TIDMAZN

RNS Number : 8657S

AstraZeneca PLC

09 November 2023

AstraZeneca

9 November 2023

9M and Q3 2023 results

Strong momentum in the year to date leads to increased guidance for Total Revenue ex COVID-19 medicines and Core EPS

Revenue and EPS summary

 
                                         9M 2023                      Q3 2023 
                                ------  ---------  ---------  ------  -------  ---- 
                                              % Change                  % Change 
                                    $m     Actual    CER [1]      $m   Actual   CER 
-----------------------------   ------  ---------  ---------  ------  -------  ---- 
 
  *    Product Sales            32,466          1          4  11,018        4     5 
 
  *    Alliance Revenue [2]      1,004         99         99     377       76    75 
 
  *    Collaboration Revenue       317       (28)       (28)      97     (46)  (47) 
------------------------------  ------  ---------  ---------  ------  -------  ---- 
Total Revenue                   33,787          2          5  11,492        5     6 
------------------------------  ------  ---------  ---------  ------  -------  ---- 
Total Revenue ex 
 COVID-19                       33,453         12         15  11,492       12    13 
------------------------------  ------  ---------  ---------  ------  -------  ---- 
 
Reported [3] EPS [4]             $3.22    *    2x    *    2x   $0.89     (16)   (6) 
Core [5] EPS                     $5.80         10         17   $1.73        4     9 
------------------------------  ------  ---------  ---------  ------  -------  ---- 
 

Financial performance (9M 2023 figures unless otherwise stated , growth numbers at CER)

   --    Total Revenue $33,787m, up 5% despite a decline of $2,896m from COVID-19 medicines [6] 
   --    Excluding COVID-19 medicines, both Total Revenue and Product Sales increased 15% 

-- Total Revenue from Oncology medicines increased 20%, CVRM [7] 19%, R&I [8] 9%, and Rare Disease 12%

-- Core Product Sales Gross Margin [9] of 82%, up two percentage points, reflecting the decline in sales of lower margin COVID--19 medicines

-- Core Operating Margin of 35% increased by three percentage points including the previously-announced gain from an update to the contractual relationships for Beyfortus, totalling $712m and recorded in Core Other operating income

   --    Core EPS increased 17% to $5.80 

-- FY 2023 Total Revenue excluding COVID-19 medicines now expected to increase by a low-teens percentage at CER

-- FY 2023 Core EPS now expected to increase by a low double-digit to low-teens percentage at CER

Pascal Soriot, Chief Executive Officer, AstraZeneca, said:

"Our company continued its strong growth trajectory in the third quarter with Total Revenue from our non -- COVID-19 medicines up 13% compared to last year.

We initiated several Phase III trials of high-potential molecules this quarter, including for volrustomig, our PD--1/CTLA-4 [10] bispecific antibody. Our portfolio of bispecifics has the potential to replace the first-generation checkpoint inhibitors across a range of cancers. We also initiated a fixed dose combination study of zibotentan with Farxiga which has the potential to significantly improve outcomes for patients with kidney disease not well controlled on current standard of care.

I am excited about the acceleration of our cardiometabolic and obesity pipeline with today's licensing agreement for ECC5004, a potential best-in-class, oral GLP-1RA [11] . This molecule could offer an important advance, as both a monotherapy and in combinations, for the estimated one billion people living with cardiometabolic diseases such as type-2 diabetes and obesity.

Given the momentum in the year to date we have increased our full-year guidance for Total Revenue excluding COVID medicines as well as for Core EPS."

Key milestones achieved since the prior results announcement

   --    Key positive read-outs: datopotamab deruxtecan in metastatic HR [12] -positive breast cancer (TROPION--Breast01); Imfinzi in liver cancer (EMERALD-1); Fasenra in EGPA [13] (MANDARA) 

-- Key regulatory approvals: EU approval for Enhertu in HER2 [14] -mutant lung cancer (DESTINY--Lung02); China approvals for Forxiga in heart failure regardless of ejection fraction (DELIVER); Calquence in r/rCLL [15] (ASC); Soliris in NMOSD [16] . Japan approvals for Lynparza in prostate cancer (PROpel); Enhertu in HER2-mutant lung cancer (DESTINY-Lung02)

-- Other milestones: Tagrisso granted US Breakthrough Therapy Designation and US Priority Review in combination with chemotherapy for treatment of patients with locally advanced or metastatic EGFRm [17] NSCLC [18] (FLAURA2); Enhertu granted US Breakthrough Therapy Designations in HER2-positive colorectal

cancer (DESTINY-CRC01, DESTINY-CRC02) and multiple types of HER2--expressing tumours (DESTINY--PanTumor02)

Guidance

The Company updates its Total Revenue and Core EPS guidance for FY 2023 at CER, based on the average foreign exchange rates through 2022.

Total Revenue is expected to increase by a mid single-digit percentage

(previously low-to-mid single-digit).

Excluding COVID-19 medicines, Total Revenue is expected to increase by a low-teens percentage

(previously low double-digit).

Core EPS is expected to increase by a low double-digit to low-teens percentage

(previously high single-digit to low double-digit).

Other elements of the Income Statement are expected to be broadly in line with the indications issued in the Company's H1 2023 results announcement.

The Company is unable to provide guidance on a Reported basis because it cannot reliably forecast material elements of the Reported results, including any fair value adjustments arising on acquisition-related liabilities, intangible asset impairment charges and legal settlement provisions. Please refer to the cautionary statements section regarding forward-looking statements at the end of this announcement.

Currency impact

If foreign exchange rates for October to December 2023 were to remain at the average rates seen in September 2023, it is anticipated that FY 2023 Total Revenue would incur a low single-digit adverse impact versus the performance at CER, and Core EPS would incur a mid single-digit adverse impact (previously a low-to-mid single-digit adverse impact).

The Company's foreign exchange rate sensitivity analysis is provided in Table 19.

Table 1 : Key elements of Total Revenue performance in Q3 2023

 
  % Change 
 
 
Revenue type                 $m  Actual    CER 
----------------------   ------  ------  -----  ---------------------------------------------------------- 
                                                    * Double-digit growth at CER 
Product Sales            11,018       4      5       in Oncology, CVRM and Rare Disease 
                                                    * $266m for Enhertu (Q3 2022: 
                                                     $160m) 
                                                     * $74m for Tezspire (Q3 2022: 
Alliance Revenue            377      76     75       $26m) 
                                                    * $71m for Beyfortus regulatory 
Collaboration Revenue        97    (46)   (47)       milestone 
                                                    * Excluding COVID-19 medicines, 
                                                     Q3 2023 Total Revenue increased 
Total Revenue            11,492       5      6       by 12% (13% at CER) 
-----------------------  ------  ------  -----  ---------------------------------------------------------- 
                                 Actual 
Therapy areas                $m       %  CER % 
----------------------   ------  ------  -----  ---------------------------------------------------------- 
                                                    * Strong performance across key 
                                                     medicines and regions 
                                                     * No milestones from Lynparza 
Oncology                  4,664      15     17       in the quarter (Q3 2022: $75m) 
                                                    * Farxiga up 41%, Lokelma up 
                                                     30% (31% at CER), roxadustat 
                                                     up 31% (39% CER), Brilinta declined 
CVRM                      2,687      14     16       2% (1% at CER) 
R&I                       1,549       3      5      * Fasenra up 10%, Breztri up 
                                                     66% (69% CER). Saphnelo and Tezspire 
                                                     also continue to grow rapidly 
                                                     during their launch phase, partially 
                                                     offset by a 12% decline (10% 
                                                     at CER) in Symbicort following 
                                                     entry of a generic competitor 
                                                     in the US during the quarter 
V&I [19]                    312    (64)   (65)      * $nil revenue from COVID-19 
                                                     mAbs and Vaxzevria in the quarter 
                                                     (Q3 2022: $536m and $180m respectively) 
                                                     * Beyfortus $138m, including 
                                                     $50m of Product Sales from product 
                                                     supplied to Sanofi, $71m of Collaboration 
                                                     Revenue for a regulatory milestone 
                                                     and $17m of Alliance Revenue 
                                                     for AstraZeneca's share of gross 
                                                     profit outside US 
                                                    * Ultomiris up 50% (49% at CER), 
                                                     partially offset by decline in 
                                                     Soliris of 13% (12% at CER) 
                                                     * Strensiq up 20% (21% at CER) 
                                                     and Koselugo up 81% reflecting 
Rare Disease              1,974      13     14       strong patient demand 
                                                    * Nexium generic competition 
Other Medicines             306    (36)   (32)       in Japan 
Total Revenue            11,492       5      6 
-----------------------  ------  ------  -----  ---------------------------------------------------------- 
                                 Actual 
Regions inc. COVID-19        $m       %  CER % 
----------------------   ------  ------  -----  ---------------------------------------------------------- 
US                        4,859       5      4 
Emerging Markets          2,964       4     12 
-----------------------  ------  ------  ----- 
- China                   1,452     (6)      1 
- Ex-China Emerging 
 Markets                  1,513      15     25 
-----------------------  ------  ------  ----- 
Europe                    2,392      16      9 
Established RoW           1,276    (10)    (6) 
Total Revenue inc.       11,492       5      6 
 COVID-19                                           *    Growth rates impacted by lower sales of COVID--19 
                                                         medicines (see table below) 
----------------------   ------  ------  -----  ---------------------------------------------------------- 
                                 Actual 
Regions ex. COVID-19         $m       %  CER % 
----------------------   ------  ------  -----  ---------------------------------------------------------- 
US                        4,859      12     12 
Emerging Markets          2,964       8     16 
-----------------------  ------  ------  ----- 
- China                   1,452     (6)      1 
-----------------------  ------  ------  ----- 
- Ex-China Emerging 
 Markets                  1,513      25     36 
-----------------------  ------  ------  ----- 
Europe                    2,392      23     16 
Established RoW           1,276       5     10 
Total Revenue ex. 
 COVID-19                11,492      12     13 
-----------------------  ------  ------  -----  ---------------------------------------------------------- 
 

Table 2 : Key elements of financial performance in Q3 2023

 
Metric          Reported   Reported      Core       Core      Comments [20] 
                             change                 change 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
                                                               * Excluding COVID-19 medicines, 
                                                                Q3 2023 Total Revenue increased 
                                                                by 12% (13% at CER) 
                                                                * See Table 1 and the Total 
                           5% Actual              5% Actual     Revenue section of this document 
Total Revenue   $11,492m     6% CER    $11,492m     6% CER      for further details 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
Product           81%     +9pp Actual    81%     +1pp Actual   + Favourable mix of sales 
 Sales Gross               +10pp CER               +1pp CER    from Oncology and Rare Disease 
 Margin                                                        medicines 
                                                               + No sales of COVID-19 medicines 
                                                                *    Increasing mix of products with profit-sharing 
                                                                     arrangements, where AstraZeneca books Product Sale 
                                                               s 
                                                                     and records an expense in COGS [21] for the profit 
                                                                     share due to its partner 
 
 
                                                               * Variations in Product Sales 
                                                               Gross Margin can be expected 
                                                               between periods due to product 
                                                               seasonality, foreign exchange 
                                                               fluctuations and other effects 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
                                                               + Increased investment in 
                                                                the pipeline 
                                                                * Core R&D-to-Total Revenue 
                                                                ratio of 22% 
                                                                (Q3 2022: 21%) 
                                                                * Year-on-year comparisons 
                                                                can be impacted by differences 
                           5% Actual              5% Actual     in cost phasing driven by 
R&D expense     $2,584m      4% CER    $2,485m      5% CER      study starts and execution 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
                                                               + Market development for recent 
                                                                launches and pre-launch activities 
                                                                + Reported SG&A impacted by 
                                                                increased charges for legal 
                                                                provisions, including a $425m 
                                                                charge to provisions relating 
                                                                to a legal settlement in Q3 
                                                                2023 (see Note 6) 
                                                                * Core SG&A-to-Total Revenue 
                                                                ratio of 29% 
                                                                (Q3 2022: 29%) 
                                                                * Year-on-year comparisons 
                          12% Actual              6% Actual     can be impacted by differences 
SG&A expense    $4,800m     12% CER    $3,355m      7% CER      in cost phasing 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
Other             $70m    -34% Actual    $70m    -35% Actual 
operating                   -33% CER               -34% CER      *    Discontinuation of brazikumab development 
income 
(and expense) 
[22] 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
                                                                  * See Product Sales Gross 
                                                  Stable at        Margin, expenses and Other 
Operating                 +6pp Actual               Actual         operating income and expense 
 Margin           17%       +7pp CER     31%       +1pp CER        commentary above 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
                                                               + Higher interest received 
                                                                on cash and short-term investments, 
                                                                broadly offset by higher rates 
Net finance               -9% Actual             -12% Actual    on floating debt and bond 
 expense         $291m      -6% CER     $223m      -7% CER      issuances 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
                          n/m Actual             +1pp Actual      * Variations in the tax rate 
Tax rate          17%       n/m CER      19%       +1pp CER        can be expected between periods 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
                                                                  * Further details of differences 
                          -16% Actual             4% Actual        between Reported and Core 
EPS              $0.89      -6% CER     $1.73       9% CER         are shown in Table 14 
--------------  --------  -----------  --------  -----------  --------------------------------------------------------- 
 

Table 3 : Pipeline highlights since prior results announcement

 
 Event              Medicine       Indication / Trial                   Event 
-----------------  -------------  -----------------------------------  --------------------------- 
 Regulatory         Lynparza       mCRPC [23] (1st-line)                Regulatory approval 
  approvals                         (PROpel)                             (JP) 
  and other 
  regulatory 
  actions 
                    Enhertu        HER2m [24] NSCLC (2nd-line+)         Positive CHMP Opinion 
                                    (DESTINY-Lung02)                     (EU), Regulatory approval 
                                                                         (EU, JP) 
                    Calquence      CLL [25] (ASC)                    Regulatory approval 
                                                                         (CN) 
                    Forxiga        HFpEF [26] (DELIVER)                 Regulatory approval 
                                                                         (CN) 
                    Soliris        NMOSD                                Regulatory approval 
                                                                         (CN) 
                   -------------  -----------------------------------  --------------------------- 
 Regulatory         Tagrisso       EGFR m NSCLC (1st-line)              Regulatory submission 
  submissions                       (FLAURA2)                            (US, EU, CN), Priority 
  or acceptances*                                                        Review (US) 
                    Imfinzi        NSCLC (neoadjuvant)                  Regulatory submission 
                                    (AEGEAN)                             (US) 
                    capivasertib   HR+/HER2-negative breast             Regulatory submission 
                                    cancer (2nd-line) (CAPItello-291)    (CN) 
                    roxadustat     Chemotherapy-induced                 Regulatory submission 
                                    anaemia                              (CN) 
                    FluMist        Self-administered influenza          Regulatory submission 
                                    vaccine                              (US) 
-----------------  -------------  -----------------------------------  --------------------------- 
 Major Phase        Imfinzi        Liver cancer (locoregional)          Primary endpoint met 
  III data                          (EMERALD-1) 
  readouts 
  and other 
  developments 
----------------- 
                    datopotamab    HR+/HER2-breast cancer               Primary endpoint met 
                     deruxtecan     (inoperable and/or metastatic) 
                                    (TROPION-Breast01) 
----------------- 
                    Fasenra        EGPA (MANDARA)                       Primary endpoint met 
-----------------  -------------  -----------------------------------  --------------------------- 
 

*US, EU and China regulatory submission denotes filing acceptance

Upcoming pipeline catalysts

For a table of anticipated timings of key trial readouts, please refer to page 2 of the Clinical Trials Appendix, available on www.astrazeneca.com/investor-relations.html.

Other pipeline updates

Ultomiris discontinued plans to deliver subcutaneous administration for adults with aHUS [27] or PNH [28] . This decision follows persistent efforts to reliably secure the availability of the on-body delivery system.

Table 4 : Phase III trials started since 1 January 2023

 
Medicine             Trial name               Indication 
-------------------  -----------------------  ------------------------------------------- 
datopotamab          AVANZAR                  NSCLC (1st-line) 
 deruxtecan 
                     TROPION-Lung07           Non-squamous NSCLC (1st-line) 
camizestrant         CAMBRIA-1                HR-positive/HER2-negative adjuvant 
                                               breast cancer 
                     CAMBRIA-2                HR-positive/HER2-negative adjuvant 
                                               breast cancer 
capivasertib         CAPItello-292            HR-positive/HER2-negative advanced 
                                               breast cancer 
volrustomig          eVOLVE-Cervical          High-risk locally advanced cervical 
                                               cancer 
                     eVOLVE-Lung02            mNSCLC (1st-line) with PD-L1 [29] 
                                               <50% 
zibo/dapa            ZENITH High Proteinuria  CKD [30] and high proteinuria 
Saphnelo             DAISY                    Systemic sclerosis 
Tezspire             CROSSING                 Eosinophilic oesophagitis 
Breztri              LITHOS                   Mild to moderate asthma 
Breztri              ATHLOS                   COPD [31] 
pMDI [32] portfolio  HFO1234ze                Mucociliary clearance in healthy volunteers 
pMDI portfolio       HFO1234ze                Well-controlled or partially-controlled 
                                               asthma 
tozorakimab          MIRANDA                  Symptomatic COPD 
AZD3152              SUPERNOVA                COVID-19 prophylaxis 
Ultomiris            ARTEMIS                  Cardiac surgery-associated acute kidney 
                                               injury 
-------------------  -----------------------  ------------------------------------------- 
 

Corporate and business development

In September, AstraZeneca and Verge Genomics (Verge) announced a multi-target collaboration to identify novel drug targets for rare neurodegenerative and neuromuscular diseases. Verge is a clinical-stage drug discovery company using artificial intelligence and patient tissue data. Under the terms of the four-year agreement, Verge will receive up to $42 million, consisting of upfront fee, equity, and near-term payments, with potential downstream royalties. AstraZeneca will take an equity position in Verge.

In September, AstraZeneca completed the definitive purchase and licence agreement for a portfolio of preclinical rare disease gene therapy programmes and enabling technologies from Pfizer Inc. The agreement has a total consideration of up to $1bn, plus tiered royalties on sales.

Cellectis

In November, AstraZeneca announced a collaboration and investment agreement with Cellectis, a clinical-stage biotechnology company, to accelerate the development of next generation therapeutics in areas of high unmet need, including oncology, immunology and rare diseases. Under the terms of the collaboration agreement, AstraZeneca will leverage the Cellectis proprietary gene editing technologies and manufacturing capabilities, to design novel cell and gene therapy products, strengthening AstraZeneca's growing offering in this space. As part of the agreement, 25 genetic targets have been exclusively reserved for AstraZeneca, from which up to 10 candidate products could be explored for development.

In Q4 2023, Cellectis will receive an initial payment of $105m from AstraZeneca, which comprises a $25m upfront cash payment under the terms of a research collaboration agreement and an $80m equity investment. A further $140m equity investment is expected to close in early 2024 subject to the signing of a final binding agreement. Post-closing of this second investment, AstraZeneca will hold a total equity stake of approximately 44% in Cellectis. Under the terms of the research collaboration, Cellectis is also eligible to receive an investigational new drug option fee and development, regulatory and sales-related milestone payments, ranging from $70m up to $220m, per each of the 10 candidate products, plus tiered royalties.

Eccogene licence

In November, AstraZeneca and Eccogene entered into an exclusive licence agreement for ECC5004, an investigational oral once-daily glucagon-like peptide 1 receptor agonist (GLP-1RA) for the treatment of obesity, type-2 diabetes and other cardiometabolic conditions . Preliminary results from the Phase I trial have shown a differentiating clinical profile for ECC5004, with good tolerability and encouraging glucose and body weight reduction across the dose levels tested compared to placebo.

Under the terms of the agreement, Eccogene will receive an initial upfront payment of $185m and up to an additional $1.825bn in future clinical, regulatory, and commercial milestones and tiered royalties. AstraZeneca is granted exclusive global rights for the development and commercialisation of ECC5004 for any indication in all territories except China, where Eccogene has the right to co-develop and co-commercialise alongside AstraZeneca.

Sustainability summary

This quarter AstraZeneca entered into long-term renewable energy partnerships in the UK and Sweden. The UK agreement will support the transition away from fossil fuels at Company sites in Macclesfield, Cambridge, Luton and Speke. The Sweden agreement corresponds to approximately 80 percent of total electricity needs at both the Company's Gothenburg site and at Södertälje, one of the world's largest drug manufacturing centres. See the Sustainability section for further details.

Conference call

A conference call and webcast for investors and analysts will begin today, 9 November 2023, at 14:00 UK time. Details can be accessed via astrazeneca.com .

Reporting calendar

The Company intends to publish its full year and fourth quarter results on Thursday 8 February 2024.

Operating and financial review

All narrative on growth and results in this section is based on actual foreign exchange rates, and financial figures are in US$ millions ($m), unless stated otherwise. The performance shown in this announcement covers the nine-month period to 30 September 2023 ('the period' or '9M 2023') compared to the nine-month period to 30 September 2022 ('9M 2022'), or the three-month period to 30 September 2023 ('the quarter' or 'Q3 2023') compared to the three-month period to 30 September 2022 ('Q3 2022'), unless stated otherwise.

Core financial measures, EBITDA, Net debt, Product Sales Gross Margin (formerly termed as Gross Margin), Operating Margin and CER are non-GAAP financial measures because they cannot be derived directly from the Group's Interim financial statements. Management believes that these non-GAAP financial measures, when provided in combination with Reported results, provide investors and analysts with helpful supplementary information to understand better the financial performance and position of the Group on a comparable basis from period to period. These non-GAAP financial measures are not a substitute for, or superior to, financial measures prepared in accordance with GAAP.

Core financial measures are adjusted to exclude certain significant items, such as:

-- Amortisation and impairment of intangible assets, including impairment reversals but excluding any charges relating to IT assets

-- Charges and provisions related to restructuring programmes, which includes charges that relate to the impact of restructuring programmes on capitalised IT assets

-- Alexion acquisition-related items, primarily fair value adjustments on acquired inventories and fair value impact of replacement employee share awards

-- Other specified items, principally the imputed finance charges and fair value movements relating to contingent consideration on business combinations or asset acquisitions, imputed finance charges and remeasurement adjustments on certain Other payables arising from intangible asset acquisitions, legal settlements and remeasurement adjustments relating to Other payables assumed from the Alexion acquisition

   --    The tax effects of the adjustments above are excluded from the Core Tax charge 

Details on the nature of Core financial measures are provided on page 63 of the Annual Report and Form 20-F Information 2022 .

Reference should be made to the Reconciliation of Reported to Core financial measures table included in the financial performance section in this announcement.

Product Sales Gross Margin (formerly termed Gross Margin) is the percentage by which Product Sales exceeds the Cost of Sales, calculated by dividing the difference between the two by the sales figure. The calculation of Reported and Core Product Sales Gross Margin excludes the impact of Alliance Revenue and Collaboration Revenue and any associated costs, thereby reflecting the underlying performance of Product Sales.

EBITDA is defined as Reported Profit before tax after adding back Net finance expense, results from Joint ventures and associates and charges for Depreciation, amortisation and impairment. Reference should be made to the Reconciliation of Reported Profit before tax to EBITDA included in the financial performance section in this announcement.

Operating Margin is defined as Operating profit as a percentage of Total Revenue.

Net debt is defined as Interest-bearing loans and borrowings and Lease liabilities, net of Cash and cash equivalents, Other investments, and Net derivative financial instruments. Reference should be made to Note 3 'Net debt' included in the Notes to the Interim financial statements in this announcement.

The Company strongly encourages investors and analysts not to rely on any single financial measure, but to review AstraZeneca's financial statements, including the Notes thereto, and other available Company reports, carefully and in their entirety.

Due to rounding, the sum of a number of dollar values and percentages in this announcement may not agree to totals.

Total Revenue

Table 5 : Therapy area and medicine performance - Product Sales and Total Revenue

 
                                     9M 2023                        Q3 2023 
                          -----------------------------  ----------------------------- 
                                             % Change                       % Change 
Product Sales                 $m  % Total  Actual   CER      $m  % Total  Actual   CER 
-----------------------   ------  -------  ------  ----  ------  -------  ------  ---- 
  Oncology                12,692       38      17    20   4,389       38      16    17 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  - Tagrisso               4,380       13       7    10   1,465       13       5     6 
  - Imfinzi [33]           3,102        9      53    56   1,126       10      53    54 
  - Lynparza               2,070        6       6     9     702        6       7     8 
  - Calquence              1,839        5      25    26     654        6      16    15 
  - Enhertu                  178        1     >3x   >3x      73        1     >3x   >3x 
  - Orpathys                  33        -     (3)     4      12        -       6    13 
  - Zoladex                  699        2     (3)     5     239        2       -     5 
  - Faslodex                 217        1    (16)  (10)      64        1    (21)  (16) 
  - Others                   174        1    (36)  (32)      54        -    (33)  (30) 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  BioPharmaceuticals: 
   CVRM                    7,887       23      14    18   2,683       23      14    16 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  - Farxiga                4,358       13      36    40   1,554       14      41    41 
  - Brilinta                 996        3     (2)     -     331        3     (2)   (1) 
  - Lokelma                  300        1      44    49     102        1      30    31 
  - roxadustat               208        1      41    51      74        1      31    39 
  - Andexxa                  129        -      16    19      40        -     (3)   (5) 
  - Crestor                  860        3       4    11     275        2     (1)     6 
  - Seloken/Toprol-XL        496        1    (30)  (23)     153        1    (36)  (29) 
  - Onglyza                  180        1    (12)   (8)      53        -    (20)  (17) 
  - Bydureon                 123        -    (40)  (40)      35        -    (48)  (49) 
  - Others                   237        1    (16)  (13)      66        1    (23)  (21) 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  BioPharmaceuticals: 
   R&I                     4,517       13       5     8   1,451       13       2     3 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  - Symbicort              1,842        5     (4)   (1)     555        5    (12)  (10) 
  - Fasenra                1,134        3      12    13     389        3      10    10 
  - Breztri                  478        1      69    73     171        1      66    69 
  - Saphnelo                 191        1     >2x   >2x      76        1     >2x   >2x 
  - Tezspire                  51        -    >10x  >10x      21        -    >10x  >10x 
  - Pulmicort                493        1       3    10     148        1       2     7 
  - Bevespi                   42        -     (2)   (2)      13        -     (5)   (4) 
  - Daliresp/Daxas            41        -    (74)  (74)      11        -    (79)  (79) 
  - Others                   245        1    (30)  (27)      67        1    (31)  (28) 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  BioPharmaceuticals: 
   V&I                       667        2    (82)  (81)     224        2    (74)  (74) 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  - COVID-19 mAbs [34]       126        -    (91)  (90)       -        -     n/m   n/m 
  - Vaxzevria                 28        -    (98)  (98)       -        -     n/m   n/m 
  - Beyfortus                 52        -     n/m   n/m      50        -     n/m   n/m 
  - Synagis                  383        1       -     6      99        1     (5)   (1) 
  - FluMist                   78        -      32    28      75        1      28    23 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  Rare Disease             5,793       17      11    12   1,974       17      13    14 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  - Soliris                2,429        7    (17)  (15)     781        7    (13)  (12) 
  - Ultomiris              2,141        6      56    58     777        7      50    49 
  - Strensiq                 847        3      23    24     285        2      20    21 
 
     *    Koselugo           246        1      65    65      87        1      81    81 
  - Kanuma                   130        -      17    18      44        -      21    19 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  Other Medicines            910        3    (27)  (22)     297        3    (27)  (22) 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
  - Nexium                   735        2    (25)  (20)     244        2    (22)  (17) 
  - Others                   175        1    (33)  (31)      53        -    (43)  (41) 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
Product Sales             32,466       96       1     4  11,018       96       4     5 
Alliance Revenue           1,004        3      99    99     377        3      76    75 
Collaboration Revenue        317        1    (28)  (28)      97        1    (46)  (47) 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
Total Revenue             33,787      100       2     5  11,492      100       5     6 
------------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
 

Table 6 : Alliance Revenue

 
                                    9M 2023                     Q3 2023 
                          ---------------------------  ------------------------- 
                                           % Change                   % Change 
                             $m  % Total  Actual  CER   $m  % Total  Actual  CER 
-----------------------   -----  -------  ------  ---  ---  -------  ------  --- 
Enhertu                     741       74     >2x  >2x  266       70      66   65 
Tezspire                    179       18     >4x  >4x   74       20     >2x  >2x 
Vaxzevria : royalties         -        -     n/m  n/m    -        -     n/m  n/m 
Other royalty income         59        6      16   15   18        5      10    9 
Other Alliance Revenue       25        2     >2x  >2x   19        5     >3x  >3x 
Total                     1,004      100      99   99  377      100      76   75 
------------------------  -----  -------  ------  ---  ---  -------  ------  --- 
 

Table 7 : Collaboration Revenue

 
                                       9M 2023                     Q3 2023 
                              --------------------------  ------------------------- 
                                              % Change                   % Change 
                               $m  % Total  Actual   CER  $m  % Total  Actual   CER 
---------------------------   ---  -------  ------  ----      -------  ------  ---- 
COVID-19 mAbs : licence 
 fees                         180       57     n/m   n/m   -        -     n/m   n/m 
Farxiga : sales milestones     28        9     n/m   n/m   3        3     n/m   n/m 
tralokinumab : sales 
 milestones                    20        6    (82)  (82)  20       21    (50)  (50) 
Lynparza : regulatory           -        -     n/m   n/m   -        -     n/m   n/m 
 milestones 
Beyfortus : regulatory 
 milestones                    71       22     n/m   n/m  71       73     n/m   n/m 
Other Collaboration 
 Revenue                       18        6    (76)  (76)   3        3    (95)  (95) 
Total                         317      100    (28)  (28)  97      100    (46)  (47) 
----------------------------  ---  -------  ------  ----      -------  ------  ---- 
 

Table 8 : Total Revenue by therapy area

 
                                 9M 2023                        Q3 2023 
                      -----------------------------  ----------------------------- 
                                         % Change                       % Change 
                          $m  % Total  Actual   CER      $m  % Total  Actual   CER 
-------------------   ------  -------  ------  ----  ------  -------  ------  ---- 
Oncology              13,458       40      17    20   4,664       41      15    17 
BioPharmaceuticals    13,599       40    (10)   (7)   4,548       40     (4)   (2) 
--------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
- CVRM                 7,926       23      14    19   2,687       23      14    16 
- R&I                  4,729       14       6     9   1,549       13       3     5 
- V&I                    944        3    (74)  (73)     312        3    (64)  (65) 
--------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
Rare Disease           5,793       17      11    12   1,974       17      13    14 
Other Medicines          937        3    (30)  (26)     306        3    (36)  (32) 
Total                 33,787      100       2     5  11,492      100       5     6 
--------------------  ------  -------  ------  ----  ------  -------  ------  ---- 
 

Table 9 : Total Revenue by region

 
                               9M 2023                        Q3 2023 
                    -----------------------------  ----------------------------- 
                                       % Change                       % Change 
                        $m  % Total   Actual  CER      $m  % Total   Actual  CER 
-----------------   ------  -------  -------  ---  ------  -------  -------  --- 
US                  13,940       41        6    6   4,859       42        5    4 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
Emerging Markets     9,242       27        3   10   2,964       26        4   12 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
- China              4,495       13      (2)    5   1,452       13      (6)    1 
- Ex-China           4,747       14        8   15   1,513       13       15   25 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
Europe               6,765       20        5    5   2,392       21       16    9 
Established RoW      3,840       11     (16)  (9)   1,276       11     (10)  (6) 
Total               33,787      100        2    5  11,492      100        5    6 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
 

Table 10 : Total Revenue by region - excluding COVID-19 medicines

 
                               9M 2023                        Q3 2023 
                    -----------------------------  ----------------------------- 
                                       % Change                       % Change 
                        $m  % Total   Actual  CER      $m  % Total   Actual  CER 
-----------------   ------  -------  -------  ---  ------  -------  -------  --- 
US                  13,940       42       14   14   4,859       42       12   12 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
Emerging Markets     9,038       27       12   20   2,964       26        8   16 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
- China              4,495       13      (1)    6   1,452       13      (6)    1 
- Ex-China           4,544       14       28   37   1,513       13       25   36 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
Europe               6,748       20       14   14   2,392       21       23   16 
Established RoW      3,726       11        -    8   1,276       11        5   10 
Total               33,453      100       12   15  11,492      100       12   13 
------------------  ------  -------  -------  ---  ------  -------  -------  --- 
 

Oncology

Oncology Total Revenue of $13,458m in 9M 2023 increased by 17% (20% at CER), representing 40% of overall Total Revenue (9M 2022: 35%). There was no Lynparza Collaboration Revenue in 9M 2023 (9M 2022: $250m), and Enhertu Alliance Revenue was $741m (9M 2022: $335m). Product Sales increased by 17% (20% at CER) in 9M 2023 to $12,692m, reflecting new launches and expanded reimbursement across key brands; partially offset by declines in legacy medicines.

Tagrisso

 
Total Revenue    Worldwide     US    Emerging Markets  Europe  Established 
                                                                   RoW 
-------------    ---------    -----  ----------------  ------  ----------- 
9M 2023 $m         4,380      1,679       1,261         821        619 
Actual change       7%         14%          4%           6%       (4%) 
CER change          10%        14%         11%           6%        5% 
-------------    ---------    -----  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    -------------------------------------------------------------- 
Worldwide               * Increased global demand for Tagrisso in adjuvant and 
                         1st-line settings combined with expanded reimbursement 
                         in the adjuvant setting 
US                      * Continued growth in demand in 1st-line and adjuvant 
                         settings 
Emerging Markets        * Growing demand in adjuvant and 1st-line settings offset 
                         by impact of NRDL [35] renewal price in China effective 
                         March 2023, some additional impact in China in the third 
                         quarter resulting from reduced promotional activities 
                         following the government campaign announced at the end 
                         of July 2023 
Europe                  * Increased demand growth in 1st-line and growing adjuvant 
                         demand 
Established             * Increased demand in 1st-line and adjuvant settings 
 RoW                     offset by mandatory price reduction in Japan effective 
                         June 2023 
----------------    -------------------------------------------------------------- 
 

Imfinzi and Imjudo

 
Total Revenue    Worldwide     US    Emerging Markets  Europe  Established 
                                                                   RoW 
-------------    ---------    -----  ----------------  ------  ----------- 
9M 2023 $m         3,102      1,708        270          547        577 
Actual change       53%        55%         20%          36%        90% 
CER change          56%        55%         31%          35%        >2x 
-------------    ---------    -----  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ------------------------------------------------------------------ 
Worldwide               * Includes $161m of Total Revenue from Imjudo, which 
                         launched in Q4 2022 following approvals in the US for 
                         patients with unresectable liver cancer (HIMALAYA) and 
                         Stage IV NSCLC (POSEIDON) 
                         * Growth across all regions, driven by recent launches 
                         (BTC [36] , HCC [37] , Stage IV NSCLC) and established 
                         indications (Stage III NSCLC, SCLC [38] ) 
US                      * Continued demand growth for BTC and HCC indications, 
                         increased uptake in SCLC 
Emerging Markets        * Growth across markets driven by BTC launches and recovery 
                         of diagnosis and treatment rates following the COVID-19 
                         pandemic, slightly offset by decreased promotional activities 
                         in China due to the government campaign announced at 
                         the end of July 2023 
Europe                  * Competitive share gain in SCLC, and expanded reimbursement 
                         for new launch indications (BTC, HCC and Stage IV NSCLC) 
Established             * Growth driven by launch of HCC and BTC and increased 
 RoW                     share across indications in Japan 
----------------    ------------------------------------------------------------------ 
 

Lynparza

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m         2,070      902        409          543        216 
Actual change      (6%)       1%         14%         (27%)       7% 
CER change         (3%)       1%         24%         (27%)       16% 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Product Sales    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m         2,070      902        409          543        216 
Actual change       6%        1%         14%          10%        7% 
CER change          9%        1%         24%          10%        16% 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ------------------------------------------------------------------ 
Worldwide               * Lynparza remains the leading medicine in the PARP 
                         [39] inhibitor class globally across four tumour types 
                         (ovarian, breast, prostate, pancreatic), as measured 
                         by total prescription volume 
                         * No regulatory milestones received in the period 
US                      * Continued share growth within the PARP inhibitor class, 
                         offset by declining class use and the label restriction 
                         in 2nd-line ovarian cancer effective September 2023 
Emerging Markets        * Increased demand, offset by price reduction in China 
                         associated with NRDL renewal that took effect March 
                         2023 for ovarian cancer indications (PSR [40] and BRCAm 
                         [41] 1st-line maintenance) and new NRDL enlistment in 
                         prostate cancer (PROfound) as well as some impact in 
                         the third quarter resulting from reduced promotional 
                         activities following the government campaign announced 
                         end of July 2023 
Europe                  * Demand growth from increased uptake in 1st-line HRD-positive 
                         ovarian cancer, gBRCAm [42] HER2--negative early breast 
                         cancer and mCRPC, offset by reduced use in 2nd-line 
                         ovarian cancer and pricing 
                         * Total Revenue in the prior year period included $250m 
                         of milestones 
Established             * Growth driven by increased uptake in testing and use 
 RoW                     in 1st-line HRD-positive ovarian cancer 
----------------    ------------------------------------------------------------------ 
 

Enhert u

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          919       518        179          204        17 
Actual change       >2x       >2x        >3x          >2x        >3x 
CER change          >2x       >2x        >3x          >2x        >3x 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    -------------------------------------------------------------------- 
Worldwide               * Combined sales of Enhertu, recorded by Daiichi Sankyo 
                         Company Limited (Daiichi Sankyo) and AstraZeneca, amounted 
                         to $1,844m in 9M 2023 (9M 2022: $750m) 
                         * AstraZeneca's Total Revenue of $919m in the period 
                         includes $741m of Alliance Revenue from its share of 
                         gross profit and royalties in territories where Daiichi 
                         Sankyo records product sales 
US                      * US in-market sales, recorded by Daiichi Sankyo, amounted 
                         to $1,087m in 9M 2023 (9M 2022: $532m) 
                         * Increased demand across launched indications. Q3 2023 
                         impacted by HER2-low bolus depletion 
Emerging Markets        * Continued uptake driven by recent approvals and launches 
                         including strong demand growth in China following HER2-positive 
                         and HER2-low breast cancer launches 
Europe                  * Continued growth driven by increasing adoption in 
                         HER2-positive and HER2-low metastatic breast cancer 
Established             * In Japan, AstraZeneca receives a mid-single-digit 
 RoW                     percentage royalty on sales made by Daiichi Sankyo 
----------------    -------------------------------------------------------------------- 
 

Calquence

 
Total Revenue    Worldwide     US    Emerging Markets  Europe  Established 
                                                                   RoW 
-------------    ---------    -----  ----------------  ------  ----------- 
9M 2023 $m         1,839      1,337         69          353        80 
Actual change       25%        12%         >2x          76%        64% 
CER change          26%        12%         >2x          77%        74% 
-------------    ---------    -----  ----------------  ------  ----------- 
 
 
Region        Drivers and commentary 
---------    -------------------------------------------------------------- 
Worldwide        * Increased penetration globally; leading BTKi [43] 
                  in key markets 
US               * Leadership maintained in growing BTKi class, sustained 
                  leading share in the front-line setting, offset by some 
                  competitive impact in relapsed refractory setting and 
                  increased utilisation of free goods program in Q3 
EU               * Solid growth continued amidst growing competitive 
                  pressure 
                  * Increased new patients starts following expanded access 
                  in key markets 
---------    -------------------------------------------------------------- 
 

Orpathys

Orpathys Total Revenue of $34m declined 1% (6% increase at CER), (9M 2022: $35m), following its inclusion in the updated NRDL in China from March 2023, for the treatment of patients with NSCLC with MET exon 14 skipping alterations.

Other Oncology medicines

 
  9M 2023  Change 
 
 
Total Revenue     $m   Actual   CER 
---------------   ---  ------  -----  ------------------------------------------------- 
Zoladex           723   (2%)    5%        * Underlying growth due to continued demand 
                                           growth in Emerging Markets, partially 
                                           offset by price reduction in China following 
                                           NRDL renewal 
Faslodex          217  (16%)   (10%)      * Generic competition 
Other Oncology    174  (36%)   (32%)      * Generic competition 
----------------  ---  ------  -----  ------------------------------------------------- 
 

BioPharmaceuticals

BioPharmaceuticals Total Revenue decreased by 10% (7% at CER) in 9M 2023 to $13,599m, representing 40% of overall Total Revenue (9M 2022: 45%). The decline was driven by COVID-19 medicines, partially offset by strong growth from Farxiga and newer R&I medicines.

BioPharmaceuticals - CVRM

CVRM Total Revenue increased by 14% (19% at CER) to $7,926m in 9M 2023, driven by the strong Farxiga performance, and represented 23% of overall Total Revenue (9M 2022: 21%).

Farxiga

 
Total Revenue    Worldwide     US    Emerging Markets  Europe  Established 
                                                                   RoW 
-------------    ---------    -----  ----------------  ------  ----------- 
9M 2023 $m         4,389      1,000       1,655        1,356       378 
Actual change       37%        34%         35%          42%        35% 
CER change          41%        34%         43%          41%        45% 
-------------    ---------    -----  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    -------------------------------------------------------------------- 
Worldwide               * Farxiga volume is growing faster than the overall 
                         SGLT2 [44] market in most major regions, fuelled by 
                         launches in heart failure and CKD 
                         * Additional benefit from continued growth in the overall 
                         SGLT2 inhibitor class 
US                      * Growth driven by heart failure and CKD for patients 
                         with and without T2D [45] resulting in an increasing 
                         market share 
Emerging Markets        * Solid growth despite generic competition in some markets 
Europe                  * Benefited from the addition of cardiovascular outcomes 
                         trial data to the label and growth in HFrEF [46] , CKD 
                         and the HFpEF approval in February 2023. ESC [47] guidelines 
                         updated in August 2023 to also include treatment of 
                         patients with HFpEF 
                         * Continued strong volume growth in the quarter and 
                         expanded class leadership in several key markets 
Established             * In Japan, AstraZeneca sells to collaborator Ono Pharmaceutical 
 RoW                     Co., Ltd, which records in-market sales. Continued volume 
                         growth driven by HF and CKD launches. Generics launched 
                         in Canada in the third quarter 
----------------    -------------------------------------------------------------------- 
 

Brilinta

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          996       551        224          203        18 
Actual change      (2%)       2%          1%          (5%)      (54%) 
CER change           -        2%         10%          (5%)      (51%) 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ------------------------------------------------------------ 
US                      * Sales in the third quarter benefitted from channel 
                         inventory movements 
Emerging Markets        * Sales declined by 16% (4% at CER) in the third quarter 
                         driven by tender phasing 
Europe                  * Sales partly impacted by clawbacks 
Established             * Sales decline driven by generic entry in Canada 
 RoW 
----------------    ------------------------------------------------------------ 
 

Lokelma

Lokelma Total Revenue increased 44% (49% at CER) to $300m with strong demand growth in all regions.

Roxadustat

Total Revenue increased 40% (50% at CER) to $212m, benefitting from increased demand in both the dialysis- and non-dialysis-dependent populations

Andexxa

Andexxa Total Revenue increased 7% (9% at CER) to $129m.

Other CVRM medicines

 
  9M 2023  Change 
 
 
Total Revenue    $m   Actual   CER 
--------------   ---  ------  -----  ------------------------------------------------- 
Crestor          862    4%     11%       * Continued sales growth in Emerging Markets, 
                                          partly offset by declines in the US and 
                                          Established RoW 
Seloken          496  (30%)   (23%)      * Ongoing impact of China VBP implementation 
Onglyza          180  (12%)   (8%)       * Continued decline for DPP-IV class 
Bydureon         123  (40%)   (40%)      * Continued competitive pressures 
Other CVRM       237  (16%)   (13%) 
---------------  ---  ------  -----  ------------------------------------------------- 
 

BioPharmaceuticals - R&I

Total Revenue of $4,729m from R&I medicines in 9M 2023 increased 6% (9% at CER) and represented 14% of overall Total Revenue (9M 2022: 14%). This reflected growth in Fasenra, Tezspire, Breztri and Saphnelo, offsetting a decline in Symbicort and other mature brands.

Fasenra

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m         1,134      718         48          262        106 
Actual change       12%       11%        62%          14%       (1%) 
CER change          13%       11%        69%          14%        6% 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ------------------------------------------------------------------ 
Worldwide               * Retained market share leadership in severe eosinophilic 
                         asthma across major markets 
US                      * Expanded leadership in eosinophilic asthma and maintained 
                         total share in a growing market, leading to double-digit 
                         volume growth , partially offset by managed market price 
                         difference 
Emerging Markets        * Continued strong volume growth driven by launch acceleration 
                         across key markets 
Europe                  * Expanded leadership in severe eosinophilic asthma, 
                         with strong volume growth partially offset by price 
                         in some markets 
Established             * Maintained class leadership in Japan while market 
 RoW                     growth remained stable 
----------------    ------------------------------------------------------------------ 
 

Breztri

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          478       263        123           55        37 
Actual change       69%       60%        73%          >2x        48% 
CER change          73%       60%        86%          >2x        58% 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    -------------------------------------------------------------- 
Worldwide               * Continued to gain market share within the growing 
                         FDC [48] triple class across major markets 
US                      * Consistent share growth within the FDC triple class 
                         in new-to-brand [49] and the total market 
Emerging Markets        * Maintained market share leadership in China with strong 
                         triple FDC class penetration 
Europe                  * Sustained growth across markets as new launches continue 
                         to progress 
Established             * Increased market share gains within COPD in Japan 
 RoW                     and strong launch performance in Canada 
----------------    -------------------------------------------------------------- 
 

Tezspire

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          230       179         -            28        23 
Actual change       >5x       >4x         -           n/m        n/m 
CER change          >5x       >4x         -           n/m        n/m 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region          Drivers and commentary 
-----------    ------------------------------------------------------------------- 
Worldwide          * Tezspire is approved in the US, EU and Japan (as well 
                    as other countries) for the treatment of severe asthma 
                    without biomarker or phenotypic limitation 
                    * Amgen records sales in the US, and AstraZeneca records 
                    its share of US gross profits as Alliance Revenue. AstraZeneca 
                    books Product Sales in markets outside the US 
                    * Combined sales of Tezspire by AstraZeneca and Amgen 
                    were $438m in 9M 2023 
US                 * Increased new-to-brand market share with majority 
                    of patients new to biologics 
                    * Pre-filled pen approved in February 2023 
Europe             * Achieved and maintained new-to-brand leadership in 
                    key markets 
                    * Pre-filled pen approved in January 2023 
Established        * Japan maintained new-to-brand leadership 
 RoW 
-----------    ------------------------------------------------------------------- 
 

Saphnelo

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          191       178         1            5          7 
Actual change       >2x       >2x        n/m          >4x        >3x 
CER change          >2x       >2x        n/m          >4x        >3x 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region        Drivers and commentary 
---------    ----------------------------------------------------------- 
Worldwide        * D emand acceleration in the US, and additional growth 
                  driven by ongoing launches in Europe and Japan 
---------    ----------------------------------------------------------- 
 

Symbicort

 
Total Revenue    Worldwide     US    Emerging Markets  Europe  Established 
                                                                   RoW 
-------------    ---------    -----  ----------------  ------  ----------- 
9M 2023 $m         1,842       589         600          408        245 
Actual change      (4%)       (18%)        26%          (8%)      (12%) 
CER change         (1%)       (18%)        36%          (8%)      (7%) 
-------------    ---------    -----  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ------------------------------------------------------------ 
Worldwide               * Symbicort remained the global market leader within 
                         a stable ICS [50] /LABA [51] class 
US                      * Generic competition entered the US market in the third 
                         quarter, leading to price and volume share declines 
Emerging Markets        * Strong underlying demand. Growth in China benefitted 
                         from the post-COVID-19 recovery at the start of the 
                         year 
Europe                  * Continued price and volume erosion from generics and 
                         a slowing overall market 
Established             * Generic erosion in Japan 
 RoW 
----------------    ------------------------------------------------------------ 
 

Other R&I medicines

 
  9M 2023    Change 
 
 
Total Revenue    $m   Actual   CER 
--------------   ---  ------  -----  ---------------------------------------------- 
Pulmicort        493    3%     10%       * 80% of revenues from Emerging Markets 
                                          * China market share has stabilised, with 
                                          VBP having been in effect for over 12 
                                          months 
Bevespi          42    (2%)   (2%) 
Daliresp         41   (74%)   (74%)      * Impacted by uptake of multiple generics 
                                          following loss of exclusivity in the US 
Other R&I        278  (41%)   (38%)      * Collaboration Revenue of $20m (9M 2022: 
                                          $110m) 
                                          * Product Sales of $245m decreased 30% 
                                          (27% at CER) due to generic competition 
---------------  ---  ------  -----  ---------------------------------------------- 
 

BioPharmaceuticals - V&I

Total Revenue from V&I medicines declined by 74% (73% at CER) to $944m (9M 2022: $3,673m) and represented 3% of overall Total Revenue (9M 2022: 11%). In Q3 2023, no revenue was generated from COVID--19 medicines.

COVID-19 mAbs

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          306        -         185           7         114 
Actual change      (79%)      n/m        11%         (97%)      (51%) 
CER change         (78%)      n/m        11%         (96%)      (45%) 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ---------------------------------------------------------- 
Worldwide               * All Product Sales in 9M 2023 were derived from sales 
                         of Evusheld in the first quarter 
Emerging Markets        * $180m license fee from Serum Institute of India in 
                         Q2 2023 recorded as Collaboration Revenue 
----------------    ---------------------------------------------------------- 
 

Vaxzevria

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          28         -          18           10         - 
Actual change      (98%)      n/m       (98%)        (97%)       n/m 
CER change         (98%)      n/m       (98%)        (97%)       n/m 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region        Drivers and commentary 
---------    ------------------------------------------------------- 
Worldwide        * Revenue in the period decreased by 98% due to the 
                  conclusion of Vaxzevria contracts 
---------    ------------------------------------------------------- 
 

Other V&I medicines

 
  9M 2023  Change 
 
 
Total Revenue    $m   Actual  CER 
-------------    ---  ------  ---  ----------------------------------------------------- 
Beyfortus        139   n/m    n/m      * In Q3 2023 AstraZeneca reported $50m 
                                        of Product Sales, $17m of Alliance Revenue, 
                                        and also $71m of Collaboration Revenue 
                                        relating to a regulatory milestone 
                                        * The Product Sales relates to sales to 
                                        Sanofi of Beyfortus product manufactured 
                                        by AstraZeneca. In Q3 Product Sales benefitted 
                                        from stock building for the 2023-2024 
                                        RSV [52] season 
                                        * The Alliance Revenue consists of AstraZeneca's 
                                        50% share of gross profits on sales of 
                                        Beyfortus in major markets outside the 
                                        US. AstraZeneca will also book 25% of 
                                        revenues in rest of world markets. AstraZeneca 
                                        has no participation in US profits or 
                                        losses 
Synagis          383    -     6%       * Performance broadly in-line with prior 
                                        year 
FluMist          88    49%    45%      * $10m milestone received from Daiichi 
                                        Sankyo in the second quarter following 
                                        FluMist approval in Japan 
-------------    ---  ------  ---  ----------------------------------------------------- 
 

Rare Disease

Total Revenue from Rare Disease medicines increased by 11% (12% at CER) in 9M 2023 to $5,793m, representing 17% of overall Total Revenue (9M 2022: 16%).

Performance was driven by the continued growth and durability of the C5 [53] franchise, and also the strength of Strensiq and Koselugo patient demand.

Ultomiris

 
Total Revenue    Worldwide     US    Emerging Markets  Europe  Established 
                                                                   RoW 
-------------    ---------    -----  ----------------  ------  ----------- 
9M 2023 $m         2,141      1,260         47          495        339 
Actual change       56%        63%         38%          43%        54% 
CER change          58%        63%         39%          42%        68% 
-------------    ---------    -----  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ------------------------------------------------------------ 
Worldwide               * Growth in neurology indications, expansion into new 
                         markets and continued conversion from Soliris 
                         * Quarter-on-quarter variability in revenue growth can 
                         be expected due to Ultomiris every eight-week dosing 
                         schedule and lower average annual treatment cost per 
                         patient compared to Soliris 
US                      * Growth in naïve patients in gMG [54] and NMOSD 
                         as well as successful conversion from Soliris across 
                         shared indications 
Emerging Markets        * Continued progress following launches in new markets 
Europe                  * Strong demand generation following launches in new 
                         markets, particularly in neurology indications, as well 
                         as accelerated conversion from Soliris in key markets 
Established             * Continued conversion from Soliris and strong demand 
 RoW                     following new launches, particularly NMOSD in Japan 
----------------    ------------------------------------------------------------ 
 

Soliris

 
Total Revenue    Worldwide     US    Emerging Markets  Europe  Established 
                                                                   RoW 
-------------    ---------    -----  ----------------  ------  ----------- 
9M 2023 $m         2,429      1,313        338          530        248 
Actual change      (17%)      (22%)        55%         (15%)      (36%) 
CER change         (15%)      (22%)        74%         (15%)      (31%) 
-------------    ---------    -----  ----------------  ------  ----------- 
 
 
Region               Drivers and commentary 
----------------    ---------------------------------------------------------- 
US                      * Decline driven by successful conversion of Soliris 
                         patients to Ultomiris in PNH, aHUS and gMG, partially 
                         offset by Soliris growth in NMOSD 
Emerging Markets        * Continued progress, launching in new markets 
Europe,                 * Decline driven by successful conversion from Soliris 
 Established             to Ultomiris, partially offset by growth in NMOSD 
 RoW 
----------------    ---------------------------------------------------------- 
 

Strensiq

 
Total Revenue    Worldwide    US   Emerging Markets  Europe  Established 
                                                                 RoW 
-------------    ---------    ---  ----------------  ------  ----------- 
9M 2023 $m          847       690         29           64        64 
Actual change       23%       26%        14%           9%        12% 
CER change          24%       26%        16%           8%        22% 
-------------    ---------    ---  ----------------  ------  ----------- 
 
 
Region        Drivers and commentary 
---------    ------------------------------------------------------------ 
Worldwide        * Strong patient demand particularly in the US and Japan 
---------    ------------------------------------------------------------ 
 

Other Rare Disease medicines

 
  9M 2023  Change 
 
 
Total Revenue    $m   Actual  CER  Commentary 
-------------    ---  ------  ---  ---------------------------------------------- 
Koselugo         246   65%    65%      * Driven by patient demand and expansion 
                                        in new markets 
Kanuma           130   17%    18%      * Continued demand growth in ex-US markets 
-------------    ---  ------  ---  ---------------------------------------------- 
 

Other medicines (outside the main therapy areas)

 
  9M 2023  Change 
 
 
Total Revenue    $m   Actual   CER   Commentary 
-------------    ---  ------  -----  --------------------------------------------- 
Nexium           748  (30%)   (25%)      * Generic launches in Japan in the latter 
                                          part of 2022 
Others           189  (31%)   (29%)      * Continued impact of generic competition 
-------------    ---  ------  -----  --------------------------------------------- 
 

Financial performance

Table 11 : Reported Profit and Loss

 
  9M 2023  9M 2022  % Change  Q3 2023  Q3 2022  % Change 
 
 
                                 $m        $m  Actual    CER       $m       $m  Actual    CER 
------------------------   --------  --------  ------  -----  -------  -------  ------  ----- 
Total Revenue                33,787    33,144       2      5   11,492   10,982       5      6 
- Product Sales              32,466    32,200       1      4   11,018   10,590       4      5 
- Alliance Revenue            1,004       504      99     99      377      214      76     75 
- Collaboration Revenue         317       440    (28)   (28)       97      178    (46)   (47) 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Cost of sales               (5,960)   (9,491)    (37)   (38)  (2,095)  (2,982)    (30)   (31) 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Gross profit                 27,827    23,653      18     22    9,397    8,000      17     20 
Product Sales Gross 
 Margin                       81.6%     70.5%   +11pp  +12pp    81.0%    71.8%    +9pp  +10pp 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Distribution expense          (394)     (380)       4      6    (129)    (126)       2      2 
% Total Revenue                1.2%      1.1%       -      -     1.1%     1.1%       -      - 
R&D expense                 (7,862)   (7,137)      10     12  (2,584)  (2,458)       5      4 
% Total Revenue               23.3%     21.5%    -2pp   -2pp    22.5%    22.4%       -      - 
SG&A expense               (13,845)  (13,798)       -      2  (4,800)  (4,277)      12     12 
% Total Revenue               41.0%     41.6%    +1pp   +1pp    41.8%    38.9%    -3pp   -2pp 
OOI [55] & expense            1,233       325     >3x    >3x       70      106    (34)   (33) 
% Total Revenue                3.6%      1.0%    +3pp   +3pp     0.6%     1.0%       -      - 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Operating profit              6,959     2,663     >2x    >2x    1,954    1,245      57     69 
Operating Margin              20.6%      8.0%   +13pp  +14pp    17.0%    11.3%    +6pp   +7pp 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Net finance expense           (945)     (936)       1      1    (291)    (324)     (9)    (6) 
Joint ventures and 
 associates                    (12)       (4)     >2x    >2x     (11)        1     n/m    n/m 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Profit before tax             6,002     1,723     >3x    >3x    1,652      922      79     91 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Taxation                    (1,000)       668     n/m    n/m    (274)      720     n/m    n/m 
Tax rate                        17%      -39%                     17%     -78% 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
Profit after tax              5,002     2,391     >2x    >2x    1,378    1,642    (16)    (6) 
Earnings per share            $3.22     $1.54     >2x    >2x    $0.89    $1.06    (16)    (6) 
-------------------------  --------  --------  ------  -----  -------  -------  ------  ----- 
 

Table 12 : Reconciliation of Reported Profit before tax to EBITDA

 
  9M 2023  9M 2022  % Change  Q3 2023  Q3 2022  % Change 
 
 
                                  $m     $m  Actual  CER     $m     $m  Actual  CER 
---------------------------   ------  -----  ------  ---  -----  -----  ------  --- 
Reported Profit before 
 tax                           6,002  1,723     >3x  >3x  1,652    922      79   91 
Net finance expense              945    936       1    1    291    324     (9)  (6) 
Joint ventures and 
 associates                       12      4     >2x  >2x     11    (1)     n/m  n/m 
Depreciation, amortisation 
 and impairment                4,060  4,000       2    3  1,282  1,334     (4)  (4) 
EBITDA                        11,019  6,663      65   77  3,236  2,579      25   32 
----------------------------  ------  -----  ------  ---  -----  -----  ------  --- 
 

EBITDA for the comparative 9M 2022 was negatively impacted by $3,175m unwind of inventory fair value uplift recognised on the acquisition of Alexion. EBITDA for the comparative Q3 2022 was negatively impacted by $857m unwind of inventory fair value uplift recognised on the acquisition of Alexion. This unwind had a $78m negative impact on 9M 2023 and a $23m negative impact on Q3 2023. It will continue to be minimal and will unwind fully over the next quarter.

Table 13 : Reconciliation of Reported to Core financial measures: 9M 2023

 
9M 2023    Reported  Restructuring           Intangible  Acquisition  Other  Core    Core 
                                     Asset Amortisation   of Alexion   [56]         % Change 
                                          & Impairments 
 
 
                           $m     $m     $m     $m     $m        $m  Actual   CER 
------------------   --------  -----  -----  -----  -----  --------  ------  ---- 
Gross profit           27,827    133     24     82    (4)    28,062       4     8 
Product Sales 
 Gross Margin           81.6%                                 82.4%    +1pp  +2pp 
-------------------  --------  -----  -----  -----  -----  --------  ------  ---- 
Distribution 
 expense                (394)      -      -      -      -     (394)       4     6 
R&D expense           (7,862)    117    386      5      1   (7,353)       5     7 
SG&A expense         (13,845)    163  2,863      7  1,107   (9,705)       5     8 
-------------------  --------  -----  -----  -----  -----  --------  ------  ---- 
Total operating 
 expense             (22,101)    280  3,249     12  1,108  (17,452)       5     7 
-------------------  --------  -----  -----  -----  -----  --------  ------  ---- 
Other operating 
 income & expense       1,233   (61)      -      -      -     1,172     >3x   >3x 
-------------------  --------  -----  -----  -----  -----  --------  ------  ---- 
Operating 
 profit                 6,959    352  3,273     94  1,104    11,782      10    16 
Operating 
 Margin                 20.6%                                 34.9%    +2pp  +3pp 
-------------------  --------  -----  -----  -----  -----  --------  ------  ---- 
Net finance 
 expense                (945)      -      -      -    220     (725)     (1)   (2) 
Taxation              (1,000)   (81)  (617)   (22)  (329)   (2,049)      12    19 
EPS                     $3.22  $0.17  $1.72  $0.05  $0.64     $5.80      10    17 
-------------------  --------  -----  -----  -----  -----  --------  ------  ---- 
 

Table 14 : Reconciliation of Reported to Core financial measures: Q3 2023

 
Q3 2023    Reported  Restructuring           Intangible  Acquisition  Other  Core    Core 
                                     Asset Amortisation   of Alexion   [57]         % Change 
                                          & Impairments 
 
 
                          $m     $m     $m     $m     $m       $m  Actual   CER 
------------------   -------  -----  -----  -----  -----  -------  ------  ---- 
Gross profit           9,397     15      8     25    (1)    9,444       6     7 
Product Sales 
 Gross Margin          81.0%                                81.4%    +1pp  +1pp 
-------------------  -------  -----  -----  -----  -----  -------  ------  ---- 
Distribution 
 expense               (129)      -      -      -      -    (129)       3     2 
R&D expense          (2,584)     48     49      2      -  (2,485)       5     5 
SG&A expense         (4,800)     61    957      3    424  (3,355)       6     7 
-------------------  -------  -----  -----  -----  -----  -------  ------  ---- 
Total operating 
 expense             (7,513)    109  1,006      5    424  (5,969)       6     6 
-------------------  -------  -----  -----  -----  -----  -------  ------  ---- 
Other operating 
 income & expense         70      -      -      -      -       70    (35)  (34) 
-------------------  -------  -----  -----  -----  -----  -------  ------  ---- 
Operating 
 profit                1,954    124  1,014     30    423    3,545       4     9 
Operating 
 Margin                17.0%                                30.8%       -  +1pp 
-------------------  -------  -----  -----  -----  -----  -------  ------  ---- 
Net finance 
 expense               (291)      -      -      -     68    (223)    (12)   (7) 
Taxation               (274)   (29)  (189)    (7)  (125)    (624)       8    13 
EPS                    $0.89  $0.06  $0.53  $0.01  $0.24    $1.73       4     9 
-------------------  -------  -----  -----  -----  -----  -------  ------  ---- 
 

Profit and Loss drivers

Gross profit

-- The calculation of Reported and Core Product Sales Gross Margin excludes the impact of Alliance Revenue and Collaboration Revenue. The change in Product Sales Gross Margin (Reported and Core) in the nine months was impacted by:

-- Positive effects from product mix. The increased contribution from Rare Disease and Oncology medicines had a positive impact on the Product Sales Gross Margin. Vaxzevria sales, which are dilutive to Product Sales Gross Margin, declined substantially

-- Dilutive effects from product mix. The rising contribution of Product Sales with profit sharing arrangements (Lynparza, Enhertu and Tezspire) has a negative impact on Product Sales Gross Margin because AstraZeneca records product revenues in certain markets but pays away a share of the gross profit to its collaboration partners

-- Dilutive effects from geographic mix. Emerging Markets, where Product Sales Gross Margin tends to be below the Company average, grew as a proportion of Total Revenue excluding COVID-19 medicines

-- Variations in Product Sales Gross Margin performance between periods can continue to be expected due to product seasonality, foreign exchange fluctuations and other effects.

R&D expense

   --    The change in R&D expense (Reported and Core) in the period was impacted by: 

-- Recent positive data read-outs for several high priority medicines that have ungated late-stage trials

   --    Investment in platforms, new technology and capabilities to enhance R&D productivity 
   --    Reported R&D expense was also impacted by intangible asset impairments 

SG&A expense

-- The change in SG&A expense (Reported and Core) in the period was driven primarily by market development activities for launches

-- Reported SG&A expense was also impacted by amortisation of intangible assets related to the Alexion acquisition and other acquisitions and collaborations

-- Reported SG&A expense was also impacted by a $510m charge to provisions relating to a legal settlement in Q2 2023 with Bristol-Myers Squibb and Ono Pharmaceutical, and a $425m charge to provisions in Q3 2023 for product liability litigations related to Nexium and Prilosec. The prior nine month period was impacted by a $775m legal settlement with Chugai Pharmaceutical Co. Ltd

Other operating income and expense

-- Reported and Core Other operating income and expense in the period included a $712m gain resulting from an update to the contractual relationships for Beyfortus (nirsevimab), a $241m gain on the disposal of the US rights to Pulmicort Flexhaler, and other disposal proceeds on the sale of tangible assets, and royalties on certain medicines

-- In the third quarter Reported and Core Other operating income decreased by $36m and $37m respectively, principally due to the discontinuation of brazikumab development. Prior to this, AstraZeneca received quarterly development contributions for brazikumab development from AbbVie, which were recognised as Other operating income

Net finance expense

-- Reported Net finance expense was impacted by the discount unwind on acquisition-related liabilities. Core Net finance expense reduced by 1% (2% at CER) with higher interest received on cash and short-term investments, broadly offset by higher rates on floating debt and bond issuances

Taxation

-- The effective Reported Tax rate for the nine months to 30 September 2023 was 17% (9M 2022: (39%)) and the effective Core Tax rate was 19% (9M 2022: 18%). The Q3 2022 effective Reported Tax rate was lower as it included a one-time favourable adjustment of $883m relating to deferred taxes arising from an internal reorganisation to integrate the Alexion business

-- The cash tax paid for the nine months to 30 September 2023 was $1,710m (9M 2022: $1,335m), representing 28% of Reported Profit before tax (9M 2022: 77%)

-- On 20 June 2023, Finance (No.2) Act 2023 was substantively enacted in the UK, introducing a global minimum effective tax rate of 15%. The legislation implements a domestic top-up tax and a multinational top-up tax, effective for accounting periods starting on or after 31 December 2023. The Company is currently assessing the impact of these rules upon its financial statements. The Company has applied the exception under the IAS 12 'Income Taxes' amendment for recognising and disclosing information about deferred tax assets and liabilities related to top-up income taxes

Table 15 : Cash Flow summary

 
                                                    9M 2023  9M 2022   Change 
                                                         $m       $m       $m 
                                                    -------  -------  ------- 
Reported Operating profit                             6,959    2,663    4,296 
Depreciation, amortisation and impairment             4,060    4,000       60 
Decrease in working capital and short-term 
 provisions                                             150    3,458  (3,308) 
Gains on disposal of intangible assets                (247)     (88)    (159) 
Fair value movements on contingent consideration 
 arising from 
 business combinations                                  202      293     (91) 
Non-cash and other movements                          (623)    (973)      350 
Interest paid                                         (826)    (608)    (218) 
Taxation paid                                       (1,710)  (1,335)    (375) 
--------------------------------------------------  -------  -------  ------- 
Net cash inflow from operating activities             7,965    7,410      555 
--------------------------------------------------  -------  -------  ------- 
Net cash inflow before financing activities           4,978    4,699      279 
--------------------------------------------------  -------  -------  ------- 
Net cash outflow from financing activities          (6,276)  (6,465)      189 
--------------------------------------------------  -------  -------  ------- 
 

In 9M 2022, the Reported Operating profit of $2,663m included a negative impact of $3,175m relating to the unwind of the inventory fair value uplift recognised on the acquisition of Alexion. This was offset by a corresponding item (positive impact of $3,175m) in Decrease in working capital and short-term provisions. Overall, the unwind of the fair value uplift had no impact on Net cash inflow from operating activities. This unwind had $78m negative impact on 9M 2023 Reported Operating profit and offsetting positive impact on Working capital movements, and will continue to be minimal in the next quarter. As a result of the update to the contractual relationships between AstraZeneca, Sobi and Sanofi relating to the future sales of Beyfortus (nirsevimab) in the US, a gain of $712m has been recorded in non-cash and other movements, with no overall net impact on the Net cash inflow from operating activities.

Included within Net cash inflow before financing activities is a movement in the profit-participation liability of $190m, including a cash receipt from Sobi in Q1 2023 after achievement of a regulatory milestone. The associated cash flow is presented within investing activities.

The decrease in Net cash outflow from financing activities of $189m is primarily driven by the Issue of loans and borrowings of $3,816m, offset by the increase in Repayment of loans and borrowings of $3,394m.

Capital expenditure

Capital expenditure amounted to $836m in the nine months to 30 September 2023 (9M 2022: $719m).

Table 16 : Net debt summary

 
                                                          At 30      At 31      At 30 
                                                       Sep 2023   Dec 2022   Sep 2022 
                                                             $m         $m         $m 
---------------------------------------------------   ---------  ---------  --------- 
Cash and cash equivalents                                 4,871      6,166      4,458 
Other investments                                           244        239        440 
----------------------------------------------------  ---------  ---------  --------- 
Cash and investments                                      5,115      6,405      4,898 
----------------------------------------------------  ---------  ---------  --------- 
Overdrafts and short-term borrowings                      (515)      (350)      (743) 
Lease liabilities                                         (979)      (953)      (878) 
Current instalments of loans                            (4,857)    (4,964)    (4,665) 
Non-current instalments of loans                       (22,225)   (22,965)   (23,013) 
----------------------------------------------------  ---------  ---------  --------- 
Interest-bearing loans and borrowings (Gross debt)     (28,576)   (29,232)   (29,299) 
----------------------------------------------------  ---------  ---------  --------- 
Net derivatives                                              90       (96)      (141) 
Net debt                                               (23,371)   (22,923)   (24,542) 
----------------------------------------------------  ---------  ---------  --------- 
 

Net debt increased by $448m in the nine months to 30 September 2023 to $23,371m. Details of the committed undrawn bank facilities are disclosed within the going concern section of Note 1. Details of the Company's solicited credit ratings and further details on Net Debt are disclosed in Note 3.

Capital allocation

The Board's aim is to continue to strike a balance between the interests of the business, financial creditors and the Company's shareholders. The Company's capital allocation priorities include: investing in the business and pipeline; maintaining a strong, investment-grade credit rating; potential value-enhancing business development opportunities; and supporting the progressive dividend policy.

In approving the declaration of dividends, the Board considers both the liquidity of the company and the level of reserves legally available for distribution. Dividends are paid to shareholders from AstraZeneca PLC, a Group holding company with no direct operations. The ability of AstraZeneca PLC to make shareholder distributions is dependent on the creation of profits for distribution and the receipt of funds from subsidiary companies. The consolidated Group reserves set out in the Condensed consolidated statement of financial position do not reflect the profit available for distribution to the shareholders of AstraZeneca PLC.

Summarised financial information for guarantee of securities of subsidiaries

AstraZeneca Finance LLC ("AstraZeneca Finance") is the issuer of 0.700% Notes due 2024, 1.200% Notes due 2026, 4.875% Notes due 2028, 1.750% Notes due 2028, 4.900% Notes due 2030, 2.250% Notes due 2031 and 4.875% Notes due 2033 (the "AstraZeneca Finance Notes"). Each series of AstraZeneca Finance Notes has been fully and unconditionally guaranteed by AstraZeneca PLC. AstraZeneca Finance is 100% owned by AstraZeneca PLC and each of the guarantees by AstraZeneca PLC is full and unconditional and joint and several.

The AstraZeneca Finance Notes are senior unsecured obligations of AstraZeneca Finance and rank equally with all of AstraZeneca Finance's existing and future senior unsecured and unsubordinated indebtedness. The guarantee by AstraZeneca PLC of the AstraZeneca Finance Notes is the senior unsecured obligation of AstraZeneca PLC and ranks equally with all of AstraZeneca PLC's existing and future senior unsecured and unsubordinated indebtedness. Each guarantee by AstraZeneca PLC is effectively subordinated to any secured indebtedness of AstraZeneca PLC to the extent of the value of the assets securing such indebtedness. The AstraZeneca Finance Notes are structurally subordinated to indebtedness and other liabilities of the subsidiaries of AstraZeneca PLC, none of which guarantee the AstraZeneca Finance Notes.

AstraZeneca PLC manages substantially all of its operations through divisions, branches and/or investments in subsidiaries and affiliates. Accordingly, the ability of AstraZeneca PLC to service its debt and guarantee obligations is also dependent upon the earnings of its subsidiaries, affiliates, branches and divisions, whether by dividends, distributions, loans or otherwise.

Please refer to the consolidated financial statements of AstraZeneca PLC in our Annual Report on Form 20-F and reports on Form 6-K with our quarterly financial results as filed or furnished with the SEC [58] for further financial information regarding AstraZeneca PLC and its consolidated subsidiaries. For further details, terms and conditions of the AstraZeneca Finance Notes please refer to AstraZeneca PLC's reports on Form 6-K furnished to the SEC on 3 March 2023 and 28 May 2021.

Pursuant to Rule 13-01 and Rule 3-10 of Regulation S-X under the Securities Act of 1933, as amended (the "Securities Act"), we present below the summary financial information for AstraZeneca PLC, as Guarantor, excluding its consolidated subsidiaries, and AstraZeneca Finance, as the issuer, excluding its consolidated subsidiaries. The following summary financial information of AstraZeneca PLC and AstraZeneca Finance is presented on a combined basis and transactions between the combining entities have been eliminated. Financial information for non-guarantor entities has been excluded. Intercompany balances and transactions between the obligor group and the non-obligor subsidiaries are presented on separate lines.

Table 17 : Obligor group summarised Statement of comprehensive income

 
                                                                     9M 2023  9M 2022 
                                                                          $m       $m 
                                                                     -------  ------- 
Total Revenue                                                              -        - 
Gross profit                                                               -        - 
Operating loss                                                           (2)      (3) 
Loss for the period                                                    (695)    (404) 
Transactions with subsidiaries that are not issuers or guarantors      9,758      502 
-------------------------------------------------------------------  -------  ------- 
 

Table 18 : Obligor group summarised Statement of financial position

 
                                                                    At 30 Sep 2023  At 30 Sep 2022 
                                                                                $m              $m 
-----------------------------------------------------------------   --------------  -------------- 
Current assets                                                                   6               5 
Non-current assets                                                               -               - 
Current liabilities                                                        (4,760)         (3,067) 
Non-current liabilities                                                   (22,077)        (22,556) 
Amounts due from subsidiaries that are not issuers or guarantors            12,921           7,349 
Amounts due to subsidiaries that are not issuers or guarantors               (295)           (301) 
------------------------------------------------------------------  --------------  -------------- 
 

Foreign exchange

The Company's transactional currency exposures on working-capital balances, which typically extend for up to three months, are hedged where practicable using forward foreign exchange contracts against the individual companies' reporting currency. Foreign exchange gains and losses on forward contracts for transactional hedging are taken to profit or loss. In addition, the Company's external dividend payments, paid principally in pounds sterling and Swedish krona, are fully hedged from announcement to payment date.

Table 19 : Currency sensitivities

The Company provides the following currency-sensitivity information:

 
         Average        Annual impact ($m) of 5% strengthening (FY2023 average rate vs. FY 2022 average) ([59]) 
       rates vs. USD 
      --------------    --------------------------------------------------------------------------------------- 
 
 
Currency       Primary                FY         YTD  Change      Sep 2023  Change [63]         Total         Core 
               Relevance       2022 [60]   2023 [61]     (%)          [62]          (%)       Revenue    Operating 
                                                                                                            Profit 
EUR            Total Revenue        0.95        0.92       3          0.94            1           323          159 
CNY            Total Revenue        6.74        7.04     (4)          7.30          (8)           309          174 
JPY            Total Revenue      131.59      138.18     (5)        147.71         (11)           181          122 
Other ([64])                                                                                      385          202 
----------------------------  ----------  ----------  ------  ------------  -----------  ------------  ----------- 
               Operating 
GBP             expense             0.81        0.80       1          0.81            0            46         (92) 
               Operating 
SEK             expense            10.12       10.59     (4)         11.08          (9)             7         (55) 
 

Sustainability

Since the last quarterly report, AstraZeneca:

Access to healthcare

-- Hosted the first dedicated side-event on Chronic Kidney Disease (CKD) "How improving kidney health can transform health systems for all" during the 78th United Nations General Assembly (UNGA) meeting in New York, with public, private and patient voices represented. During UNGA, the Company also engaged with the cancer community on access, services within universal health coverage (UHC) and the need for investment in cancer and non-communicable diseases (NCDs)

   --    Continued to make a high-level contribution to the work of the Partnership for Health System Sustainability and Resilience (PHSSR), which provides a valuable platform for dialogue with policymakers, the Company and other stakeholders. In Canada, a workshop with participation from the Minister of Health of Quebec fed into the discussions on transformation of Quebec's health system. In Japan, AstraZeneca's Chair Michel Demaré participated in a PHSSR roundtable co-hosted by the British Embassy, which focused on health equity and digital healthcare. PHSSR also engaged at leading global and regional healthcare events, including the European Health Forum Gastein, the Global Congress on Population, Health and Development, ICHOM 2023 and the World Health Summit in Berlin 

-- Ruud Dobber, EVP BioPharmaceuticals Business Unit, delivered the opening keynote address at the POLITICO EU Healthcare Summit in Brussels where he called for bold action and collaboration across the healthcare ecosystem to support early diagnosis and treatment. He highlighted the need for regulatory frameworks that accelerate access to medical innovation, as well as the urgency to combat the effects of the climate crisis on health

-- Marked World Heart Day and the ninth anniversary of Healthy Heart Africa (HHA)'s launch, by convening African health stakeholders to take stock of the programme's achievements and share insights on the critical role of public-private partnerships in supporting primary healthcare. Speakers included representatives of Ministries of Health from nine countries and HHA implementing partners, with more than 70 attendees. HHA has trained more than 11,000 healthcare workers and conducted over 43 million blood pressure screenings, identifying 8.6 million with elevated blood pressure since launch, moving closer to the programme ambition of 10 million by 2025, and achieving one million screenings per month since February 2023 (data as at end of September 2023)

-- Young Health Programme is now active in 40 countries, with new programmes launched in Costa Rica and Taiwan. Through the Young Health Programme Impact Fellowship, the Company supported a delegation of 17 young health leaders from 13 countries to attend One Young World 2023 in Belfast. Three of these changemakers joined AstraZeneca leadership in on-stage appearances, discussing their impact on NCD prevention for young people in their communities. AstraZeneca and Plan International UK were awarded 'Highly Commended' at the Corporate Engagement Awards for Best Educational Programme

Environmental protection

-- Entered into an agreement in Sweden with Statkraft, Europe's largest renewable energy producer, on wind power deliveries that will increase the supply of renewable electricity in Sweden. The agreement is based on the commissioning of new wind farms. Under the agreement, AstraZeneca commits to purchasing 200 gigawatt-hours per year for 10 years, equivalent to two terawatt-hours. This corresponds to approximately 80 percent of total electricity needs at both the Company's Gothenburg site and at Södertälje, the largest manufacturing centre and one of the world's largest drug manufacturing centres

-- Agreed a 15-year partnership with Future Biogas to establish the first unsubsidised industrial-scale supply of biomethane in the UK. This biomethane will support the transition away from fossil fuels at Company sites in Macclesfield, Cambridge, Luton and Speke. A new biomethane plant will add renewable energy capacity to existing UK infrastructure and supply more than 100 gigawatt hours of biomethane, equivalent to the heat needs of more than 8,000 homes. Using crops grown locally as part of diverse crop rotations, the plant will also contribute to the development of a circular economy, supporting UK farms with sustainable land management practices

-- In China, CEO Pascal Soriot and EVP and China President Leon Wang witnessed the launch of the Sustainable Markets Initiative (SMI) China Council Health Working Group. Inspired by the SMI Health Systems Task Force, members of this new partnership will collaborate to accelerate the delivery of a net zero health system, for domestic and global impact. AstraZeneca China will co-chair this Working Group, which comprises China-based organisations and Chinese affiliates of global pharmaceutical companies

-- In the U.S., advocated for climate action and sustainable healthcare reform during Climate Week NYC by convening high-level representatives from the US government, WHO, civil society and philanthropy at a plenary event with Climate Group on "Addressing the climate-health-equity nexus: The path to a sustainable future". The Company also discussed accelerating health sector decarbonisation at the Forbes Sustainability Leaders Summit in a session on "How the healthcare industry is responding to climate change" alongside US National Academy of Medicine President Dr. Victor J. Dzau. Furthermore, the Company participated in an event on water stewardship

-- Contributed to a joint report on Advancing water stewardship through supplier collaboration in partnership with the World Wide Fund for Nature

-- Ranked in first position for climate action in a new STAT Report "Climate rankings: How top drug companies measure up in combating climate change", which noted that "Companies like AstraZeneca are the exception in an industry that, as a whole, could be doing much more to measure and report its climate impacts, according to organizations that pool data on this topic"

-- Received the EcoVadis Gold Medal for 2023, improving on the 2022 Silver rating. AstraZeneca was scored in four areas: Environment, Ethics, Labor and Human Rights, and Sustainable Procurement, and received an Advanced rating in the Environment and Human Rights categories

-- Recognised with two awards from My Green Lab and the International Institute for Sustainable Laboratories' in the 2023 Freezer Challenge: the Top Organization Award and the Small Size Lab Award for our site in Gothenburg, Sweden

Ethics and transparency

-- Received three supplier diversity awards from the Diversity for Science Alliance including 2023 Company of the year

-- Launched Global Ethics training ahead of Global Ethics Day in October, an annual reminder to employees of the Company's commitment to high ethical standards in all areas of AstraZeneca's business, marking the day with local and virtual events and an #EmpoweringEthics employee social campaign

-- Held an internal Power of Diversity panel discussion with members of the Company's Global Inclusion & Diversity (I&D) Council on the topic of putting an I&D lens over our AZ Values. This focused on building a sense of belonging through allyship, mutual support and the sharing of diverse perspectives. Supporting materials were made available through employee communication channels

Research and development

This section covers R&D events and milestones that have occurred since the prior results announcement on 28 July 2023, up to and including events on 8 November 2023.

A comprehensive view of AstraZeneca's pipeline of medicines in human trials can be found in the latest Clinical Trials Appendix, available on www.astrazeneca.com/investor-relations . The Clinical Trials Appendix includes tables with details of the ongoing clinical trials for AstraZeneca medicines and new molecular entities in the pipeline.

Oncology

AstraZeneca presented new data across its diverse portfolio of cancer medicines at two major medical congresses during the quarter: the 2023 World Conference on Lung Cancer (WCLC) in September and the 2023 European Society of Medical Oncology (ESMO) in October. At WCLC, AstraZeneca presented more than 40 abstracts featuring eight approved and potential new medicines, including nine oral presentations and a late-breaking plenary Presidential Symposium presentation of results from the FLAURA2 Phase III trial of Tagrisso plus chemotherapy in 1st-line EGFRm NSCLC. At ESMO, AstraZeneca presented nearly 100 abstracts featuring 19 approved and potential new medicines including 26 oral presentations and two late-breaking Presidential Symposia of the TROPION-Lung01 and TROPION-Breast 01 Phase III trials of monotherapy Dato-DXd versus conventional chemotherapy in lung and breast cancers.

Tagrisso

 
Event                         Commentary 
-------------  -----------    -------------------------------------------------------- 
Breakthrough   US             Tagrisso in combination with chemotherapy for 
 Designation                   the treatment of adult patients with locally 
                               advanced or metastatic EGFRm lung cancer. (FLAURA2, 
                               August 2023) 
Presentation:  FLAURA2        Interim analysis of the Phase III FLAURA2 trial, 
 WCLC                          presented at WCLC, demonstrated Tagrisso plus 
                               chemotherapy extended median PFS [65] by nearly 
                               nine months and reduced the risk of disease progression 
                               by 38% in EGFRm advanced lung cancer vs. Tagrisso 
                               monotherapy. (September 2023) 
Priority       US             Tagrisso in combination with chemotherapy for 
 Review                        the treatment of adult patients with locally 
                               advanced or metastatic EGFRm lung cancer. (FLAURA2, 
                               October 2023) 
Presentation:  FLAURA2 CNS    Prespecified exploratory analysis of the Phase 
 ESMO           analysis       III FLAURA2 trial, presented at ESMO, showed 
                               Tagrisso plus chemotherapy demonstrated a 42% 
                               improvement in CNS [66] PFS vs. Tagrisso monotherapy 
                               in patients with EGFRm advanced lung cancer and 
                               brain metastases at baseline, representing 40% 
                               of patients in the trial, as assessed by blinded 
                               independent central review. (October 2023) 
-------------  -----------    -------------------------------------------------------- 
 

Imfinzi and Imjudo

 
Event                        Commentary 
-------------  ----------    ------------------------------------------------------ 
Positive       EU            The Committee for Medicinal Products for Human 
 Opinion                      Use (CHMP) issued a positive opinion for Type 
                              II Extension of Indication Variation for Imfinzi 
                              as monotherapy for the first line treatment of 
                              adults with advanced or unresectable HCC. (HIIMALAYA, 
                              July 2023) 
Presentation:  MATTERHORN    Interim analysis of the Phase III MATTERHORN 
 ESMO                         III trial, presented at ESMO, showed that Imfinzi 
                              in combination with standard-of-care FLOT [67] 
                              neoadjuvant chemotherapy demonstrated a statistically 
                              significant and clinically meaningful 12% improvement 
                              in the key secondary endpoint of pCR [68] vs. 
                              neoadjuvant chemotherapy alone for patients with 
                              resectable, early-stage and locally gastric and 
                              GEJ [69] cancers. (October 2023) 
Phase III      EMERALD-1     Positive high-level results from the EMERALD-1 
 data readout                 Phase III trial showed Imfinzi in combination 
                              with TACE [70] and bevacizumab demonstrated a 
                              statistically significant and clinically meaningful 
                              improvement in the primary endpoint of PFS versus 
                              TACE alone in patients with HCC eligible for 
                              embolisation. The trial continues to follow the 
                              secondary endpoint of OS [71] . (November 2023) 
-------------  ----------    ------------------------------------------------------ 
 

Lynparza

 
Event                               Commentary 
-----------------  -------------    ------------------------------------------------------ 
Approval           Japan            Lynparza in combination with abiraterone and 
                                     prednisolone for the treatment of adult patients 
                                     with BRCAm mCRPC. (August 2023) 
Label restriction  US               Restriction of the Lynparza indication for the 
                                     maintenance treatment of adult patients with 
                                     recurrent epithelial ovarian, fallopian tube, 
                                     or primary peritoneal cancer who are in a complete 
                                     or partial response to platinum-based chemotherapy 
                                     to the BRCAm (germline or somatic) patient population 
                                     only. (September 2023) 
Presentation:      DUO-E            Primary analysis of the Phase III DUO-E Phase 
 ESMO               (Lynparza        III trial, presented at ESMO, showed that treatment 
                    and Imfinzi)     with Imfinzi plus chemotherapy followed by either 
                                     Imfinzi monotherapy or Imfinzi plus Lynparza 
                                     demonstrated a reduction in the risk of disease 
                                     progression or death, by 45% and 29%, respectively, 
                                     vs. chemotherapy alone in patients with advanced 
                                     or recurrent endometrial cancer. (October 2023) 
-----------------  -------------    ------------------------------------------------------ 
 

Enhertu

 
Event                            Commentary 
-------------  --------------    ------------------------------------------------------- 
Approval       Japan             For the treatment of adult patients with unresectable 
                                  advanced or recurrent NSCLC with HER2 (ERBB2) 
                                  mutations that has progressed after chemotherapy. 
                                  (DESTINY-Lung02, August 2023) 
Breakthrough   US                For the treatment of adult patients with unresectable 
 Designation                      or metastatic HER2-positive (IHC [72] 3+) solid 
                                  tumours that have progressed following prior 
                                  treatment and who have no alternative treatment 
                                  options. (DESTINY-PanTumor02, August 2023) 
                                 For the treatment of patients with HER2-positive 
                                  (IHC 3+) metastatic colorectal cancer who have 
                                  received two or more prior regimens. (DESTINY-CRC01, 
                                  DESTINY-CRC02, August 2023) 
Presentation:  DESTINY-Lung02    Results from the primary analysis of the DESTINY-Lung02 
 WCLC                             Phase II trial, presented at WCLC, showed Enhertu 
                                  provided a median PFS of 9.9 months at a dose 
                                  of 5.4mg/kg, and 15.4 months at a dose of 6.4mg/kg, 
                                  with a favourable safety profile that confirm 
                                  5.4mg/kg is the optimal dose in this tumour type. 
                                  (September 2023) 
 
 
Approval  EU    As monotherapy for the treatment of adult patients 
                 with advanced NSCLC whose tumours have an activating 
                 HER2 (ERBB2 [73] ) mutation and who require systemic 
                 therapy following platinum-based chemotherapy 
                 with or without immunotherapy. (DESTINY-Lung02, 
                 October 2023) 
 
 
Presentation:  DESTINY-PanTumor02    Primary analysis of the Phase II DESTINY-PanTumor02 
 ESMO                                 trial, presented at ESMO, showed that treatment 
                                      with Enhertu resulted in confirmed ORR [74] of 
                                      37.1%, a median PFS of 6.9 months and median 
                                      OS of 13.4 months in previously treated patients 
                                      across multiple HER2-expressing advanced solid 
                                      tumours. (October 2023) 
-------------  ------------------    --------------------------------------------------- 
 

Calquence

 
Event              Commentary 
--------  -----    ------------------------------------------------- 
Approval  China    For the treatment of adult patients with CLL 
                    or SLL [75] who have received at least one prior 
                    therapy. (ASC, September 2023) 
--------  -----    ------------------------------------------------- 
 

datopotamab deruxtecan (Dato-Dxd)

 
Event                              Commentary 
-------------  ----------------    ------------------------------------------------------- 
Presentation:  TROPION-Lung04      Results from a planned interim analysis of the 
 WCLC                               Phase Ib TROPION-Lung04 trial, presented at WCLC, 
                                    showed that Dato-DXd in combination with Imfinzi, 
                                    with or without carboplatin demonstrated objective 
                                    response rates of 77% and 50% and disease control 
                                    rates of 92% and 93% respectively, with no new 
                                    safety signals in patients with previously untreated 
                                    advanced or metastatic NSCLC without actionable 
                                    genomic alterations. (September 2023) 
Presentation:  BEGONIA             Updated results from the Phase Ib/II BEGONIA 
 ESMO                               trial, presented at ESMO, showed Dato-DXd plus 
                                    Imfinzi demonstrated a confirmed objective response 
                                    rate of 79% and a median PFS of 13.8 months in 
                                    patients with previously untreated advanced or 
                                    metastatic triple-negative breast cancer. (October 
                                    2023) 
Presentation:  TROPION-Lung01      Primary analysis for the Phase III TROPION-Lung01 
 ESMO                               trial, presented at ESMO, showed that Dato-DXd 
                                    reduced the risk of disease progression or death 
                                    by 25% in the overall population and by 37% in 
                                    non-squamous tumours vs. docetaxel in patients 
                                    with previously treated NSCLC. (October 2023) 
Presentation:  TROPION-Breast01    Primary analysis for the Phase III TROPION-Breast01 
 ESMO                               trial, presented at ESMO, showed that Dato-DXd 
                                    reduced the risk of disease progression or death 
                                    by 37%, providing a two-month median PFS benefit, 
                                    and was well tolerated in the post-endocrine 
                                    therapy setting vs. investigator's choice of 
                                    chemotherapy in patients with inoperable or metastatic 
                                    HR-positive, HER2-low or HER2-negative breast 
                                    cancer previously treated with endocrine-based 
                                    therapy and at least one systemic therapy. (October 
                                    2023) 
-------------  ----------------    ------------------------------------------------------- 
 

Other oncology pipeline

 
Event                         Commentary 
-------------  -----------    -------------------------------------------------------- 
Trial update   MONETTE        Phase II trial of ceralasertib + Imfinzi in unresectable 
                               or advanced melanoma and resistance to PD-(L)1 
                               inhibition stopped enrolment following a pre-specified 
                               futility (efficacy) assessment. There were no 
                               concerning safety signals identified at this 
                               interim analysis or during the two prior data 
                               review meetings. 
Presentation:  NCT04805307    Interim analysis for the Phase I trial (NCT04805307) 
 ASCO Virtual                  of CMG901 (Claudin 18.2 ADC [76] ) demonstrated 
 Plenary                       promising clinical efficacy in patients with 
                               heavily pre-treated CLDN18.2-positive gastric/GEJ 
                               cancer, with a manageable safety profile. (November 
                               2023) 
-------------  -----------    -------------------------------------------------------- 
 

BioPharmaceuticals - CVRM

AstraZeneca presented 19 abstracts, including 10 oral presentations and five late-breaking presentations, at the European Society of Cardiology (ESC) Congress in August, including data highlighting the opportunities for improved management in heart failure, and AstraZeneca's leadership across the interconnectedness of chronic diseases. At the American Society of Nephrology's (ASN) Kidney Week in November, AstraZeneca presented 53 abstracts showcasing the strength of its portfolio, including new ZORA and REVOLUTIONIZE real-world evidence data for Lokelma and compelling next-wave pipeline innovation with results from the ZENITH-CKD Phase IIb trial for zibotentan/dapagliflozin.

Farxiga

 
Event                Commentary 
--------  -------    ------------------------------------------------------ 
Approval  China      Approved in China to reduce the risk of cardiovascular 
                      death, hospitalisation for HF [77] or urgent 
                      HF visits in adults with symptomatic chronic 
                      HF. (June 2023) 
Data      T2NOW      P ositive data from the Phase III T2NOW trial, 
                      demonstrating a significant reduction in A1C 
                      in patients aged 10-17 years compared to patients 
                      receiving placebo. (October 2023) 
Data      DAPA-MI    Pr imary endpoint met, non-registrational trial. 
                      (August 2023) 
--------  -------    ------------------------------------------------------ 
 

zibotentan/dapagliflozin

 
Event                        Commentary 
-------------  ----------    -------------------------------------------------------------- 
Presentation:  ZENITH-CKD    Phase IIb data showed statistically significant 
 ASN                          and clinically meaningful reductions in urinary 
                              albumin-to-creatinine ratio (UACR), used to assess 
                              albuminuria, at 12 weeks compared with the standard 
                              of care of dapagliflozin alone. After 12 weeks 
                              of treatment, the UACR difference of zibotentan/dapagliflozin 
                              versus dapagliflozin alone was -33.7% (90% CI 
                              -42.5 to -23.5; p<0.001) for high-dose (1.5 mg 
                              zibotentan / 10 mg dapagliflozin ) and -27.0% 
                              (90% CI -38.4 to -13.6; p=0.002) for low dose 
                              ( 0.25 mg/10mg ) . (November 2023) 
-------------  ----------    -------------------------------------------------------------- 
 

Eplontersen

 
Event               Commentary 
------------        --------------------------------------------------- 
Orphan Drug   EU    Orphan drug d esignation received for the treatment 
 Designation         of ATTR [78] . (October 2023) 
------------        --------------------------------------------------- 
 

BioPharmaceuticals - R&I

AstraZeneca presented new data across its inhaled, biologic and early science respiratory portfolio at the European Respiratory Society (ERS) International Congress 2023. The company presented over 90 abstracts, including 18 oral presentations, which focused on unmet needs in severe asthma, chronic obstructive pulmonary disease and other acute respiratory diseases. Data from Fasenra and Tezspire advanced clinical remission as a treatment target to change the trajectory of severe asthma care.

Fasenra

 
Event                     Commentary 
-------------  -------    ----------------------------------------------------------- 
Phase III      MANDARA    Positive high-level results from the MANDARA 
 data readout              Phase III trial for Fasenra demonstrated non-inferior 
                           rates of remission compared to mepolizumab in 
                           patients with EGPA who were receiving oral corticosteroids 
                           with or without stable immunosuppressive therapy. 
                           MANDARA was the first head-to-head trial of biologics 
                           in EGPA, comparing a single monthly injection 
                           of Fasenra to three injections per month of mepolizumab, 
                           the only currently approved treatment. (September 
                           2023) 
Presentation:  SHAMAL     SHAMAL assessed the ability of Fasenra to permit 
 ERS                       a progressive reduction from high-dose ICS/LABA 
                           down to anti-inflammatory reliever whilst maintaining 
                           control in SEA [79] pts who were well-controlled 
                           on Fasenra. Fasenra enabled the majority of SEA 
                           patients to maintain disease control and remain 
                           exacerbation-free despite a reduction in background 
                           therapy to anti-inflammatory reliever only. (September 
                           2023) 
Presentation:  MIRACLE    The positive MIRACLE Phase III trial demonstrated 
 ERS                       a reduction in annual asthma exacerbation rate 
                           of 74% among patients in China with uncontrolled 
                           SEA vs. placebo. A filing for regulatory approval 
                           in China has been submitted, with a decision 
                           expected in H2 2024. (September 2023) 
-------------  -------    ----------------------------------------------------------- 
 

Tezspire

 
Event                         Commentary 
-------------  -----------    ------------------------------------------------------- 
Presentation:  DESTINATION    In a post-hoc exploratory analysis of the DESTINATION 
 ERS                           Phase III trial of patients with severe, uncontrolled 
                               asthma, a numerically greater proportion of patients 
                               who received tezepelumab than placebo achieved 
                               remission during the time periods assessed. (September 
                               2023) 
               -----------    ------------------------------------------------------- 
 
 

BioPharmaceuticals - V&I

AZD3152

 
Event                             Commentary 
-------------  ---------------    ---------------------------------------------------- 
Presentation:  In-vitro           In vitro neutralisation data presented at ID 
 ID Week        neutralisation     Week showed that AZD3152 potently neutralises 
                data               across a broad range of historical and contemporary 
                                   SARS-CoV-2 variants, including the newly emerging 
                                   BA.2.86 variant. AZD3152 loses activity against 
                                   XBB variants with the F456L mutation. (October 
                                   2023) 
 
                                   The SUPERNOVA Phase III efficacy trial, which 
                                   is now fully enrolled, will assess the potential 
                                   benefit of AZD3152 in protecting immunocompromised 
                                   patients in an environment with many variants 
                                   in circulation. 
               ---------------    ---------------------------------------------------- 
 
 

FluMist

 
Event                               Commentary 
-----------  -------------------    ----------------------------------------------------------- 
sBLA         Self administration    The FDA has accepted for review a sBLA for the 
 submission                          approval of a self- or caregiver-administered 
                                     option for FluMist. If approved, FluMist will 
                                     be the first flu vaccine available to be self-administered 
                                     by eligible patients or administered by caregivers. 
                                     The sBLA is supported by a usability study which 
                                     confirmed that individuals over 18 years of age 
                                     could self-administer or administer FluMist to 
                                     eligible patients 2-49 years of age when given 
                                     instructions for use without any additional guidance. 
                                     (October 2023) 
-----------  -------------------    ----------------------------------------------------------- 
 

Rare Disease

Alexion, AstraZeneca Rare Disease presented new real-world and clinical data at the European Committee for Treatment and Research in Multiple Sclerosis and Americas Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS-ACTRIMS), offering further evidence to support the established safety and efficacy of Soliris and Ultomiris in treating NMOSD.

Alexion, AstraZeneca Rare Disease presented new clinical data at the American Society of Nephrology (ASN) for Ultomiris in IgAN [80] as well as real-world data in aHUS.

Alexion, AstraZeneca Rare Disease presented new real-world and clinical data at the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Annual Meeting and Myasthenia Gravis Foundation of America Scientific Session (MGFA SS). Data shared across 13 abstracts, reinforcing the safety and efficacy of C5 inhibition in treating generalized myasthenia gravis (gMG).

Soliris

 
Event              Commentary 
--------  -----    ----------------------------------------------- 
Approval  Japan    Paediatric patients with gMG. (August 2023) 
Approval  China    Adults with anti- aquaporin-4 antibody-positive 
                    NMOSD. (October 2023) 
--------  -----    ----------------------------------------------- 
 

Ultomiris

 
Event                       Commentary 
-------------  ---------    ----------------------------------------------------------- 
CRL            US           The US FDA issued a CRL [81] regarding the sBLA 
                             [82] for Ultomiris for the treatment of adults 
                             with NMOSD. The sBLA included data from the CHAMPION-NMOSD 
                             Phase III trial, which met the primary endpoint 
                             with a safety profile consistent with the known 
                             profile of the medicine. The CRL requested modifications 
                             to enhance the Ultomiris Risk Evaluation and 
                             Mitigation Strategy to further validate patients' 
                             meningococcal vaccination status or prophylactic 
                             administration of antibiotics prior to treatment. 
                             (September 2023) 
Presentation:  SANCTUARY    Ultomiris demonstrated c linically meaningful 
 ASN            Phase II     efficacy and proof-of-concept as a potential 
                             treatment for IgAN, based on rapid and sustained 
                             proteinuria reduction. (November 2023) 
-------------  ---------    ----------------------------------------------------------- 
 

vemircopan

 
Event                      Commentary 
-----------  ----------    ----------------------------------------------------- 
Termination  ACH228-110    Trial discontinued due to lack of efficacy. Following 
              Phase II      an interim analysis, vemircopan's ability to 
                            appropriately control intravascular haemolysis 
                            was not adequately shown, due to significantly 
                            increased rates of breakthrough haemolysis and 
                            high levels of LDH [83] . No new safety findings 
                            were observed, and the safety profile of vemircopan 
                            has been favourable to date. This decision does 
                            not impact ongoing Phase II trials. (September 
                            2023) 
-----------  ----------    ----------------------------------------------------- 
 

gefurulimab

 
Event               Commentary 
------------        ----------------------------------------------- 
Orphan Drug   US    gefurulimab was granted orphan drug designation 
 Designation         by the FDA for the treatment of patients with 
                     gMG. (September 2023) 
------------        ----------------------------------------------- 
 

ALXN2220

 
Event               Commentary 
------------        ---------------------------------------------- 
Orphan Drug   US    ALXN2220 was granted orphan drug designation 
 Designation         by the FDA for the treatment of patients with 
                     ATTR-CM [84] . (September 2023) 
------------        ---------------------------------------------- 
 

Interim financial statements

Table 20 : Condensed consolidated statement of comprehensive income: 9M 2023

 
For the nine months ended 30 September                                                             2023      2022 
                                                                                                     $m        $m 
                                                                                               --------  -------- 
Total Revenue [85]                                                                               33,787    33,144 
Product Sales                                                                                    32,466    32,200 
Alliance Revenue                                                                                  1,004       504 
Collaboration Revenue                                                                               317       440 
---------------------------------------------------------------------------------------------  --------  -------- 
Cost of sales                                                                                   (5,960)   (9,491) 
---------------------------------------------------------------------------------------------  --------  -------- 
Gross profit                                                                                     27,827    23,653 
---------------------------------------------------------------------------------------------  --------  -------- 
Distribution expense                                                                              (394)     (380) 
Research and development expense                                                                (7,862)   (7,137) 
Selling, general and administrative expense                                                    (13,845)  (13,798) 
Other operating income and expense                                                                1,233       325 
---------------------------------------------------------------------------------------------  --------  -------- 
Operating profit                                                                                  6,959     2,663 
---------------------------------------------------------------------------------------------  --------  -------- 
Finance income                                                                                      236        50 
Finance expense                                                                                 (1,181)     (986) 
Share of after tax losses in associates and joint ventures                                         (12)       (4) 
---------------------------------------------------------------------------------------------  --------  -------- 
Profit before tax                                                                                 6,002     1,723 
---------------------------------------------------------------------------------------------  --------  -------- 
Taxation                                                                                        (1,000)       668 
---------------------------------------------------------------------------------------------  --------  -------- 
Profit for the period                                                                             5,002     2,391 
---------------------------------------------------------------------------------------------  --------  -------- 
Other comprehensive income 
Items that will not be reclassified to profit or loss 
Remeasurement of the defined benefit pension liability                                              (1)     1,283 
Net gains/(losses) on equity investments measured at fair value through other comprehensive 
 income                                                                                              45      (21) 
Fair value movements related to own credit risk on bonds designated as fair value through 
 profit or loss                                                                                       5         1 
Tax on items that will not be reclassified to profit or loss                                          -     (291) 
---------------------------------------------------------------------------------------------  --------  -------- 
                                                                                                     49       972 
                                                                                               --------  -------- 
Items that may be reclassified subsequently to profit or loss 
Foreign exchange arising on consolidation                                                         (201)   (2,493) 
Foreign exchange arising on designated liabilities in net investment hedges                        (63)     (321) 
Fair value movements on cash flow hedges                                                             62     (214) 
Fair value movements on cash flow hedges transferred to profit and loss                              28       250 
Fair value movements on derivatives designated in net investment hedges                              47        33 
Costs of hedging                                                                                    (3)      (11) 
Tax on items that may be reclassified subsequently to profit or loss                                (7)        95 
---------------------------------------------------------------------------------------------  --------  -------- 
                                                                                                  (137)   (2,661) 
                                                                                               --------  -------- 
Other comprehensive loss, net of tax                                                               (88)   (1,689) 
---------------------------------------------------------------------------------------------  --------  -------- 
Total comprehensive income for the period                                                         4,914       702 
---------------------------------------------------------------------------------------------  --------  -------- 
Profit attributable to: 
---------------------------------------------------------------------------------------------  --------  -------- 
Owners of the Parent                                                                              4,995     2,387 
Non-controlling interests                                                                             7         4 
---------------------------------------------------------------------------------------------  --------  -------- 
                                                                                                  5,002     2,391 
                                                                                               --------  -------- 
Total comprehensive income attributable to: 
---------------------------------------------------------------------------------------------  --------  -------- 
Owners of the Parent                                                                              4,907       701 
Non-controlling interests                                                                             7         1 
---------------------------------------------------------------------------------------------  --------  -------- 
                                                                                                  4,914       702 
                                                                                               --------  -------- 
Basic earnings per $0.25 Ordinary Share                                                           $3.22     $1.54 
Diluted earnings per $0.25 Ordinary Share                                                         $3.20     $1.53 
Weighted average number of Ordinary Shares in issue (millions)                                    1,549     1,548 
Diluted weighted average number of Ordinary Shares in issue (millions)                            1,560     1,560 
---------------------------------------------------------------------------------------------  --------  -------- 
 

Table 21 : Condensed consolidated statement of comprehensive income: Q3 2023

 
For the quarter ended 30 September                                                                2023     2022 
                                                                                                    $m       $m 
                                                                                               -------  ------- 
Total Revenue (85)                                                                              11,492   10,982 
Product Sales                                                                                   11,018   10,590 
Alliance Revenue                                                                                   377      214 
Collaboration Revenue                                                                               97      178 
---------------------------------------------------------------------------------------------  -------  ------- 
Cost of sales                                                                                  (2,095)  (2,982) 
---------------------------------------------------------------------------------------------  -------  ------- 
Gross profit                                                                                     9,397    8,000 
---------------------------------------------------------------------------------------------  -------  ------- 
Distribution expense                                                                             (129)    (126) 
Research and development expense                                                               (2,584)  (2,458) 
Selling, general and administrative expense                                                    (4,800)  (4,277) 
Other operating income and expense                                                                  70      106 
---------------------------------------------------------------------------------------------  -------  ------- 
Operating profit                                                                                 1,954    1,245 
---------------------------------------------------------------------------------------------  -------  ------- 
Finance income                                                                                     101       15 
Finance expense                                                                                  (392)    (339) 
Share of after tax (losses)/profits in associates and joint ventures                              (11)        1 
---------------------------------------------------------------------------------------------  -------  ------- 
Profit before tax                                                                                1,652      922 
---------------------------------------------------------------------------------------------  -------  ------- 
Taxation                                                                                         (274)      720 
---------------------------------------------------------------------------------------------  -------  ------- 
Profit for the period                                                                            1,378    1,642 
---------------------------------------------------------------------------------------------  -------  ------- 
Other comprehensive income 
Items that will not be reclassified to profit or loss 
Remeasurement of the defined benefit pension liability                                             (8)      252 
Net gains/(losses) on equity investments measured at fair value through other comprehensive 
 income                                                                                             93      (9) 
Fair value movements related to own credit risk on bonds designated as fair value through 
 profit or loss                                                                                      1      (1) 
Tax on items that will not be reclassified to profit or loss                                         5     (16) 
---------------------------------------------------------------------------------------------  -------  ------- 
                                                                                                    91      226 
                                                                                               -------  ------- 
Items that may be reclassified subsequently to profit or loss 
Foreign exchange arising on consolidation                                                        (306)  (1,167) 
Foreign exchange arising on designated liabilities in net investment hedges                         38    (126) 
Fair value movements on cash flow hedges                                                          (27)     (76) 
Fair value movements on cash flow hedges transferred to profit and loss                             99      119 
Fair value movements on derivatives designated in net investment hedges                              7      (1) 
Costs of hedging                                                                                   (2)        2 
Tax on items that may be reclassified subsequently to profit or loss                              (19)       49 
---------------------------------------------------------------------------------------------  -------  ------- 
                                                                                                 (210)  (1,200) 
                                                                                               -------  ------- 
Other comprehensive loss, net of tax                                                             (119)    (974) 
---------------------------------------------------------------------------------------------  -------  ------- 
Total comprehensive income for the period                                                        1,259      668 
---------------------------------------------------------------------------------------------  -------  ------- 
Profit attributable to: 
---------------------------------------------------------------------------------------------  -------  ------- 
Owners of the Parent                                                                             1,374    1,640 
Non-controlling interests                                                                            4        2 
---------------------------------------------------------------------------------------------  -------  ------- 
                                                                                                 1,378    1,642 
                                                                                               -------  ------- 
Total comprehensive income attributable to: 
---------------------------------------------------------------------------------------------  -------  ------- 
Owners of the Parent                                                                             1,255      667 
Non-controlling interests                                                                            4        1 
---------------------------------------------------------------------------------------------  -------  ------- 
                                                                                                 1,259      668 
                                                                                               -------  ------- 
Basic earnings per $0.25 Ordinary Share                                                          $0.89    $1.06 
Diluted earnings per $0.25 Ordinary Share                                                        $0.88    $1.05 
Weighted average number of Ordinary Shares in issue (millions)                                   1,549    1,548 
Diluted weighted average number of Ordinary Shares in issue (millions)                           1,560    1,559 
---------------------------------------------------------------------------------------------  -------  ------- 
 

Table 22 : Condensed consolidated statement of financial position

 
                                                                     At 30 Sep  At 31 Dec  At 30 Sep 
                                                                          2023       2022       2022 
                                                                            $m         $m         $m 
------------------------------------------------------------------   ---------  ---------  --------- 
Assets 
Non-current assets 
Property, plant and equipment                                            8,723      8,507      8,352 
Right-of-use assets                                                        977        942        875 
Goodwill                                                                19,939     19,820     19,707 
Intangible assets                                                       37,687     39,307     39,585 
Investments in associates and joint ventures                                62         76         53 
Other investments                                                        1,228      1,066      1,049 
Derivative financial instruments                                           151         74        112 
Other receivables                                                          761        835        792 
Deferred tax assets                                                      4,057      3,263      3,436 
-------------------------------------------------------------------  ---------  ---------  --------- 
                                                                        73,585     73,890     73,961 
                                                                     ---------  ---------  --------- 
Current assets 
Inventories                                                              5,292      4,699      5,078 
Trade and other receivables                                             11,300     10,521      9,336 
Other investments                                                          244        239        440 
Derivative financial instruments                                            97         87        105 
Intangible assets                                                            -          -         82 
Income tax receivable                                                      697        731        725 
Cash and cash equivalents                                                4,871      6,166      4,458 
Assets held for sale                                                         -        150          - 
-------------------------------------------------------------------  ---------  ---------  --------- 
                                                                        22,501     22,593     20,224 
                                                                     ---------  ---------  --------- 
Total assets                                                            96,086     96,483     94,185 
-------------------------------------------------------------------  ---------  ---------  --------- 
Liabilities 
Current liabilities 
Interest-bearing loans and borrowings                                  (5,372)    (5,314)    (5,408) 
Lease liabilities                                                        (235)      (228)      (210) 
Trade and other payables                                              (20,542)   (19,040)   (17,694) 
Derivative financial instruments                                          (83)       (93)       (68) 
Provisions                                                             (1,193)      (722)      (377) 
Income tax payable                                                     (1,163)      (896)    (1,093) 
-------------------------------------------------------------------  ---------  ---------  --------- 
                                                                      (28,588)   (26,293)   (24,850) 
                                                                     ---------  ---------  --------- 
Non-current liabilities 
Interest-bearing loans and borrowings                                 (22,225)   (22,965)   (23,013) 
Lease liabilities                                                        (744)      (725)      (668) 
Derivative financial instruments                                          (75)      (164)      (290) 
Deferred tax liabilities                                               (2,752)    (2,944)    (3,479) 
Retirement benefit obligations                                         (1,048)    (1,168)      (919) 
Provisions                                                             (1,189)      (896)      (930) 
Other payables                                                         (2,244)    (4,270)    (4,882) 
-------------------------------------------------------------------  ---------  ---------  --------- 
                                                                      (30,277)   (33,132)   (34,181) 
                                                                     ---------  ---------  --------- 
Total liabilities                                                     (58,865)   (59,425)   (59,031) 
-------------------------------------------------------------------  ---------  ---------  --------- 
Net assets                                                              37,221     37,058     35,154 
-------------------------------------------------------------------  ---------  ---------  --------- 
Equity 
Capital and reserves attributable to equity holders of the Parent 
Share capital                                                              387        387        387 
Share premium account                                                   35,166     35,155     35,137 
Other reserves                                                           2,078      2,069      2,081 
Retained earnings                                                        (434)      (574)    (2,471) 
-------------------------------------------------------------------  ---------  ---------  --------- 
                                                                        37,197     37,037     35,134 
Non-controlling interests                                                   24         21         20 
Total equity                                                            37,221     37,058     35,154 
-------------------------------------------------------------------  ---------  ---------  --------- 
 

Table 23 : Condensed consolidated statement of changes in equity

 
                                 Share     Share      Other   Retained          Total  Non-controlling    Total 
                               capital   premium   reserves   earnings   attributable        interests   equity 
                                         account                            to owners 
                                                                               of the 
                                                                               parent 
                                    $m        $m         $m         $m             $m               $m       $m 
---------------------------   --------  --------  ---------  ---------  -------------  ---------------  ------- 
At 1 Jan 2022                      387    35,126      2,045      1,710         39,268               19   39,287 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
Profit for the period                -         -          -      2,387          2,387                4    2,391 
Other comprehensive 
 loss                                -         -          -    (1,686)        (1,686)              (3)  (1,689) 
Transfer to other 
 reserves                            -         -         36       (36)              -                -        - 
Transactions with 
 owners: 
Dividends                            -         -          -    (4,486)        (4,486)                -  (4,486) 
Issue of Ordinary 
 Shares                              -        11          -          -             11                -       11 
Share-based payments 
 charge for the period               -         -          -        471            471                -      471 
Settlement of share 
 plan awards                         -         -          -      (831)          (831)                -    (831) 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
Net movement                         -        11         36    (4,181)        (4,134)                1  (4,133) 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
At 30 Sep 2022                     387    35,137      2,081    (2,471)         35,134               20   35,154 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
 
At 1 Jan 2023                      387    35,155      2,069      (574)         37,037               21   37,058 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
Profit for the period                -         -          -      4,995          4,995                7    5,002 
Other comprehensive 
 loss                                -         -          -       (88)           (88)                -     (88) 
Transfer to other 
 reserves                            -         -          9        (9)              -                -        - 
Transactions with 
 owners: 
Dividends                            -         -          -    (4,487)        (4,487)                -  (4,487) 
Dividends paid to 
 non-controlling interests           -         -          -          -              -              (4)      (4) 
Issue of Ordinary 
 Shares                              -        11          -          -             11                -       11 
Share-based payments 
 charge for the period               -         -          -        429            429                -      429 
Settlement of share 
 plan awards                         -         -          -      (700)          (700)                -    (700) 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
Net movement                         -        11          9        140            160                3      163 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
At 30 Sep 2023                     387    35,166      2,078      (434)         37,197               24   37,221 
----------------------------  --------  --------  ---------  ---------  -------------  ---------------  ------- 
 

Table 24 : Condensed consolidated statement of cash flows

 
For the nine months ended 30 September    2023  2022 
---------------------------------------- 
                                            $m    $m 
                                          ----  ---- 
 
 
Cash flows from operating activities 
Profit before tax                                          6,002    1,723 
Finance income and expense                                   945      936 
Share of after tax losses of associates and 
 joint ventures                                               12        4 
Depreciation, amortisation and impairment                  4,060    4,000 
Decrease in working capital and short-term provisions        150    3,458 
Gains on disposal of intangible assets                     (247)     (88) 
Fair value movements on contingent consideration 
 arising from business combinations                          202      293 
Non-cash and other movements                               (623)    (973) 
-------------------------------------------------------  -------  ------- 
Cash generated from operations                            10,501    9,353 
-------------------------------------------------------  -------  ------- 
Interest paid                                              (826)    (608) 
Tax paid                                                 (1,710)  (1,335) 
-------------------------------------------------------  -------  ------- 
Net cash inflow from operating activities                  7,965    7,410 
-------------------------------------------------------  -------  ------- 
 
  Cash flows from investing activities 
Acquisition of subsidiaries, net of cash acquired          (189)        - 
Payments upon vesting of employee share awards 
 attributable to business combinations                      (84)    (297) 
Payment of contingent consideration from business 
 combinations                                              (610)    (570) 
Purchase of property, plant and equipment                  (836)    (719) 
Disposal of property, plant and equipment                    131       17 
Purchase of intangible assets                            (1,996)  (1,298) 
Disposal of intangible assets                                288      442 
Movement in profit-participation liability                   190        - 
Purchase of non-current asset investments                  (109)     (28) 
Disposal of non-current asset investments                     32       42 
Movement in short-term investments, fixed deposits 
 and other investing instruments                            (12)    (321) 
Payments to associates and joint ventures                      -      (5) 
Interest received                                            208       26 
-------------------------------------------------------  -------  ------- 
Net cash outflow from investing activities               (2,987)  (2,711) 
-------------------------------------------------------  -------  ------- 
Net cash inflow before financing activities                4,978    4,699 
-------------------------------------------------------  -------  ------- 
 
  Cash flows from financing activities 
Proceeds from issue of share capital                          12       11 
Issue of loans and borrowings                              3,816        - 
Repayment of loans and borrowings                        (4,655)  (1,261) 
Dividends paid                                           (4,479)  (4,364) 
Hedge contracts relating to dividend payments               (19)    (127) 
Repayment of obligations under leases                      (194)    (182) 
Movement in short-term borrowings                            110      378 
Payment of Acerta Pharma share purchase liability          (867)    (920) 
-------------------------------------------------------  -------  ------- 
Net cash outflow from financing activities               (6,276)  (6,465) 
-------------------------------------------------------  -------  ------- 
Net decrease in Cash and cash equivalents in 
 the period                                              (1,298)  (1,766) 
Cash and cash equivalents at the beginning of 
 the period                                                5,983    6,038 
Exchange rate effects                                       (66)     (86) 
-------------------------------------------------------  -------  ------- 
Cash and cash equivalents at the end of the 
 period                                                    4,619    4,186 
-------------------------------------------------------  -------  ------- 
Cash and cash equivalents consist of: 
Cash and cash equivalents                                  4,871    4,458 
Overdrafts                                                 (252)    (272) 
-------------------------------------------------------  -------  ------- 
                                                           4,619    4,186 
                                                         -------  ------- 
 

Notes to the Interim financial statements

Note 1: Basis of preparation and accounting policies

These unaudited condensed consolidated Interim financial statements for the nine months ended 30 September 2023 have been prepared in accordance with International Accounting Standard 34, 'Interim Financial Reporting' (IAS 34), as issued by the International Accounting Standards Board (IASB), IAS 34 as adopted by the European Union, UK-adopted IAS 34 and the Disclosure Guidance and Transparency Rules sourcebook of the United Kingdom's Financial Conduct Authority and with the requirements of the Companies Act 2006 as applicable to companies reporting under those standards.

The unaudited Interim financial statements for the nine months ended 30 September 2023 were approved by the Board of Directors for publication on 9 November 2023.

This results announcement does not constitute statutory accounts of the Group within the meaning of sections

434(3) and 435(3) of the Companies Act 2006. The annual financial statements of the Group for the year ended 31 December 2022 were prepared in accordance with UK-adopted International Accounting Standards and with the requirements of the Companies Act 2006. The annual financial statements also comply fully with IFRSs as issued by the IASB and International Accounting Standards as adopted by the European Union. Except for the estimation of the interim income tax charge, the Interim financial statements have been prepared applying the accounting policies that were applied in the preparation of the Group's published consolidated financial statements for the year ended 31 December 2022.

The comparative figures for the financial year ended 31 December 2022 are not the Group's statutory accounts for that financial year. Those accounts have been reported on by the Group's auditors and have been delivered to the registrar of companies; their report was (i) unqualified, (ii) did not include a reference to any matters to which the auditors drew attention by way of emphasis without qualifying their report, and (iii) did not contain a statement under section 498(2) or (3) of the Companies Act 2006.

Alliance and Collaboration Revenues

Effective 1 January 2023, the Group has updated the presentation of Total Revenue on the face of the Statement of Comprehensive Income to include Alliance Revenue as a separate element to Collaboration Revenue. Alliance Revenue, previously reported within Collaboration Revenue, comprises income related to sales made by collaboration partners, where AstraZeneca is entitled to a profit share, revenue share or royalties, which are recurring in nature while the collaboration arrangement remains in place. Alliance Revenue does not include Product Sales where AstraZeneca is leading commercialisation in a territory. Collaboration Revenue arising from collaborative arrangements where the Group retains a significant ongoing economic interest and receives upfront amounts and event-triggered milestones, which arise from the licensing of intellectual property, will continue to be reported as Collaboration Revenue. In collaboration arrangements either AstraZeneca or the collaborator acts as principal in sales to the end customer. Where AstraZeneca acts as principal, we record 100% of sales to the end customer within Product Sales. The revised presentation reflects the increasing importance of income arising from profit share arrangements where collaboration partners are responsible for booking revenues in some or all territories.

The comparative revenue reported in 9M 2023 relating to the nine months to 30 September 2022 has been retrospectively adjusted to reflect the new split of Total Revenue, resulting in Alliance Revenue of $504m being reported for the nine months to 30 September 2022, however the combined total of Alliance Revenue and Collaboration Revenue is equal to the previously reported Collaboration Revenue total for the nine months to 30 September 2022.

Going concern

The Group has considerable financial resources available. As at 30 September 2023, the Group has $11.8bn in financial resources (Cash and cash equivalent balances of $4.9bn and undrawn committed bank facilities of $6.9bn available, of which $2.0bn of the facilities are available until February 2025 and the other $4.9bn are available until April 2026, with $5.6bn of borrowings due within one year). These facilities contain no financial covenants and were undrawn at 30 September 2023.

The Group's revenues are largely derived from sales of medicines covered by patents which provide a relatively high level of resilience and predictability to cash inflows, although government price interventions in response to budgetary constraints are expected to continue to adversely affect revenues in some of our significant markets. The Group, however, anticipates new revenue streams from both recently launched medicines and those in development, and the Group has a wide diversity of customers and suppliers across different geographic areas.

Consequently, the Directors believe that, overall, the Group is well placed to manage its business risks successfully. Accordingly, they continue to adopt the going concern basis in preparing the Interim financial statements.

Legal proceedings

The information contained in Note 6 updates the disclosures concerning legal proceedings and contingent liabilities in the Group's Annual Report and Form 20-F Information 2022 .

IAS 12 'Income Taxes'

On 25 May 2023, the IASB issued an amendment to IAS 12 'Income Taxes' to clarify how the effects of the global minimum tax framework should be accounted for and disclosed effective 1 January 2023. This was endorsed by the UK Endorsement Board on 19 July 2023 and has been adopted by the Company for 2023 reporting. The Company is currently assessing the potential impact of these rules upon its financial statements. The Company has applied the exception to recognising and disclosing information about deferred tax assets and liabilities related to Pillar 2 income taxes.

Note 2: Intangible assets

In accordance with IAS 36 'Impairment of Assets', reviews for triggers of impairment or impairment reversals at an individual asset or cash generating unit level were conducted, and impairment tests carried out where triggers were identified. As a result, total impairment charges of $376m have been recorded against intangible assets during the nine months ended 30 September 2023 (9M 2022: $44m net charge). Impairment charges in respect of medicines in development were $359m (9M 2022: $61m net charge) including the $244m impairment of the ALXN1840 intangible asset, following decision to discontinue this development programme in Wilson's disease. Impairment charges in respect of launched medicines were $17m (9M 2022: $nil).

As previously disclosed, on 16 January 2023 AstraZeneca completed the acquisition of Neogene Therapeutics Inc. (Neogene), a global clinical-stage biotechnology company pioneering the discovery, development and manufacturing of next-generation T-cell receptor therapies (TCR-Ts). The purchase price allocation exercise has completed, with the fair value of total consideration determined at $267m. Intangible assets of $100m and goodwill of $158m were recognised in the acquisition balance sheet, as well as a cash outflow of $189m net of cash acquired. Future contingent milestones-based and non-contingent consideration is payable to a maximum of $120m. Neogene's results have been consolidated into the Group's results from 16 January 2023.

The acquisition of CinCor completed on 24 February 2023, recorded as an asset acquisition, with consideration and net assets acquired of $1,268m, which included intangible assets acquired of $780m, $424m of cash and cash equivalents, and $75m of marketable securities. The Condensed consolidated statement of cash flows includes a $1,204m payment for the intangible assets which is presented net of the $424m cash and cash equivalents acquired within Purchase of intangible assets, whilst the $75m increase in marketable securities is presented within Movement in short-term investments, fixed deposits and other investing instruments. Contingent consideration of up to $496m could be paid on achievement of regulatory milestones, and will be recognised when the associated milestones are triggered.

Note 3: Net debt

The table below provides an analysis of Net Debt and a reconciliation of Net Cash Flow to the movement in Net Debt. The Group monitors Net Debt as part of its capital-management policy as described in Note 28 of the Annual Report and Form 20-F Information 2022 . Net Debt is a non-GAAP financial measure.

Table 25 : Net debt

 
                                At 1 Jan 2023  Cash flow  Acquisitions  Non-cash  Exchange movements  At 30 Sep 2023 
                                                                         & other 
                                           $m         $m            $m        $m                  $m              $m 
-----------------------------   -------------  ---------  ------------  --------  ------------------  -------------- 
Non-current instalments of 
 loans                               (22,965)    (3,826)             -     4,592                (26)        (22,225) 
Non-current instalments of 
 leases                                 (725)        (1)           (6)      (23)                  11           (744) 
------------------------------  -------------  ---------  ------------  --------  ------------------  -------------- 
Total long-term debt                 (23,690)    (3,827)           (6)     4,569                (15)        (22,969) 
Current instalments of loans          (4,964)      4,655             -   (4,587)                  39         (4,857) 
Current instalments of leases           (228)        215           (2)     (230)                  10           (235) 
Bank collateral received                 (89)       (95)             -         -                   -           (184) 
Other short-term borrowings 
 excluding overdrafts                    (78)       (15)             -         -                  14            (79) 
Overdrafts                              (183)       (69)             -         -                   -           (252) 
------------------------------  -------------  ---------  ------------  --------  ------------------  -------------- 
Total current debt                    (5,542)      4,691           (2)   (4,817)                  63         (5,607) 
------------------------------  -------------  ---------  ------------  --------  ------------------  -------------- 
Gross borrowings                     (29,232)        864           (8)     (248)                  48        (28,576) 
Net derivative financial 
 instruments                             (96)         19             -       167                   -              90 
------------------------------  -------------  ---------  ------------  --------  ------------------  -------------- 
Net borrowings                       (29,328)        883           (8)      (81)                  48        (28,486) 
Cash and cash equivalents               6,166    (1,229)             -         -                (66)           4,871 
Other investments - current               239         12             -         -                 (7)             244 
------------------------------  -------------  ---------  ------------  --------  ------------------  -------------- 
Cash and investments                    6,405    (1,217)             -         -                (73)           5,115 
------------------------------  -------------  ---------  ------------  --------  ------------------  -------------- 
Net debt                             (22,923)      (334)           (8)      (81)                (25)        (23,371) 
------------------------------  -------------  ---------  ------------  --------  ------------------  -------------- 
 

Non-cash movements in the period include fair value adjustments under IFRS 9 Financial Instruments.

The Group has agreements with some bank counterparties whereby the parties agree to post cash collateral on financial derivatives, for the benefit of the other, equivalent to the market valuation of the derivative positions above a predetermined threshold. The carrying value of such cash collateral held by the Group at 30 September 2023 was $184m (31 December 2022: $89m) and the carrying value of such cash collateral posted by the Group at 30 September 2023 was $175m (31 December 2022: $162m).

The equivalent GAAP measure to Net debt is 'liabilities arising from financing activities', which excludes the amounts for cash and overdrafts, other investments and non-financing derivatives shown above and includes the Acerta Pharma share purchase liability of $819m (31 December 2022: $1,646m), which is shown in current other payables.

Net debt increased by $448m in the nine months to 30 September 2023 to $23,371m. Details of the committed undrawn bank facilities are disclosed within the going concern section of Note 1.

During the quarter to 30 September 2023, Moody's upgraded the Company's solicited long term credit rating from A3 to A2 and its short term rating from P-2 to P-1. Standard and Poor's credit ratings were unchanged (long term: A; short term: A-1).

Note 4: Financial Instruments

As detailed in the Group's most recent annual financial statements, the principal financial instruments consist of derivative financial instruments, other investments, trade and other receivables, cash and cash equivalents, trade and other payables, lease liabilities and interest-bearing loans and borrowings.

The Group has certain equity investments that are categorised as Level 3 in the fair value hierarchy that are held at $281m at 30 September 2023 (31 December 2022: $186m) and for which fair value gains of $17m have been recognised in the nine months ended 30 September 2023 (9M 2022: $50m). In the absence of specific market data, these unlisted investments are held at fair value based on the cost of investment and adjusting as necessary for impairments and revaluations on new funding rounds, which are seen to approximate the fair value. All other fair value gains and/or losses that are presented in Net gains/(losses) on equity investments measured at fair value through other comprehensive income in the Condensed consolidated statement of comprehensive income for the nine months ended 30 September 2023 are Level 1 fair value measurements, valued based on quoted prices in active markets.

Financial instruments measured at fair value include $1,296m of other investments, $3,551m held in money-market funds, $289m of loans designated at fair value through profit or loss and $90m of derivatives as at 30 September 2023. With the exception of derivatives being Level 2 fair valued, certain equity investments as described above and an equity warrant of $14m categorised as Level 3, the aforementioned balances are Level 1 fair valued. Financial instruments measured at amortised cost include $175m of cash collateral pledged to counterparties. The total fair value of interest-bearing loans and borrowings at 30 September 2023, which have a carrying value of $28,576m in the Condensed consolidated statement of financial position, was $26,576m.

As announced in April 2023, the contractual relationship between AstraZeneca and Swedish Orphan Biovitrum AB (Sobi) relating to future sales of Beyfortus (nirsevimab) in the US has been replaced by a royalty relationship between Sanofi and Sobi. As a result, a non-current other payable representing AstraZeneca's future obligations to Sobi was eliminated from AstraZeneca's Statement of Financial Position in the quarter to 30 June 2023, and AstraZeneca recorded a gain of $712m in Core Other operating income.

Table 26 : Financial instruments - contingent consideration

 
  2023  2022 
 
 
                                           Diabetes alliance  Other  Total  Total 
                                                          $m     $m     $m     $m 
----------------------------------------   -----------------  -----  -----  ----- 
At 1 January                                           2,124     98  2,222  2,865 
-----------------------------------------  -----------------  -----  -----  ----- 
Additions through business combinations                    -     60     60      - 
Settlements                                            (608)    (2)  (610)  (570) 
Disposals                                                  -      -      -  (121) 
Revaluations                                             229   (27)    202    293 
Discount unwind                                           93      6     99    126 
-----------------------------------------  -----------------  -----  -----  ----- 
At 30 September                                        1,838    135  1,973  2,593 
-----------------------------------------  -----------------  -----  -----  ----- 
 

Contingent consideration arising from business combinations is fair valued using decision-tree analysis, with key inputs including the probability of success, consideration of potential delays and the expected levels of future revenues.

The contingent consideration balance relating to BMS's share of the global diabetes alliance of $1,838m (31 December 2022: $2,124m) would increase/decrease by $184m with an increase/decrease in sales of 10%, as compared with the current estimates.

Note 5: Pensions and other post-retirement benefit obligations

During the nine months ended 30 September 2023, AstraZeneca Pharmaceuticals PLP terminated its main defined benefit pension plan. A total of $839m of pension obligations were discharged, $142m of which was settled via a cash payment to the participants and the remaining $697m was transferred to an external insurer via a buy-out. At 30 September 2023, the plan contained immaterial residual assets and obligations which are expected to be discharged by the end of 2023, with minimal impact to the income statement.

Note 6: Legal proceedings and contingent liabilities

AstraZeneca is involved in various legal proceedings considered typical to its business, including litigation and investigations, including Government investigations, relating to product liability, commercial disputes, infringement of intellectual property (IP) rights, the validity of certain patents, anti-trust law and sales and marketing practices. The matters discussed below constitute the more significant developments since publication of the disclosures concerning legal proceedings in the Company's Annual Report and Form 20-F Information 2022 and the Interim Financial Statements for the six months ended 30 June 2023 (the Disclosures).

As discussed in the Disclosures, the majority of claims involve highly complex issues. Often these issues are subject to substantial uncertainties and, therefore, the probability of a loss, if any, being sustained and/or an estimate of the amount of any loss is difficult to ascertain.

Unless specifically identified below, AstraZeneca considers each of the claims to represent a contingent liability or a contingent asset where the matter is brought by AstraZeneca, and discloses information with respect to the nature and facts of the cases in accordance with IAS 37.

In cases that have been settled or adjudicated, or where quantifiable fines and penalties have been assessed and which are not subject to appeal, or where a loss is probable and we are able to make a reasonable estimate of the loss, AstraZeneca records the loss absorbed or makes a provision for its best estimate of the expected loss. The position could change over time and the estimates that the Company made, and upon which the Company have relied in calculating these provisions are inherently imprecise. There can, therefore, be no assurance that any losses that result from the outcome of any legal proceedings will not exceed the amount of the provisions that have been booked in the accounts. The major factors causing this uncertainty are described more fully in the Disclosures and herein.

AstraZeneca has full confidence in, and will vigorously defend and enforce, its IP.

Matters disclosed in respect of the third quarter of 2023 and to 9 November 2023

Patent litigation

Legal proceedings brought against AZ considered to be contingent liabilities

Enhertu

US patent proceedings

In October 2020, Seagen Inc. (Seagen) filed a complaint against Daiichi Sankyo Company, Limited (Daiichi Sankyo) in the US District Court for the Eastern District of Texas (District Court) alleging that Enhertu infringes a Seagen patent. AstraZeneca Pharmaceuticals LP co-commercialises Enhertu with Daiichi Sankyo, Inc. in the US. After trial in April 2022, the jury found that the patent was infringed and awarded Seagen $41.82m in past damages. In July 2022, the District Court entered final judgment and declined to enhance damages on the basis of willfulness. In October 2023, the District Court entered an amended final judgment that requires Daiichi Sankyo to pay Seagen a royalty of 8% on US sales of Enhertu from April 1, 2022 through November 4, 2024, in addition to the past damages previously awarded by the Court.

In December 2020 and January 2021, AstraZeneca and Daiichi Sankyo, Inc. filed post-grant review (PGR) petitions with the US Patent and Trademark Office (USPTO) alleging, inter alia, that the Seagen patent is invalid for lack of written description and enablement. The USPTO initially declined to institute the PGRs, but, in April 2022, the USPTO granted the rehearing requests, instituting both PGR petitions. Seagen subsequently disclaimed all patent claims at issue in one of the PGR proceedings. In July 2022, the USPTO reversed its institution decision and declined to institute the other PGR petition. AstraZeneca and Daiichi Sankyo requested reconsideration of the decision not to institute review of the patent. In February 2023, the USPTO reinstituted the PGR proceeding. An oral hearing took place in August 2023. The parties await a decision.

Legal proceedings brought by AZ considered to be contingent assets

Faslodex

Patent proceedings outside the US

In 2021 in Japan, AstraZeneca received notice from the Japan Patent Office (JPO) that Sandoz K.K. (Sandoz) and Sun Pharma Japan Ltd. (Sun) were seeking to invalidate the Faslodex formulation patent. AstraZeneca defended the challenged patent, and Sun withdrew from the JPO patent challenge. In July 2023, the JPO issued a final decision upholding various claims of the challenged patent and determining that other patent claims were invalid. In August 2023, Sandoz appealed the JPO decision to the Japan IP High Court.

Calquence

US patent proceedings

In February 2022, in response to Paragraph IV notices from multiple ANDA filers, AstraZeneca filed patent infringement lawsuits in the US District Court for the District of Delaware. In its complaint, AstraZeneca alleges that a generic version of Calquence, if approved and marketed, would infringe patents listed in the US FDA Orange Book with reference to Calquence that are owned or licensed by AstraZeneca. Trial has been scheduled for March 2025.

In February 2023, Sandoz Inc. filed a petition for inter partes review with the US Patent and Trademark Office (USPTO) of certain Calquence patent claims. AstraZeneca has asserted claims for patent infringement against Sandoz and other defendants in the US ANDA litigation. In August 2023, the Patent Trial and Appeal Board issued a decision denying institution of inter partes review.

Product liability litigation

Legal proceedings brought against AZ for which a provision has been taken

Nexium and Losec/Prilosec

US proceedings

In the US, AstraZeneca is defending various lawsuits brought in federal and state courts involving multiple plaintiffs claiming that they have been diagnosed with various injuries following treatment with proton pump inhibitors (PPIs), including Nexium and Prilosec. The vast majority of those lawsuits related to allegations of kidney injuries. In August 2017, the pending federal court cases were consolidated in a multidistrict litigation (MDL) proceeding in the US District Court for the District of New Jersey for pre-trial purposes. A bellwether trial had been scheduled for October 2023, with subsequent bellwether trials scheduled for November 2023 and January 2024. In addition to the MDL cases, there were cases filed in Delaware and New Jersey state courts.

In addition, AstraZeneca has been defending lawsuits involving allegations of gastric cancer following treatment with PPIs. One such claim was filed in the US District Court for the Middle District of Louisiana and is scheduled to go to trial in April 2024.

In October 2023, AstraZeneca resolved all pending claims in the MDL, as well as all of the pending claims in Delaware and New Jersey state courts, for $425m, for which a current provision has been taken. A single case remains pending in the US District Court for the Middle District of Louisiana.

Legal proceedings brought against AZ considered to be contingent liabilities

Farxiga and Xigduo XR

US proceedings

In several jurisdictions in the US, AstraZeneca has been named as a defendant in lawsuits involving plaintiffs claiming physical injury, including Fournier's Gangrene and necrotising fasciitis, from treatment with Farxiga and/or Xigduo XR. A majority of these claims are filed in Delaware state court and remain pending. In September of 2023, the parties resolved by settlement one case, filed in state court in Minnesota, previously scheduled for trial in October 2023.

Commercial litigation

Legal proceedings brought against AZ for which a provision has been taken

Alexion Shareholder Litigation (US)

In December 2016, putative securities class action lawsuits were filed in the US District Court for the District of Connecticut (the District Court) against Alexion and certain officers and directors, on behalf of purchasers of Alexion publicly traded securities during the period 30 January 2014 through 26 May 2017. The amended complaint alleges that defendants engaged in securities fraud, including by making misrepresentations and omissions in its public disclosures concerning Alexion's Soliris sales practices, management changes, and related investigations. In August 2021, the District Court issued a decision denying in part Defendants' motion to dismiss the matter. The Court granted plaintiffs' motion for class certification in April 2023. In August 2023, the parties reached a settlement in principle of this matter. In September 2023, the court granted preliminary approval of the class settlement. The court scheduled a hearing in December 2023 to rule on final approval. A provision has been recognised in the quarter.

Legal proceedings brought by AZ considered to be contingent assets

US 340B litigations and proceedings

US proceedings

AstraZeneca has been involved in several matters relating to its contract pharmacy recognition policy under the 340B Drug Pricing Program in the US.

In August 2023, AstraZeneca filed a lawsuit against the Attorney General of the State of Louisiana alleging that the Louisiana's 340B statute, which requires manufacturers to recognize an unlimited number of contract pharmacies, is preempted on several grounds and violates the Contracts Clause of the U.S. Constitution.

In September 2023, the Arkansas Insurance Department sent AstraZeneca an administrative complaint concerning compliance with Arkansas's 340B Statute, which requires manufacturers to recognize an unlimited number of contract pharmacies. AstraZeneca response is due in November 2023.

Inflation Reduction Act Litigation

US proceedings

In August 2023, AstraZeneca filed a lawsuit in the US District Court for the District of Delaware challenging aspects of the drug price negotiation provisions of the Inflation Reduction Act and the implementing guidance and regulations promulgated by the Department of Health and Human Services.

Government investigations/proceedings

Legal proceedings brought against AZ considered to be contingent liabilities

340B Qui Tam

US Proceedings

In July 2023, AstraZeneca was served with an unsealed civil lawsuit brought by a qui tam relator on behalf of the United States, several states, and the District of Columbia in the United States District Court for Central District of California. The complaint alleges that AstraZeneca violated the False Claims Act and State-Law Counterparts. In September 2023, AstraZeneca filed a motion to dismiss the relator's claims.

Subsequent events

In November, AstraZeneca announced a collaboration and investment agreement with Cellectis, a clinical-stage biotechnology company, to accelerate the development of next generation therapeutics in areas of high unmet need, including oncology, immunology and rare diseases. In Q4 2023, under the terms of the collaboration agreement, Cellectis will receive an initial payment of $105m from AstraZeneca, which comprises a $25m upfront cash payment and an $80m equity investment. AstraZeneca expects to treat its investment in Cellectis as an associate.

In November, AstraZeneca and Eccogene entered into an exclusive licence agreement for ECC5004, an investigational oral once-daily GLP-1RA for the treatment of obesity, type-2 diabetes and other cardiometabolic conditions. Under the terms of the agreement, AstraZeneca obtained exclusive global rights for development and commercialisation in all territories except China where Eccogene has the right to co-develop and co-commercialise alongside AstraZeneca. Eccogene will receive an initial upfront payment of $185m and up to an additional $1.825bn in future clinical, regulatory, and commercial milestones and tiered royalties.

Note 7

Table 27 : 9M 2023 - Product Sales year-on-year analysis [86]

 
         World  US  Emerging Markets  Europe  Established RoW 
 
 
                          $m    Act    CER      $m  % chg     $m    Act    CER     $m    Act    CER     $m    Act    CER 
                              % chg  % chg                        % chg  % chg         % chg  % chg         % chg  % chg 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Oncology              12,692     17     20   5,652     20  2,925      7     15  2,428     19     19  1,687     18     28 
Tagrisso               4,380      7     10   1,679     14  1,261      4     11    821      6      6    619    (4)      5 
Imfinzi                3,102     53     56   1,708     55    270     20     31    547     36     35    577     90    n/m 
Lynparza               2,070      6      9     902      1    409     14     24    543     10     10    216      7     16 
Calquence              1,839     25     26   1,337     12     69    n/m    n/m    353     76     77     80     64     74 
Enhertu                  178    n/m    n/m       -      -    121    n/m    n/m     40    n/m    n/m     17    n/m    n/m 
Orpathys                  33    (3)      4       -      -     33    (3)      4      -      -      -      -      -      - 
Zoladex                  699    (3)      5      12      9    521      3     11     98    (2)    (1)     68   (31)   (24) 
Faslodex                 217   (16)   (10)       9   (38)    113    (6)      -     22   (50)   (50)     73    (8)      - 
Others                   174   (36)   (32)       5   (36)    128   (38)   (34)      4   (41)   (40)     37   (29)   (22) 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
BioPharmaceuticals: 
 CVRM                  7,887     14     18   1,972     11  3,507     10     18  1,825     29     29    583     10     19 
Farxiga                4,358     36     40   1,000     34  1,653     35     43  1,356     42     41    349     26     36 
Brilinta                 996    (2)      -     551      2    224      1     10    203    (5)    (5)     18   (54)   (51) 
Lokelma                  300     44     49     156     28     37    n/m    n/m     41     98     99     66     32     44 
roxadustat               208     41     51       -      -    208     41     51      -      -      -      -      -      - 
Andexxa                  129     16     19      57    (8)      -      -      -     44     51     51     28     40     54 
Crestor                  860      4     11      40   (19)    678      8     15     41     38     38    101   (11)    (4) 
Seloken /Toprol-XL       496   (30)   (23)       -      -    482   (30)   (24)      8   (19)   (19)      6   (18)   (13) 
Onglyza                  180   (12)    (8)      44   (26)     99      1      9     25   (17)   (17)     12   (30)   (27) 
Bydureon                 123   (40)   (40)     101   (43)      2     15     14     20   (30)   (30)      -      -      - 
Others                   237   (16)   (13)      23   (13)    124   (19)   (13)     87   (10)   (10)      3   (52)   (49) 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
BioPharmaceuticals: 
 R&I                   4,517      5      8   1,900    (3)  1,315     19     29    847      7      7    455    (1)      6 
Symbicort              1,842    (4)    (1)     589   (18)    600     26     36    408    (8)    (8)    245   (12)    (7) 
Fasenra                1,134     12     13     718     11     48     62     69    262     14     14    106    (1)      6 
Breztri                  478     69     73     263     60    123     73     86     55    n/m    n/m     37     48     58 
Saphnelo                 191    n/m    n/m     178    n/m      1    n/m    n/m      5    n/m    n/m      7    n/m    n/m 
Tezspire                  51    n/m    n/m       -      -      -      -      -     28    n/m    n/m     23    n/m    n/m 
Pulmicort                493      3     10      22   (58)    392     16     24     49    (1)      -     30   (18)   (13) 
Bevespi                   42    (2)    (2)      24   (23)      5     21     32     12     70     70      1     59     10 
Daliresp /Daxas           41   (74)   (74)      32   (79)      2   (23)   (10)      6    (9)    (9)      1      3   (25) 
Others                   245   (30)   (27)      74   (44)    144   (20)   (14)     22   (35)   (34)      5    (4)      2 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
BioPharmaceuticals: 
 V&I                     667   (82)   (81)      15   (98)    181   (82)   (81)    236   (66)   (66)    235   (76)   (73) 
COVID-19 mAbs            126   (91)   (90)       -    n/m      5   (97)   (97)      7   (97)   (96)    114   (51)   (45) 
Vaxzevria                 28   (98)   (98)       -    n/m     18   (97)   (97)     10   (97)   (97)      -    n/m    n/m 
Beyfortus                 52    n/m    n/m       -      -      -      -      -     52      -      -      -      -      - 
Synagis                  383      -      6     (1)    n/m    158      9     15    109   (12)    (9)    117      2     11 
FluMist                   78     32     28      16     44      -    n/m    n/m     58     28     22      4     79     71 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Rare Disease           5,793     11     12   3,469      9    487     54     68  1,165      8      8    672      1      9 
Soliris                2,429   (17)   (15)   1,313   (22)    338     55     74    530   (15)   (15)    248   (36)   (31) 
Ultomiris              2,141     56     58   1,260     63     47     38     39    495     43     42    339     54     68 
Strensiq                 847     23     24     690     26     29     14     16     64      9      8     64     12     22 
Koselugo                 246     65     65     144     26     49    n/m    n/m     38    n/m    n/m     15    n/m    n/m 
Kanuma                   130     17     18      62     11     24     53     55     38     13     12      6      4     12 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Other medicines          910   (27)   (22)     104    (7)    580    (5)      3     67   (29)   (29)    159   (63)   (60) 
Nexium                   735   (25)   (20)      88    (6)    458      5     14     36    (1)    (2)    153   (63)   (60) 
Others                   175   (33)   (31)      16   (13)    122   (29)   (25)     31   (47)   (47)      6   (54)   (50) 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Total Product Sales   32,466      1      4  13,112      3  8,995      1      8  6,568      7      7  3,791   (16)    (9) 
--------------------  ------  -----  -----  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
 

Table 28 : Q3 2023 - Product Sales year-on-year analysis [87]

 
         World  US  Emerging Markets  Europe  Established RoW 
 
 
                          $m    Act    CER     $m  % chg     $m    Act    CER     $m    Act    CER     $m    Act    CER 
                              % chg  % chg                       % chg  % chg         % chg  % chg         % chg  % chg 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Oncology               4,389     16     17  1,986     16    971      4     13    849     22     15    583     28     35 
Tagrisso               1,465      5      6    577     11    409      1      8    281      5    (1)    198    (3)      2 
Imfinzi                1,126     53     54    610     48     87    (4)      7    208     54     45    221    n/m    n/m 
Lynparza                 702      7      8    322      3    131     12     26    178      8      2     71     11     16 
Calquence                654     16     15    468      2     28    n/m    n/m    128     63     54     30     65     72 
Enhertu                   73    n/m    n/m      -      -     48    n/m    n/m     16    n/m    n/m      9    n/m    n/m 
Orpathys                  12      6     13      -      -     12      6     13      -      -      -      -      -      - 
Zoladex                  239      -      5      5     29    182      4     11     31    (1)    (6)     21   (29)   (25) 
Faslodex                  64   (21)   (16)      3   (41)     32   (19)   (13)      6   (53)   (55)     23    (5)      - 
Others                    54   (33)   (30)      1   (59)     42   (34)   (32)      1     11     11     10   (30)   (22) 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
BioPharmaceuticals: 
 CVRM                  2,683     14     16    690      9  1,161      7     15    657     40     32    175      6     10 
Farxiga                1,554     41     41    366     31    579     41     48    506     54     45    103     24     29 
Brilinta                 331    (2)    (1)    193      4     64   (16)    (4)     68      4    (2)      6   (45)   (46) 
Lokelma                  102     30     31     51     15     13     39     48     16     97     87     22     31     38 
roxadustat                74     31     39      -      -     74     30     39      -      -      -      -      -      - 
Andexxa                   40    (3)    (5)     20      -      -      -      -     15     32     20      5   (50)   (47) 
Crestor                  275    (1)      6     14   (10)    219      2      9      9      6      3     33   (11)    (7) 
Seloken /Toprol-XL       153   (36)   (29)      -      -    149   (36)   (29)      2   (45)   (45)      2    (4)   (18) 
Onglyza                   53   (20)   (17)      9   (57)     33      -      9      8    (9)   (16)      3   (27)   (25) 
Bydureon                  35   (48)   (49)     28   (52)      1     97     90      6   (25)   (30)      -      -      - 
Others                    66   (23)   (21)      9     15     29   (40)   (37)     27    (1)    (2)      1   (42)   (39) 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
BioPharmaceuticals: 
 R&I                   1,451      2      3    609    (8)    422     14     23    266      9      2    154      3      7 
Symbicort                555   (12)   (10)    156   (34)    195     15     24    123    (7)   (13)     81   (11)    (8) 
Fasenra                  389     10     10    249      9     19     56     67     86     12      5     35      1      4 
Breztri                  171     66     69     98     69     42     51     62     19    n/m    n/m     12     37     46 
Saphnelo                  76    n/m    n/m     71    n/m      -      -      -      2    n/m    n/m      3    n/m    n/m 
Tezspire                  21    n/m    n/m      -      -      -      -      -     11    n/m    n/m     10    n/m    n/m 
Pulmicort                148      2      7      5   (69)    119     16     24     13   (11)   (16)     11    (8)    (5) 
Bevespi                   13    (5)    (4)      8   (23)      2    (2)      7      3     77     72      -      -      - 
Daliresp /Daxas           11   (79)   (79)      8   (83)      -   (36)    (2)      2    (2)   (18)      1    n/m      - 
Others                    67   (31)   (28)     14   (55)     45   (20)   (14)      7   (14)   (19)      1    (7)      7 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
BioPharmaceuticals: 
 V&I                     224   (74)   (74)     15   (95)     32   (76)   (75)    122   (33)   (35)     55   (78)   (77) 
COVID-19 mAbs              -    n/m    n/m      -    n/m      -    n/m    n/m      -    n/m    n/m      -    n/m    n/m 
Vaxzevria                  -    n/m    n/m      -      -      -    n/m    n/m      -    n/m    n/m      -    n/m    n/m 
Beyfortus                 50    n/m    n/m      -      -      -      -      -     50      -      -      -      -      - 
Synagis                   99    (5)    (1)      -      -     32   (13)    (7)     16    (4)   (10)     51      1      6 
FluMist                   75     28     23     15     41      -      -      -     56     22     16      4     81     76 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Rare Disease           1,974     13     14  1,179      9    163     49     70    397     15      8    235     16     22 
Soliris                  781   (13)   (12)    420   (20)    124     47     71    163   (14)   (19)     74   (28)   (26) 
Ultomiris                777     50     49    445     41     17    n/m    n/m    184     51     41    131     70     78 
Strensiq                 285     20     21    237     23      5   (32)   (10)     22     17      8     21     13     19 
Koselugo                  87     81     81     54     51     11     51     69     15    n/m    n/m      7    n/m    n/m 
Kanuma                    44     21     19     23     27      6    (4)    (2)     13     31     23      2   (10)    (5) 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Other medicines          297   (27)   (22)     36    (3)    190   (11)    (4)     19   (32)   (34)     52   (59)   (56) 
Nexium                   244   (22)   (17)     29    (6)    153      3     13     11      5    (2)     51   (59)   (56) 
Others                    53   (43)   (41)      7     10     37   (44)   (41)      8   (54)   (53)      1   (66)   (57) 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
Total Product Sales   11,018      4      5  4,515      2  2,939      3     12  2,310     18     11  1,254    (7)    (3) 
--------------------  ------  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  -----  ----- 
 

Table 29 : Alliance Revenue

 
                          9M 2023  9M 2022 
                               $m       $m 
                          -------  ------- 
Enhertu                       741      335 
Tezspire                      179       42 
Vaxzevria: royalties            -       67 
Other royalty income           59       51 
Other Alliance Revenue         25        9 
------------------------  -------  ------- 
Total                       1,004      504 
------------------------  -------  ------- 
 

Table 30 : Collaboration Revenue

 
                                     9M 2023  9M 2022 
                                          $m       $m 
                                     -------  ------- 
Lynparza : regulatory milestones           -      250 
COVID-19 mAbs: licence fees              180        - 
Farxiga : sales milestones                28        - 
tralokinumab: sales milestones            20      110 
Beyfortus : regulatory milestones         71        - 
Other Collaboration Revenue               18       80 
-----------------------------------  -------  ------- 
Total                                    317      440 
-----------------------------------  -------  ------- 
 

Table 31 : Other operating income and expense

 
                                                                      9M 2023  9M 2022 
                                                                           $m       $m 
                                                                      -------  ------- 
brazikumab licence termination funding                                     75      104 
Divestment of rights to Plendil                                             -       61 
Divestment of US rights to Pulmicort Flexhaler                            241        - 
Update to the contractual relationships for Beyfortus (nirsevimab)        712        - 
Other                                                                     205      160 
--------------------------------------------------------------------  -------  ------- 
Total                                                                   1,233      325 
--------------------------------------------------------------------  -------  ------- 
 

Other shareholder information

Financial calendar

Announcement of full year and fourth quarter 2023 results: 8 February 2024

Dividends are normally paid as follows:

   First interim:          Announced with the half year results and paid in September 
   Second interim:     Announced with full year results and paid in March 

Contacts

For details on how to contact the Investor Relations Team, please click here . For Media contacts, click here .

Addresses for correspondence

 
 
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                        transfer office   Securities Depository    Deutsche Bank Trust 
                                                                     Company Americas 
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        Avenue           Aspect House         AB PO Box 191          6201 15th Avenue 
 Cambridge Biomedical    Spencer Road      SE-101 23 Stockholm           Brooklyn 
        Campus              Lancing                                      NY 11219 
      Cambridge           West Sussex 
       CB2 0AA             BN99 6DA 
   United Kingdom       United Kingdom           Sweden               United States 
 
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                       +44 (0) 121 415 
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                                                                   db@astfinancial.com 
 

Trademarks

Trademarks of the AstraZeneca group of companies appear throughout this document in italics. Medical publications also appear throughout the document in italics. AstraZeneca, the AstraZeneca logotype and the AstraZeneca symbol are all trademarks of the AstraZeneca group of companies. Trademarks of companies other than AstraZeneca that appear in this document include Arimidex and Casodex, owned by AstraZeneca or Juvisé (depending on geography); Beyfortus, a trademark of Sanofi Pasteur Inc.; Enhertu, a trademark of Daiichi Sankyo; Losec, owned by AstraZeneca or Cheplapharm (depending upon geography); Seloken, owned by AstraZeneca or Taiyo Pharma Co., Ltd (depending on geography); Synagis, owned by AstraZeneca or Sobi aka Swedish Orphan Biovitrum AB (publ). (depending on geography); and Tezspire, a trademark of Amgen, Inc .

Information on or accessible through AstraZeneca's websites, including astrazeneca.com , does not form part of and is not incorporated into this announcement.

AstraZeneca

AstraZeneca (LSE/STO/Nasdaq: AZN) is a global, science-led biopharmaceutical company that focuses on the discovery, development, and commercialisation of prescription medicines in Oncology, Rare Disease, and BioPharmaceuticals, including Cardiovascular, Renal & Metabolism, and Respiratory & Immunology. Based in Cambridge, UK, AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide. Please visit astrazeneca.com and follow the Company on Twitter @AstraZeneca .

Cautionary statements regarding forward-looking statements

In order, among other things, to utilise the 'safe harbour' provisions of the US Private Securities Litigation Reform Act of 1995, AstraZeneca (hereafter 'the Group') provides the following cautionary statement:

This document contains certain forward-looking statements with respect to the operations, performance and financial condition of the Group, including, among other things, statements about expected revenues, margins, earnings per share or other financial or other measures. Although the Group believes its expectations are based on reasonable assumptions, any forward-looking statements, by their very nature, involve risks and uncertainties and may be influenced by factors that could cause actual outcomes and results to be materially different from those predicted. The forward-looking statements reflect knowledge and information available at the date of preparation of this document and the Group undertakes no obligation to update these forward-looking statements. The Group identifies the forward-looking statements by using the words 'anticipates', 'believes', 'expects', 'intends' and similar expressions in such statements. Important factors that could cause actual results to differ materially from those contained in forward-looking statements, certain of which are beyond the Group's control, include, among other things:

   --    the risk of failure or delay in delivery of pipeline or launch of new medicines 

-- the risk of failure to meet regulatory or ethical requirements for medicine development or approval

-- the risk of failures or delays in the quality or execution of the Group's commercial strategies

   --    the risk of pricing, affordability, access and competitive pressures 
   --    the risk of failure to maintain supply of compliant, quality medicines 
   --    the risk of illegal trade in the Group's medicines 
   --    the impact of reliance on third-party goods and services 
   --    the risk of failure in information technology or cybersecurity 
   --    the risk of failure of critical processes 

-- the risk of failure to collect and manage data in line with legal and regulatory requirements and strategic objectives

-- the risk of failure to attract, develop, engage and retain a diverse, talented and capable workforce

-- the risk of failure to meet regulatory or ethical expectations on environmental impact, including climate change

   --    the risk of the safety and efficacy of marketed medicines being questioned 
   --    the risk of adverse outcome of litigation and/or governmental investigations 
   --    intellectual property-related risks to our products 
   --    the risk of failure to achieve strategic plans or meet targets or expectations 

-- the impact that global and/or geopolitical events may have or continue to have on these risks, on the Group's ability to continue to mitigate these risks, and on the Group's operations, financial results or financial condition

   --    the risk of failure in financial control or the occurrence of fraud 
   --    the risk of unexpected deterioration in the Group's financial position 

Nothing in this document, or any related presentation/webcast, should be construed as a profit forecast.

- End of document -

[1] Constant exchange rates. The differences between Actual Change and CER Change are due to foreign exchange movements between periods in 2023 vs. 2022. CER financial measures are not accounted for according to generally accepted accounting principles (GAAP) because they remove the effects of currency movements from Reported results.

[2] Effective 1 January 2023, the Group has updated the presentation of Total Revenue. For further details of the presentation of Alliance Revenue and Collaboration Revenue, see the Basis of preparation and accounting policies section of the Notes to the Interim financial statements section.

[3] Reported financial measures are the financial results presented in accordance with UK-adopted International Accounting Standards and International Financial Reporting Standards (IFRSs) as issued by the International Accounting Standards Board (IASB) and International Accounting Standards as adopted by the European Union.

[4] Earnings per share.

[5] Core financial measures are adjusted to exclude certain items. The differences between Reported and Core measures are primarily due to costs relating to the acquisition of Alexion, amortisation of intangibles, impairments, legal settlements and restructuring charges. A full reconciliation between Reported EPS and Core EPS is provided in Table 13 and Table 14 in the Financial performance section of this document.

[6] The COVID-19 medicines are Vaxzevria, Evusheld, and AZD3152 - the COVID-19 antibody currently in development.

[7] Cardiovascular, Renal and Metabolism.

[8] Respiratory & Immunology.

[9] The calculation of Reported and Core Product Sales Gross Margin (formerly termed as Gross Margin) excludes the impact of Alliance Revenue and Collaboration Revenue.

   [10]             Programmed cell death protein 1/cytotoxic T-lymphocyte-associated protein 4. 
   [11]             Glucagon-like peptide 1 receptor agonist. 
   [12]             Hormone receptor. 
   [13]             Eosinophilic granulomatosis with polyangiitis. 
   [14]             Human epidermal growth factor receptor 2. 
   [15]             Relapsed or refractory chronic lymphocytic leukaemia. 
   [16]             Neuromyelitis optica spectrum disorder. 
   [17]             Epidermal growth factor receptor mutation. 
   [18]             Non-small cell lung cancer. 
   [19]             Vaccines & Immune Therapies. 

[20] In Table 2, the plus and minus symbols denote the directional impact of the item being discussed, e.g. a '+' symbol next to an R&D expense comment indicates that the item increased the R&D expense relative to the prior year.

   [21]             Cost of goods sold. 

[22] Income from disposals of assets and businesses, where the Group does not retain a significant ongoing economic interest, continue to be recorded in Other operating income and expense in the Company's financial statements.

   [23]             Metastatic castration-resistant prostate cancer. 
   [24]             Human epidermal growth factor receptor mutant. 
   [25]             Chronic lymphocytic leukaemia. 
   [26]             Heart failure with preserved ejection fraction. 
   [27]             Atypical haemolytic uraemic syndrome. 
   [28]             Paroxysmal nocturnal haemoglobinuria. 
   [29]             Programmed death-ligand 1. 
   [30]             Chronic kidney disease. 
   [31]             Chronic obstructive pulmonary disease. 
   [32]             Pressure metered dose inhaler. 

[33] Product Sales shown in the Imfinzi line include Product Sales from Imjudo.

[34] COVID-19 monoclonal antibodies.

[35] National reimbursement drug list.

[36] Biliary tract cancer.

[37] Hepatocellular carcinoma.

[38] Small cell lung cancer.

[39] Poly ADP ribose polymerase.

[40] Platinum sensitive relapse.

[41] Breast cancer gene mutation.

[42] Germline (hereditary) breast cancer gene mutation.

[43] Bruton tyrosine kinase inhibitor.

[44] Sodium-glucose cotransporter 2.

[45] Type-2 diabetes.

[46] Heart failure with reserved ejection fraction.

[47] European Society of Cardiology.

[48] Fixed dose combination.

[49] 'New-to-brand' share represents a medicine's share in the dynamic market.

[50] Inhaled corticosteroid.

[51] Long-acting beta-agonist.

[52] Respiratory syncytial virus.

[53] Complement component 5.

[54] Generalised myasthenia gravis.

[55] Other Operating Income.

[56] Other adjustments include fair-value adjustments relating to contingent consideration on business combinations and other acquisition-related liabilities, discount unwind on acquisition-related liabilities (see Note 4) and provision movements related to certain legal matters, including a $510m charge to provisions relating to a legal settlement with BMS and Ono and a $425m charge to provisions relating to a multidistrict litigation proceeding legal settlement in 9M 2023 (see Note 6).

[57] Other adjustments include fair-value adjustments relating to contingent consideration on business combinations and other acquisition-related liabilities, discount unwind on acquisition-related liabilities (see Note 4) and provision movements related to certain legal matters, including a $425m charge to provisions relating to a multidistrict litigation proceeding legal settlement in Q3 2023 (see Note 6).

[58] Securities Exchange Commission.

[59] Based on best prevailing assumptions around currency profiles.

[60] Based on average daily spot rates 1 Jan 2022 to 31 Dec 2022.

[61] Based on average daily spot rates 1 Jan 2023 to 30 Sep 2023.

[62] Based on average daily spot rates 1 Sep 2023 to 30 Sep 2023.

[63] Change vs. the average spot rate for the previous year

[64] Other currencies include AUD, BRL, CAD, KRW and RUB.

[65] Progression free survival.

[66] Central nervous system.

[67] Fluorouracil, oxaliplatin and docetaxel .

[68] Pathologic complete response.

[69] Gastro oesophageal junction.

[70] Transarterial chemoembolisation.

[71] Overall survival.

[72] Immunohistochemistry.

[73] v-erb-b2 avian erythroblastic leukemia viral oncogene homolog 2.

[74] Overall response rate.

[75] Small lymphocytic lymphoma.

[76] Antibody drug conjugate.

[77] Heart failure.

[78] Transthyretin-mediated amyloid cardiomyopathy and transthyretin-mediated amyloid polyneuropathy

[79] Severe eosinophilic asthma.

[80] Immunoglobulin A neuropathy.

[81] Compete Response Letter.

[82] Supplemental biologics license application.

[83] Lactic dehydrogenase.

[84] Transthyretin-mediated amyloid cardiomyopathy.

[85] Effective 1 January 2023, the Group has updated the presentation of Total Revenue. See Note 1 for further details of the presentation of Alliance Revenue.

[86] The table provides an analysis of year-on-year Product Sales, with Actual and CER growth rates reflecting year-on-year growth. Due to rounding, the sum of a number of dollar values and percentages may not agree to totals.

[87] The table provides an analysis of year-on-year Product Sales, with Actual and CER growth rates reflecting year-on-year growth. Due to rounding, the sum of a number of dollar values and percentages may not agree to totals.

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November 09, 2023 02:00 ET (07:00 GMT)

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