Good morning and welcome to Pfizer's earnings call. I'm Francesca DeMartino, Chief Investor Relations Officer.

On behalf of the Pfizer team, thank you for joining us. This call is being made available via audio webcast at pfizer.com.

Earlier this morning, we released our results for the first quarter 2026 via press release that is available on our website at pfizer.com. I'm joined today by Dr.

Albert Bourla, our Chairman and CEO, and Dave Denton, our CFO. Albert and Dave have some prepared remarks and we will then open the call for questions.

Members of our leadership team will be available for the Q&A session. Before we get started, I want to remind you that we will be making forward-looking statements and discussing certain non-GAAP financial measures.

I encourage you to read the disclaimers in our slide presentation, the press release we issued this morning, and the disclosures in our SEC filings, which are all available on the IR website on pfizer.com. Forward-looking statements on the call are subject to substantial risks and uncertainties, speak only as of the call's original date, and we undertake no obligation to update or revise any of the statements.

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

Thank you, Francesca. Good morning, everyone.

Thank you for joining our call. It's a wonderful day here in New York.

We've had a strong start to the year. Our business continues to perform well, and we are making strategic progress.

One of our great strengths is the ability to execute. We are delivering on our financial commitments while we also invest to strengthen Pfizer for future growth and impact.

In the first quarter, we exceeded expectations for both total revenues and adjusted diluted earnings per share. We have made progress so far this year in delivering our 2026 critical R&D milestones, including three positive Phase 3 readouts and encouraging mid-stage readouts for both approved and investigational medicines.

We are keeping pace with our robust agenda of approximately 20 planned pivotal study starts this year. We also had two significant legal developments that improved our growth profile post-2028 and, of course, our cash flow outlook.

Our recent settlement agreements resolving infringement of patent related to Vyndamax have the potential to change the growth profile of the company significantly post-2028. This gives us greater confidence that starting in 2029, we will enter a five-year period of high single-digit revenue CAGR.

Additionally, we view the recent Belgium court ruling regarding Comirnaty contracts with EU member countries as a positive for future EPS and cash flows. The improved visibility into our cash flow provide is a positive for our longer-term capital allocation priorities, including, of course, our ability to preserve and support the dividend.

As we look to the rest of the year, we are clearly focused on our most impactful opportunities to create value for patients and our shareholders. We previously shared our strategic priorities for 2026, and I will walk you through the progress we are making on all four.

Our launched and acquired products had a tremendous start to the year with 22% growth. Three of our business development transactions represent about 80% of the invested capital in recent years, and they are all progressing very well.

Oncology represents our most advanced and concentrated area of research and commercial focus, and our Seagen acquisition is a central reason why. Since bringing the company to Pfizer, we have transformed our oncology organization, unifying our team, expanding our commercial portfolio, and advancing a leading ADC platform.

The 20% year-over-year operational revenue growth in the quarter of our Seagen products shows that we have made good progress in deepening our presence within the oncology community. We continue to strengthen physician engagement and drive greater recognition of the clinical value of our medicines.

We are also executing with focus to maximize the value of our Metsera acquisition. This underpins the strategy intended to position Pfizer as a leader in the next generation of obesity therapeutics.

We intend to advance 10 Phase 3 studies this year, and we are targeting a first approval in 2028 from a portfolio that includes ultra long-acting peptides with the potential, if successful, developed and approved, for competitive efficacy and tolerability with a differentiated monthly maintenance dosing schedule. The success we have achieved with Nurtec since our Biohaven acquisition shows the power of our leading field force and commercial capabilities at work.

Nurtec contributed in the first quarter with 41% operational growth driven by robust demand and for both acute and preventive migraine treatments. We continue to see a meaningful growth opportunity in the oral CGRP class of medicines for patients with migraine.

Of course, 2026 is a pivotal year for R&D, and I'm pleased with our early progress this quarter. While we have a large, active pipeline, we rely on a rigorous and disciplined approach to focus resources where we see the greatest potential.

We are targeting approximately 20 pivotal study starts, eight key data readouts, and four regulatory decisions this year. Our critical R&D milestones reinforce how we are concentrating investment in key areas, such as oncology, metabolic disease, and vaccines, where we have existing commercial infrastructure, scientific expertise, and significant opportunity for competitive differentiation.

Roughly half our anticipated key data readouts and regulatory decisions in 2026 are expected to come from oncology, where we are advancing multiple programs across areas such as breast, genitourinary, thoracic, gastrointestinal, and blood cancers. During the quarter, we presented notable EV-304 study findings for Padcev at ASCO GU.

The results show that Padcev and pembrolizumab reduces the risk of recurrence or death by nearly 50% in patients with cisplatin-eligible muscle-invasive bladder cancer. Combined with the recent compelling data from the EV-303 trial, this highlights the potential of this regimen to become the new standard of care for patients with muscle-invasive bladder cancer regardless of cisplatin eligibility.

Bladder cancer is diagnosed in more than 600,000 patients each year globally, including an estimated 85,000 in the US. MIBC represents approximately 30% of all these bladder cancer cases.

The positive top-line results we shared last week from the Phase 3 MagnetisMM-5 study of Elrexfio represent a meaningful step towards our goal of reaching more patients earlier in the course of their disease. In this study, Elrexfio significantly improved progression-free survival for double-class exposed patients with relapsed or refractory multiple myeloma who received at least one prior line of treatment.

This is a significant opportunity to address patient need. Multiple myeloma, an aggressive and currently incurable blood cancer, is the second most common type of blood cancer worldwide, with over 36,000 new cases each year in the United States and over 187,000 new cases globally.

During the quarter, we also shared randomized Phase 2 data for atirmociclib, our potential first-in-class CDK4 inhibitor in patients with HR-positive, HER2-negative breast cancer who received prior CDK4/6 inhibitor-based therapy. These data suggest atirmociclib has the potential to differentiate from the CDK4/6 inhibitor class with improved efficacy and tolerability, reinforcing our confidence in the molecule.

Looking ahead, we remain focused on accelerating this investigational medicine's development in first-line and early breast cancer, where it may provide even greater impact for patients. We view this as an important opportunity to deliver a next-generation backbone therapy building on Pfizer's long commitment to patients with breast cancer.

In vaccines, we have been working with regulators on the pathway for expanding coverage through our next-generation pneumococcal conjugate vaccine to extend our leadership in this competitive space. Yesterday, we initiated our Phase 3 program for our 25-valent pediatric vaccine candidate with increased valency and next-generation serotype 3 technology.

I am also pleased to provide an update on our strategy in the adult market. We have decided to advance directly to our fifth-generation adult vaccine candidate.

Today, I'm proud to share, for the first time, that it includes coverage for 35 serotypes. We believe this gives us the strongest opportunity to maintain our current market leadership in the adult market over the long term, and we expect to enter clinical development this year.

In I&I, we announced a positive readout in March from a Phase 2 trial of tilrakimab, our investigational tri-specific antibody in atopic dermatitis. We intend to advance a broad clinical development program for this investigational medicine, which was discovered in-house at Pfizer and is currently being evaluated in atopic dermatitis and also in asthma and COPD.

We remain on track with our commitment and our continued focus on what matters most, maximizing the long-term value of our pipeline for patients, our shareholders. We are investing with strategic discipline and focus to build a foundation supporting our aim of high single-digit five-year revenue CAGR.

It's vital that our R&D organization has the resources to advance our robust pipeline, including both internally discovered programs and opportunities we have added through strategic moves, such as our acquisition of Metsera and our in-licensing agreements with 3S Bio and YaoPharma. Our commercial teams are leaders in translating scientific progress into real-world impact.

We are furthering investments to provide them with capabilities, technology, and support, helping our medicines reach the right patients at the right time so we can deliver sustained value. We also remain deeply committed to our shareholders.

We intend to maintain and, over time, grow our dividend as we continue to deliver and build long-term value. Embedding the use of artificial intelligence across our company is a key strategic priority, and we are driving continue progress in R&D, commercial, manufacturing, and core enterprise functions.

We are empowering our colleagues to accelerate innovation by pairing frontier AI tools tailored to function and role with comprehensive and continuously updated training. One of the areas where we see the most substantial promise is the discovery, development, and delivery of new medicines and vaccines.

Leveraging the power of AI to compress timelines and improve decision-making is central to our innovation strategy. We are embedding AI into each functional line of R&D.

Pfizer has a vast repository of small and large molecule, translational, and clinical data, and AI is creating the opportunity to unlock insights that could drive a significant impact on how we discover and develop medicines and vaccines. With that now, I will turn it over to Dave to speak about the financial performance of the company.

Great. Thank you, Albert, and good morning.

Let me begin by highlighting that our strong first quarter performance reflects the continued disciplined execution across our strategic priorities and, importantly, continued progress in repositioning the company for sustainable growth. We are making targeted investments today to drive revenue growth later in the decade and beyond.

Looking ahead, Pfizer is entering a new phase. Our launched and acquired products, combined with a strengthening pipeline, are positioning the company with the ability to deliver growth towards the end of the decade.

While we remain focused on managing near-term LOE headwinds, we are actively building the foundation for durable, long-term value creation. With that as context, I'll review our first quarter results, discuss our capital allocation priorities, and conclude with an update on our '26 guidance, which we are reaffirming today.

In the first quarter of '26, revenues were $14.5 billion, exceeding our expectations and representing an operational increase of 2%. Excluding our COVID products, the underlying business delivered approximately 7% operational revenue growth, reflecting solid demand across key brands and continued strong commercial execution.

On the bottom line, first quarter reported diluted earnings per share was 47 cents, and adjusted diluted earnings per share was 75 cents, also exceeding our expectations. In addition to our strong revenue, this outperformance also reflects our ongoing commitment to managing our cost base and to drive productivity across the organization.

Our results this quarter demonstrate the effectiveness of our refined commercial strategy. We saw solid contributions across our product portfolio, primarily driven by Padcev, Eliquis, Nurtec, Lorbrena, and the Vyndaqel family, each reflecting focused execution in our key therapeutic areas.

Our launched and acquired products delivered $3.1 billion in the fourth- four- in the first quarter, and revenues grew by approximately 22% operationally. These results demonstrate the early impact of our portfolio transition and our investment strategies.

We continue to invest behind these product groups to support their growth, which we expect will enable the company to partially offset upcoming LOE headwinds over the next several years. Adjusted gross margin for the first quarter was approximately 76%, primarily the result of product mix during the quarter and ongoing cost control measures.

I do want to note accrued royalty expense was higher in this quarter and dampened gross margin compared to the first quarter of last year. With that said, strong cost management across our manufacturing footprint remains a top priority.

As a reminder, over the past several years, our adjusted gross margins have generally remained in the mid to upper 70s when excluding Comirnaty, which has a 50/50 profit split with our partner BioNTech. We continue to expect approximately $700 million in savings from our Phase 1 of our manufacturing optimization program this year, with approximately $175 million realized in this quarter.

Total adjusted operating expenses were $5.5 billion for the first quarter of '26, an increase of 4% operationally versus the first quarter of last year. Now looking at the components, adjusted SI&A expenses decreased 5% operationally, primarily reflecting lower marketing and promotional spending on various products from more targeted investments and ongoing productivity improvements, as well as lower spending in corporate enabling functions.

Adjusted R&D expenses increased 11% operationally, primarily driven by an increase in spending in certain oncology and obesity product candidates. First quarter 2026 adjusted operating margin was strong at 38% and above pre-pandemic levels, demonstrating effective cost management as well as revenue performance.

We have already made meaningful progress on our productivity initiatives and remain on track to deliver the majority of the anticipated $7.2 billion in total net cost savings by the end of '26. Looking ahead, we will continue to identify opportunities to further enhance efficiencies while prioritizing investments that support future growth.

Turning to the bottom line, Q1 reported diluted earnings per share, again, was 47 cents, and our adjusted diluted earnings per share was 75%, 75 cents, which benefited from our strong non-COVID revenue and efficient operating structure. Now with that, let me turn to our capital allocation strategy.

Our strategy is designed to enhance long-term shareholder value while preserving flexibility. It includes reinvesting in the business at appropriate returns, maintaining and over time growing our dividend, and preserving optionality for future value-enhancing actions, including share repurchases.

In Q1, we invested $2.5 billion in internal R&D, returned $2.4 billion to shareholders via the quarterly dividend, and our completed business development activity was minimal. We closed on the sale of our stake in Haleon in the second quarter, providing us with approximately $1.65 billion in net proceeds after taxes and customary closing costs.

Our BD capacity, when including the Haleon proceeds, is approximately $7 billion. First quarter '26 operating cash flow was $2.6 billion, and leverage ended the quarter at approximately 2.8 times.

As just a reminder, given the LOE headwinds over the next few years, we expect leverage to remain around the current levels or even slightly higher through the transition period. I will also mention that we made our final TCJA repatriation tax payment of approximately $2.6 billion in April.

Based on our performance to date and continued execution, we are reaffirming our full year '26 guidance today. We continue to expect total company revenues in the range of $59.5 billion to $62.5 billion and adjusted diluted earnings per share in the range of $2.80 to $3 a share.

This outlook reflects our expectation of strong contributions across our product portfolio, adjusted gross margins in the mid-70s range, disciplined cost management, and continued investments to support growth by the end of this decade. As a reminder, sustained low disease levels of COVID will likely continue to weigh on Paxlovid utilization over the next several months.

Additionally, our plan assumes that the majority of Comirnaty sales will occur towards the end of the year and consistent with the vaccination season. As always, we continue to monitor currency fluctuations as the year progresses.

In closing, over the next several years, our focus remains on investing in key assets while managing upcoming LOE events, primarily from this year through 2028. As we look towards the end of the decade, growth is expected to be driven by our advancing R&D pipeline and the continued progress of our launched and acquired products.

Following the Vyndamax settlement, we now have a clear line of sight to a high single-digit five-year revenue CAGR post-2028. Furthermore, this event, combined with our legal win in the Belgium court regarding the EU Comirnaty contract, will enhance our cash flow post-2028.

We continue to position Pfizer for durable, long-term growth and shareholder value. With that, I'll now turn the call back over to Albert to begin the Q&A session.

Thanks, Dave. Nice quarter.

Now, operator, please assemble the queue.

Great. Thanks for taking the questions.

I'll keep it to one. I think a lot of focus is on the upcoming ADA meeting.

I'm curious if you can just kind of clarify exactly what we should expect to see then. I know obviously Vesper 3, but any other data that we should expect from a Pfizer perspective?

Then I think you've been talking about hosting an investor event in conjunction with the meeting, curious if there's any other details you can share around that as well. Thanks.

Chris, the question is for you, how much of the data you're going to disclose in the ADA.

Thank you very much for the question. It's obviously very important program.

We excited with the progress. Since the close of Metsera, as we had exceptional execution not only the clinical development, but also on the commercial development side, and as well as CMC and on the pharmaceutical sciences as well as the devices.

Detailed Phase 3 detail data from Vesper 3 will be shared. The top-line data we presented last time at I think 4Q '25 earnings.

Data from Vesper 1, the open-label extension, will be shared, as well as data from Vesper 2, which is weekly perobetatide, our new name for GLP-1, with or without titration in participants with type 2 diabetes will be shared. We will not share yet at ADA data on amylin mono.

We expect 24 weeks monotherapy and 28 weeks combination with the amylin and GLP-1, that will be shared in the second half of this year.

Thank you, Chris. Next question, please.

Yes. Thanks very much.

My questions are on your oncology readouts this year that could move the needle for the company. Could you comment on your expectations for SV and mevro pivotal readouts this year?

Then separately, if you could just please provide an update on your restructuring of corporate strategy and business development operations at the company. Thank you.

Great.

Thank you very much, Dave. Let me take the second one and then Chris will address the SV and the mevro.

We did some changes in our organizational structure that are aligned with our constant effort to simplify. We have reduced the members of my executive team by four over the next couple of years- last year- the last two years.

The business development moved under Chris Boshoff because most of the business development are right now related with R&D pipeline and choices. We see significant improvement in any friction that could exist and how smooth things could work by doing that.

We also moved the commercial development, which is all the commercial strategies that were sitting in that group, into the global marketing of the organization. It creates also significant amount of synergies by having global and the new products global marketing deal with new products and with our old products.

That went under Aamir. Alexandre took over the responsibility to manage the portfolio management team, he's the new chair, and he is focusing on prioritizing the pipeline.

Then the strategy group moved to my chief of staff, in the office of the CEO, where I can have also better supervision. This is the changes that happened into our organization.

We feel that they are consistent with everything we were planning, which is simplification of our business. Chris?

Thank you very much. To start with SV, important program for us.

Integrin beta-6 is a highly differentiated target, overexpressed in 90% of lung cancers, little expressed in normal tissue in the lung. We were encouraged by the Phase 1 data which we shared, albeit a single-arm experience with a median overall survival of approximately 16.3 months.

The second-line study, just a reminder, is focused on non-squamous based on the signals we've seen. Phase 3 study against docetaxel.

The study is statistically powered, should it be positive for overall survival, it will also be clinically meaningful. Just a reminder, we also have an ongoing Phase 3 trial in the TPS high, TPS more than 50.

Data will be shared at ASCO from the Phase 1 experience. This is pembro versus pembro plus SV.

A reminder that last year we shared data for that combination in PD-L1 high handful of patients, but everyone responded in that population, it was a 100% response rate in a small population. For mefrometostat, again, an important, highly specific differentiated EZH2.

The first study that will read out is MEVRO-1, which is in patients post-abiraterone, a significant unmet need, of enzalutamide plus EZH2 versus physician's choice of enzalutamide or docetaxel. That should read out middle or second half of this year.

Thank you.

Thank you, Chris. Operator, next question, please.

great. Thanks so much for the questions.

Maybe just two for me. First, maybe for Dave or the broader team.

I know you typically don't raise guidance with 1Q, but it does seem like a very solid start to the year from a revenue perspective. Can you just talk generally about the business trends versus your expectations and just how you're thinking about the year progressing from here?

Then a second question for me was on BD capacity. You mentioned $7 billion.

I guess just given the Vyndamax clarity, could the company look at larger transactions if the right deal were to present itself or is the focus still much more on the internal pipeline and maybe smaller tuck-ins from here? Thank you.

Yeah.

Chris, Dave here. Thank you.

I think to your first question, company's off to a really solid start in Q1. If you look kind of up and down and across the board from a product perspective, we exceeded expectations on top line and bottom line, and really strong cost control and cost management in very disciplined execution.

Yes, setting ourselves up really well for delivery for the balance of the year. As you well know, Chris, I have a philosophy of not really adjusting in Q1.

I think as you well know, if you look at our COVID franchise, it will always be back-half weighted because of the seasonality of this. We, if anything, have de-risked delivery on that without raising guidance.

Absent that, we probably would be raising guidance, how's that? Again, strong performance.

Secondly, as I said, we do have $7 billion in BD capacity. Obviously, this development from a legal perspective actually gives us more confidence in our cash flow delivery over the next several years, and we constantly look at BD and understand what is appropriate strategically to do from a BD perspective to support the needs of the company and to deliver long-term value.

Thank you, Dave. Next question, please.

Thank you for taking my question. Just on Comirnaty, I wonder if you can just talk a little bit more about the vaccination rates you're expecting this year within the US and international regions.

Then just coming back to the international region, can you talk a little bit more about the existing European contracts? Remind us of those existing phased payments.

In the context of that recent Belgian court decision, the two items there together, how should we think about the evolution of ex-US sales for that vaccine?

Okay. Let's start with international, then with Alexandre, and then Aamir will speak about vaccination rates in the US.

Yes, thanks for the question. Just to put context, the decline that you see in Q1 on Comirnaty has nothing to do with vaccination.

It's really the effect of last year. We shipped our last elements of our contract with the UK, we don't have that contract in 2026, and that's why you have a reduction.

It doesn't really talk about the vaccination rate. Actually, we went through the vaccinations numbers in Europe in 2025 and mostly stable versus 2024.

Of course, you have differences. For instance, in France, the vaccination rate is around 25% of the other adults.

In Spain, it's going to be around 35%. Those rates are stable, and we see governments willing to continue to invest and increase awareness of their older and at-risk population to get vaccination.

In 2026, we will work with those government across the European Unions to actually continue to execute our contract the same way we did in previous years. Now with regard to the legal case and the court judgment on April 1st, 2026, the court judgment is very clear, and we've started to work with the governments in Poland and Romania to actually execute the judgment, and we're discussing the best paths forward to implement that judgment.

Thank you, Alexandre. Aamir, what about the US?

Vaccination rates in the US obviously is very different for every segment. In COVID with Comirnaty, there was a narrowing of the label, we did see a shrinking of the market a bit.

In the case of RSV, we are seeing going past our third seasons with a tougher to activate adult population, but growing on the maternal space, and there's population dynamics with Prevnar, both with peds and adults. We see ups and downs in the vaccination rates as a result of those dynamics.

What I feel very good and very confident about is the way that we're executing in that market. If you look at every single one of our franchises, we have market-leading positions: Abrysvo at more than 60%, Comirnaty more than 60%, Prevnar peds now at 84%, and Prevnar adult, even after many months of competition from Merck, holding share steady at 70%.

I feel very good about the way that we're executing in a slightly turbulent market.

Thank you for the confidence, Aamir. I share it with you.

Next question, please.

Hi, guys. Thanks for taking my question.

I appreciate some of the comments you made around maintaining the dividend. I just thought I would approach it from two different angles, if I may.

First, I guess, what's the likelihood that Pfizer entertains a transformative M&A in near or medium term, which could end up impacting dividend, as we've seen in history? Then, secondly, Albert, I guess how are you, personally, but also the board, thinking about your tenure at Pfizer and how it ties to dividend integrity beyond?

Thank you very much.

Look, we never say never, and we always look at every possible business combination for an M&A. If you ask me if right now we think that we are going to go for something very big, a big merger, no.

We think that right now, in the next few years, it is the time to execute on AI transformation of this organization. That requires not the disruption of a mega-merger.

I would say that we are open to everything and we are looking at everything that can create shareholder value, but it is not right now very high in our list to find something like that. The second question, how I see my tenure, I see it like continuing.

I said multiple times that I was very proud for what we were able to achieve with COVID, but then if you are spoiled with this feeling of satisfaction, you want to do it again. I'm planning to do it again, and hopefully with cancer and obesity and vaccines this time.

Next question.

Great. Thanks for taking the question.

Albert, just going back to last December's guidance call, you highlighted $17 billion of annual revenue impacted by LOEs by 2030, and now with the tafamidis patent settlement extending that to mid-2031, your comments that you are aiming to achieve high single-digit five-year revenue growth starting in 2029. Just if you could double-click on that a little bit more, just looking at the pipeline and the current BD aperture that you just described, just level-set us on any updated thoughts on bridging the gap around how we should be thinking about the levers to drive this growth against the stacked LOEs.

Then just related, embedded in this high single-digit CAGR, what are the assumptions around your base business, such as COVID and the current oncology products? Thank you.

Yes. It is easier, of course, to forecast the base business because it's constant.

It is following the normal trends that we expect based product by product. The LOEs also are easy to predict because they have the certainty of occurrence.

Right now, you're right, with this 2.5 years delay of the LOE of a product that it's $6 billion-plus, it is providing significant, as you can understand, opportunity for cash flows, EPS, and changes the growth profiles. That's why we spoke now because with this uncertainty going about our projections about the growth profile, which we said it is starting in '29, it's a five-year high single-digit CAGR.

How that is built with the current portfolio, with the decline through the LOEs, and with the additions of pipeline that they are heavily risk-adjusted. It's not that we are having binary events.

The pipeline are multiple, as you know. We have a series of readouts right now that will affect the revenues in the '29.

I think I feel confident about that because when it is a large number of pipeline assets risk-adjusted, statistics usually work. Those that will fail will fail, and those that will succeed will succeed, but the risk adjustment takes into consideration about that.

Very confident about the growth trajectory of the company starting in '29, and I'm also very confident that we navigate the LOEs, as you saw right now, very well, started already this year the LOEs. I also want to emphasize that always the strategy for LOEs was new and acquired products to do well because they were launched and acquired to offset the LOEs.

They are growing 22% this year. They are already on $3.1 billion of dollars in a quarter.

If you, without saying that that's the guidance, but if you multiply by four, just to give you, we are talking about over $12 billion this year and growing. The $17 billion of LOEs now after Vynda, they are more 14 to 15 rather than $17.

I think it's looks good, looks good. Thank you.

Next question, please.

Hi, guys. Thank you so much for taking my question.

I really wanted to touch on capital deployment, specifically when it comes to share repurchases. Dave, I know that that's been a method that you've wanted to employ.

Now with clarity on Vyndamax and the CAGR post-2028, what else do you need to see to potentially start buying back shares, especially at these levels? Thank you so much.

Evan. Great question.

We always look at our capital allocation strategy and balance between the three options that we have. At the moment, our focus is really on investing in our R&D platform and in business development to drive long-term value.

With the development in these court cases, that does give us a bit more confidence in our cash flow over time, you'll see us the capital allocation share repurchase lever will come back into greater consideration going forward. Great question, something we always look at, and we're always looking to do what's best for the company and shareholders long term.

Thank you, Dave. Very clear.

Next question, please.

Hi, Pfizer team. Thanks for taking a question today.

I just wanted to probe a little bit more on sigvotatug vedotin and positioning in that front-line setting all-comers relative to the SYMBIOTIC-Lung01 study that you've already started with the PD-1 VEGF. I also note that you've got kind of a Phase 1/2 running combining these two assets.

Can you help contextualize that new Phase 3 all-comers that you intend to start this year for SV first line and how that may be positioned relative to SYMBIOTIC-Lung01? Thank you so much.

All right, Chris.

Thank you very much for the question. Lung cancer is obviously a very significant unmet need, and having a number of shots on goal now with a very differentiated portfolio gives us confidence that we can continue to play an important role in in lung cancer beyond just in the targeted therapies like lorlatinib.

For SV, we are very encouraged by the data we've seen for the combination of pembrolizumab plus SV in the PD-1 PD-L1 high population where we previously showed in a small number small cohort of patients that they all responded in the PD-L1 high to that combination. The Phase 3 study that's ongoing for pembrolizumab versus pembrolizumab plus for for SV, that study is recruiting well in the first-line setting and we confident that for the readout for that for that study.

Ongoing also is the second-line study, which is against docetaxel, which was encouraged by the previous data we've seen, albeit in a single-arm experience with the median o- overall survival of 16.3 months. That study should read out mid-year.

That's docetaxel versus SV second-line, powered for obviously for overall survival, and if it's positive, as said as I said earlier, it will be clinically meaningful. Then ongoing studies being pl- planned also for the broader com- population, combination with chemo plus pembrolizumab, and we will share some of the data at later this year for the the early data for that combination.

In terms of 4404, at ASCO, we will share the Phase 2 data of 4404 monotherapy in first-line PD-L1-expressing non-small cell lung cancer. As we recently shared data at AACR where we sho- repeated the preclinical and early data generated by 3S Bio in China.

We're really confident that this is a differentiated molecule. The binding against VEGF-A is we've shown at AACR is better is higher affinity affinity than what's seen with bevacizumab or that's seen with competitive VEGF-PD-1 molecules.

Confident in the molecule. We'll share more data later this year with the broad program starting, including in combination with chemo, and just a reminder that at ASCO, we'll also share data with 4401 plus chemo in first-line advanced recurring recurrent endometrial cancer, another program that we plan to start a Phase 3 program in.

Thank you, Chris. Next question, please.

Last question.

Hi. Thanks for taking my question.

I wanted to ask you, which key products do you think will drive the reacceleration of your growth in 2029 and beyond? Then regarding the international obesity opportunity, just curious what you've learned from the launch of your GLP-1 in China.

Thank you.

Yeah. Alexandre, let's start with you again this time because the obesity in international has, of course, the Lilly numbers have surprised how big the international market is, and then also speak about key products that will drive your growth.

In '29, and then Aamir, US key products that will drive growth in '29. Please.

A good question on the ecnoglutide launch in China. Of course, it's very, very early day.

We really launched the product Monday last week, it's only a weeks, I can't really talk to you about the penetration of ecnoglutide in China. What is really interesting is actually the incidence of chronic weight in China is quite high.

It's 50% of the Chinese population, and considering the size of the China population, that makes it one of the larger market for chronic weight management. That's the reason why we decided on February of this year to actually do this collaboration with Sciwind Biosciences for the commercialization of ecnoglutide in China.

Since then, we got the approval and commercialized this asset. Ecnoglutide has a very interesting profile, and actually he's demonstrating in a placebo-controlled study a 15.1% weight loss at 48 weeks, which is in par with the best GLP-1 with this biased mechanism of action of GLP-1.

We think that we are bringing to market a very effective asset with a good tolerability profile. Of course, we're going to leverage our very strong primary care capabilities in China that put Pfizer China as one of the leading primary care.

The combination of a very attractive clinical profile plus our knowledge in this area will we believe make us a leader in this category. We're not coming very late into the market because remember Lilly really introduced their asset in the beginning of last year, it's not like we're coming many years after the introduction of those assets.

As I said, I'm very optimistic, both due to the profile of this asset and the capability that we have developed in China. Now, when it comes into the growth engine of the international, I just want to step back one second.

If you look at the quarter and the fact that our non-COVID primary care grew double-digit growth, we delivered $2 billion this quarter, remember we closed last year with a double-digit growth on primary care. Now if you look at the specialty care, it's about $1.5 billion this quarter, we're delivering a double-digit growth again.

That was on the back of a double-digit growth last year. There are assets in those different area that will continue to power our growth.

If I come back to primary care, our vaccines are growing very strongly. The reason why we are growing very strongly on vaccine is because both on pneumococcal and on RSV, we have a large population.

As you know in pneumococcal, it's a very large population, and two-third of our vaccine business come from pediatric, and of course, we have a large pediatric population to continue to grow, both in maternal immunization and on pneumococcal. The vaccines have a potential to grow in pediatric and in adults.

Of course, a big growth at the end of the decade will come from the Metsera assets in chronic weight management because there are two elements of that: one, it's an underserved category with a large epidemic across the world, right, in some of the emerging market. We have a very high prevalence in Saudi, in Brazil, in Mexico of obesity, and our presence in those market, well, with a strong primary care will allow us to actually tap this potential.

Also, it is a cash market, which also is a big advantage in Europe, in Japan, and other developed market where, right after approval, we can introduce those products, which is not the case today in many of our category because it takes a lot of time for reimbursement negotiation with the payers. You see, we have an inline asset that will continue to power the growth, and we are bringing assets like the Metsera that will go straight to market.

Of course, the oncology asset will come, but it will take longer for reimbursement negotiation.

Thank you, Alexandre. Aamir, now excite us for US.

Louise, thanks for the question. There's many things that give us confidence about driving growth in the US in '29.

If you take the first category, we have products that are on the market today that have a lot of upside to them. If you think about Padcev, all of our recent growth has been primarily driven by LA and UC where at the high 50% penetration there and we've got lots of upside in MIBC, 303 and 304, there's a lot of headroom for growth there.

Secondly, you look at a product like Nurtec, we've got a lot of tailwind behind us now, but only 60% of people who write a triptan have yet to write an oral CGRP. There's a lot of headroom for growth and we're executing really well against that.

Second, you look at some of our existing large franchises, we have a lot of confidence in what's going to happen with Vynda. Now with 2.5 years of additional exclusivity gives us the opportunity to invest and to continue to grow diagnosis, and we are doing a great job defending our existing patient base as well as ensuring that it is the top choice for new patient starts.

We think we have a lot of momentum on franchises like that as well. Then just to complement what Alexandre was saying, if I think about new areas of growth, we talked a lot about the oncology assets already, but obviously we're very excited about what we have to bring to the market in obesity.

The assets speak for themselves, but what I'm particularly excited about is the fact that we have unique capabilities as a company to win in this area, both in terms of our ability to activate consumers and patients in very different ways, as well as our legacy in this space and the fact that almost 60% of physicians who are going to write these products, we already touch today through a combination of all of our field forces. Those combinations are just some examples of what gives us confidence to grow in '29 and beyond.

Thank you, Aamir. Thank you, everyone, for your attention.

Our strong performance in the quarter reflects the impact of our continued focus and disciplined execution. We are engaging with precision to maximize the value of our commercial portfolio, and we are seeing the result in our financial performance.

In R&D, we are making meaningful progress with a robust slate of critical milestones ahead in 2026 that we believe will further demonstrate the strength and breadth of our pipeline. I want to thank my Pfizer team.

I believe we have the best team Pfizer ever had. They are dedicated to our purpose, continue to deliver and embrace our commitment to creating long-term value for patients and for our shareholders.

Thank you for joining the call today, and thank you for your interest in Pfizer. We look forward to sharing further updates as we execute our priorities throughout the year.