Roche Holding AG

SIX:ROG

Earnings Call Transcript 2020-Q1

[Operator]

Ladies and gentlemen, welcome to the Roche's First Quarter Sales 2020 Audio Webcast and Conference Call. I am Shari, the Chorus Call operator. [Operator Instructions] The conference must not be recorded for publication or broadcast. At this time, it's my pleasure to hand over to Mr. Karl Mahler, Head of Investor Relations and Roche Group Planning. Please go ahead.

[Karl Mahler, Head of Investor Relations]

Yes. Thanks so much, operator. Welcome from my side. We will have the usual setup, and I hope that you had an opportunity and chance to download the presentation by now from our website. And also welcome to those who follow us via the WebEx.Severin will start off and give us his corporate perspective, and that's on the Q1 and that he confirms the outlook. And we have Bill and Thomas, both businesses, Pharma and Diagnostics, are off to a good start. And they will also share with us their view and the impact of COVID on Q1 and also for the rest of the year. Alan will close with his perspectives. He will also do some advertisement on the digital day, which we will have in May, also some advertising from my side and some organizational things, which I wanted to highlight here. You have the opportunity to ask questions via the telephone line. So usually, the operator will announce later on how you can place the questions, but you also have an opportunity to ask questions via the webcast. And then I will read those questions that you have to the audience. And with this one, I wanted to hand over to Severin. Severin, please?

[Severin Schwan, CEO & Executive Director]

Karl, thank you very much, and welcome to everybody to our Q1 briefing. Overall, as you have seen from the results, our business in the first quarter has been quite resilient. But still, the COVID-19 pandemic has impacted us significantly. If we turn right to Page 6, then you see that we responded really in 2 very specific areas to this pandemic. First, on the testing side, as you know, we have been the first to launch a commercial coronavirus test. We have first launched that back in January on our lower throughput systems called MagNA Pure LightCycler. And in March, we also launched a coronavirus test on our high throughput system, which you can see on this slide, the cobas 6800 and the cobas 8800, which, of course, is a huge relief for health care systems because it is fully automated and much less labor-intensive. We have also recently announced that we will launch a highly reliable antibody test beginning of May, which will run on our cobas platforms. The good news here is that we can scale up very fast and that we have a huge installed base out there with over 40,000 instruments on which this test can run. So unlike in the molecular testing setting, we are very confident that we can really go into broader testing for broader parts of the population with the antibody test. And again, key, of course, with this test is specificity. And from the data we have in-house already, we know that this will be a highly precise and reliable test.On the other hand, ACTEMRA on the Pharma side has been adopted in a number of countries in their treatment guidelines. As a result of it, of course, demand went up, to start with. But we also initiated a randomized Phase III trial, COVACTA, which we expect to bring in results in early summer, in June. And at the same time, we are ramping up our capacity to, on the one hand, cover current demand, but that, even more importantly, be prepared in case the study reads out positively. And the first evidence, which we have received so far, is confirmed in this trial. If we turn to Page 7, let me just give a bit of an overview on our assessment for the full year. So we expect quite some volatility over the coming months and quarters. But overall, based on our current assessment, we confirm our old outlook. If you look a bit more into the details, and let me start with Pharmaceuticals, you have seen that we enjoy continued strong demand for our newly launched medicines. And as expected, those sales overcompensate for the entry of biosimilars. So overall, sales growth in the first quarter was 7%. Now the launch of new molecular entities, and we will come back to that, pivotal readouts and pivotal trials, I mean, that is largely on track. Where we now see more volatility is, of course, with Actemra on the upside. And again, we are looking forward to the readout of the ongoing trial. But there are also watchouts, and that's mainly the case for chronic diseases, OCREVUS and LUCENTIS specifically, because what is happening is patients are just delaying their appointments. They are not going to the doctor. They are not going to the hospital. And as a result of that, because they are so worried to potentially be infected or because, in certain countries, they are even asked not to leave their home and only go to the hospital in very acute cases. So as a result of this, appointments are delayed. And of course, the doses are delayed. So we have seen the first impact of that, again, primarily for OCREVUS and LUCENTIS. Now at some point, things will normalize again, and we think we are now really in the critical phase. So we also expect a rebound in the second half of the year. But it's certainly an area to be watched at. And then the second one is, of course, for trials. In particular, if we start new trials, new patients, that is more difficult as health care centers focus so much on COVID-19, and this is especially the case outside of oncology. Shifting to Diagnostics. Overall, sales are pretty much in line with expectations, with the 5% for the first quarter. But the mix is certainly different than we would have expected at the beginning of the year. So what you see here is the strong demand for our COVID-19 tests. And on the other hand, when it comes to the routine testing, then the demand has been lower, in particular, I should say, in China, because in China, the lockdown was really massive. And people in this setting, there's no primary care, right? So everybody goes to the hospitals. The hospitals were really reserved for very acute cases and COVID-19. And as a result, of course, routine testing in the first quarter was impacted, compensated on the other hand by COVID-19 testing. So here, the focus is very much about ramping up our capacities for COVID-19 testing, and that's true both for the pCR molecular tests and antibody tests. So on Page 8, again, 7% up in Pharma; 5% up in Diagnostics. On Page 9, you see the trend very much as expected. On Slide 10, importantly, you see the slide, which we continue to show you on a quarterly basis, and that's really about the transition from the newly launched medicines to those -- from those medicines, which are affected by the biosimilars. And this transition is really on a good way. As expected, you see now, over 1/3 of our Pharma sales are already made up by the newly launched medicines. They have added altogether about CHF 1.6 billion additional sales in the first quarter. And then on the other hand, you see the impact from biosimilars, which is, overall, CHF 857 million. So this is pretty significant, but it's exactly in line with our expectations. Remember, when we gave the outlook at the beginning of the year, our estimation was about CHF 4 billion impact for biosimilars, and that's pretty much in line with what we would have predicted. So overall, actually, really good to see the underlying transition of our portfolio continues as planned with good underlying demand for the newly launched medicines. On Slide 11, you see the geographic mix and exactly as expected. And it's not the other way around, like you have seen it over the last couple of years, where we had much more pressure in Europe because we were going to the biosimilar erosion. And the newly launched medicines were a little bit delayed as usual as we go through reimbursement negotiations. Now of course, the biosimilar effect has been decreasing, and the new medicines are getting more important. And we are in the double-digit growth here. And the contrary is still in the U.S. In the U.S., we benefited in the last couple of years of the strong growth of the new product, but we had no impact for biosimilars. Now we have the impact from biosimilars as expected. And therefore, the growth from the new products is offset accordingly and in the lower single digits, and we would expect this trend to continue for the remainder of the year. Page 13. As expected, good progress on new filings. We had one setback with idasanutlin in AML. The good news is that for VENCLEXTA, the readout for AML was positive. Unfortunately, here, it was negative. But otherwise, really good progress. Tecentriq now filed in liver cancer, in melanoma. We have filed the fixed-dose combination Perjeta, Herceptin. And by and large, we are on track for the launch of risdiplam and satralizumab. You have seen the PDUFA date has been delayed to August, but there is no underlying issues whatsoever. The data are very strong, so it's just a matter of timing that the FDA works through the file. But we will prepare for the launch as planned. To conclude on Slide 14. Putting all that together, with only uncertainty, still, we remain confident to grow in the low to mid-single digits, grow core EPS in line with sales. And on this basis, also, again, further increase the dividend in Swiss francs. Thank you very much. And with this, I hand over to Bill.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

All right. Thanks, Severin. So let's see, I'm going to start by talking about the progress that we're making overall in the Pharma business in terms of growing our pipeline, growing our portfolio. And we really had a quite a high-achieving quarter in the first quarter this year, starting with OCREVUS, where we've now filed for the shorter infusion study in both the U.S. and EU. This is particularly important as it helps to bolster the convenience profile of OCREVUS. So now instead of 2 3.5-hour infusions per year, it ends up being 2 2-hour infusions per year, which is a very low burden of treatment for leading MS therapy. And we think it's something that will be very popular with physicians and patients. But also, we're pleased to see that the regulators are responding very positively on this in terms of expediting approval in light of the advantage also of reducing patients' time in medical facilities. Risdiplam, as Severin mentioned, we got the additional data on part 2 of FIREFISH and part 2 of SUNFISH, all very consistent with what we had seen in the earlier data. This has all now been included in the file, and the FDA asks for 3 more months to review, but we're hopeful for an approval in the summer now. And in the meantime, we've been trying to help patients if they're needing options because of the congested health care facilities. Risdiplam is an oral molecule, whereas the other 2 options require either intrathecal injections or, in the gene -- in the case of gene therapy, immunosuppression regimen. So this is an alternative for patients as well in this time of viral outbreak. Tominersen, which is our drug RNAi-based therapy for Huntington's disease, we're really excited to say that we've now fully approved the Phase III study. It's a 2-year endpoint. So 2 years from now, we look forward to, hopefully, what will be the first-ever positive study, controlled study in Huntington's disease. It's a terrible diagnosis. There's tens of thousands of families and patients affected in the U.S. and Europe and around the world. And so this is really a big step forward. I won't go through all the details of the additional ones, but we've got a number of cancer approvals including, I think, very significantly the -- or approvals in -- on the outlook, the HCC filing, hepatocellular carcinoma filing, for Tecentriq plus Avastin now in the U.S., Europe and China. And we've also gotten our first approval for Tecentriq in China, which is in small cell lung cancer. So really, a lot of good news and positive progress there. Moving on to the next slide. I think just -- if I was going to characterize overall the business in Pharma with respect to the COVID-19 situation, as you see, the new products performing well, overcompensating for the biosimilar impact. Q1 was relatively mildly impacted by COVID-19. We do see, in this time of a pandemic, patients tend to have a preference to stay on whatever therapy they're already on. And so I think, in some cases, that can lead to delays in new patient starts for new therapies, including the innovative new therapies. In general, we see less of that impact in oncology. And we don't think this is a long-term impact, but rather probably some sort of time dynamic. And the magnitude of the impact will depend a lot on how quickly the health care system recovers from the first outbreak. Let's see what else should I say. We're doing a lot of our education -- physician education needs via remote means. And actually, we were already on that trend, but this has sort of accelerated that, and that seems to be working very well. And I'm most proud and pleased to say our supply continuity has been really remarkable. I mean, we have not missed shipments of any of our medicines really anywhere. And there have been some really heroic actions on the part of our technical folks and logistics folks, including chartering planes. In fact, I saw -- recently, I saw a photo of the airspace over North Africa and there was only one plane in the airspace, and it was a Boeing 767 we had chartered to fly medicines from Germany and Switzerland to Morocco and Algiers. And it's really -- there's a lot of stories like that. It's pretty impressive. But I'm really pleased to say we've been able to fulfill every order, and we've been able to also provide products, like ACTEMRA, that have been on high demand wherever they've been needed. So we're working really hard and really proud of our folks that are manning the front lines on that. If I go to the next slide and look at the impact on things like launches and trials, first off, I'm happy to say that our major launches in 2020 are largely on track. You can see the list: risdiplam in August, satralizumab is in the second half of the year. We've now filed the fixed-dose combination for Perjeta plus Herceptin, and that will be a nice advantage for women with breast cancer, the 12-month regimen. And now instead of having to have IV -- sort of serial IV infusions of Perjeta and then Herceptin, they can actually get one subcu injection that has both the Perjeta and Herceptin. And again, that's another advantage for a strained health care system. So we look forward to bringing that out soon. Avastin and Tecentriq with first approvals happening as early as this summer in the U.S. in liver cancer, again, really remarkable results. So we look forward to bringing that forward. And then we had positive results in first-line AML with the combination of VENCLEXTA plus azacitidine. And so another combination for VENCLEXTA, and another win. I won't go through in detail, but I will say that our pivotal readouts and pivotal trial starts in 2020 are largely on track. This is really an area of first concern for us with the pandemic, and I'm pleased to say that it looks like all the things that we had planned for readouts in 2020 and to start in 2020 are largely on track. In terms of ongoing studies, the clinical studies in oncology seem to be less impacted. Unfortunately, cancer doesn't take note of pandemics. And so these patients, their need remains high, and we are continuing to enroll studies in cancer. We're looking very closely at our ongoing studies in chronic diseases, both because of missed doses and just overall data integrity. If patients miss evaluation appointments, that can be difficult on the endpoint measurement. And so we have folks around the world working with health care professionals, investigators on mitigation tactics. And there's a lot of creative work going on. We'll understand this better in a few months. And obviously, the ultimate impact is going to depend on the length and severity of this first wave. But again, I think, overall, really proud of our people and the efforts they've made. Moving ahead, if you look at the response with ACTEMRA. I think Severin mentioned the key facts. I would just say there's a number of studies of ACTEMRA. There have been a number of single-arm studies initiated. There's a large study that will read out from Italy by early May. There's a number of studies that are multidrug studies that include ACTEMRA, including in the U.S. and Europe. And then we have the large Phase III study in 9 countries and a very rigorous study that will, I think, answer a lot of the detailed questions beyond what we can get from either the single-arm studies or the sort of more simple multidrug studies. And then you see the picture there in terms of the supply. But as soon as we heard from China that ACTEMRA might be a significant treatment for COVID-19 pneumonia, we immediately began ramping up the production capacity, and we've got our largest facility in Vacaville, California, that's essentially dedicated to ACTEMRA. We've also begun emergency fills in Hillsboro, Oregon, for ACTEMRA. We're still producing in Japan at Chugai. And we're -- we've got additional production capacity if we need it. But so far, we've been able to supply everything required, and we're working on building a stockpile. All right. If I turn to sales, 7% result, which I think we're very pleased with, again, because of the significant biosimilar impact. To be able to continue to drive that level of sales growth is, I think, quite remarkable. Importantly, that reflects 18% volume growth and 11% overall decline in price. And again, if you think about the scope, magnitude and breadth of the Roche medicine portfolio, if you think about an 18% volume growth, it's really quite dramatic. There's really kind of 2 geographic segments, if you will, starting with the U.S. and Japan. These are areas where we have really pretty intense biosimilar competition. At the moment, in the U.S., where we now have Herceptin, Rituxan and Avastin, multiple biosimilars for all 3 and to be able to drive 3% growth despite that, I think, is really impressive. And likewise in Japan, there's biosimilars to Herceptin -- well to all 3, but larger impacts on Herceptin and Avastin. So continued strong performance there. And then in Europe and international, you see, basically, what we're capable of when there's less biosimilar impacts, that even in markets like Europe, where, overall, it's a tough market, but we're growing 14%. And so I think a really strong result. If you look at it on the next slide, on a product basis, again, I think a really nice picture. You see our top 3 products, Tecentriq, Hemlibra and OCREVUS are all contributing more than $1 billion of growth on an annualized basis, and that's just a great strength to build behind in terms of our ongoing investment in R&D. You also see Perjeta, very large growth. I'll come back to ACTEMRA. But also maybe I would point out on here, Alecensa and Gazyva, which are, again, stepping up contributions, 43%, 49% incremental growth. And other thing I want to point out, you see a couple of effects here. Like if you look at the Esbriet line, 22% growth, and we think this does probably reflect a bit of stockpiling at the patient level. So this would be patients that are concerned about -- these are pulmonary fibrosis patients. They don't want to be out and at-risk of getting the virus. And so maybe they're asking for 2 refills instead of 1. And so we see a little bit of bump in sales there. That's probably a stocking effect. And then down at Lucentis, you see a minus 13%. And again, this is probably the beginnings of -- because this would only really reflect the March impact of the elderly patients wanting to stay out of the health care facilities. And so I think that's sort of the beginning of the impact during this pandemic wave. Finally, you see the biosimilars at the bottom effects on Avastin, MabThera and Herceptin. Again, if you consider the magnitude of those impacts and the ability to grow 7% through it, I think it's, again, pretty strong outlook. Moving on to oncology. There's -- I think this is pretty straightforward. But you can see, overall, oncology, we were roughly flat with the quarter from the year earlier. And again, it's strong growth in new products offset by the biosimilar impact. I'll just go to the next slide and look a little more detail on the HER2 franchise. Again, here, you can see that now Perjeta and Kadcyla combined are actually significantly larger than Herceptin, and that's exactly sort of how as we intended it. We think we're going to have continued strong growth here because of Kadcyla and Perjeta continued uptake in the early breast cancer space. Also we now have Perjeta and Kadcyla in early breast cancer in China, so that's a strong one. And then as I mentioned, we've now filed the fixed-dose combination of Perjeta and Herceptin in the U.S. So some good outlooks offsetting the biosimilar impact on Herceptin. Moving on to hematology. Again, strong growth from Gazyva driven by both first-line CLL and first-line follicular lymphoma. VENCLEXTA, which doesn't show up on the chart, but if it did, the chart would look rather stable than declining. We've had strong growth again on VENCLEXTA. The precise numbers will be reported by AbbVie, our partner, and they booked the sales. So we experienced the economics on our P&L, but not the sales. But again, strong -- some progress there and a good continued outlook for the rest of the hematology franchise beyond MabThera.Now if I move on to Tecentriq. I hope you'll agree, we've all been looking at a lot of exponential growth curves in recent days, but this is actually a good exponential growth curve. This is just showing the benefits of Tecentriq for patients with small cell lung cancer, non-small cell lung cancer, TNBC and other indications. And I think, again, really strong growth story, continuing to accelerate on growth. Just a couple really especially strong spots here. In Europe, Tecentriq is up 170% year-over-year, in Japan, up 111% year-over-year. And this is some of those core indications really kicking in, getting traction with reimbursement coming through in a good way. And then as I mentioned, we've now filed in the U.S., Europe and China for hepatocellular carcinoma. And as you recall, there's -- I think it's 900 patients a day diagnosed with hepatocellular carcinoma in China, so we think this could be a real big driver of patient benefit and growth there. Now moving on to immunology. This one, we had a little higher growth than we would have anticipated. And this is driven by, as I said, a bit of stocking likely at the patient level on Esbriet. And then ACTEMRA with 30% growth in the quarter, again, we expect that to be higher in Q2 due to the timing of the wave 1 peak. And we're doing everything possible to prepare for continued supply. You can see XOLAIR, strong results, despite competition. And so overall, immunology continues to be a stable for the Roche portfolio. Now in neuroscience, so the update on OCREVUS, really a good picture here in terms of the historical trajectory. And in fact, we achieved well over 40% new and switching patient share in the latest results. So I think that combined -- that ongoing belief in the efficacy and safety of OCREVUS, combined with the shorter infusion, is a really strong recipe for future success with patients. I do want to make a few comments about OCREVUS in the context of COVID-19. So when the virus first started spreading and people started being concerned about it, the question came up about, well, what about B-cell depleting therapies and a viral outbreak. Should patients not go on OCREVUS? Should they have their doses delayed if they're already on OCREVUS? And there was some sort of mixed guidance. Some countries suggested delays. Other countries didn't. But what's happened in the meantime is that there's been a lot of registry data collected, including in Italy, which was the first big hotspot with MS patients with COVID-19 on various disease-modifying therapies. And there's also data coming into our normal pharmacovigilance channels as well as data starting to accumulate from other countries. And I think we can look forward to this data being published in the near future. But the bottom line is we don't see anything particularly concerning at this point. And so we think the outlook is good in terms of -- from the safety questions. And so basically, what we think is going to happen is in Q2, we'll have some delays in therapy. We'll have some delays in patients getting re-dosed, delays in new patient starts. But we expect this to be a phenomenon that would be relatively short-lived. And we should see a strong recovery after the initial wave. That brings me to the rest of the neuroscience franchise. So good strong progress on risdiplam. We look forward to launching in Types I, II and III SMA this summer in the U.S. And then satralizumab, which will be, again, in the second half of the year, an important new therapy for NMO spectrum disorder. So again, lots more coming in neuroscience. Finally, in terms of the franchises in hemophilia A, continue to gain share in non-inhibitors in the U.S. Also now strong non-inhibitor uptake in some of the initial launch countries in Europe. And overall, we've got more than 6,500 patients treated globally. You can see we're now over the CHF 2 billion annualized run rate as of Q1. Again, just a real testament to the power of this therapy for people with hemophilia. And so we think there may be a couple of factors going on here. If we look out into Q2 and 2020, there may be some impact on new patient starts just because, in a time of people trying to avoid going out or going to health care facilities, that may delay some new starts. And then we may be seeing some stocking effects. It's a little hard to read where patients maybe are getting 2 months' worth of therapy or 3 months' worth instead or 1 month, but it's hard for us to read through it. But we think, again, these will be temporal effects. Now there's one other thing that I want to do in this call because this is the first call where we've had a chance to really fully integrate the Spark acquisition and have a chance to partner with our great colleagues at Spark on their programs. And so I wanted to provide an update because they historically were providing updates on their programs. And so I just wanted to give a bit of a flavor of what's happening there and a bit of a news flow. So our teams are already collaborating very well, leveraging our success in hemophilia A with Spark's proven gene therapy expertise. Let me just sort of say a word about our line strategy, and I think we came together very quickly on this. Our objective is to develop gene therapies for hemophilia A, that with the lowest effective dose and the optimal immunomodulatory regimen just demonstrate really high, high safety, predictability, efficacy and durability in a manner that's similar to the results that we saw with the hemophilia B asset that's currently in Phase III. And maybe a way to think about this is in the presence of a product like Hemlibra, where it's dosed as infrequently as once a month subcu, very high efficacy, very strong safety profile, the bar is really high for gene therapy. The willingness of patients to take what may be their only chance in a lifetime to get a gene therapy is a very precious thing. And patients and doctors are not willing to do that, unless they have a gene therapy that is super well tolerated, long-lasting, strong expression of factor. And so for all those reasons, we're setting the bar incredibly high. We've been very encouraged with the progress of patients that are treated with the SPK-8011 in the Phase I/II clinical study at the 5 x 10 11 and 5 -- and 1 x 10 12 doses. And Spark is going to present these data. They hope to present those at the virtual ISTH meeting in July. In line with the strategy, Spark is also continuing to work to optimize the dose and the immunomodulatory regimen and to really get that optimized for both SPK-8011 and SPK-8016. So as a result of this, we now expect to dose patients in a Phase III clinical study in 2021. And additionally, Spark has filed with FDA request to use drug substance manufactured using a suspension cell culture process in a Phase III dosing study in 2021. So their scale is now nearly 500 liters, and they've got corresponding chromatography purification process, which is the scale that's required to meet the clinical and potential commercial demand for hemophilia A. So apologize, that's a lot of information, but I know, for those of you who've been following Spark closely, that's probably helpful. So let me close, just kind of recapitulating the overall outlook. We've got now -- our new product sales are exceeding annualized rate of CHF 18 billion. It's, again, a remarkable trajectory over the last 4 years, 15 approvals since 2012 and, again, continued strong progress on our goals. In terms of the news flow for the remainder of 2020, some of the things to look forward to are listed here. I would just highlight the risdiplam Phase III data, and it's going to be presented at our virtual IR event on April 28. Also an IR event on digital technology and advanced analytics on May 7. And hopefully, we'll see all of you one way or another, virtually or live, on Roche Pharma Day on September 14. So thanks very much. And with that, I'll pass it on to Thomas.

[Thomas Schinecker, Chief Executive Officer of Roche Diagnostics]

Thank you very much, Bill. Good morning, good afternoon, everybody. I'm very happy to present the Diagnostics division sales, so can we please go to Slide 33. With sales of roughly CHF 2.9 billion, we had more than 9% -- more than 5% growth in the first quarter. And excluding diabetes care, that's actually more than 7%. So overall, we had very good performance and outperformed the market. The growth was driven mostly by Molecular Diagnostics at 29% growth. This was specifically driven by point-of-care flu testing as well as COVID-19 molecular testing. Now within the Centralized and Point-of-Care portfolio, you can see that the Central Lab testing actually declined by 2%, and this was due to the COVID-19 outbreak in China and other countries where we've experienced less routine testing and also less surgeries, which has impacted that business. On the other hand, we could offset that to a certain degree because our Point of Care sales increased by 8%, and this was driven by demand for blood gas testing, which is key for emergency use, but also other acute testing. Now when you look at Tissue Diagnostics. Tissue Diagnostics grew at 12%, and this was driven mostly by advanced staining. And here, we had no impact from COVID-19. Diabetes Care sales declined 2%, and this is still impacted by continued adoption of competing technology to BGM. So overall, sales are in line with our expectations. Although we do see some opposing shifts due to COVID-19, we could compensate losses because of the lockdown to new sales. I believe, personally, there was never a time when our portfolio strength, breadth and diversity was more evident than today. If we go to Slide 34, looking at our regional sales growth. The growth is driven by North America with 12% and EMEA by 7% growth. This is, again, due to the molecular testing. Latin America grew nicely as well 20% as well as Japan with 14%. Now in Asia Pacific, we had negative growth of 11%, and this was really driven mostly by China, where we had a reduced number of hospital bills. As you may know, we don't have -- or there is no primary care segment in China, so there is a bigger impact there, for sure. And that's why China declined by 24%. Now if we go to the next slide, please, Slide 35. So here, you see some of the highlights throughout the different business areas. Sales in Centralized and Point of Care Solutions declined minus 1%, as mentioned before. This was driven mostly by the immunodiagnostics business, which declined by 4%. Again, this was due to COVID-19 outbreak in China and other countries, and we could offset that with Point of Care as mentioned before. Molecular testing had a very strong growth, 29%, driven by the Point of Care flu testing on earlier as well as COVID-19 testing. And within the virology number that you see there, this is also where our high-volume test is being reported. And remember, we only launched this test 4 weeks ago, so we only had 2 weeks of sales in the first quarter. And virology also includes HIV, HPV, which actually saw a decline. So there, you can see the huge impact we had with the assay coming on margin. Within the LightMix Systems, you see 87%. This is the MagNA Pure LightCycler systems that you'll see in a second. Here, we launched the TIB Molbiol assay already late January. So if you really go back, in China, we didn't have any assay to test against the virus. The sequence was just released. And within record time, we came on a low volume solution and a high throughput solution to really help combat this pandemic on a global scale in a very rapid way. Really, our team is working very nice on both in R&D and operations to make sure that we can help many patients as possible. Tissue Diagnostics grew 12%. And as mentioned, this was the advanced staining. Now going to next slide, Slide 36, you can see the different -- 2 options we have that we tried to the market. So on the top, you see the 6800 and 8800 on which we have launched the high throughputs -- the SARS-CoV-2 high throughput test. So in response to this pandemic, Roche was actually the first company to receive emergency use authorization from the FDA and also [ the CE ] mark for the high throughput test on a fully automated system. We've launched the system about 4 years ago. We have now more than 850 systems in the market. And we're continuously installing because there's a huge demand that we see now. And it's going to go forward because, really, from a customer feedback, there's no system that can meet the high throughput needs the same way as these systems can. On the bottom, you see that Roche launched also the TIB Molbiol LightMix model assays and MagNA Pure LightCycler, but we also enable other assays to run on those platforms. And also here, we provide millions of tests per month, and we're really doing our utmost, working day and night, over weekends, Easter, et cetera, to make sure we can supply as much reagents as possible. Now looking back to the last 4 weeks, we supplied more than 15 million tests alone in the last 4 weeks. Again, going back to January, there was nothing, 0, so this is a huge ramp-up and a testament to the strength of our organization also from the manufacturing side. So we're very proud on how this happened in a very short period of time. Our third contribution to fight the pandemic, you will see on Slide 37. So we will launch an assay to detect antibody for COVID-19, and this will be available in early May. And this detection of antibody is essentially to help, again, people who have been infected by the virus, especially those that are asymptomatic. We've also accelerated manufacturing here, really ramping up, so we will be able to provide a high double-digit million tests per month already in June, and we will continue to ramp up from there. And this will run on more than 40,000 systems worldwide. So we have a very broad installed base on which we can support the world in fighting this pandemic. On the next slide, Slide 38, we are also very happy that in Q1, we've got the FDA approval for both the HPV test on the 6800 and 8800, but also for the CINtec PLUS Cytology test. And this was based on clinical validation data from a registrational IMPACT study that enrolled more than 35,000 women. This is truly a landmark study on the diagnostic side. In CINtec Plus, we are the only ones that provide this kind of solution to the market. It's the first time that's being launched on the U.S. market. This will have a huge impact. And our screening portfolio allows physicians to manage women based on the level of risk for cervical cancer and will help make decisions that result in improved clinical outcomes and low healthcare costs. Compared to traditional tests, which is still done widely around the world, actually, the IMPACT trial data shows that CINtec PLUS Cytology has demonstrated 31% increase in disease detection in women that have positive high-risk HPV. With the addition of HPV also on 6800 and 8800, we are continuously building out our menu for the U.S. markets and can offer comprehensive solution in infection disease in the U.S. On Slide 39, please, you can see that we have received FDA breakthrough device designation for Elecsys GALAD score. This score is a combination of gender and age with 3 biomarkers. And these 3 biomarkers are AFP, AFP-L3 and PIVKA-II. AFP-L3 is still in development since we launched, and this is intended to aid in the diagnosis of early-stage hepatocellular carcinoma. And hepatocellular carcinoma, if you're diagnosed very late, there's a very high death rate. Actually, less than 16% of people who survived the 5-year period. But if you use this kind of technology and have an early diagnosis of HCC, this survival rate can go up to 30% -- up to 70%.And the Elecsys GALAD score will be first score with regulatory approval for B2 diagnostics, and it's an integrated part of our Liver Indication Program, which aims to improve diagnostic workflows for chronic liver disease management. And as you can see also on the slide, on the left side, we already have an HPV Test on the market, but we also have a development in our pipeline that it protected to also diagnose NASH, which is non-alcohol steatohepatitis. So again, making superb progress in our pipeline also in these areas. And finally, we've also released the Roche Diabetes Care platform. It's a cloud-based successor for all digital diabetes management solutions. It connects health care professionals seamlessly to people with diabetes. It's a modular platform, and it facilitates efficient analysis and decision support for health care professionals. It includes a pattern-detection model to help increase understanding of insulin dosing, glucose monitoring, behavior, time and range and treatment adherence. So with that, we're going to help patients manage their disease better in conjunction with their health care professionals. On the key launches, we've made good progress with already 4 of the planned launches in 2020, and we're also on track with the other launches that are planned for the remaining -- remainder of the year. With that, I thank you very much for your attention, and I hand over to Alan.

[Alan Hippe, Chief Financial & IT Officer]

Yes. Thanks, Thomas. Yes. Well, not so much to say. Basically, a couple of comments on currencies. I would like to start on Slide 44. This is the summary of the group sales Q1 2020. You see on the left-hand side how we have grown in absolute terms as well as in percentages, and my colleagues did a great job to explain that. So I would like to point you to the right-hand side of the slide, where you see on one hand, in blue, the roughly CHF 1 billion sales growth in absolute terms. Then unfortunately, you have to deduct the CHF 698 million due to the current effect that we've seen in Q1, which leaves us with a growth in Swiss francs of 2%. So this is really driven by a lot of effect, and you can see them on Slide 45. And basically, what has happened is that the Swiss franc has strengthened against all major currencies and predominantly, against the U.S. dollar and the euro. And even -- and I ask myself, okay, this is end of March. What happens if you do that in the 20th of April? And if you were doing it at the 20th of April, the picture would be the same. So there is not a lot of movement for the time being. Certainly, I think when the recovery is coming, so whatever that means, I think we will also see some movements on the currency side, I would assume. With that, let's go to Slide 46. And as you can take on 46, on the left-hand side, is the currency impact at average reduced slightly over the course of 2019. So really not much coming from the base of 2019. There was -- the average there was pretty flat. That means that there is not much impact coming and not lots of positives on the currency side from the comparison to last year. On the right-hand side, you see our projection assuming that the currency rate as of March 31 remains stable until year-end, which is not very likely, but nevertheless, for us, the best prediction we're having. And what you see is we would have a major impact on sales core operating profit and EPS growth. And when you look at half year, with an impact, a projected impact of minus 5 percentage points on sales, with minus 6 percentage points on core operating profit and with minus 7 percentage points on core EPS, that is, on one hand, pretty significant. And on the other hand, pretty likely because, well, there is a lot of product left until we get to the half year. So let's see what happens until year-end. Certainly, the projections for year-end are much more volatile than what we're having for the half year. So as I said, the recovery in the second half would be helpful. Let me point out on Slide 47 that we have an upcoming virtual event where you might see me at a different role, another role I'm having as well, and I'm excited about that. Basically, that event is an answer to multiple analyst and investor requests. So we will provide a session about digital and advanced analytics at Roche. It will be a rather condensed session and will be surely very exciting. And with that, let's go to Slide 48. The outlook once again, and as Severin said, based on the current assessment, we confirm our guidance. I think important to mention that we stick to our expectation that the biosimilar impact for 2020 is roughly CHF 4 billion. So we stick to that. On rough terms, I think that should be the number. And as said, I think a certain recovery in the second half would be helpful. So with that, we are -- we thank for your attention, and we're happy to take your questions. Thanks.

[Operator]

[Operator Instructions]

[Karl Mahler, Head of Investor Relations]

We do have one question from the web, which is from Brian [ Dan Yves ] and he was wondering about the subcutaneous usage in particular in Europe and if there is an increased interest in subcutaneous use. I think this is a question, which is going to you, Bill. And maybe operator, if you could kindly also let us know on how everybody could dial-in into the call later on again. Thank you.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

Right. So Karl, Karl, just to clarify, did you say subcutaneous use of the oncology medicine?

[Karl Mahler, Head of Investor Relations]

Herceptin. Yes, exactly. Herceptin, trastuzumab. It's about the question of Erica.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

Yes. Yes, we have had increased interest in that in a number of places in Europe and the U.S., and we've been supporting urgent request to ship product to, yes, a number of doctors. I don't know that it's a material long-term change, but we've certainly been fielding those requests in the last few weeks.

[Karl Mahler, Head of Investor Relations]

Maybe the next question over the line, operator, please.

[Operator]

[Operator Instructions] The first question comes from the line of Luisa Hector from Berenberg.

[Luisa Hector;Berenberg;Analyst]

And perhaps we should also thank all of your employees for the amazing efforts in this crisis. So I wanted to just get to the guidance, obviously, reiterated today, but perhaps you could talk a little bit about any changes within that. I'm sort of thinking perhaps a little bit more of a contribution from diagnostics. You have your serology test. We're seeing some impact already on the LUCENTIS, possibly OCREVUS. So is there anything outside of that, that you would add?And also on the cost lines, should we expect differences in the cost lines versus the start of the year? So perhaps higher cost of goods as you secure your manufacturing lines but possibly lower costs due to some of the stay-at-home measures? And any cost reductions that you are taking over and above just that natural fallout from those staying at home? And perhaps you could also comment on just the baseline assumption for COVID-19, are you assuming a peak in April with no second wave and then a recovery? And how do you plan to get your workforce completely back in the field overlaps and so on?

[Severin Schwan, CEO & Executive Director]

This is Severin. First of all, thank you very much for your feedback and the appreciation of all the colleagues at Roche, too. That's very appreciated. And we're equally proud of the contributions they make. In terms of the guidance, I think we covered the main elements in the presentation. It's really about specific medicines. We touched on ACTEMRA upside on the one hand, OCREVUS, LUCENTIS, some pressure certainly in the second quarter. And then on the diagnostics side, strong demand for molecular tests, and we'll see how it plays out for antibody tests but probably also some upside from that side. As far as costs are concerned, I mean, we also confirm our guidance in this respect. That is to grow EPS in line with the sales growth. I mean you have seen the exchange rate effect. So we have to make that caveat. But overall, we should be broadly in line with sales and should be also managed as a consequence -- be able to manage the cost side as a consequence. Bill, I know we have had a lot of discussions about potential scenarios of how the pandemic could develop. Perhaps you could share a bit our assumptions.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

Sure. Sure. Yes. We've actually -- we have a number of infectious disease specialists at the company because of our historical work in hepatitis and influenza and now, we're working in SARS, too, in COVID-19. So we've actually done quite a bit of modeling of the different scenarios. And while there's almost an infinite number of scenarios, I guess, the 2 that we're probably focused the most on, there's 1 scenario, where after wave 1, we have sort of intermittent restrictions case where restrictions are eased up, but then cases return and then there's new restrictions, and it sort of goes back and forth a bit on that. And then the other probably significant scenario we look at is one where there's a sort of medium to low level of cases that are tolerated in an ongoing basis. And then societal restrictions are kind of eased or adjusted to kind of get to the sweet spot where we're able to handle the case load without overloading the intensive care facilities. And so in that scenario, that's probably a faster of getting people back to work in general in society but does require more health care intervention. So we're preparing for both of those scenarios. In terms of getting our employees back to work, our first priority all along has been both our employee safety and then the business continuity for delivering essential medicines and diagnostic tests. Again, we've, I think in both Diagnostics and Pharma, done an amazing job of keeping all our facilities running and really at record output levels. After that, we will start to bring back more essential site-based functions. So like employees that are based in labs and things which, in general, have not been on-site will -- first priority will be to get them back so that we can get their experiments running again. And then the rest of the workforce is probably going to be working from home a lot for quite some time because we've found that we can be remarkably effective at keeping our essential mission work on track, thanks to the new tools that are available and the great support from our IT colleagues and so we will basically try to keep as much distancing as is possible while we continue the mission forward.

[Operator]

The next question comes from the line of Mark Purcell, Morgan Stanley.

[Mark Douglas Purcell, Equity Analyst]

I have 2. Firstly, I mean clearly, the COVID outbreak is generating greater appreciation of diagnostics and greater investment by the industry leaders, including Roche, where significant capital purchasing across different platforms to diversify testing infrastructure across labs and government labs. So could you help us understand where Roche is in terms of the installed base today? I know historically, you talked about increasing your relative share in the U.S. and China and how this installed base is expected to change over the course of 2020. So Thomas, provide us some qualitative comments. Wondered if you could be more quantitative. But then more importantly, in terms of the long-term legacy and the opportunity that's going to be created once the immediate demands weigh now over the next sort of 12 to 24 months or so, which areas of diagnostics do you see as opportunities to strengthen by adding in new technologies and innovation on top of your existing base? And then the second one is just a quick one in terms of the -- on the Pharma business, do you anticipate any significant changes in payer mix based on COVID-19 pressures in 2020 and maybe into next year? So there's a lot of chatter about increase of $340 billion potentially some off-cycle price cuts in Europe. So any thoughts in terms of payer mix would be gratefully received as well.

[Karl Mahler, Head of Investor Relations]

Thomas, you want to start with payer mix?

[Thomas Schinecker, Chief Executive Officer of Roche Diagnostics]

Yes. I mean, what I can say is that we have extremely high demand, not only for the test but also for the systems. So in effect, we have probably more than 1 year what we would produce in 1 year as recurrent demand, a lot on the instrument side. And what we also know is that we're being contacted by a lot of governments that looking at preparing themselves for future dynamics or for future rates also wanting to have more systems in place of the 6800, 8800. I mean, these systems make sense. You have seen them in some of our sites or in customers. These are fairly big system, particularly 8800 alone has 23,000 parts, and it's fully automated. So it can run a lot of samples in a very short period of time. And really, in this pandemic, I mean the people has said that these systems are actually ideal for really these kind of situations. So we see that governments have high interest to purchase more of that. So with that, I do believe that there will be, not only a higher installed base after this situation but also going forward, different governments will invest more into the health care infrastructure and specifically into diagnostics. And I think this will benefit not only us but the industry overall. And I think it's right. I personally believe that diagnostics for a long time has been underestimated, not only from a complexity perspective but also from the value it brings to society, to patients and to health care overall. So I think that this will definitely mean a difference for diagnostics care.

[Severin Schwan, CEO & Executive Director]

Thank you, Thomas. Perhaps I can add 1 other thought here, which -- I think there is an echo here. But another thought here, which might come up in the second half of this year, and that's about the flu. Traditionally, in Europe, flu is not considered as a disease. I mean people say, well, this is like a cold. What's the big deal? This is different in the U.S. This is different in Japan, but I could well see that in combination with this coronavirus outbreak, we will have a completely different attitude towards flu in Europe. There will be very important questions. I mean just think of you personally. If you get fever, you want to know, do I have flu? Or do I have the coronavirus? There are very important questions in terms of what is the prognosis if I'm potentially co-infected? And you can immediately see the consequences for that. And that is also very relevant for us as a business as we are active in virology as a company. And as we have not only an offering for the COVID-19, in particular, on the testing side, potentially with ACTEMRA. We are also looking at antivirus, which are at the earlier stage, but also very much on the flu side. So when we have been talking with government last year in Europe, I should say, in particular, and we were talking about the value Xofluza brings to society because it reduces the viral shedding compared to Tamiflu. I mean governments didn't even understand what we were talking about. They literally didn't understand what we were talking about. And they said, "Well, do you get rid of flu or not?" And we said well, the efficacy of Tamiflu and Xofluza is comparable from all what we have seen so far from the data. But what we know for sure is with Xofluza, you may take 1 dose upfront, and the virus stops spreading after 24 hours, which is completely different to Tamiflu. And people were looking at us like what are you talking about. I continue with Tamiflu. I mean, we didn't even get through with our message. What I see already happening is people have a completely different awareness in terms of testing because now everybody knows what that could potentially mean, especially if we have a combination of an ongoing coronavirus level and the flu on top of it. And people now understand in a intuitive way how important the virus spreading is to keep such a pandemic in check. So I think there is a almost historic chance, I have to say, that the awareness of the severity of flu, which has been very low in Europe, will now change. And that will also have an immediate impact on us and other companies active in this field.

[Alan Hippe, Chief Financial & IT Officer]

And there was a question about changes in the payer mix. I think that, that was a phenomenon that was seen, for example, in the U.S. in the financial crisis in 2007, 2008, and there was an increase that was seen in terms of use of free drug programs and use of various indigent programs. I think it's probably too soon to speculate on that now. I don't think anybody claims to know how deep and hard the economic impacts of COVID-19 are going to be. So I think it's something we'll watch and similarly, with European payers. So I think we'll have to stay tuned.

[Karl Mahler, Head of Investor Relations]

Yes. Thank you. Before we go into the next question, I have a bit of a health warning for all of us because I see a long queue of questions. It's 11 now, and we have 30 minutes left. So if you could kindly maybe restrict the questions to two, that would be ideal to also give a chance to all the colleagues to ask their questions.

[Operator]

The next question from the phone comes from the line of Sachin Jain, Bank of America.

[Sachin Jain, Managing Director]

Sachin Jain, Bank of America. A few questions, please. Firstly, on the serology test, I wonder if you could just provide a bit more details around the reliability in terms of specificity and sensitivity and its ability to detect neutralizing antibodies. There's been a lot of media since a variety of approvals regarding the usefulness of a serology test in general.Second question is on ACTEMRA pricing for the COVID situation, how you think about that in a broad level? Do we expect us pricing to be consistent with the existing indication? And then just a clarification question back to guidance on the first question. Just to check on OCREVUS, LUCENTIS and Hemlibra. Are your expectations of the full year growth expectations are the same post-COVID? I know we're debating it's mainly phasing through the year. Or are you expecting a softer full year outlook for those 3 products? And on the COVID upside, any color you can give on what side you've baked into guidance for testing and ACTEMRA relative to what could be quite a substantial opportunity.

[Karl Mahler, Head of Investor Relations]

Thomas, on the antibody test.

[Thomas Schinecker, Chief Executive Officer of Roche Diagnostics]

Yes. I hope I heard the full question because it was breaking up.

[Karl Mahler, Head of Investor Relations]

It was about specificity and sensitivity of our tests.

[Thomas Schinecker, Chief Executive Officer of Roche Diagnostics]

Okay. Good. So at the moment, we're still finalizing all that data. It will all be finalized by Friday. What is key for the use case that we're looking at, specificity is the most important number to look at because you don't want to have any false positive, specifically in the amount of people that have been infected is still very low. Specificity is critical, really critical in order to make sure that you understand who is truly positive not that you get any false positives. So you want to get that number as close to 100% as possible. 100% never exists. I mean, if you have 100%, basically, you didn't test enough samples to be clear about that, but we aim to be very close to the 100%. And so we believe we have a very reliable test in hand. So very -- we're very comfortable to say that now already. And more, we will communicate it at launch.

[Severin Schwan, CEO & Executive Director]

Right. So perhaps I can just add here. I mean the more samples you test against patients, the smaller your confidence in the bell curve. And of course, the more precise the information will be. And we continue to test the test and validate them. So what we can say is we have enough data to be absolutely certain that this will be a super reliable test. But we don't communicate an exact number and the number behind the comma because we want to wait for the very final data, which we then communicate together with the launch. So stay with us for the details. We don't want to confuse our customers or the wider public with several kind of small differences along the numbers now for literally the next 1.5 weeks. But we can assure you with certainty from the data we have, this is really an excellent test. And the reality is when you develop an antibody test, you also need a little bit of luck. And the good news is we had the right targets among those which we investigated, and that allowed us also to achieve these levels of specificity and sensitivity, which are, you will see pretty astonishing. But the precise numbers will come out when we launch.

[Alan Hippe, Chief Financial & IT Officer]

And you had the questions about individual products and the impact of COVID-19. I'm sure you know we don't normally quantify our guidance for individual products, but we have taken into account some of the temporary cause effects, such as stocking and delayed patient starts. And then we've also sort of foreseen some additional revenues in other areas that are driven by COVID-19. So there's some ups and downs. And I think on the balance, that's -- we came to the conclusion that we should reconfirm our guidance at this point because that's our best outlook.

[Karl Mahler, Head of Investor Relations]

There was a question also there on the pricing for ACTEMRA.

[Alan Hippe, Chief Financial & IT Officer]

Oh, sorry. Yes, yes, sorry. Yes. So in terms of pricing for ACTEMRA, we will certainly look at that. I mean we're going to wait for our Phase III trial results, and it's hard to price something if you don't know precisely what it does. And so -- but you can be assured that we'll be very mindful to make sure that the price is something that enables broad patient access. We want to make sure that we do everything possible to help the world fight off this pandemic.

[Karl Mahler, Head of Investor Relations]

Thanks. Next question, please.

[Operator]

The next question comes from the line of Steve Scala from Cowen.

[Stephen Michael Scala, MD & Senior Research Analyst]

I have 2 questions. The Phase III TIGIT non-small cell lung cancer trial is in PD-L1 high patients. Does this indicate that there is only activity in this subgroup? Or was this more of a strategic decision? And then the second question is with the second quarter nearly 1/3 over, what can you tell us about the status and progress of clinical trials in April, which seems to be the peak for the virus in many areas? Is it markedly different than what was seen in Q1? Or is it about the same as what we saw in Q1?

[Alan Hippe, Chief Financial & IT Officer]

Yes. As to your question on TIGIT, I think we would expect -- well, first off, we will be studying TIGIT in PD-L1-positive patients and in some settings in all-comers. It's going to depend somewhat on the combination, whether it's with or without chemo. Also, yes, so I think the story is yet to be written in terms of where TIGIT will find its best utilization. But I think we would hope that we would see -- use both in the biomarker-identified patients as well as all-comers in some tumor settings. What was the question?

[Karl Mahler, Head of Investor Relations]

It was about the clinical trials.

[Alan Hippe, Chief Financial & IT Officer]

Oh, yes, sorry. Clinical trials in April. Yes. Yes. Unfortunately, I mean it's April 22, and we're -- we mostly have anecdotes rather than data at this point. We know a lot of things have continued progressing. And then we know in places like -- you can imagine in New York City, in early April, there weren't a lot of patient visits happening in chronic therapy studies. So it's really a mix. And our clinical operations people are making heroic efforts to interface with the investigators and mitigate where someone missing an appointment? Is there a way to reschedule it? Is there a way to come up with an alternative like an at-home visit? So we're doing all kinds of creative things, but we won't really have a full accounting of the impact probably until at least maybe the next quarter call.

[Karl Mahler, Head of Investor Relations]

Thanks. If we go to the next question, please.

[Operator]

The next question comes from the line of Richard Vosser, JPMorgan.

[Richard Vosser, Senior Analyst]

Two, please. Firstly, just going back to the serology testing. Obviously, the WHO has put some -- called some assertion on the test just -- and obviously, that's something to do with the specificity. But what appetite do you see from the government for widespread testing across large waves of the population? Are they still thinking of that? What's the latest thoughts there? And then second question, just going back on the biosimilars. You talked about new product launches being impacted by COVID. Could we see any maybe slowdown? Are you seeing any slowdown in terms of the adoption of biosimilars due to COVID-19? And maybe also what's underlying the differences? Rituxan seems to hold up better. Is that the label around Teva's biosimilar being less broad? Just some thoughts there about the differences we're seeing in the U.S.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

So should I start, Severin?

[Severin Schwan, CEO & Executive Director]

Yes, please.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

Yes. So with regard to WHO, the question around specificity, I mean looking at the tests that are in the market, there is a wide range of performance, I would say. And I mean one thing is for certain that from a technological perspective. If you do a point of care level of flow test and you take it from the finger prick, you will never get as good as a result as when you take it from the [ mean ] and you run it on these high-performance systems. And so some of these performance data that I have seen, I would take that with a certain level of caution as well. So I would agree with the WHO on that one. The second thing that the WHO has also mentioned, I mean, and I think that's also important. I mean, we're now identifying the antibody to really understand if there's immunity. How long is the immunity? We need more data, so this is a very new virus. Given the experience with other virus, there is an assumption, a working hypotheses that you would have immunity for a certain period of time. To your question regarding government, yes, we are contacted regularly by governments. And Severin and I have a lot of calls. And of course, antibody testing is of high interest to them as well, specifically also to test the health care workers to see who's been infected already, et cetera. So there is definitely a huge demand. It varies from country to country, just like also with the PCR test on how they handled the crisis. But yes, there is a lot of demand.

[Thomas Schinecker, Chief Executive Officer of Roche Diagnostics]

Okay. And then on the biosimilars, Richard, you asked about the COVID impact and would that potentially slow adoption of biosimilars. I guess, potentially, it could. It's too early for us to really tell. And then in terms of why Rituxan looks better, I think it's really some timing because the Avastin, Herceptin biosimilars launched in early Q3 of last year, whereas Rituxan didn't launch until middle of the end of Q4. So I think, yes, Avastin, Herceptin just had a head start.

[Karl Mahler, Head of Investor Relations]

Thank you. Next question, please.

[Operator]

Next question comes from the line of Parekh, Keyur, Goldman Sachs.

[Keyur Parekh, Equity Analyst]

Three questions, please. Severin, one for you from a big-picture perspective. How do you think the corona virus kind of on a longer-term basis impacts the way various governments are thinking about investments in health care? And what do you think this means for the allocation of resources across the various parts of the health care value chain? Secondly, one for Bill. Bill, can you talk about any plans on your end for providing kind of home infusions potentially in the unfortunate circumstance that the lockdowns were to extend for a few more months? And kind of how should we think about your ability and willingness to go into home infusions for some of your kind of products? In the same way, are you looking at a subcutaneous version of OCREVUS? And if not, what might be the technical difficulties there? And lastly for Thomas. Thomas, you guys have been kind of pretty much at the front of the pack as it comes to both the PCR testing and now the serologic testing. Can you just help us think about kind of where you are on a potential kind of point-of-care test? And how far we might be from that from a Roche perspective? What some of the challenges that you're facing there might be?

[Severin Schwan, CEO & Executive Director]

So this is Severin. Let me take the first question on the longer-term impact of this coronavirus pandemic and the learnings for the health care system. I think in -- we'll see how it plays out. But I think there's 2 elements which are pretty clear already. The first one is what we see is that certain countries just do not have a good health care infrastructure in place. I mean in a pandemic, your system is stressed. And you see quickly the difference between countries, which has a robust health care infrastructure. And there's a number of those. And you see a number of countries, which are really struggling. And I have no doubt in my mind because now there is such a huge public awareness in those regions and countries where the public health care system is not working well and where the infrastructure needs to be upgraded, that this public awareness will lead into pressure to invest more into health care, in general. Then, of course, the question is where does it go and where are those resources allocated to. I mean, as far as Roche is concerned, I have no doubt that people will invest more into high-throughput testing systems. I mean this has proved to be a bottleneck in many countries. And the good thing is there was the other side of this. Those countries who have high-throughput systems, they actually did extremely well. So that is a learning, which will have an impact. There will be more means for that. We see that already. And we, as a company, will benefit from that. The second area, which I think is important. And again, this is already very clear. I think this will give a boost to the digitalization in health care. Bill has referred to the troubles with clinical trials when people missed appointments. We see the same in chronic diseases in the daily care. Telemedicine now gets a completely different focus, things which have been hanging around in Europe, in particular, for a long time, like electronic patient trials, which are now so critical if you want to communicate in a virtual way, be it at a different focus. So we have been talking about the digitalization in health care a lot. Certain countries have made more progress than others. But I think by now, it's every -- it's clear to everybody that also health care will turn to be more virtual and that it will also protect in situations as we are going through now. Bill, there was a couple of questions for you.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

Yes. So about providing home infusions, so we've actually done that in some countries in certain times and even in an ongoing way. But I know that we are looking at this. It's really country- and region-specific in terms of what the health care infrastructure is, what kind of third-party suppliers exist. But we are looking into some of that for sure. And then as to whether we're pursuing a subcu version of OCREVUS, yes, we are. And that will likely be based on a Halozyme formulation, similar to what we have with Herceptin and MabThera and now, the fixed-dose combination of Herceptin and Perjeta. So that's something in our development pipeline. And I think -- was there another question about -- it was for Thomas, right?

[Karl Mahler, Head of Investor Relations]

From Thomas, point of care testing.

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

Yes.

[Thomas Schinecker, Chief Executive Officer of Roche Diagnostics]

Yes. Yes. So I mean these are a very good questions. So first, let me start by saying that although they're probably a lot of -- more than 100 PCR assays in the meantime on the market, there's a big difference, right? There's a big difference on the one hand in terms of automation because when you have to handle so many samples, you'll get into a huge backlog when you don't have fully automated it. So the automation of the system is key. And the second part that is key is the level of detection. So until how many copies per mil, down to which level can you detect? And we are at 24 copies per mil, whereas, the majority is in the hundreds copies per mil. So this is extremely important when you design an assay. Moreover, because it's an RNA virus, you want to do a dual target design, which means that you're actually targeting conservative regions of the virus, but 2 different possibilities. This is not as easily done on the point-of-care system as it is done on a high-throughput, very sophisticated lab machine. Now we obviously have a system in-house. That's the molecular system that can deliver that performance. But we want to make sure that it performs equally well to a lab test. We are not going to launch an exterior product. Obviously, we're working on it and we're making good progress. If we come with it, it's going to be a multiple assay between Flu A/B and the SARS-CoV, but we want to make sure we hit the target performance that is living up to standard that we set for ourselves. That is this one point. And regarding serology testing or antibody testing or antigen testing, yes, we're also looking into that. But again, I want to be very clear. You will never get with a point-of-care test, specifically with this strip test. You will never get the same performance as with lab. Yes. That's just impossible from a technology perspective. So for us, it's important that we launch a good quality product. And we're working in all of these areas.

[Karl Mahler, Head of Investor Relations]

Thank you, Thomas. Do we have time for one more question, please?

[Severin Schwan, CEO & Executive Director]

We may have -- maybe we should maybe take 2 more, but maybe 1 question for each and short answers if that is possible. For the rest of the other people, which is for -- we will get back individually.

[Karl Mahler, Head of Investor Relations]

Okay. So let's take the first question then.

[Operator]

The next question comes from the line of Michael Leuchten, UBS.

[Michael Leuchten, Co]

I'll stick to 1. Sorry, just going back to Thomas. Do you think your serology test, your amino assay, is different from your large competitors in terms of number of antibodies you're testing? And then how long do you think it will take you to understand the antibody? So when we think about clinical validation in terms of neutralizing antibodies, how long do you think it will take to get to some answer?

[Thomas Schinecker, Chief Executive Officer of Roche Diagnostics]

Yes. So first, in terms of difference. So what we worked on specifically is the topic of specificity. And so the way we have designed the assay is actually a sandwich assay using 2 antigen. So with that, we believe we can achieve a higher level of specificity. Furthermore, we use certain molecules, they are called [ chaperone ] molecules that will help also increase the specificity. So the way we have designed it is in a way that, yes, we can definitely deliver on that side. I cannot say exactly how other companies have decided, but we've taken some proprietary technologies that we have in-house to make sure -- and again, this is a good benefit of having Pharma and Diagnostics under one roof. So we can define at a very high-quality level, and this has shown to be valid than also in the different experiments that we've done running different patient channels. And we started with more than 50 different antibody tests. I mean just to put it in perspective, we didn't just start with one. We really did everything parallel, so we could get to a very good solution in a very quick way. With regards to the question around immunity, I mean, the antibody test is clearly key to even understand whether or not the population will develop immunity, yes? And potentially also the amount of antibody that has been developed. So it's going to be key to look at that for the coming months. But I think society has no other chance than to work with hypothesis because, I mean, we cannot wait for all these data to be there.

[Karl Mahler, Head of Investor Relations]

And the last question, please.

[Operator]

The last question comes from the line of Andrew Baum, Citi Healthcare.

[Andrew Simon Baum]

One question on TIGIT. Have you applied for breakthrough? And if so, when? And then second, on ACTEMRA, if you were to take a time point, let's say, September or October this year, how much ACTEMRA do you think you may be able to stockpile to satisfy demand in the event the trials in COVID-19 are supported?

[William N. Anderson, Chief Executive Officer of Roche Pharmaceuticals]

Right. Yes. So in terms of TIGIT and breakthrough designation, we usually disclose the breakthrough designation when we receive it, not when we filed for it. So you'll have to wait for that one. But we are very hopeful that the results will warrant a breakthrough drug designation and look forward to presenting the -- some of the Phase II data at upcoming meetings. In terms of ACTEMRA in September and how much will we stockpile, I mean, we are producing -- we'll produce millions of doses of ACTEMRA. And we just want to make sure that ACTEMRA is an important part of helping the world fight through this COVID-19 situation that we're doing everything in our power to support that. So again, I'm terribly grateful to the people who've been working 24/7 for now going on 3 months in our plants and our quality labs and fill facilities and logistics to keep it going. And also big hats off to the regulators and the governments around the world who's been very cooperative in every way possible to make sure that the goods keep flowing and that the borders stay open for free transport of goods. That's vital.

[Severin Schwan, CEO & Executive Director]

Thank you, Bill. On that positive note, thank you all for your interest. I think, Karl, that was it, right?

[Karl Mahler, Head of Investor Relations]

Yes. That was it. I just wanted to let you know that we have 500 people over the web and 470 people on the line. So it was a very busy and -- call, and I wanted to thank you also in the name of Roche. Thanks for your interest in Roche. For those who we couldn't get back to, Simon, Arash, Sam and so on, we will get back to you individually. I'm sorry for this one. And I wish everybody a nice day, and thanks, again, for your interest. And thanks to the speakers, and thanks for those people who helped us prepare the presentation on the call. Bye-bye.

[Severin Schwan, CEO & Executive Director]

Bye.

[Operator]

Ladies and gentlemen, the conference is now over. Thank you for choosing Chorus Call, and thank you for participating in the conference. You may now disconnect your lines. Goodbye.