events or MACE. So why should that be? It turns out the shingles virus itself isn't exactly harmless to your blood vessels. It can damage them, spur up inflammation and even trigger clotting, all of which nudge up your risk of stroke and heart attacks. We think Shingrix, thanks to our AS01 adjuvant, might also be doing some quiet work behind the scene, calming inflammation and potentially bending the curve on chronic diseases in older adults. So what does this all mean? This matters a lot. Cardiovascular disease is expected to nearly double by 2050 with costs in the U.S. alone set to top over $400 billion a year. We believe the real-world evidence you're seeing on this slide is compelling enough that we are launching a formal Phase III randomized controlled trial this year to nail down whether this is actually causal, not just correlation. We expect the study to start soon. Another opportunity to improve outcomes in older adults is to prevent influenza infection. This disease burden of influenza is significant in adults -- in older adults with the majority of hospitalizations occurring in older adults. It's a segment we have not previously competed in. We know from published literature that influenza vaccination reduces cardiovascular disease burden and respiratory complications, underpinning the theme of broadening the protective effects of vaccine, especially in older adults. As you can see from this visual, currently available flu vaccine effectiveness has varied from 20% to 60% over the past 15 flu seasons, illustrating why there's a true unmet need to improve flu vaccine effectiveness. We believe there's an opportunity using our mRNA technology to establish benefit over current standard of care. We can optimally leverage this technology, its differentiating characteristics to develop our next best-in-class flu vaccine. We will present our positive Phase II results at the Options meeting next month, where you'll hear the exciting data. So let me conclude. What's our focus and where is our focus? Our focus is expanding the role of vaccines, the vaccines play in helping older adults living a longer and healthier life. If you can back that up with strong clinical outcome data and a real understanding of the biology behind it, it could support future labels that reflect these broader benefits. And that changes things. It gives health care professionals more confidence to recommend vaccination and give more people reason to get vaccinated no matter what their current health status is. What really excites us is the growing signs connecting infection to chronic disease. It makes an already strong economic case for vaccination even stronger. Opens up new opportunities across our portfolio. And thanks to Shingrix, it gives us a real working example of how to unlock that value and help shift the trajectory of chronic diseases for older adults. It's now my pleasure to hand over to Charlotte, who will talk to you about our HIV business.

Thank you, Sanjay. I am Charlotte Allerton, Head of R&D and CSO for ViiV Healthcare at GSK. Despite decades of progress, HIV remains a major unmet public health challenge. More than 40 million people are living with HIV globally. And in the U.S., around 30% of people diagnosed with HIV are not virally suppressed, equating to approximately 400,000 people, the majority of whom are still taking daily oral antiretroviral medications as their standard of care. Real-world barriers such as adherence and stigma continue to negatively affect health outcomes, quality of life and transmission risk, reinforcing the need for long-acting medicines that address these challenges while delivering public health benefits and significant revenue growth. Treatment represents 90% of the current HIV market, the largest unmet medical need and remains our priority. By 2035, we expect this market to be worth approximately GBP 25 billion, with growth driven by uptake of new long-acting regimens despite daily oral generics entry and pricing pressure. For prevention, we expect this market to be worth approximately GBP 6 billion by 2035. Across both treatment and prevention, long-acting injectables are the fastest-growing segment, and we are leading this market transformation from daily oral to long-acting HIV care that improves patient experience, supports adherence and drive sustained competitive growth. We have been at the forefront of HIV innovation for nearly 4 decades, leading transformational changes in patient care through the first 2 drug oral therapies and then Cabenuva and Apretude, the first-to-market long-acting injectables for treatment and prevention. Our current portfolio and future pipeline are built on the foundation of integrase strand transfer inhibitors, or INSTIs, which are trusted by health care providers worldwide due to their superior efficacy, long-term tolerability, high barrier to resistance, and they form the basis of over 80% of treatment regimens globally. Today, we will focus on our near-term growth drivers, 3 times a year treatment, 2 times a year treatment and 3 times a year prevention. However, as you can see beyond these transformational opportunities, we will continue to innovate to address the health of people impacted by HIV for many years to come. This includes best-in-class long-acting orals, which we see as an opportunity to reach the around 30% of patients who our market research suggests may not choose injectable treatment. We have initiated a Phase I study for VH359, a capsid inhibitor and have multiple potential weekly oral INSTIs and capsid inhibitors in preclinical development. Our leadership in long-acting will continue to fuel our growth with each innovation building on our expertise to shape the future standard of care and reach more people impacted by HIV. Given our lead, we will have launched our second and potentially third long-acting injectable treatment before anyone else enters the market. Cabenuva is the first and only complete long-acting injectable HIV treatment. More than 5 years' worth of real-world and clinical evidence continues to validate the strength of Cabenuva, showing robust antiviral effectiveness and barrier to resistance comparable to daily oral medications with strong persistence out to 2 years and substantial patient preference compared to oral therapy. In addition, Cabenuva demonstrated superiority over oral standard of care in the LATITUDE study, delivering nearly 2x lower regimen failure and 4x lower virological failure, leading to early study termination due to overwhelming efficacy in this suppressed high-risk HIV population with adherence challenges. The real-world data in viremic patients is also compelling, and we look forward to seeing data from our CROWN study in the second half of '26, assessing Cabenuva in viremic patients with adherence challenges to daily oral therapy. The entirety of this data shows the power of Cabenuva to lead the -- to lead the market growth in long-acting injectables through addressing preference, stigma, adherence and reducing the burden of daily oral therapies, supported by a robust IP strategy with cabotegravir NCE patent protection into 2031 and addition no patent protection now granted into 2040. As the first mover in long-acting treatment, we have built the market from the ground up, establishing the evidence, infrastructure, provider experience and patient confidence needed to accelerate the adoption of future long-acting injectable innovations. We are now focused on franchise growth, continuing to address stigma and adherence challenges while meeting patients and health care provider preference for less frequent administration. The profile of our 3 times a year treatment constituting novel formulations of cabotegravir and rilpivirine is compelling. It builds on the proven efficacy and trust experience with Cabenuva, takes 365 oral daily treatment days down to just 3 injection visits per year, doubling provider capacity compared to Cabenuva, enabling clinics to serve more patients without increasing infrastructure. And this competitive profile is underpinned by a robust IP strategy with additional patent protection pending into 2047. I am pleased to share that QUATTRO, our 3 times a year Phase III registrational study in suppressed switch patients has begun, supporting potential approval in 2028. We remain confident that 3 times a year treatment will be transformational, not incremental, making long-acting treatment easier to choose, deliver and sustain, unlocking substantial switch opportunity from both oral therapy and existing Cabenuva, which will drive long-acting injectable market growth. Having set a high bar with our 3 times a year treatment, we are driven to keep innovating for people living with HIV by delivering a 2 times a year long-acting injectable treatment. Our preferred regimen is the combination of our third-generation INSTI, VH184, with our novel capsid inhibitor, VH499, a combination with NCE patent protection into at least 2040 and additional patents pending into at least 2047. We believe this regimen can set a new standard of care for a broad HIV population, bringing confidence in efficacy and a high barrier to resistance while further addressing adherence challenges. VH184 is currently in a Phase IIb clinical study, where we have seen rapid patient recruitment, reflecting the community's interest in its third-generation INSTI profile. Our differentiated capsid inhibitor, VH499, will commence its Phase IIb study in the second half of 2026. And we have a bold plan to get to Phase III in 2028 and approval by the end of the decade, combining operational insights from our ongoing 3 times a year QUATTRO study and utilizing the entirety of our Phase I and II data to select optimal doses and formulations to achieve what we believe will be a practice-changing profile. The data on this slide represents a subset of evidence of that practice-changing profile. The chart on the left shows VH184 retains superior potency over second-generation INSTI bictegravir against the majority of second-generation INSTI resistance mutations from the DAWNING clinical study. Its high potency and enhanced resistance profile positions it to transform HIV treatment, and we plan to determine its clinical efficacy in an in resistant population to further inform our Phase III plans. The graph on the right shows VH499 does not cause the CYP3A-mediated drug-drug interactions that can lead to safety concerns for patients taking common concomitant medications or recreational drugs. It shows that VH499 had no effect on the pharmacokinetic profile of midazolam, the FDA recommended probe for exploring CYP3A drug-drug interactions. This data, combined with 499 and 184's strong efficacy and encouraging tolerability gives us a combination that is not just less frequent, but clinically and commercially differentiated, maximizing patient reach and transforming options for people living with HIV once again. Now moving to HIV prevention. The unmet need is significant. Despite the 2.2 million people in the U.S. that could benefit from prevention, only 25% use it. Daily oral persistence remains low, creating a major opportunity for long-acting options that better fit people's lives. Our 3 times a year prevention candidate, which contains a new formulation of cabotegravir builds on Apretude's greater than 99% efficacy and extensive real-world experience and is protected by a robust IP strategy with additional patents pending into 2045. 6 months after a single dose of cabotegravir and lenacapavir in our CLARITY study, follow-up data reinforced cabotegravir's highly preferred injection profile with fewer, less visible and shorter-lasting injection site reactions, whereas 90% of participants continue to report lenacapavir-associated modules at 6 months with 20% being reported as severe over that time period. Delivered through a single intramuscular injection, our 3 times a year prevention has the potential to combine strong tolerability, a favorable drug-drug interaction profile, a dosing schedule aligned to routine sexual health visits and the fewest maintenance injections per year, reducing treatment burden and supporting long-term persistence. With registrational study data from EXTEND4M anticipated in the second half of 2026 and approval in 2027, we remain confident it represents the optimal prevention option for both patients and providers. To close, HIV remains a significant, persistent and unresolved public health challenge. The market is moving towards long-acting the innovation we have built and lead with [Instantly] at the core to drive the market transformation. Cabenuva demonstrates the power of long-acting treatment and creates the foundation for continued innovation and a pipeline that keeps raising the standard of care. Our near-term long-acting injectable growth drivers are clear. 3x a year treatment to unlock the next wave of growth targeted for '28 approval, 2 times a year treatment, novel molecules designed for differentiation plan for Phase III start in '28 and 3 times a year prevention optimized based on patient and provider feedback targeted for '27 approval. As HIV care continues to evolve, we are uniquely positioned to shape where the market goes next, combining scientific leadership, long-acting innovation and deep patient insight to deliver the next generation of treatment and prevention options. That brings us to the end of the R&D part of the presentation, and I will now hand over to Julie to share more on the funding of accelerate growth and our outlook.

Thank you very much, Charlotte, and also to all my R&D colleagues. So as you've seen, GSK has a broad and rich portfolio of opportunities. And the purpose of this section is to show you how we plan to fund it. Moving on to the next one. So one of our 3 priorities is to simplify the way we work. And this will be enabled by the Accelerate growth program. We've identified GBP 1.9 billion of cumulative annual benefits to be delivered by 2029. And the majority of these will fund the investment opportunities outlined by Tony and his team today, accelerating 7 assets across 18 indications, and we have more than 20 Phase III trial starts in 2026. Now a proportion of the savings will also drop through, strengthening the margin through the dolutegravir loss of exclusivity period, which is 28 to 30. The program will deliver incremental sales from 2030 -- it has a very strong IRR, and it will be implemented with financial discipline as usual, ensuring we retain capacity for business development. Turning to the details of the program. We expect 90% of the cumulative annual savings to be delivered by 2028. And we have undertaken an enterprise-wide review to identify opportunities with processes redesigned and enabled by tech and AI. Support functions and key processes across the organization will be streamlined for efficiency and impact. Procurement will be enhanced further to deliver maximum value. And we will also be reallocating resources from mature brands towards the key specialty growth drivers. And finally, there will be further automation and simplification of the supply chain and the network to align with the evolution of our portfolio. The program will cost GBP 2.4 billion to be reflected in adjusting items, of which GBP 2.1 billion is cash and the payback is 2.5 years before the reinvestment. We have a compelling track record of deploying cash in line with our capital allocation framework. First, invest for growth; and second, shareholder distributions, all underpinned, as you know, by a strong investment-grade balance sheet. Since the start of 2021, we have delivered more than GBP 40 billion of cash generated from operations. We've deployed GBP 18 billion to invest for growth by way of capital expenditure and business development. We have distributed GBP 16 billion to shareholders through the dividends and the buyback. And we've reduced net debt through this period by GBP 6 billion, decreasing net debt to core EBITDA to 1.3x. This represents a considerable transformation of GSK and considerably improved cash generation and a significant reduction in net debt has led to the strengthening of our balance sheet, affording us the optionality to execute BD and further strengthen the pipeline, as you've recently seen through the acquisition of Nuvalent. We also have a strong track record of delivering profitable growth and increasing returns whilst continuing to increase the investment we've placed in R&D. So from '21 to '26, we are on track to deliver yearly sales growth of 8%, operating profit growth of 13% and more than a 540 basis point improvement in the margin. Now this is all whilst R&D investment has stepped up, increasing more than 50% to now more than GBP 7 billion and supporting a doubling of the Phase III starts in 2026, as Tony outlined. So looking ahead to our longer-term outlook and the impact to accelerate growth. We remain committed to our outlook of more than GBP 40 billion of sales in 2031, with more than 50% of our business in Specialty Medicines. Our operating margin is now expected to be stable to improving through the dolutegravir, a loss of exclusivity period, supported by a number of things. First, specialty continues to grow as a proportion of the portfolio. Second, we were driving increased productivity gains across the business. And third, part of the savings from the program overall will drop through to the margin in that 3-year period. Growth is then expected to accelerate from 2031 onwards, given the portfolio of products and the opportunity for further BD, the latter of which would be incremental to our commitments. This program allows GSK to build on the strong foundations we've laid over the past 5 years and accelerate growth from 2031 onwards. Thank you, and I will now hand back to Luke for final words.

Thanks, Julie. Next slide, please. So today, I open by saying that our focus was on products and growth. And this slide here shows the pathway we are building with our products to drive growth and with it, delivering long-term value. So the presentations from the team today were designed to give you greater insight into how we're actually going to make that happen. And to reanchor you, at the start of the day, I outlined that we would demonstrate to you the following: Firstly, confidence in our ability to drive the business now and beyond to 2031 by showcasing our late-stage pipeline and our focus on defined value propositions and by providing some detail on how we are reallocating capital and resources to change and invest in R&D. With that, I think we're going to go to questions. I'll ask, Guys are quick. I wouldn't want me get a gunfight with you. So we'll bring the team up. So Julie, Nina, Charlotte, Kaivan and I think Sanjay as well. And as we said earlier, raise your hand, you guys clearly remember that. So Zain, I think you were -- do you want to go first? And then I'll just wait while everyone sits down. Zain over to you.

Zain over from JPMorgan. First question is just on the 2031 target and beyond. I think Julie sort of ended with a comment on it in terms of 2031 now sounds like it's organic, but just to confirm that Nuvalent included in the 2031 are greater than $40 billion. And then the target or ambition for accelerating growth beyond 2031, you mentioned that it's organic in terms of delivery on your commitments, but how much of that is dependent on BD in terms of the ambition beyond 2031. That's the first question. The second question is just a follow-up on 2027 margins because I think the path on 28% to 30% is relatively clear. And you have the cost savings that will help offset some of the dolutegravir. But next year, you've got the Gilead royalty going in Q4 IRA impact potentially and R&D, you've mentioned will significantly outgrow sales. So just how should we think about '27 in terms of margins? I think consensus has got margin expansion. So what are the other drivers that could get towards margin expansion?

Okay. So in terms of the first question related to Nuvalent and so we've emphasized that we are totally committed to more than 40%. Obviously, the Nuvalent acquisition happened recently, and we've now got accelerate growth. Accelerate growth for sales start in 2030, but they're quite minor in 2030. It's more of a longer-term play. But net-net, we just -- we'd like to emphasize that we are saying we will deliver and we will deliver more than 40 but we didn't want to get into minor increments each way along. I think as Luke mentioned, it is a portfolio. We obviously had the camlipixant news just over a week ago, but it is a portfolio, and we believe we will deliver more than 40% overall when you take it asset by asset. Everything we do as well. I think as most people know, is PTRS adjusted probability of technical and regulatory success. But inevitably, you get movements in the portfolio now that we've built to build that optionality. And then none of it at all is dependent on what you might call new BD. So if we do further deals, which we do intend to do, we've got capacity to do them, as Luke outlined, they would be incremental on top, if that answers that question. And then in terms of the margins, I got this question in the break actually from quite a few people. So we have guided the margin to the end of 2026, which is more than 31% at 25 average exchange rates. We then guided the dolutegravir period because we knew and appreciated that investors were quite concerned about that period because of the profitability of HIV. So we did an extensive amount of work as a team to basically understand how we could underpin that margin through that period. But we did not want to get into guiding a margin every year. So we gave the assurance based on a whole series of factors that we could hold the margin stable through the dolutegravir loss of exclusivity. What we're now seeing because this program then generates the additional savings, which total GBP 1.9 billion by 2029, it allows us to drop through some of those benefits to give not just a stable margin, but the optionality to also have an improving margin through that period. And it builds 28 to 30. So the period when dolutegravir hits the most, it's most protective.

I'm trying to pick the rest of you. Have you had a question before? And then we'll go to James and then anyone in the back.

Naresh Chouhan from Intron Health. Just one on vaccines. It seems that the pharma business and the vaccines business are going to have increasingly different outlook in terms of innovation growth rates, capital requirements. So how wedded are you to continuing to own vaccines, which presumably, if they are separated would unlock quite a lot of value and would further simplify the business.

Short answer is very wedded. I mean the capital intensity really is in Regis' shop. I think the main challenge with vaccines, frankly, is the paucity of novel targets of innovation. But again, we're trying to capitalize on that and some of the signals that we've observed there. But I mean, it's a fantastic business. It's very hard to get into. Okay, it's under short-term pressure, frankly, because of politics in some locations and post-COVID hangover. But frankly, I think if you look at the medium to longer term, it's a very durable business with very high barriers to entry. The question is what can we do to be more operationally effective? How do we make this plant more productive? And then when we do see innovation, how do we make sure that we're participating in it faster and more aggressively than others. So yes, long story short, we like the business. But again, the hierarchy for us in terms of capital allocation, you can see is specialty. And again, that's why we're highlighting that from 2031 plus. And then James, and then I think Sean will go to you. Is that Sean up there? I think Yes, Sean and then I promise we'll get to everyone.

So James Gordon at Barclays. Two on HIV and one quick one on R&D. So on HIV, I think the previous plan was to have a 6-monthly prevention product. I think it was in 2028, but I couldn't see it on the slide. So are you not doing 6 monthly prevention anymore? And on treatment, I think it was 6 month treatment, 28 to 30. So I could see that you're -- I think starting the Phase III in '28, but when do you think that launch is that beyond '29 so post dolutegravir LOE is when you'd have a 6-monthly treatment? And then also just a clarification on orals, I think you also talked about, but when do you think you could have a weekly oral or a monthly oral in the market, please? And then the final one, just squeeze R&D spend. I think before you said R&D would grow faster than sales is the way you put it. Should we assume that's the assumption that effectively you spend less on SG&A, but R&D keeps on growing faster than sales? How should we model that, please?

Yes. Sure. I mean, long story short, yes, we want to drive R&D as the portfolio changes. When I joined GSK, we launched Trelegy and a few thousand people in the U.S. You look at zidesamtinib, we're talking 10, 20 people. So Charlotte, over to you. And then, Julie, if you want to add anything on that one as well, if I May.