Q4 2025 AstraZeneca PLC Earnings Call

February 10, 2026

Speaker #2: Good morning to those joining from the UK and the US. Good afternoon to those in Central Europe, and good evening to those listening in Asia.

[Company Representative] (AstraZeneca): Good morning to those joining from the UK and the US. Good afternoon to those in Central Europe, and good evening to those listening in Asia. Welcome, ladies and gentlemen, to AstraZeneca's full-year and Q4 2025 results conference call for investors and analysts. Before I hand over to AstraZeneca, I'd like to read the Safe Harbor Statement. The company intends to utilize the Safe Harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Participants on this call may make forward-looking statements with respect to the operations and financial performance of AstraZeneca. Although we believe our expectations are based on reasonable assumptions, by their very nature, forward-looking statements involve risks and uncertainties and may be influenced by factors that could cause actual results to differ materially from those expressed or implied by these forward-looking statements.

Speaker #2: Welcome, ladies and gentlemen, to AstraZeneca's full year and Q4 2025 results conference call for investors and analysts. Before I hand over to AstraZeneca, I'd like to read the safe harbor statement.

Speaker #2: The company intends to utilize the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Participants on this call may make forward-looking statements with respect to the operations and financial performance of AstraZeneca.

Speaker #2: Although we believe our expectations are based on reasonable assumptions, by their very nature, forward-looking statements involve risks and uncertainties, and may be influenced by factors that could cause actual results to differ materially from those expressed or implied by these forward-looking statements.

Q4 2025 AstraZeneca PLC Earnings Call

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Q4 2025 AstraZeneca PLC Earnings Call

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Tuesday, February 10th, 2026 at 11:45 AM

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[Company Representative] (AstraZeneca): Any forward-looking statements made on this call reflect the knowledge and information available at the time of this call. The company undertakes no obligation to update forward-looking statements. Please also carefully review the forward-looking statements disclaimer in the slide deck that accompanies this meeting. For those joining remotely, there will be an opportunity to ask questions after today's presentations. Please use the raise-a-hand feature to indicate you wish to ask a question at any time during the call. For those attending in person, roving microphones will be available to ask questions during the Q&A. After the presentation, you'll be invited to raise your hand in the air, and we will bring the microphone to you. When you receive the microphone, please state your name and organization. I must advise you that this presentation is being recorded today. With that, I will now hand you over to the company.

Andy Barnett: Right. A warm welcome, everybody, to AstraZeneca's full-year and fourth quarter 2025 presentation conference call and webcast for investors and analysts. I'm Andy Barnett, Head of Investor Relations. Before I hand over to Pascal and the rest of the executive team, I'd like to cover some housekeeping items. Firstly, all the materials presented today are already available on the AstraZeneca investor relations website. Next slide, please. This slide contains our forward-looking statements, including the Safe Harbor provisions, which I'd encourage you to take the time to read. We were making comments on our performance using constant exchange rates, or CER, core financial numbers, and other non-GAAP measures. Non-GAAP to GAAP reconciliation is contained within the results announcements, and all numbers quoted today are in millions of US dollars unless stated otherwise. Next slide, please. Here's the agenda for today's call.

Pascal Soriot: Thank you, Andy. Welcome, everyone. It's really a great pleasure to see you all again and to present our full-year results. It's been a great year. Our company, if we can move to the next slide, our company delivered very strong performance both on the financial and, most importantly, the pipeline front. On the financial side, revenue grew 8%, and product revenue, importantly, grew 10%, driven by continued global demand for our innovative medicines. Our core EPS, as you can see here, grew by 11%. We had 16 blockbuster medicines in 2025, with 17 of those growing at double digits with 17 medicines, sorry, growing at double digits. And we have the potential to get to 25 blockbusters by 2030. Remember, when we announced our $80 billion target back in May 2024, we had 12 blockbusters at the time. We now have 16, and we hope to get 25.

Pascal Soriot: It's important also for me to recognize the work everybody's done in the company as far as the company to do this, in particular, our global operations colleagues, because each time we launch one product, for them, it's probably 50, 60 launches, so many different SKUs around the world. So everybody's done a tremendous job across the organization. If we move to the next slide, the strength of our portfolio was clear in 2025, and we are now taking significant steps to continue to strengthen our manufacturing and R&D footprints in both the US and China. Together, our global reach and our diverse revenue streams really support our low concentration risk and ensure resilience to regional disruptions. Important to keep in mind, I know a couple of years ago, many questions we were getting were, "Are your pipeline complicated?

Pascal Soriot: Is it diversified?" I struggled to get my head around it. I hope today people realize better the value of this diversification. We're now talking about concentration risk. It's great to have one or two big, big products. It makes you very, very profitable and makes you look good. But if you lose one of those, as we've seen happen to some actors in the industry lately, it really becomes very painful very quickly. So this diversification, both product-wise but also geographically, is suddenly becoming more apparent as we drive growth through therapy areas but also through regions. So if you look at this chart, we saw growth across Oncology and R&I, in particular, growing each 17% and 12%, respectively. CVRM, of course, was impacted by the patent expiry of Brilinta and Farxiga in the UK, and there will be more of this, unfortunately, in 2026.

Pascal Soriot: Despite this, we still grew 2%. Overall, biopharmaceuticals still grew 6% and represent about 40% of our global sales. Rare disease grew 5% despite the impact of biosimilars on Soliris. I would say the transition from Soliris to Ultomiris is not totally finished but close to being completed, and Ultomiris is now growing very nicely. We continue to see increasing demand for medicines across all our regions. Of course, strong growth in the US, 10%. We continue to grow in Europe. But importantly, I think I would like to highlight or attract your attention to the emerging markets outside of China. China still grew 4% despite losing Pulmicort to generics. We still grew 4%, which is quite nice, and we remain the largest pharma company in China. But outside of China, 22%. This part of the world is starting to really play an important role.

Pascal Soriot: As I said, Europe, we still grow 7%. Next slide, please. Importantly, our momentum through the pipeline continues. We now have more than 100 phase three trials that are ongoing. Think about that. 100 phase three trials. It's an enormous momentum going through the pipeline. And this year, we should have 20 phase three readouts. And those readouts, fingers crossed, of course, if they are positive, they will collectively drive another more than $10 billion of peak revenue. And the pipeline 27 should also, again, deliver a similar number, actually slightly higher, in 2027. Of course, not all, but at least the great majority of these phase three readouts need to be positive. Importantly, you can see that there's a growing number of, let's say, assets, but importantly, an increasing value per indication. As our pipeline grows, we continue to focus and prioritize.

Pascal Soriot: Of course, we prioritize the most valuable projects. You can see in light pink the average peak revenue per indication. That reflects the increasing individual value of projects and the continuous effort we make to prioritize, even though we have a lot of projects. Next slide, please. The question is often asked, "Oh, let's be on 2030." We said back in May 2024, and we continue saying the same, "We want to be a growth company until 2030, reach this $80 billion ambition, but also be a growth company post-2030." That is why we need to continue investing in R&D. That is why we need to continue focusing on technologies and new medicines that will actually change the future of medicines and drive our growth post-2030. You can see here the list of the five technologies that we prioritize and decided to invest in.

Pascal Soriot: And if you look at weight management, cardiovascular risk factors, we now have two products in phase III. Of course, our oral PCSK9, for which we will get data in 2027. But we also announced that we have moved our oral GLP-1 into phase III, and we have a broad set of studies covering diabetes, weight loss in monotherapy, combination products, cardiovascular outcome studies. So we have a very ambitious plan for our oral GLP-1. But beyond this, we're also investing in new products that will actually shape the future of this weight management sector, which is in the initial steps, really. And the future will be made of better convenience, longer duration of action for injectables, moving to weekly to monthly. And some of this will come from the partnership we announced with CSPC recently, but also new mechanisms.

Pascal Soriot: So we are waiting for data on our GLP-1 glucagon and our amylin product. The GLP-1 glucagon in itself has independent value, but we also will combine it with amylin. So we should get data this year. So oral agents, long-acting injectables, new mechanisms helping patients lose more fat and less muscle are the directions we are heading into. Now, if you look at ADC and radioconjugates, we now have 8 ADCs that are ADCs that came out of our own pipeline, our own efforts. Three of those are in Phase III. We will get data in the first half of this year for one of those, as you can see here, AZD0901. And importantly, we have new ones, both as ADCs but also radioconjugates that are moving through early development. We have novel linker combinations, payload combinations. We have dual payload ADC. We have radioligands.

Pascal Soriot: So we continue to build this that will drive our growth post-2030. We, of course, invest in our next-generation IO bispecifics, in particular, Rilvegostomig. And we combine those with our ADCs, as we've said in the past. Cell therapy, T-cell engagers. We're making good progress with AZD0120 that has good encouraging data in phase 1 but is entering phase 3 this year. And we are moving as fast as we can to move it into hematology indications but also immunology indications. And we also have very exciting data, early data, for Sirovetamig. And it's also moving into phase 3. And on top of this, we have multiple approaches to CAR-T, not only CAR-T but also allogeneic projects that some of them will be in the clinic this year. And we're working on the in vivo approach, as you know. And then we also have new platforms, TCE platforms.

Aradhana Sarin: Thank you, Pascal. And good afternoon, everyone. And good morning to our colleagues in the US who woke up very early to join us. So as usual, I'll start with our reported P&L. Next slide, please. Total revenue increased 8% in 2025. Product revenue, which consists of product sales and alliance revenue, increased 10% with continued growth across all key regions. Alliance revenue increased by 38%, reflecting increased contribution from our share of profits with partnered products such as Enhertu, Tezspire, and Beyfortus in regions where our partners book product sales. Next slide, please. This is our core P&L. The core gross margin landed at 82% in 2025, in line with expectations set out at the start of the year. Fourth-quarter gross margin reflected the normal seasonal pattern as well as $235 million of royalty buyouts for Saphnelo and Rilvegostomig, which were recorded in the cost of sales.

Aradhana Sarin: Core R&D expenses increased by 12%, reflecting the growing number of investment opportunities in our broad and deep pipeline. At the end of 2025, we had more than 300 active trials. As Pascal mentioned, more than 100 of these in phase three. SG&A expenses increased by only 3% in 2025, reflecting continued cost discipline and focus on operating leverage. We continue to streamline our business. As a proportion of total revenue, SG&A expenses decreased from 28% in 2024 to 26% in 2025. Operating profit increased by 9%, with operating leverage continuing to be a key focus for the company. We manage our P&L in totality, enabling flexibility in investment decisions throughout the year. The lower tax rate seen in the fourth quarter reflected release of certain tax provisions taken in prior years. Core EPS increased by 11% in line with our full-year guidance. Next slide, please.

Aradhana Sarin: We continue to see strong cash flow from operating activities, which increased by 23% to $14.6 billion in 2025. We saw CapEx increasing by $1.1 billion to $3.3 billion, in line with the expectations set out at the beginning of the year. For 2026, we anticipate CapEx investment to increase by approximately one-third versus 2025 as we expand capacity to support future growth. This includes our recently announced US and China investments and previously announced investments in our ADC facility in Singapore, all of which are multi-year projects. Total deal payments in 2025 amounted to $4.2 billion, of which around $3 billion were payments relating to past deals, and the remaining were payments for deals announced in 2025, such as Eccogene. In 2026, we anticipate success-based milestones and sales payments relating to past deals to total around $2.5 billion. Our capital allocation priorities remain unchanged.

Aradhana Sarin: We currently have interest-bearing debt of close to $30 billion, which is a level we're comfortable with as we continue making investments to drive future growth, expand our supply chain globally, and further strengthen our R&D pipeline. Our net debt-to-EBITDA ratio currently sits at 1.2 times. Today, we are pleased to confirm a second interim dividend of $2.17 per share, resulting in a full-year 2025 declared dividend of $3.20 per share. In 2026, we intend to increase the annual declared dividend to $3.30 per share, in line with our progressive dividend policy. Today, we also issue our 2026 guidance. As usual, our full-year guidance is at constant exchange rates. We anticipate total revenue to grow by a mid to high single-digit percentage, driven by strong underlying momentum in the business. The growth will be delivered despite known headwinds in 2026, including VBP in China this quarter for Farxiga, Lynparza, and Roxadustat.

Aradhana Sarin: Farxiga will also face loss of exclusivity in the US in April. In 2025, US Farxiga generated $1.7 billion or 21% of global revenues, while China represented just under half of emerging markets revenue. In Europe, which accounts for 35% of Farxiga total revenue, patent protections across EU markets extend to 2028. While the MFN deal presents a headwind in 2026, the effect is already factored in our guidance and can be absorbed given our large and growing revenue base. Despite these headwinds, we anticipate a broadly flat to slightly higher core gross margin in 2026, driven by backing out the royalty buyout and product sales mix. We expect a core tax rate between 18% and 22% in 2026 and core EPS growth of low double-digit % at constant exchange rates.

Aradhana Sarin: Based on January average exchange rates, we anticipate a low single-digit positive FX impact on total revenue and neutral impact on core EPS. Next slide, please. As I mentioned earlier, we continue to make significant R&D investments in emerging areas such as ADCs, cell therapy, bispecific, and late-stage CVRM portfolio, which have the potential to drive growth beyond 2030. As a result, we anticipate R&D expenses to be at the upper end of the low 20s % range of total revenue in 2026. SG&A's percentage of total revenue has continued to decline over recent years, reflecting our disciplined approach to efficiency and operating leverage. At the same time, we're making targeted investment to support the next wave of growth with several important NME launches ahead of us, including Baxdrostat, Camizestrant, and Garadacimab, all of which are medicines with blockbuster potential.

Dave Fredrickson: Thank you, Aradhana. Next slide, please. In 2025, oncology delivered total revenues of $25.6 billion, an increase of 14% on the prior year or 17% excluding the 2024 Lynparza sales milestone. Many of our key medicines have surpassed notable multi-blockbuster milestones, with Tagrisso achieving over $7 billion in full-year revenues, Imfinzi over $6 billion, Calquence over $3.5 billion, and Enhertu over $2.5 billion in AZ revenues. This performance is a tangible demonstration of our commitment to bringing medicines with transformative potential to patients globally and is particularly notable given the headwinds from the introduction of the 20% manufacturer's liability under Medicare Part D reform from last year. Turning now to our fourth-quarter performance, total revenues exceeded $7 billion for the first time, up 20% on the year excluding the Lynparza milestone, with all our key medicines in regions demonstrating double-digit growth.

Dave Fredrickson: Tagrisso global revenues were up 10%, reflecting continued demand growth across all indications. In the first-line setting, we are now seeing a significant proportion of patients receiving a combination regimen, with FLAURA2 being the clear preference across key markets. In earlier lines, increased adoption of ADAURA and LAURA has been another meaningful source of growth. Imfinzi and Imjudo delivered 37% and 26% growth respectively, reflecting continued demand across tumor types. This growth is broad-based from both continued expansion of newer indications such as ADRIATIC and small-cell lung cancer, and NIAGARA and bladder cancer, as well as increased uptake of more established indications such as HIMALAYA and liver cancer. Calquence total revenues increased 17% in the fourth quarter, driven by additional demand in front-line CLL as we maintain our class leadership position across major markets.

Speaker #2: increased 17% in the revenues fourth quarter , driven by demand Calquence total additional in frontline CLL . As maintain we our leadership class position Adriatic across major markets , specifically in the United States , we've market share , leadership course of seen our year over the , demonstrating our grow competitive positioning and differentiation in Her2 delivered total revenue growth of 46% in the fourth quarter across all regions in is seeing share gains both Her2 positive Her2 low and breast metastatic and in China , cancer demand continues to increase following Nrdl the enlistment in January of last year , Truqap 41% in the revenues grew fourth year over year quarter , with benefiting from both inventory build in comparisons the US of reversal pricing In Europe .

Dave Fredrickson: Specifically, in the United States, we've seen our market share leadership grow over the course of the year, demonstrating our competitive positioning and differentiation. Enhertu delivered total revenue growth of 46% in Q4. Across all regions, Enhertu is seeing share gains both in HER2-positive and HER2-low metastatic breast cancer. In China, demand continues to increase following NRDL enlistment in January of last year. Truqap revenues grew 41% in Q4, with year-over-year comparisons benefiting from both inventory build in the US and the reversal of pricing accruals in Europe. In the US, we now believe Truqap is at peak, with further incremental growth to be driven by other markets. Finally, Dato-DXd revenues of $40 million in Q4 reflect our early launch momentum in late-line EGFR-mutated lung cancer, including an emerging leadership position in the third-line. Next slide, please.

Dave Fredrickson: The strong momentum in 2025 continues into 2026. For Imfinzi, we were pleased to see the US approval for Matterhorn and early gastric cancer at the end of November, and are already seeing encouraging uptake. Potomac and bladder cancer will add another growth opportunity this year, with the first approval expected in the first half. We expect data in 2026 for several Imfinzi combinations, including Imjudo, bladder cancer, and HCC, and with Dato-DXd and lung, with commercial launches planned in 2027 pending, of course, positive results and regulatory approvals. 2026 is set to be another landmark year for Enhertu as we further expand our position as the standard of care in HER2-positive breast cancer by bringing this transformational medicine to three new settings.

Dave Fredrickson: This includes the first-line metastatic setting following the recent approval of DESTINY-Breast09, with approvals in early breast cancer for DESTINY-Breast11 and DESTINY-Breast05 also expected this year. Looking to 2027 and beyond, we remain focused on bringing Enhertu to more patients globally, including in settings beyond breast cancer such as lung cancer. For Calquence, we expect the imminent US launch of the Amplify fixed-duration therapy regimen to be an important driver of growth for the year. This complements the sustained demand in the treat-to-progression segment within first-line CLL, where Calquence remains the leading BTK inhibitor. Looking ahead, we aim to leverage our broader hematology portfolio to improve outcomes through combination approaches in CLL as well as in other hematologic malignancies.

Dave Fredrickson: Building on double-digit growth for Tagrisso in 2025, we anticipate strong performance in 2026, driven by further adoption and geographic expansion of LAURA and ADAURA in early disease, and sustained leadership in first-line metastatic disease, particularly within the growing combination market. Longer term, we look forward to the results of multiple combination trials that have the potential to reinforce Tagrisso as the backbone TKI, both in later lines with Savolitinib and TROPION-Lung15, and in the front line with TROPION-Lung14. As we reflect on another strong year of growth, we continue to see sustained momentum in our oncology business heading into 2026, with a clear focus on expanding the reach of our medicines into new markets and with additional indications. With that, please advance to the next slide. I'll hand over to Susan, who will discuss our key readouts that we anticipate this year.

Susan Galbraith: Thank you, Dave. Momentum continues to build across our oncology portfolio. As we enter 2026 with a robust pipeline, we have an important opportunity to advance therapies for patients with high unmet needs. Today, I want to spotlight several key catalysts supporting our continued growth, starting with our TROP2 ADC, Dato-DXd. Last year, we saw Dato-DXd demonstrate its profile as best-in-class TROP2 ADC, with launches in HR-positive breast cancer and later-line EGFR-mutated lung cancer, and with compelling data presented at ESMO in triple-negative breast cancer, demonstrating a five-month improvement in overall survival versus standard-of-care chemotherapy. TROPION-Breast02 has now been accepted by the FDA for priority review. This year, we expect the readout for AVANZAR, a pivotal trial evaluating Dato-DXd as the first-line lung cancer setting. AVANZAR investigates the combination of Dato-DXd with Imfinzi and carboplatin, aiming to deepen and extend responses for this large, high-unmet-need population.

Susan Galbraith: Crucially, AVANZAR will be the first trial to validate our QCS TROP2 NME biomarker, designed to identify patients most likely to respond to Dato-DXd in this first-line lung cancer setting. Success here could enable broader application of this technology in other tumor types and across our ADC portfolio. Building on Dato-DXd's current approval in later-line EGFR-mutated lung cancer, we also anticipate the readout from TROPION-Lung15, which evaluates Dato-DXd alone or in combination with Tagrisso for patients who have progressed on a TKI. This trial aims to set new standards for second-line treatment, further reinforcing Tagrisso's role as the backbone of care in EGFR-mutant lung cancer and paving the way for TROPION-Lung14 in first-line setting, which can build on the success of FLAURA and FLAURA2. Imfinzi continues to deliver transformative benefits across cancer types.

Susan Galbraith: This year's key readouts in GI, lung, and bladder cancer signal a third wave of Imfinzi growth, highlighting the potential of combination regimens. I want to highlight two today. Firstly, the EMERALD3 trial aims to bring the combination of Imfinzi and Imjudo into the local regional setting for hepatocellular carcinoma, building on the transformative results we've already demonstrated in the later-line HIMALAYA trial. Secondly, VOLGA looks to build on our existing presence in muscle-invasive bladder cancer. The NIAGARA regimen established a role for Imfinzi as the first perioperative immunotherapy regimen in cisplatin-eligible patients. VOLGA explores whether the combination of enfortumab vedotin and Imfinzi, plus or minus Imjudo, can improve outcomes for the 50% of patients that are not candidates for cisplatin. This regimen is differentiated in two important ways. First, enfortumab vedotin is limited to the neoadjuvant setting, aiming to optimize outcomes while balancing the overall benefit-risk profile.

Susan Galbraith: And secondly, acknowledging bladder cancer's sensitivity to CTLA4 blockade, VOLGA includes an arm delivering three cycles of Imjudo, two preoperatively and one postoperatively, with the goal of further deepening responses in this patient population. In 2026, we will also see the second pivotal readout for Camizestrant, our next-generation oral SERD. Last year, we shared the first phase III data for Camizestrant in patients with first-line hormone receptor-positive disease with emerging ESR1 mutations. The transformational SARINA6 results demonstrated that intervening at the earliest opportunity and switching to a more effective endocrine option ahead of progression with Camizestrant and switching with Camizestrant offers the chance to retain control of a patient's disease for longer and thereby realizes the full potential of first-line treatment.

Susan Galbraith: In the second half of this year, SERENA4 will readout, targeting a broader, upfront first-line population eligible for the combination of a CDK4/6 inhibitor and an aromatase inhibitor, and assessing whether Camizestrant can replace the aromatase inhibitor to improve outcomes. Our confidence is driven not only by our data from the phase II SERENA2 and the phase III SERENA6 results, but also from recent readouts in the competitive space that demonstrate the value of this class in ESR1 wild-type, endocrine-sensitive disease. Finally, progress is accelerating across our ADC portfolio, with AZD0901, our claudin 18.2 targeted ADC, on track to deliver its first phase III data in second-line gastric cancer in the first half of the year. These six trials represent only a fraction of the opportunities of our oncology portfolio, which is poised to drive continued growth.

Ruud Dobber: Thank you very much, Susan. Next slide, please. Our biopharmaceuticals medicines delivered strong performance in 2025, with total revenue up 5% to $23 billion, with our growth medicines substantially outpacing the impact of generic entry on a limited number of brands, such as Brilinta in the US and Europe, and Farxiga in the UK. In Q4, RNI revenues were up by 10%, with revenue from growth medicines having increased by 27%. CVRM revenues were 6% down on the prior year, with generic competition slowing Farxiga's growth to 2% and Brilinta continuing to decline. VNI total revenue was down 33% year-over-year, largely due to the Beyfortus sales milestone booked in Q4 2024. Next slide, please. Biologic medicines continue to gain share among severe asthma patients.

Ruud Dobber: Our medicines now make up more than half of the new-to-brand prescriptions for the severe asthma biologic segment in several markets. Fasenra is the leading IL-5 medicine for severe eosinophilic asthma, and its product profile was recently strengthened with the launch of the EGPA indication. Overall, we expect Fasenra's positive momentum to continue in 2026, with growth in the emerging markets set to accelerate following inclusion in the National Reimbursement Drug List in China. Tezspire has made rapid market share gains in severe asthma since its launch, and its growth potential has been enhanced by recent approvals for use in chronic rhinosinusitis with nasal polyps, where Tezspire has demonstrated that it can nearly eliminate the need for surgery. Nasal polyps are a common comorbidity for asthma patients, so this approval further enhances its clinical profile. Breztri is the fastest-growing medicine within the expanding COPD.

Ruud Dobber: We are the clear market leader in China and have been gaining share in most other major markets. Additionally, regulatory reviews are underway for asthma based on the KALOS and LOGOS trials, and we anticipate first approvals in the first half of 2026. Saphnelo, our biological medicine for the treatment of SLE, is continuing to grow strongly, with the IV formulation having gained market leadership in several major markets. Saphnelo's subcutaneous formulation was recently approved in Europe and will extend its reach to the larger segment of patients who favor self-administration. We are expecting further approvals of subcutaneous Saphnelo in other regions this year, including in the United States and Japan in the first half. 2026 marks a transition year for our CVRM franchise. We anticipate Lokelma's strong growth to continue into 2026, driven by market leadership within the growing potassium binder class.

Ruud Dobber: We have also increased additional manufacturing capacity to support our growth ambitions. In 2026, as mentioned, we anticipate Farxiga VBP implementation in China during Q1 and the first generic competition in the United States in April. While Farxiga revenues in the United States, Japan, and China are expected to decline this year, we anticipate strong demand growth to continue in Europe and the emerging markets. Looking beyond 2026, dapagliflozin fixed-dose combinations have the potential to unlock new waves of medicines for patients, and we already have three fixed-dose combinations of dapagliflozin in phase III development, with the first two phase III trials due to readout in 2027. We are currently preparing for the launch of Baxdrostat in uncontrolled and treatment-resistant hypertension. The U.S. approval is anticipated to broadly coincide with the entry of generic dapagliflozin in this market, allowing us to leverage our existing commercial infrastructure.

Sharon Barr: Thanks, VUD. Next slide, please. We saw strong progress across our biopharma clinical pipeline in 2025 and are entering 2026 with a broad and deep pipeline across CVRM and R&I. Today, I want to highlight two high-value phase III catalysts anticipated this year, positioned to deliver meaningful impact for patients and AstraZeneca's growth ambition. Starting with Wainua, we expect the CardioTransform readout in ATTR-CM in the second half of this year. Wainua is an antisense oligonucleotide designed selectively to suppress hepatic production of transthyretin, addressing the upstream driver of amyloid fibril formation. ATTR-CM is often underdiagnosed as symptoms overlap with common cardiac issues, leading to delayed diagnosis, poor prognosis, and high morbidity. This highlights the need for better diagnostics and innovative new treatment options.

Sharon Barr: CardioTransform is the largest study ever conducted in this disease, enrolling more than 1,400 patients to receive Wainua or placebo on top of standard of care for 140 weeks. The trial's primary endpoint is a robust composite of cardiovascular mortality and recurrent cardiovascular clinical events designed to capture clinically meaningful outcomes. Importantly, Wainua can be administered once monthly as a single dose via a subcutaneous autoinjector, enabling convenient at-home dosing. That's an advantage for this largely aging population. Wainua represents just one component of our leading amyloidosis portfolio. We believe that multiple mechanisms of action will be needed to address the full spectrum of ATTR cardiomyopathy, and we look forward to initiating clinical development of Wainua in combination with our depletor, Coramitug, in the near future.

Sharon Barr: Turning now to the phase III program for our differentiated IL-33 biologic, tozorakimab in COPD, which we anticipate will readout in the first half of this year. We have three trials ongoing: Oberon, Titania, and Miranda, which have the potential to redefine the management of this complex, heterogeneous, and progressive disease. The trials all have the same primary endpoint: the reduction in annualized rate of moderate to severe COPD exacerbations in former smokers. The program will also evaluate efficacy in a broader COPD population, irrespective of eosinophil count or smoking status, and explores a range of dosing regimens to maximize the potential population that could benefit from tozorakimab. Should the results be positive, tozorakimab could be the first-in-class IL-33 biologic for COPD. I also wanted to take the opportunity to highlight advances in our weight management portfolio.

Ruud Dobber: Thank you, Sharon. Can I get to the next slide, please? Rare Disease delivered total revenue of $9.1 billion in 2025, up 4% over the last year, driven by growth in neurology indications, increased patient demand, and continued global expansion. In the quarter, Ultomiris grew 15%, driven by patient demand across indications, including the competitive gMG and PNH markets. Soliris revenues continue to decline due to the successful conversion to Ultomiris, as well as biosimilar pressure. Strensiq grew 15% due to strong demand, with the quarter benefiting from tender order timing. We also saw strong underlying demand for Koselugo offset in the fourth quarter by order timing in certain tender markets. We continue to see great momentum across the Rare Disease portfolio, with further approvals for Koselugo and Ultomiris, expanding our geographic reach for these medicines.

Ruud Dobber: Five years after announcing the acquisition, I am pleased to report that Alexion has delivered low double-digit compounded annual growth from 2020 to 2025 at constant exchange rates. We have also significantly expanded our global reach. At the time of the acquisition, Alexion medicines were available in 20 countries. By leveraging AstraZeneca footprint and the outstanding efforts of our teams, our life-changing rare disease therapies are now available in more than 75 countries worldwide. Finally, we have made meaningful progress in deepening scientific collaborations between AstraZeneca and Alexion researchers, further accelerating innovation. Our work across similar disease areas, such as the transthyretin cardiac amyloidosis or the development of our dual CD19 BCMA CAR-T across multiple therapeutic areas, are two evidences of this. This integrated approach enabled the seamless exchange of technologies and advancements across medicinal and process chemistry, molecular editing, and library platform.

Ruud Dobber: We have now more than 120 collaborative initiatives across AstraZeneca and Alexion, which are advancing our ambition to pioneer new treatments and lead in our core therapeutic area. Please advance to the next slide. In 2026, we expect Ultomiris to grow, to continue to grow, driven primarily by neurology indication, including new-to-brain patients and those switching from Soliris, as well as further market expansions. We indicated peak your sales for Ultomiris to be above $5 billion, with contribution from both existing and new indications, such as HSCT-TMA, IgAN, and CSA-AKI. In the first half of the year, we anticipate high-level results in IgAN, where we have guided for the first endpoint at 34 weeks, assessing proteinuria. If positive, we will explore the potential for an accelerated approval in certain major markets. We also anticipate results from adult patients with HSCT-TMA.

Ruud Dobber: This data builds on a positive finding from the single-arm pediatric study completed in 2025. For Strensiq, we expect continued adoption supported by hypophosphatasia guidelines, which have led to increased disease awareness, diagnosis rates, and accelerated new patient starts. As global market expansion progresses, our priority remains advancing disease education to strengthen market readiness ahead of the readouts for eosinophil ALPHA, which we anticipate in the first half of 2026. Patient demand and geographic expansion in pediatric patients, in addition to the recent approval in adult patients, will continue to drive Koselugo's growth. We are well placed to deliver another year of strong performance supported by global demand for rare disease medicine, as well as meaningful indication expansion opportunities. Please advance to the next slide.

Ruud Dobber: Our antibody-based depletion portfolio for cardiac and systemic amyloidosis continues to advance, with a focus on the two most prevalent forms of amyloidosis, transthyretin, and light chain. We announced the first phase III result last year for our most advanced pipeline candidate, Anselamimab. In the CARES phase III program, Anselamimab demonstrated a highly clinically meaningful improvement in both all-cause mortality and cardiovascular hospitalization in the subgroup of patients with kappa light chain amyloidosis. Global regulatory reviews and submissions are on the way. We have also expanded our collaboration with Neurimmune in December 2025 to include NI009, a fibril depleting antibody for the lambda light chain amyloidosis, which represents 80% of the light chain population and complements Anselamimab to address the broad patient population. We have accelerated development plan to move this molecule as quickly as possible into the clinic.

Ruud Dobber: Coramitug, our first collaboration with Neurimmune, is now in phase III for ATTR-CM. The depletor trial completed enrollment, a full year ahead of plan, with more than 1,000 patients recruited. As Sharon mentioned, we also plan to initiate a phase IIB of our silencer Wainua with our depletor Coramitug, and we believe the combination of these two medicines has the potential to deliver a new standard of care for patients with ATTR-CM. The data generation to date reinforces our belief that targeted amyloid febril depletion with specific antibodies can significantly reduce mortality and hospitalization, transforming the course of the disease for these patients. And with that, please advance to the next slide, and I will hand back to Pascal. Thank you, Mark. Please next slide. As you can see here, the momentum of our pipeline continues not just in 2026 but also through to 2027.

Ruud Dobber: We have a significant number of high-value phase iii trials that can readout and support our growth to 2030 and beyond. In 2026 alone, the risk-adjusted combined peaker revenue opportunities in excess of $10 billion, as I said before, and again, the same in 2027. If we move to the next slide. In closing, we saw strong commercial momentum and great delivery across the pipeline in 2025, and our confidence in delivering the $80 billion ambition by 2030 is definitely increasing. With our broad portfolio in our deep pipeline, the meaningful progress we're making with our multiple transformation technologies, we can definitely reach this $80 billion ambition we have but also continue to grow past 2030. If we move to the next slide. Before we move to the Q&A, I want to thank Andy Barnett for his amazing contribution as head of investor relations over the last few years.

Ruud Dobber: Joris has driven tremendous growth throughout our company in the United States, in particular, built Farxiga to what it is, Fasenra, Tezspire, and really done a great job. Joris, before being in the US, worked in Asia, and so he has really great experience across Asia, the US, and Europe, and since he joined the company in 2000. So I'm sure Joris will also do a great job in IR, and I'm sure you'll enjoy working with him. So, as we move to the next slide, as Andy mentioned at the start of the call, please limit the number of questions you ask to allow everybody a fair chance to participate. And again, for those of you online, please use the raise hand function on Zoom. And with that, let's move to the first question. There are so many first questions. Over to you.

Iskra Reic: I have it here, but I don't know whether it works. So let me try. Is it better now? Yeah. I don't know. It definitely gives confidence in the outlook of 2026. Now, when you think about 2026 in China, I think there are two main components. One is obviously the headwind of the VBP for Farxiga, Roxadustat, and Lynparza. And as we have always seen, there are expectations of the decline post-VBP that is driven by both price decrease as well as volume reduction. But when it comes specifically to Farxiga, I do believe that we can also expect the brand recovery in the midterm. And we saw the similar trend with Brilinta and Crestor in the past. And it is really driven by the strong brand perception, strong brand loyalty, and recovery specifically in the retail channel.

[Company Representative] (AstraZeneca): Yeah. Thanks, Pascal. So my reflection, if you like, of the last decade in oncology about the success rates we've had has been predicated on being able to identify the right patient populations to treat. You've seen that. That's been important with Lynparza. It's been important with Tagrisso. I think that continues to be something that's important. The foundation model work that we've got with Tempus Pathos, the ambition is that we'll have the largest multimodal foundation model that will take the unstructured data that's in patient records, the lab data, the genomics data, transcripts-only data where available, imaging, and pathology, and integrate all of that into the largest foundation model for oncology because of the large dataset that we have with Tempus and Pathos.

[Company Representative] (AstraZeneca): The hope is, I mean, what we've already been doing is using those kinds of real-world evidence datasets to both help design our phase III trials and predict what the control arm performance is going to be, particularly when you're going in with a new biomarker. You don't necessarily have the historical literature data, but if you can benchmark that using these data, it's helpful. So the idea is that you would reduce the uncertainty in both the design and the prediction of outcome of phase III trials by using these foundation models. The hope is also that you could better identify the patient populations where the biology is a little more complicated. So we're still relying, for example, on PD-L1 in the IO space as the only biomarker that has really broadly been uptaken, and everybody is aware that that is imperfect.

Dave Fredrickson: So Luisa said very specifically on the readouts that Pascal went through, Emerald III is a blockbuster-plus opportunity in HDC, and I think builds off of a program that has currently success with Imfinzi. Certainly, when you take a look at data across AVANZAR 07, that is for just the AZ share alone, multi-blockbuster opportunity if those studies are positive, and we've got an opportunity to move forward with that. SERENA IV is multi-blockbuster in terms of the opportunity that it represents. And then lastly, PAC-9. We don't talk a lot about PAC-9, but I think PAC-9, if that study were to come through, gives an opportunity to actually build off of our Pacific leadership where we've been able to enjoy a space without having much competition coming into the area. So those are the highlights I'd hit.

Dave Fredrickson: So Lisa said very specifically on the readouts that Pascal went through, Emerald III is a blockbuster-plus opportunity in HDC, and I think builds off of a program that has currently success with Imfinzi. Certainly, when you take a look at data across AVANZAR 07, that is for just the AZ share alone, multi-blockbuster opportunity if those studies are positive, and we've got an opportunity to move forward with that. SERENA IV is multi-blockbuster in terms of the opportunity that it represents. And then lastly, PAC-9. We don't talk a lot about PAC-9, but I think PAC-9, if that study were to come through, gives an opportunity to actually build off of our Pacific leadership where we've been able to enjoy a space without having much competition coming into the area. So those are the highlights I'd hit.

Pascal Soriot: Yeah, and a few highlights from a biopharma perspective. Lorundrostat, our oral PCSK9, we're going to expect the first dataset in the course of 2027. It's, in our view, a very high potential, potentially a $5 billion-plus potential. Clearly, Baxdrostat I'm sure many more questions about Baxdrostat not only the monocomponent but also the combination, I think, with the SGLT2. Dapagliflozin is a very important one. And then the other two combinations, Balcinrenone and DAPA in kidney disease and heart failure, where there's a high metabolic need. And the combination of Zibotentan with Dapagliflozin has a sales potential between $3 and 5 billion. So there are a couple of big products. And then, of course, the bonus will be potentially Tozorakimab, as mentioned by Sharon. There's a high metabolic need still in the COPD space.

[Company Representative] (AstraZeneca): Okay. All right. So I mean, I think what we've now seen is proof, as we've been saying consistently, that SERDs, because of the mechanism of action of both full antagonism and inhibition of estrogen receptor but also degradation, can have activity not just in the ESR1 mutant but in the endocrine-sensitive ESR1 wild type. And I think you've seen that. We've been saying it for a while. But when you look at the second line setting, that is less endocrine-sensitive, and so the effect size has been smaller there. So the basis of SERENA-4's confidence is that we have tried to design the study to enrich for the endocrine-sensitive components of the first line setting. That's based on recruiting patients with recurrence and early-stage disease after at least two years of adjuvant therapy because those that are less endocrine-sensitive will progress more rapidly than that.

Susan Galbraith: Okay. All right. So I mean, I think what we've now seen is proof, as we've been saying consistently, that SERDs, because of the mechanism of action of both full antagonism and inhibition of estrogen receptor but also degradation, can have activity not just in the ESR1 mutant but in the endocrine-sensitive ESR1 wild type. And I think you've seen that. We've been saying it for a while. But when you look at the second line setting, that is less endocrine-sensitive, and so the effect size has been smaller there. So the basis of SERENA-4's confidence is that we have tried to design the study to enrich for the endocrine-sensitive components of the first line setting. That's based on recruiting patients with recurrence and early-stage disease after at least two years of adjuvant therapy because those that are less endocrine-sensitive will progress more rapidly than that.

[Company Representative] (AstraZeneca): At least 12 months must have elapsed since the patient's last dose of the adjuvant AI. Then there's some patients with de novo stage IV disease. So these are clinical features that are enriched to enrich for that endocrine-sensitive patient population. Of course, what you've also got is potentially the prevention of emergence of ESR1 mutations because you are essentially blocking that clonal selection drive because of the mechanism of action. So that's what underpins our confidence in serena-4. And I think having seen the fact that you've got activity in an adjuvant setting in an endocrine-sensitive population increases the confidence in that. But obviously, there's still those trial design features. And of course, it's in combination with a CDK4/6 inhibitor.

Susan Galbraith: At least 12 months must have elapsed since the patient's last dose of the adjuvant AI. Then there's some patients with de novo stage IV disease. So these are clinical features that are enriched to enrich for that endocrine-sensitive patient population. Of course, what you've also got is potentially the prevention of emergence of ESR1 mutations because you are essentially blocking that clonal selection drive because of the mechanism of action. So that's what underpins our confidence in serena-4. And I think having seen the fact that you've got activity in an adjuvant setting in an endocrine-sensitive population increases the confidence in that. But obviously, there's still those trial design features. And of course, it's in combination with a CDK4/6 inhibitor.

[Company Representative] (AstraZeneca): To your second question about CAMBRIA-1, again, I would just point out that we're the only company that has two adjuvant studies with our SERD, one designed for the patient population after two to five years of CDK4/6, which is CAMBRIA-1, and the other for the patient population newly diagnosed, which is CAMBRIA-2. That gives us the opportunity to be able to, if we're successful, to access the largest group of patients in the adjuvant setting from those two different patient populations. And of course, the other difference is that we are allowing a combination with abemaciclib, which is going to be very relevant as the data continue to mature for CDK4/6 in the adjuvant setting. So I think that was the basis of the trial design that we had.

Susan Galbraith: To your second question about CAMBRIA-1, again, I would just point out that we're the only company that has two adjuvant studies with our SERD, one designed for the patient population after two to five years of CDK4/6, which is CAMBRIA-1, and the other for the patient population newly diagnosed, which is CAMBRIA-2. That gives us the opportunity to be able to, if we're successful, to access the largest group of patients in the adjuvant setting from those two different patient populations. And of course, the other difference is that we are allowing a combination with abemaciclib, which is going to be very relevant as the data continue to mature for CDK4/6 in the adjuvant setting. So I think that was the basis of the trial design that we had.

James Gordon: One question, please, on Ecoglipron, if I can. You've made the announcement that you're moving to phase III, which I assume indicates confidence in the phase II profile that you've seen. But I could read that two ways because you also have a unique target product profile, I think, in phase III because you're looking about weight management in combination with other parts of your cardiovascular portfolio. So can you make some comments as to whether or not, for you, being confident to drive that move to phase III means that you think you have efficacy at least as good or better than the competition, or whether or not you think that it meets your target product profile of at least achieving modest weight loss, which you can then use in combination with other agents?

Matthew Weston: One question, please, on Ecoglipron, if I can. You've made the announcement that you're moving to phase III, which I assume indicates confidence in the phase II profile that you've seen. But I could read that two ways because you also have a unique target product profile, I think, in phase III because you're looking about weight management in combination with other parts of your cardiovascular portfolio. So can you make some comments as to whether or not, for you, being confident to drive that move to phase III means that you think you have efficacy at least as good or better than the competition, or whether or not you think that it meets your target product profile of at least achieving modest weight loss, which you can then use in combination with other agents?

Iskra Reic: Yeah. So thank you for asking the question. As you are mentioning, there are three trials. There are two trials in the pediatric population where Strensiq was originally approved. One of these trials is a switch from Strensiq to a synthetase. There is another trial in the pediatric population in the naïve, in the Strensiq naïve population against placebo. And the third trial combines both adolescent and adult. You know that the label of Strensiq, depending on the jurisdiction, is usually focusing on the pediatric population. And sometimes, we have adult with pediatric onset in the label. But the intent of the synthetase program was to test in the totality of the population from pediatric, adolescent, adult, and even adult of a certain age, if I may say.

Pascal Soriot: Yeah. So thank you for asking the question. As you are mentioning, there are three trials. There are two trials in the pediatric population where Strensiq was originally approved. One of these trials is a switch from Strensiq to a synthetase. There is another trial in the pediatric population in the naïve, in the Strensiq naïve population against placebo. And the third trial combines both adolescent and adult. You know that the label of Strensiq, depending on the jurisdiction, is usually focusing on the pediatric population. And sometimes, we have adult with pediatric onset in the label. But the intent of the synthetase program was to test in the totality of the population from pediatric, adolescent, adult, and even adult of a certain age, if I may say.

[Company Representative] (AstraZeneca): Do you want me to go first? Okay. Thanks for the question. So TROPION-Lung08 is only in the PD-L1 greater than 50% trial characteristics. It makes sense for the biomarker to be applied within the TROPION-Lung07 population. And that's what the priority has been there, very similar to what we've seen with the AVANZAR redesign where we put it in the ITT but also in the biomarker-positive patient population. Obviously, between AVANZAR and TROPION-Lung07, we'll be answering the question about the added benefit of platinum in addition as well. And I think these are all important trials that have the opportunity to really position Dato-DXd as a key component of the first-line setting across multiple segments of that patient population.

Susan Galbraith: Do you want me to go first? Okay. Thanks for the question. So TROPION-Lung08 is only in the PD-L1 greater than 50% trial characteristics. It makes sense for the biomarker to be applied within the TROPION-Lung07 population. And that's what the priority has been there, very similar to what we've seen with the AVANZAR redesign where we put it in the ITT but also in the biomarker-positive patient population. Obviously, between AVANZAR and TROPION-Lung07, we'll be answering the question about the added benefit of platinum in addition as well. And I think these are all important trials that have the opportunity to really position Dato-DXd as a key component of the first-line setting across multiple segments of that patient population.

[Company Representative] (AstraZeneca): So just to go over again, the CAMBRIA-2 study is in a setting that's very similar to lidERA, but it does allow for the combination with abemaciclib, which I think is going to become an increasing piece. So of course, what lidERA doesn't answer is the relevance of the oral SERD in that context. And given that we think that CDK4/6 prevalence in the adjuvant setting is going to grow, I think it's very important to have the data with and without that combination and after a period of CDK4/6. That's why I'm saying when you look at the two trials in totality, I think it gives us the opportunity to have the greatest segment of the patient population, the adjuvant, should they both be positive. I don't know, Dave, do you want to comment?

Susan Galbraith: So just to go over again, the CAMBRIA-2 study is in a setting that's very similar to lidERA, but it does allow for the combination with abemaciclib, which I think is going to become an increasing piece. So of course, what lidERA doesn't answer is the relevance of the oral SERD in that context. And given that we think that CDK4/6 prevalence in the adjuvant setting is going to grow, I think it's very important to have the data with and without that combination and after a period of CDK4/6. That's why I'm saying when you look at the two trials in totality, I think it gives us the opportunity to have the greatest segment of the patient population, the adjuvant, should they both be positive. I don't know, Dave, do you want to comment?

Sharon Barr: Sure. And thanks for the question. So the story about Tozorakimab is the same one that we've been telling all along, which is that we think we have a highly differentiated IL-33 biologic. And the reason we think it's differentiated is because our molecule is able to hit both the ST2 pathway as well as the RAGE EGFR pathway and, importantly, to impact signaling downstream of that. And why does that matter? Because being able to inhibit signaling through RAGE EGFR is impacting mucus production and epithelial remodeling. And that's incredibly important in COPD where mucus production drives exacerbations. Exacerbations drive mucus production, and it gives you a vicious cycle. So we think that's a really important component to our IL-33. Now, as you know, we've designed a broad study to allow us to examine the efficacy of Tozorakimab in current and former smokers.

Dave Fredrickson: So thanks, Chris, for the question. Amplify is very much an important part of the growth moving forward for Calquence, and the fact that we've got positive study approval within Europe, and we're anticipating the US approval is important. In general, the desire that we're hearing among hematologists across the multiple malignancies that they treat is to move towards more finite-based therapies. That trend has already happened within Europe. We've got, I think, a very differentiated and strong profile to be able to compete against the existing venetoclax-based options that are available there. In the US, remember that there is not a BCL2 and a BTKI combination finite CLL approach that's been approved. So we have an opportunity in the US to really be the first to come into this space. One in two patients are receiving finite as opposed to treat progression in the US.

Sharon Barr: Right. So this question comes up a lot with Wainua. And I think it really speaks to the interest in novel therapeutics for patients living with ATTR-CM, which is a growing patient population as diagnostic rates improve. Now, we have designed, as I mentioned earlier today, the largest-ever cardiomyopathy study so that we would be powered to do preplanned subgroup analyses. One of those is to be able to differentiate between patients on baseline tafamidis versus those who are not. And our trial will have the largest proportion and number of patients who are on baseline tafamidis. So should we be able to proceed through the statistical hierarchy and answer that question, we have designed a trial that allows us specifically to get at that.

Iskra Reic: Yeah. So no, I think it's a fair question. First of all, I think we truly believe that the market in itself is still quite immature. Yes, injectables have their place. The first orals are moving in. But there's still so much improvement possible. And combination therapies for obesity, overweight people, I think are very crucial in order to help those patients to reduce their risk of cardiovascular events. So that's one big ticket item. Second part is that those products are still not very much used in, let's say, the international markets. If you look at the success of Farxiga, a big part of the success of Farxiga across the three indications is that we have a very large footprint in the international markets. So there's clearly room to maneuver.

Ruud Dobber: Yeah. So no, I think it's a fair question. First of all, I think we truly believe that the market in itself is still quite immature. Yes, injectables have their place. The first orals are moving in. But there's still so much improvement possible. And combination therapies for obesity, overweight people, I think are very crucial in order to help those patients to reduce their risk of cardiovascular events. So that's one big ticket item. Second part is that those products are still not very much used in, let's say, the international markets. If you look at the success of Farxiga, a big part of the success of Farxiga across the three indications is that we have a very large footprint in the international markets. So there's clearly room to maneuver.

Iskra Reic: The third piece is that we are doing a lot of research and development work regarding the quality of weight loss. Yes, it's not only about the percentage of weight loss, but also, are you able to preserve lean muscle, yes or no? Are you able to attach or attack the bad fat, the visceral fat? So I think there are still an enormous amount of possibilities to move to the next generation of anti-obese medicines. And I truly believe that AstraZeneca is one of those companies well-equipped in order to address those questions. I think we have an excellent development and discovery team. You have seen our excitement of the deal we made last week with CSPC, which gives an opportunity to move in long-acting medicines. So I think there's still so much to win in this marketplace. And we're keen to play an important role in that.

Ruud Dobber: The third piece is that we are doing a lot of research and development work regarding the quality of weight loss. Yes, it's not only about the percentage of weight loss, but also, are you able to preserve lean muscle, yes or no? Are you able to attach or attack the bad fat, the visceral fat? So I think there are still an enormous amount of possibilities to move to the next generation of anti-obese medicines. And I truly believe that AstraZeneca is one of those companies well-equipped in order to address those questions. I think we have an excellent development and discovery team. You have seen our excitement of the deal we made last week with CSPC, which gives an opportunity to move in long-acting medicines. So I think there's still so much to win in this marketplace. And we're keen to play an important role in that.

Iskra Reic: Yeah. So let me take that question as a start. First of all, I think the respiratory and immunology portfolio is growing very fast. It was already $9 billion in the course of 2025. There's no reason to believe that products like Breztri, potentially also with asthma, what I said in my prepared remarks, products like Tezspire, Fasenra, are not growing anymore, double-digit, moving forward. So that is, I think, a very important growth driver, not only in the United States and Europe, but also clearly in the international markets. So that's one big ticket item. The other one is clearly that, hopefully, we will see the approval of Baxdrostat in the course of this year as an approval. Now, that, of course, will not immediately generate substantial sales in the course of 2026. It's a highly dominated Part D population.

Ruud Dobber: Yeah. So let me take that question as a start. First of all, I think the respiratory and immunology portfolio is growing very fast. It was already $9 billion in the course of 2025. There's no reason to believe that products like Breztri, potentially also with asthma, what I said in my prepared remarks, products like Tezspire, Fasenra, are not growing anymore, double-digit, moving forward. So that is, I think, a very important growth driver, not only in the United States and Europe, but also clearly in the international markets. So that's one big ticket item. The other one is clearly that, hopefully, we will see the approval of Baxdrostat in the course of this year as an approval. Now, that, of course, will not immediately generate substantial sales in the course of 2026. It's a highly dominated Part D population.

[Analyst] (ATPP): Hi. Rajesh Kumar from ATPP. Looking at 2026, you're sitting at 1.2 times net debt to EBITDA. You've got consensus, which is inching by the minute close to your $80 billion target by 2030. You've got a few patent cliffs soon after that. When you think of capital allocation, people have factored in a higher R&D in their models now. Would you go the organic route to basically support growth beyond 2030, or what sort of firepower do you intend to deploy for acquisitions? The question is basically underpinned by what Steve Scala was asking earlier, that you've gone to obesity at a time where almost no one is sure whether this market has the same kind of growth. And every player is going in. So if you keep going organically into different segments, you might run out of ideas.

Pascal Soriot: So let me make a general comment. Then Aradhana can make more specific comments about capital allocation. One thing I would add to what Ruud said about our GLP-1 and others is cardiometabolic is going to be, is today, the biggest issue mankind is facing. And we are in the early phase of this transformation and the way we can actually tackle this disease, if you want. And beyond our GLP-1, you also have SGLT2. And I really believe in the oral segment. Combining those two, it's going to make a huge difference to how people are treated. I think the foundation treatment of many of these people should be our GLP-1 and then SGLT2, protect the kidneys, the heart, reduce weight, improve metabolic status. And then beyond that, we have other mechanisms, of course. So I think this is going to remain. I mean, it is looking very crowded.

Pascal Soriot: If you look at it, I mean, we are in a good position. We don't have to go after a phase where assets that are proven and cost a fortune and you pay a front, which you're going to get later. We really try to focus our busy activities on earlier assets where we can add value and create shareholder value because we don't need products immediately. We need to invest for the future. And so our strategy really has been to build our pipeline, of course, and add to it, but through earlier busy investments and then add value over time. So that's really our strategy. And as you said, we have a good capacity in terms of raising debt if we wanted to. But we also have to absorb all these products in our P&L, right? So it's not only a question of cash.

[Company Representative] (AstraZeneca): Yeah. So obviously, I think subcutaneous formulations have the opportunity to offer convenience to patients, which I think is very attractive. We're obviously investing in this across our immuno-oncology portfolio, the bispecifics and the ADCs to look at. But also, we have the opportunity to look at subcutaneous formulations also with our ADC portfolio, which is perhaps slightly more surprising to people. But it is possible to do that in certain circumstances. And then, of course, across our T-cell engagers, the actual doses in the T-cell engager portfolio are often low enough that enables a subcutaneous formulation without necessarily requiring something like the hyaluronidase technology as well. So I would just say that this is a trend that you've seen already across multiple different settings and is one that I think will continue to grow across the biologic part of the portfolio.

Aradhana Sarin: Yeah. So obviously, I think subcutaneous formulations have the opportunity to offer convenience to patients, which I think is very attractive. We're obviously investing in this across our immuno-oncology portfolio, the bispecifics and the ADCs to look at. But also, we have the opportunity to look at subcutaneous formulations also with our ADC portfolio, which is perhaps slightly more surprising to people. But it is possible to do that in certain circumstances. And then, of course, across our T-cell engagers, the actual doses in the T-cell engager portfolio are often low enough that enables a subcutaneous formulation without necessarily requiring something like the hyaluronidase technology as well. So I would just say that this is a trend that you've seen already across multiple different settings and is one that I think will continue to grow across the biologic part of the portfolio.

Operator: Sure. So going back to CardioTransform for Wainua, a few things to note about our clinical trial relative to competitors' clinical trial. The first is that the key objective of CardioTransform was to have a balance of naive patients and tafamidis patients. And given that CardioTransform is the largest ever trial run in this setting, we've achieved that. So we'll be able to address that question pending positive results, which we think will be very informative to the clinical community. And the second is that CardioTransform allows for stabilizer drop-ins, so tafamidis drop-ins, which speaks to the remaining unmet medical need. We know that patients who are currently on stabilizers continue to progress on therapy. If that were not true, we wouldn't be able to enroll our trial.

Sharon Barr: Sure. So going back to CardioTransform for Wainua, a few things to note about our clinical trial relative to competitors' clinical trial. The first is that the key objective of CardioTransform was to have a balance of naive patients and tafamidis patients. And given that CardioTransform is the largest ever trial run in this setting, we've achieved that. So we'll be able to address that question pending positive results, which we think will be very informative to the clinical community. And the second is that CardioTransform allows for stabilizer drop-ins, so tafamidis drop-ins, which speaks to the remaining unmet medical need. We know that patients who are currently on stabilizers continue to progress on therapy. If that were not true, we wouldn't be able to enroll our trial.

Pascal Soriot: So the first part of your question was a bit hard to understand. But I think you're asking us about our position in China from a business viewpoint. If that's the question, let me try. And I'm absolutely convinced we need to be in China to collaborate with, partner with Chinese companies, but also to compete and learn to compete with them and how they compete, not only commercially but mostly from an R&D perspective because the world has changed. And they are increasingly becoming a fundamental part of innovation in our industry. And some of them, at some point, will become global companies. So it's fundamental for us to be there. And I think we have quite a good position to do this. We have two R&D centers. We have a strong position, strong profile in China.

Pascal Soriot: A few of the deals we've made, we were able to make because people wanted to work with us. With the recent deal we made, I know that someone else wanted to pay more money. But the company wanted to work with us. So I think that relationship we build with local Chinese companies over time, and our reputation, and our focus, and the focus they know that we have on a few limited diseases have really helped us secure a number of deals over the last few years. Now, what happens, though, is the cost, the price, the price of these busy deals is going up, right? And I assume that would be the case. And that's why after COVID, and when the country reopened, we quickly went there. And we've done quite a number of deals over the last few years at reasonable prices.

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Q4 2025 AstraZeneca PLC Earnings Call

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Q4 2025 AstraZeneca PLC Earnings Call

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