GlaxoSmithKline plc (GSK) Q2 2021 Earnings Call Transcript

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GlaxoSmithKline plc (GSK -0.83%)
Q2 2021 Earnings Call
Jul 28, 2021, 9:00 a.m. ET

Contents:

• Prepared Remarks
• Questions and Answers
• Call Participants

Prepared Remarks:

Operator

Good afternoon, ladies and gentlemen, and welcome to the Analyst Call on the GSK Second Quarter 2021 results. I will now hand you over to Iain Mackay, CFO, who will introduce today's session.

Iain Mackay -- Chief Financial Officer

Good morning and good afternoon. Thank you for joining us for our second quarter 2021 results, which were issued earlier today. You should have received our press release and can view the presentation on GSK's website. For those who are not able to view the webcast, slides that accompany today's call are located on the Investors section of the GSK website. Before we begin, please refer to slide 2 of our presentation, for our cautionary statements. Our speakers today are Emma Walmsley, Luke Miels, Deborah Waterhouse, Dr. Hal Barron, Brian McNamara and myself, Iain Mackay. Joining us for the Q&A portion of the call will be Roger Connor and David Redfern. We request that you ask only a maximum of two questions, so that everyone has a chance to participate. Our presentation will last for approximately 30 minutes in order to maximize the opportunity for questions, and with that, I'll hand the call over to Emma.

Dame Emma Walmsley -- Chief Executive Officer

Thank you, Ian, and a very warm welcome to you all. We are pleased to report a strong financial performance and continued progress against our strategic priorities this quarter. Second quarter sales and adjusted EPS were up 15% and 71% respectively at CER. These excellent results were driven by a combination of strong double-digit growth in new and specialty pharma products, a significant increase in vaccine sales reflecting both an improving picture for vaccination rates and the major sales contribution from our pandemic adjuvant, good growth in consumer healthcare with double-digit growth in six of the nine power brands and continued discipline in control of costs. As we expected, the quarter did benefit from a favorable comparison to the second quarter last year, which was heavily disrupted by the pandemic and while further disruption cannot be ruled out, we are seeing positive momentum, which we expect to continue through the second half of the year. Assuming a second half backdrop of improving demand for adult vaccinations and normalizing health and consumer trends in key markets, we believe we are likely to deliver adjusted EPS at the better end of our guidance. I just want to remind you that this guidance excludes any contribution from COVID-19 solutions, which we expect to add between 4% and 6% to our adjusted EPS in '21. Along side of our financial performance, we continue to make good progress in R&D and our strategic delivery. Among our key assets, we completed the filing of long-acting Cabotegravir for prevention of HIV, and we announced positive headline results for all five Phase 3 studies of our promising specialty medicine Daprodustat. Very importantly, we also continue to strengthen the pipeline this quarter securing three exciting new collaborations in HIV, immuno-oncology, and immunoneurology and lastly, this quarter also saw us lay out on new growth outlooks for GSK and the proposed demerger of Consumer Healthcare. Delivering scale health impact and maximizing value for shareholders are at the core of these plans, and we've received widespread support from shareholders for them together with a clear message to focus on execution and successful delivery. We are all strongly committed to doing so.

Progress for this quarter is reflected across all three of our strategic priorities. In innovation, we continue to build a high value pipeline across prevention and treatment of disease through organic and inorganic delivery. In performance, improved commercial execution is driving strong growth in new and specialty pharma products. Specifically, we are clearly seeing the beginnings of a recovery in performance as COVID vaccination programs among all the populations near completion. The US new to brand prescriptions for Shingrix were up 73% in the quarter, and we saw good performance across the consumer business with the exception of sustained weakness in cold and flu in a few specific areas where consumer trends have not yet returned to normal. And on trust, we continue to maintain leadership in ESG as evidenced by new index ratings. We recently signed as principal partner for COP26 and continue to progress our environmental commitments to be net zero in nature positive by 2030. As you heard at our Investor update, the scale of the changes we've made in the last four years is unprecedented to improve performance, strengthen capabilities, and prepare GSK for a new future. Our clear priority is to unlock the potential of two world-class businesses and in so doing, maximize value for shareholders.

With the platform we now have for GSK, we expect to deliver highly competitive sales and operating profit growth in the next five years, a step change in expected performance. And we aim to achieve sales of more than GBP33 billion by 2031, all underpinned by an R&D focus on the power of the immune system, a portfolio shift to vaccines and specialty medicines to prevent and treat disease and impacting the lives of 2.5 billion people over the next 10 years. And through the proposed demerger, we will create a new category-leading consumer healthcare business serving over a 100 markets with annual sales in 2020 of GBP10 billion driven by brands and innovation to deliver at better everyday health. This business has strong prospects for sustainable sales and profit growth, high cash generation, and to deliver attractive returns for shareholders.

So, let me now over to the team to talk you through this quarter's performance in more detail. Luke, first over to you. Thanks, Emma so we continue to make progress on commercial execution and competitiveness in the quarter against a complicated external environment due to COVID. The strong end market performance are highlighted in the recent quarters for products such as Trelegy, Nucala, and Benlysta has continued driving growth of new and specialty pharma products of 25% in the second quarter and 14% in the half year. We also saw a good recovery in the quarter in meningitis and established vaccines. So today, I want to focus my remarks on the performance and growth prospects in Shingrix and oncology [Indecipherable]. For Shingrix, our confidence in recovery has been tied to the prioritization and successful rollout of COVID-19 mass vaccination, particularly in the US. Underlying trends illustrate that Shingrix volumes are expanding, as we move into the second half of the year. Overall, despite the slower rate of recovery in ex-US market, we anticipate a strong half Q global performance from Shingrix with the potential for slight growth in sales on a full year basis. In the US with nearly 80% of adults aged 50 plus now fully vaccinated for COVID, we've now seen a related increase in weekly indirect volumes which have grown 73% to the start of quarter two. In the coming months, it is going to be important for the recovery of Shingrix in the US as our updated research shows that around half of those eligible to receive Shingrix have indicated that they expect to get it within one to three months following the completion of the pandemic vaccine series. With the implementing activities to drive this recovery with a comprehensive multi-channel DTC campaign and by focusing on relationships with US retailors, particularly as we focus on the flu vaccination season where adult vaccinations become increasingly top of mind for consumers. And we're starting to see similar trends in Germany where volumes are improving as more adults complete their COVID-19 vaccination series and in China, we continue to make steady progress in the private pay market with Shingrix now in 50 cities. At roll out, we are seeing a slower rate of shingles ex-US due to the different rates of deployment of COVID vaccinations. Looking ahead, we continue to roll out a new markets including the UK and we're now benefiting from an unconstrained supply position. Now, this is going to support the expected significant step up in Shingrix sales in 2022 assuming continuation of the improved operating environment as well as our ambition to double revenues in the next five years, protecting more than 100 million adults. I now move to oncology. Zejula had a strong performance despite the impact of COVID on the ovarian cancer market. Sales were up 38% versus Q2 '20,and we are pleased that in the US, we are significantly leading a new patient starts with 59% of patients down to a pop receiving Zejula. We're also seeing progress in US patient awareness which has significantly increased from 29% in April 2020 to almost 50% in June 2021 and a decrease pleasingly in the watch and wait usage now at 57%, although there is room for improvement. Unfortunately, with the backdrop of COVID, there is still a 20% decrease in ovarian cancer diagnosis, and we know that with delayed diagnosis, there are less patients getting debulking surgeries and therefore less patients going onto maintenance about six months later. So we expect that this impact will continue until the market returns to pre-pandemic levels. So Blaine rep [Phonetic], we're seeing encouraging progress despite competitive entrants, and we are especially pleased to see demand increasing with community oncologists in the US and also Germany. We had a very robust clinical program designed to continue to improve the product [Indecipherable] through various combinations, optimized dosing and scheduling. On this slide, we have outlined the patient opportunity and the associated clinical trials that align to earlier lines of treatment. The outcome of these trials will evolve our strategy including potential use of novel combinations and the substantial opportunity we foresee in second line where we have dose optimized pivotal trials and with that I'll pass over to Deborah for an update on the HIV portfolio.

Deborah Waterhouse -- Chief Executive Officer

Thank you, Luke. Second quarter HIV sales rebounded strongly growing by 14% and more than reversing the 11% decline that we reported in Q1 due to COVID impacts and the strong 2020 comparative. Growth in the first half of the year was 1%. Strong commercial execution continues to drive the performance of [Indecipherable], particularly in the switch market in the US and Europe. [Indecipherable] are on track to GBP1 billion in sales this year. Our recently launched innovative medicines including Rukobia now accounts for more than 25% of our total sales. A highlight this quarter was the market share of Dolutegravir regimens in Europe, which for the first time exceeded 30% driven by [Indecipherable]. Shares continued to hold firm in the US.

Turning to our portfolio long-acting injectables, in January, we received FDA approval for Cabenuva, the world's first long-acting injectable treatment for HIV. It is also approved in Europe under the brand name of Vocabria Rekambys and dosing every two months. We anticipate approval of three-monthly dosing in the US by year-end and launch in early 2022. These signals are positive with strong brand recognition from people living with HIV and high levels of physician attendance, I thought[Phonetic] that for launch meetings, which we believe will translate into increasing intend to prescribe. As it any new class of medicines, Cabenuva will take time to build and furthermore the COVID backdrop is significantly constraining switch activity, particularly where a patient needs to visit a physician's office. The confidence about its potential to transform the HIV treatment paradigm and with an anticipated five-year head start over competitors, we expect Cabenuva to [Indecipherable] long-acting treatment market that could reach GBP4 billion to GBP5 billion by 2030. This quarter we also made significant progress with Cabotegravir long-acting for prevention, we've completed the rolling submission with the FDA and anticipate launch in early 2022. If approved, we believe Cabotegravir long acting will present a new and compelling option in the PrEP market every two months with efficacy that is superior to the current standard of care. As for the treatment market, we believe the long-acting PrEP market could ultimately reach GBP45 billion in value and Cabotegravir long-acting is poised to play the leading role.

Last week at the International AIDS Society conference, we presented week 48 data from the phase 3 results of study, which demonstrated that Dovato is a compelling option, irrespective of the type of three-drug regimen a patient may be switched from. We also presented the STAT study which shows that Dovato is acceptable for same-day test and treat. For Cabenuva, we presented the customized data, which not only showed that Cabenuva is applicable in a range of healthcare settings, but the 97% of people enrolled in the study preferred the long-acting injectable over daily oral therapy and in PrEP, we presented more data from the pivotal HPT and 0-8[Phonetic] for women study demonstrating that Cabotegravir long-acting is the first and only long-acting injectable for PrEP to demonstrate superior efficacy and comparable safety to daily orals in preventing HIV acquisition in a diverse population.

Taken together, I am delighted with the progress we're making in HIV in both returning the franchise to growth and building our portfolio of innovative and pioneering long-acting medicines. I would like to turn the call next to Hal.

Hal Barron -- Chief Scientific Officer and President, R&D

Thanks Deborah, I'm going to provide a short update on some recent news flow since the June event and highlight some of the upcoming pipeline milestones over the next 18 months. Starting with the Daprodustat, we recently announced positive headline results from each of the five trials in the ASCEND clinical program. As a reminder, the ASCEND program recruited over 8,000 patients from both the dialysis and non-dialysis population and was designed to demonstrate the safety and efficacy of Daprodustat as a novel oral treatment for patients with anemia due to chronic kidney disease. We're very pleased with the results from the ASCEND-ND and ASCEND-D studies, which met the co-primary endpoints on both safety and efficacy. Daprodustat demonstrated an improvement in hemoglobin levels in untreated patients and maintained hemoglobin levels in patients previously treated with erythropoietin stimulating agent, a standard treatment option in patients with anemia of chronic kidney disease. Importantly, the two cardiovascular outcome study ASCEND-ND for non-dialysis and ASCEND-D for dialysis patients both demonstrated that Daprodustat was non-inferior when compared with erythropoietin stimulating agents in the risk of major adverse cardiac events or MACE. Additional analyses are ongoing, and we aim to present these data at a medical conference later this year.

Moving to business development, as I highlighted in June, our strategy has been to leverage business development to augment our organic pipeline, and we've made some recent progress on this with three deals, which I'll cover briefly now. First is our global collaboration with Alector for two clinical stage first-in-class monoclonal antibodies targeting sortalin for neurodegenerative diseases. This collaboration brings together Alector's leading immuno-neurology expertise with our focus on the science of the immune system and human genetics and proven late stage drug development capabilities. The lead asset AL001 is currently recruiting a Phase 3 trial for people with a progranulin gene mutation who have frontal temporal dementia or at risk for developing FTD. Both antibodies, AL001 [Indecipherable] are designed to elevate progranulin level by blocking the sortalin receptor. Progranulin is a key regulator of immune activity within the brain through modulating lysosomal function. There are compelling genetic links to multiple neurodegenerative disorders including FTD, Parkinson's, and Alzheimer's disease and these assets could offer a new approach to the treatment of patients with these considerable unmet need. Second is our collaboration with the IPOs for an anti-TIGIT monoclonal antibody in Phase 1 development which I highlighted at our investor event in June. This deal complements our focus on the CD226 axis, where we now have an anti-TIGIT and anti-CD96 and anti-PVRIG, all of which can be combined with our PD-1 inhibitor Jemperli. Preclinical data, human genetics, and recent randomized clinical trial all highlight [Indecipherable] CD226 axis, which we believe could deliver transformational medicines for patients and usher in the next generation of viral medicines.

Finally, the recent Halozyme deal announced by Deborah and the deep team, which offers the opportunity for ultra long-acting regimens containing Cabotegravir and other pipeline assets. I also want to remind everyone that these three deals are not factored into the 2031 sales ambition we issued in June and would represent upside of successful.

Lastly, this slide summarizes key data we expect to report over the next 18 months. As you can see, we anticipate a large number of pivotal data readout from 2022 as well as some important data points in the second half of 2021. Among our specialty products, I have already spoken about the five positive Phase 3 studies with Daprodustat, which we recently reported. We also have a number of data readouts and Blenrep over the next 12 to 18 months, including pivotal readouts looking to demonstrate a progression-free survival benefit compared to center to care for patients with multiple myeloma. Later this year, we should have data from a proof of concept DREAMM 5 sub-study of Low Dose Blenrep in combination with the gamma secretase inhibitor for the treatment of patients with multiple myeloma. We are investigating a number of strategies to optimize the dosing schedule for Blenrep, and we hope that this sub-study will maintain the efficacy of Blenrep, but at a lower dose, which could reduce or delay the incidence of ocular events and support the potential use of Blenrep in earlier lines of treatment. As I had previously mentioned, not only is this study important for advancing Blenrep's potential, but it could also serve as a potential additional proof point for our functional genomic strategy. Other pivotal readouts on key assets in 2022 include Otilimab in patients with rheumatoid arthritis plus data from several important vaccine candidates including RSV for older adults, RSV maternal vaccine, and data from our ABCWY pivotal studies.

Finally, we should receive a number of readouts from our COVID vaccines and therapeutics over the remainder of 2021 including pivotal data from our vaccines collaborations with Medicago and Sanofi in a Phase 2 data from the OSCAR trial of Otilimab and the [Indecipherable]. With that, let me hand it over to Brian.

Brian McNamara -- Chief Executive Officer

Thanks, Hal. Now turning to Consumer Health Care in Q2. Continuing sales excluding brands divested and under review were strong, up 7% at constant exchange rates, which included a 2% drag from retailers stocking last year ahead of the systems cut over in North America which reversed in the following quarter. Our Q2 results were supported by an easier comparator, given destocking in the same quarter last year, following the pantry loading in Q1. The 2-year CAGAR removes the distortion from the pandemic and was up 3% in Q2, which would have been up 4% excluding the impact of the unusually weak cold and flu season. Let me talk specifically about our category performance in the second quarter. In oral health, sales increased 12% with a 2-year CAGAR up 5%, demonstrating good execution and successful innovations with Sensodyne and gum health more than offsetting lower growth in dental care. Pain relief saw Q2 sales up 13% and delivered a good 2-year CAGAR up 5%. In vitamins, minerals, and supplements, sales declined 6% as we cycled the demand spike in the prior year, although the 2-year CAGAR was up 6% including partially particularly good growth in Centrum, Emergen-C, and Caltrate. Digestive Health and other sales were up 3% in the quarter with a flat 2-year. Performance in this category was mixed with strong performance of smokers health products and digestive health brands but continued weakness in brands more dependent on impulse purchase such as ChapStick. Respiratory sales increased 6% in the quarter and the 2-year CAGAR was down 3%. This reflected very different results in the two sub categories with strong allergy performance and continued weakness in cold and flu, don't forget that given seasonality, Q2 is a smaller quarter for the cold and flu business. Our focus on innovation continued, and we saw a further positive momentum with Sensodyne sensitivity and gum as well as good performance from newer innovations such as Centrum essentials in Brazil and Pronamel intensive enamel repair whitening in the US. In e-commerce, we grew approximately 30% and this was 7% of sales. Our ongoing investment in digital capabilities positions us well for growth and with continued strong results in the last month, particularly in the US, we remain confident in our ability to outperform in this key channel. Turning to our power brands, six of the nine brands gained or held share with six brands reporting double-digit growth in Q2, and collectively power brands were up double-digit. Additionally, we saw a double-digit growth in [Indecipherable] continuing business in emerging markets with particularly strong performance in India and China. Our full year sales outlook remains unchanged. Our separation and integration plans all remain firmly on track. The commercial integration is now fully complete. Our manufacturing site cut over is well underway, and separation activities progressing well and to plan. Importantly, all of our guidance for 2022 shared in 2018 including margin in synergies remain unchanged. Finally, I'd like to take a minute to remind you of who we are and what we have created through the two largest consumer healthcare transactions in the last six years. As separation will be the first listed 100% focused consumer healthcare company as well as the global leader in consumer healthcare, operating in a sector with compelling fundamentals and leadership positions in categories now more relevant than ever. We have a fantastic portfolio of brands and strong capabilities to drive sustainable market outperformance, and I'm excited to share more information with you on this incredible business as we move closer to separation. With that, I'll hand it over to Iain.

Iain Mackay -- Chief Financial Officer

Thanks, Brian. As I cover the financials, references to growth are constant exchange rates, unless stated otherwise. On slide 18 is a summary of the Group's results for Q2 and the half-year. In Q2, turnover was GBP8.1 billion, up 15% and adjusted operating profit was GBP0.2 billion, up 43%. Total earnings per share was GBP27.9, down 28%, while adjusted earnings per share was GBP28.1, up 71%. In the year-to-date, turnover was GBP15.5 billion, down 1% and adjusted operating profit was GBP4 billion, up 3%. Total earnings per share was GBP49.4, down 27% and adjusted earnings per share was GBP51, up 2%. We generated free cash flow of GBP313 million in the year-to-date in line with our expectations. On currency, there was a headwind of 9% on sales and 25% and adjusted EPS. In particular, due to the strengthening of Sterling against the US dollar relative to the second quarter of 2020.

Slide 19 summarizes the reconciliation of our total to adjusted results. The adjusting items of note for the quarter were in disposals significant legal and IR, which reflected a GBP325 million tax credit due to a significant positive revaluation of deferred tax assets in the UK, resulting from the Q2 enactment of the 2021 UK finance bill. My comments from here onwards are on adjusted results unless stated otherwise. Key drivers of revenue and profits for the Group in the second quarter compared to the prior year are set items in slide 20. Revenues grew 15% overall. Excluding revenues from our COVID Solutions, sales were up 11%. The pandemic adjuvant sales of GBP258 million represent delivering around two-thirds of contracted volumes with US and Canadian governments. The positive operating leverage from higher sales in the quarter was bolstered by continued focus on cost control and the benefits of restructuring across the Group. This was partly offset by increased investment in R&D, up 6% is expected, an additional investment behind product launches with SG&A up 5%. The resulting Q2 margin was 26.7%, and the year-to-date margin was 26%. We expect R&D growth around 10% in the full year with the first half increased 5% reflecting phasing, particularly in 2020. Moving to bottom half of P&L with highlight that interest expense was GBP185 million compared to GBP227 million last year. The decrease is primarily as a result of reduced interest expense from lower debt levels and favorable movements in foreign exchange. On share of associates in May, we sold our stake in Aviva which was the main contributor to the income line. The effective tax rate of 18.4% was in line with expectations and reflects the timing of [Indecipherable] authorities and finally, lower non-controlling interest reflected a reduced allocation of consumer healthcare JV and ViiV Healthcare profits.

Next, free cash flow for the quarter. Before going into more detail on performance drivers in each business. In the first half of the year, we generated GBP313 million of free cash flow, and improving cash flow performance continues to be a constant focus for the team. The significant step down in the year-to-date was as expected and in line with our full year. In the first half, increased adjusted operating profit and lower dividends to non-controlling interests were more than offset by adverse timing of returns and rebates and taxes, compared to the first half of 2020 and increase in working capital, adverse exchange impacts, and [Indecipherable] assets as well as reduced proceeds from disposals of intangible assets with the Consumer Brands disposal program now complete.

Turning to performance of the Pharma business in the next slide. Overall, revenues grew 12%, driven by strong growth in new and specialty medicines, a prior year comparator that was impacted by destocking, and favorable US return and rebate adjustments in the quarter. Impact of prior destocking and the prior period IR adjustments including the impact of lower than expected Medicaid usage on a number of products accounted for approximately 3 and 4 percentage points of growth respectively. In the year-to-date, revenues grew 2% and our full year outlook remains unchanged. The Established Pharma portfolio was flat. Within this established respiratory grew 6% while the rest of the Established Pharma portfolio was down 7%. We still expect Established Pharma sales to decline high single-digits in the full year. The Pharma operating margin was 29.3% in Q2 and 29.1% for the first half. The increase in Q2 primarily reflected the positive operating leverage from the increased sales as well as continued tight cost control and restructuring benefits. R&D expense grew 3% in the quarter and year-to-date R&D spend also grew 3%, which reflected phasing of spend, particularly in 2020 and we expect a higher growth rate in the third quarter.

Slide 24 gives you an overview of Vaccines performance with overall sales growth of 49%. Excluding pandemic adjuvant revenue, sales growth was 24%. In the year-to-date, total vaccines revenues were flat and down 9% excluding the pandemic adjuvant sales. In the quarter, we saw improving pediatric and adolescent vaccination rates and adult vaccination rate, although improving, continue to be affected by COVID-19 vaccination deployment. This resulted in Shingrix sales growing 1%, the meningitis sales grew 46% [Indecipherable] vaccines 28%. The operating margin was 32.7%. The increase in operating profit and margin primarily reflected the post of operating leverage from sales growth, including the pandemic adjuvant sales mix. R&D spend increased 34% as we continue to invest in, behind RSV and mandates development programs. Increased SG&A reflected investment to support [Indecipherable]. The year-to-date operating margin in vaccines was 29.3%. The recent trends in the US indicating strong recovery of pediatric pediatric, adolescent, and all vaccines are very encouraging. There remains, however, uncertainty as to the impact of COVID-19, the speed of deployment of mass immunization programs and easing of pandemic conditions. This is notable in other key markets across the group, such as Germany and China. With these dynamics in mind and excluding pandemic adjuvant sales, we expect vaccines revenues in the full year to be broadly flat.

Turning to slide 25, Q2 revenues in Consumer Health Care increased 7% excluding brands either divested or under review, including those brands turnover grew 3% and Brian outlined the main drivers of this area. In the year-to-date, revenues excluding brands either divested or under review decreased 2%. This reflected the continued negative effects of COVID-19 consumer behavior, which significantly impact of the cold and flu category and to a lesser extent dental care. The operating margin for Q2 was 21.7%, up 50 basis points of CER versus last year and this included 110 basis points in negative impact from divestments. The year-to-date operating margin was 22%. Strengthening of Sterling against the US dollar in 2021 year to date given the scale of the US consumer business has had a significant impact on operating margins. We remain on track to deliver mid to high 20s operating margins in 2022 at 2017 exchange rates. For consumer in the full year excluding brands divested or under review, we continue to expect low to mid single digit percent revenue growth.

I'll close with considerations for 2021 outlook, we're maintaining our full year guidance for adjusted EPS to decline mid to high single digits. This excludes any contribution from COVID -9 solutions. Our strong Q2 performance gives us confidence that if we continue to see improvement in demand for adult vaccinations through the balance of the year as well as the healthcare systems and consumer trends approaching amount in the second half of the key markets, we're likely to deliver adjusted earnings per toward the better end of our guidance range. However, as the pandemic landscape evolves, we continue to see global differentiation in the pace of deployment of COVID-19 vaccination programs, and the speed of economic recovery. As a result, there remains potential for further pandemic disruption, and we believe it's premature to change guidance. [Indecipherable] specifically where some one-off items in the comparator which will adversely impact the next quarter. These include a Blenrep recognition of prelaunch inventory and pharma R&D of slightly more than GBP50 million and a one-time benefit from the restructuring of post retirement benefits of a similar magnitude, which was primarily in SG&A. With these one-off items in mind, we expect earnings growth in the second half to be weighted toward Q4. Turning specifically to contribution from COVID-19 solutions, the positive impact on first half adjusted earnings per share was approximately 7 percentage points and as mentioned earlier, we fulfilled around two-thirds of contracted volumes for pandemic adjuvant and expect that the full-year contribution will be approximately 4 to 6 percentage points of adjusted EPS growth. The outcome within that range is dependent upon pandemic adjuvant contracting for '22 and the resulting potential charges within cost of goods sold as we continue to manufacture for this potential. As part of keeping you informed of our progress in executing against our strategy in the coming months we'll host business and pipeline information sessions covering among other topics, growth drivers in HIV, and updated outlook for Daprodustat and early next year, we will provide insights in our General Medicines product area, we hope you'll be able to join us for these events.

With that, operator, we're ready for Q&A.

Questions and Answers:

Operator

Thank you, everyone. Your question-and-answer session will now begin. [Operator Instructions] The first question comes from the line of Andrew Baum from Citi. Please go ahead.

Andrew Baum -- Citigroup -- Analyst

Many thanks. One question for Deborah and the second for Hal. So, Deborah the translocation inhibitor that you're about to take into the clinic for HIV, you highlighted as one of the long-term growth strategies. How confident are you in the freedom to operate on the intellectual property, given I believe it's a prodrug [Indecipherable] which has a very extensive passenger state. When the last time I looked, I couldn't see much in terms of ongoing activity between you and the US PTO on securing a patent for your compound. So that's the first question. The second on Alector, Hal, I understand the interest in progranulin from an FTG point of view, but that's a relatively modest indication. So my question is how you can thinking about selecting patients in the larger indications out time as Parkinson's, given that some of the surrogate markers, we've seen our questionable significance in those indications. Many thanks.

Dame Emma Walmsley -- Chief Executive Officer

Well thanks, Andrew. I think you directed your question very directly, so Deborah why don't you kick-off from there.

Deborah Waterhouse -- Chief Executive Officer

Sure, so Andrew is we told facet business and best rep date, we have a strong pipeline, which is call has integrates inhibited, which we believe will form the heart of any 2-drug regimen in the overall long-acting moving forward. We have a number of products in the pipeline of which we have an NRTTI, but obviously we have of this as well. Capsid been maturation inhibitor, et cetera. And our plan is to progress all of those medicines to the point at which we will make choices around which of them is the strongest moving forward. So that's all I want to say on where we are today with that pipeline. I think we talked about it in more detail at the [Indecipherable] I guess for us, our objective is to have maximum shots on goal and also with the help of our Halozyme partnership, to be able to deliver for people living with HIV longer and longer acting medicines.

Dame Emma Walmsley -- Chief Executive Officer

Hal?

Hal Barron -- Chief Scientific Officer and President, R&D

I thank you for the question. It's a good question. The genetics really give us extreme confidence, I think in the FTD progranulin gene deficient patients and a number of diseases, both from the sort of biology of non-progranulin FTD as well as potentially ALS PD we know is a lifetime of disease from a lot of genetic data and other sources, and even Alzheimer's has been, there has been some genetic suggesting that progranulin maybe playing a role. So that's why we're excited, of course neurodegeneration is a massive unmet medical need where the number of patients with these terrible diseases is growing and the treatment options are limited. So, we're very excited about, as you point out that that in drug development for ALS to some extent, more so for PD and the lot very clear and AD, that the Phase 2 surrogates hasn't been as compelling is I'd like them to be. I think there is a lot of opportunity using genetics to identify subgroups. We're exploring a lot of different markers of lysosomal function of immune activation. Imaging data can also help and other biomarkers like NFT and other sort of neuro markers of generation are being explored, and we're hoping the field advances over the next years to enable some of those to be used for go-no go criteria. But I think to really be specific, I think it's the massive unmet medical need the genetics and our confidence that with stratification variables in these biomarkers that are emerging will be able to make informed decisions when we progressively things through Phase 2.

Dame Emma Walmsley -- Chief Executive Officer

Thanks our next question, please.

Operator

Thank you. The next question is from the line of Simon Matthew of [Indecipherable]. Please go ahead.

Unidentified Participant

Good afternoon and thanks for the questions, I've got two as well. First one on the pipeline and secondly on the opportunities of COVID-19 and just on the pipeline on that, that obviously less than straightforward advisory committee meeting for Aster and roxadustat. I mean, do you believe mean can you can you can maybe comment on if you believe you've got the right dosing to reduce the risk of hemoglobin excursions and whether or not you've seen in the imbalance in the [Indecipherable] in the trials and does your do the issues that AstraZeneca faced in the, in any way change your commercial plans, given the lack of a renal franchise. And then just secondly on COVID-19 solutions, initially I was in the impression is normal profit. But clearly a strong contribution for the quarter, could you maybe help us understand the large opportunities that you could have because obviously I think the last count Sanofi it signed up 2 billion doses for 2021, 2022. So any help here with respect to the doses with that's in the 60 million relates to could potentially help us forecast the strong growth potential in 2022 and beyond. Thank you.

Dame Emma Walmsley -- Chief Executive Officer

Thanks. I mean, well, I think there is a lot of questions across the industry about the outlook for the COVID market in '22 and beyond. But we'll come to Roger. In a moment to comment on where we're at and how we see things evolving, but you're obviously right that we also depend on our partners' supply even more than our own. Let's first come to Hal on for a dosing. And I think it would be good Luke as well if you would like to make some comments to doing our proven commercial momentum more generally on how you see plans forward and approach commercially to help us then later then.

Hal Barron -- Chief Scientific Officer and President, R&D

Yeah, thanks for the question. I'm not going to comment too much on the Roxa outcome, but let me just say that we're very proud of the program we ran. It's a very robust program had over 8,000 subjects treated for up to almost four years, two and three-quarter years in a variety of patients. As you know dialysis non-dialysis incident dialysis patient trial as well. We look to quality of life, et cetera, et cetera. The study is really very robust but also because these were single trials where they were powered for 4 in the SSD in the for non-inferior MACE and we've looked at the primary endpoint, we haven't looked at all the both on safety and efficacy. But we haven't done all the subgroup analyses you want, you mentioned, but we will be doing that later and hopefully presenting that at a major medical meeting ideally later this year. What I can say is that the hemoglobin targets that we were pursuing as well as the interactions with regulators give us a fair amount of confidence that we've really designed what we think is a very large simple but robust program and it gives us a clear understanding of both the safety and efficacy of the drug.

Dame Emma Walmsley -- Chief Executive Officer

Luke?

Luke Miels -- President, Global Pharmaceuticals

Yeah, I think from a commercial perspective. a healthy results that you're seeing today give you confidence and the evidence that we can commercialize a diversity, the specialty care products, and what I think competitive segment. I think from a forecasting point of view, it's still remains quite dynamic. It's certainly radically different from what it was say 12 months ago in terms of our assumptions, but we're quite excited about this and terms of COVID assets and commercialization. I mean, so if he has the component that [Indecipherable] just trying to deal with the European community for up to 220,000 doses, just for clarity. That's 16 countries within the EC are part of that framework, and they have until between now and July 2022 to purchase that. Just before this call, we had another contract come through from another government and there is another attractive order that came through on Friday, so we're starting to make progress there with [Indecipherable].

Dame Emma Walmsley -- Chief Executive Officer

Roger, would you like to talk about the vaccines.

Roger Connor -- President, Global Vaccines

Yeah. Certainly. Thanks for the question. I think on the adjuvant partners is what we've seen this quarter, our contracted volumes that we haven't place between the US and Canada, but the represent about two-thirds of that overall expected demand for this, for this year. I think it shows the strength of the adjuvant platform. Obviously, first of all we contracted separately on this and governments understand that the adjuvant isn't just for COVID maintaining. The adjuvant can be held and then used for future pandemics as well as up the flu or for the COVID place. There is optionality in this platform from the pandemic preparedness perspective. This two variables I'd say that will determine sales going post 2021. Emma mentioned, we have to build a much this up with Alvogen around supply going forward. So whatever those volumes are, will be a key variable. And then secondly we talking to governments rolling pandemic preparedness and potential use of the adjuvant as well. So those discussions could play out. So some uncertainties there is a difficult to say, but there is certainly a lot of activity going on. And I think governments are realizing the positive niche of a stock build of ASM 3 in particular, which were have meant, some governments suddenly before this pandemic as well. And we'll just continue to update you as those discussions with governments conclude.

Dame Emma Walmsley -- Chief Executive Officer

I think more medium term as well. I mean it is worth remembering rather alarming statistics that only 13% of the world is currently doubly vaccinated. There is, as you will know, an ongoing debate around what the medium-term profile is for booster market or not and as you know, beyond our current adjuvanted partnerships with very involved on the mRNA platform to. And so we'll continue to keep you updated on all of that, but let me reiterate none of this is in either this year's guidance nor indeed in the outlooks that we shared with you in June. Next question here.

Operator

Thank you. The next question is from the line of Laura Sutcliffe of UBS, please go ahead.

Laura Sutcliffe -- UBS -- Analyst

Hello, thank you. Firstly, a more specific question on the size of the opportunity for dapro. I think you mentioned an unrisk adjusted peak sales range of GBP0.5 billion to GBP1 billion back in June, is that the extended by used in dialysis and non-dialysis or are there some scenarios at this point where the peak sales could be greater than that GBP1 billion, and then secondly, could you maybe just give us your thoughts on combination opportunities for your older adults RSV vaccine. Thanks.

Dame Emma Walmsley -- Chief Executive Officer

Yeah. So let's come to how plays and I think Laura, Iain said well during his remarks, that we would bring you an updated review once we've got more published data, but also on the outlook of dapro and just refer you to what Luke just said. The assumptions on the environment obviously shifts according to competitors situations and still today I'm clear outcomes there as well as our own data, which is across the dialysis and non-dialysis, you'll get an update on that more later in the year. But Hal do you want to, I don't know if you want to add any further comments on either dapro but more specifically on combo possibilities for our exciting RSV pipeline?

Hal Barron -- Chief Scientific Officer and President, R&D

Maybe I'm not totally understand the question, but is a combinations, meaning the adjuvant plus the pre-fusion that or is that, would you mean by combinations or do you mean multiple vaccines combined. I didn't quite understand the question. Maybe has got I'll assume it's the combination meaning why we've decided to use in adjuvant plus the pre-fusion protein, if that's what you think your question, I think, yeah, I think Laura when we did the Phase 2 study, we looked at the pre-fusion protein alone and with various adjuvants and various doses and the summary of the data is a lot of complicated data, but the bottom line, I think, is that when you look at the cell immune, cell mediated immunity, the pre-F specific CD4 positive cells, you can see that in the elderly, when you give the adjuvant ASO one, you can see a very nice bump in the [Indecipherable] which actually elevates the level that's pretty close to what you see in young adults and we think that not only is a robust B-cell response, which we saw actually both with the unadjuvanted and adjuvant components, this T-cell immune response we think is very important possibly for efficacy as well as duration and so that's why we decided to combine it with ASO-1 the same adjuvant that's used with Shingrix, which as you can see in the elderly is particularly effective and has long duration. So that was why we went ahead as opposed to others with an adjuvanted approach with the pre-fusion protein.

Dame Emma Walmsley -- Chief Executive Officer

Thanks. Next question please.

Operator

Thank you. The next question is from the line of Jo Walton of Credit Suisse. Please go ahead.

Jo Walton -- Credit Suisse -- Analyst

Thank you. I wonder if I could ask Luke a little bit more about his expectations for Shingrix in the second half of this year. There's is clearly very little progress in the ex-US sales overall in the first half of the year. So can you tell us a little bit more about your confidence in the second half, which additional countries you can go into, how the pricing is forming in this in those new countries now that you are unconstrained in supply. And can you just give us some idea of your assumptions on use of say a third dosage versus the ability to put your Shingrix vaccine in the other arm when someone goes to get a flu vaccine around September time. And my second question would be, again probably to Luke. On the marketing side, you were down 15% on your marketing spend in the first quarter, up 5% in the second quarter. Given what we've learned about ability to do more digital, etc., going forward, can you give us some help to what do you think a reasonable rate of CEO marketing growth should be over the next year or so. Thank you.

Luke Miels -- President, Global Pharmaceuticals

Okay. So, yeah, yeah. Thanks Emma. So on the second one, I mean, it's interesting, people out of the field not spending or traveling. If we look at face to face activity now in Europe and the US with the exception of oncology, which is a bit lower. We're sort of 80% to 85% versus pre-COVID levels, if you add in non-face to face digital, the total activity is actually higher than that. So in terms of expenditure will continue to allocate it to where we can drive the top line and where we see a good return. So I think the trends that you're seeing historical or probably a better indicator than quarter one and quarter two. In terms of Shingrix, it's really, really interesting. We track these as you can imagine very, very closely and it's a consistent pattern where you see countries vigorously pursue adult vaccination it's highly disruptive to to Shingrix vaccination. The good thing is those patterns are consistent. So, Germany, we are now seeing more than 80% of 60 plus adults, which is the population where it's robust are now covered with COVID and we saw the beginnings of a rebound in June in Germany of Shingrix. In China, the emphasis is still on government vaccination centers deploying COVID vaccine. So, we continue to see that disruption in terms of other markets where we're also seeing that disruptions in Hong Kong, Australia for example where we've just launched, they obviously at the same point, but we have other launches in Spain and Italy and the UK in broader populations but also sub populations in terms of pricing, we're seeing that level hold up now sometimes when we go into these markets, we go in with immunocompromised population first because we can get the most attractive price at that point. And right now, we can use all the volume in those settings. So I think for the second half, we remain confident we'll see a collective response in Shingrix. In terms of boosters, we don't assume the boost of this year and it's interesting the market research in terms of people's intention for vaccines, we've covered the 50% on the slide, but also if you asked some relative to other vaccines, it's significantly higher than pneumonia and pertussis and other options to adults and second only to flu in terms of future intention to get a vaccine. I think there may be some vaccine fatigue on the part of adults, but again, everything that we're seeing indicates that the second half will be as expected.

Dame Emma Walmsley -- Chief Executive Officer

Lastly, Jo, as well on [Indecipherable], I mean, you know, the guidance is that it is possible, but as Luke said, the experience would be that people. There is a bit of sort of just human instinct that people would rather leave it for a few months, but we have the stats on that and we are running [Indecipherable] studies as well. So that should equip us well. Fundamentally, this is a disease that one in three people get. We know the underlying demand is good and as Luke said, we are being able to maintain economics and confident in the outlook that we laid out for the 5 years, right. Clearly with lifecycle innovation, which you also saw some recent announcements on in terms of expansion of the cycle. So next question please.

Operator

Thank you. The next question is from the line of James Gordon of JP Morgan. Please go ahead.

James Gordon -- JP Morgan -- Analyst

Hello, James Gordon, JP Morgan. Thanks for taking the two questions. First question was on the old adult RSV vaccine and competition. So potentially the biggest products in the pipeline, but I, so apply the just announced that in their Phase 2 challenge study that 100% efficacy in adults and they also said they're going to kick off. As I say, in September of this year and they could report with early Q1 next year. So my question is what does that mean for GSK's out about our program. Does the Pfizer data suggests that product could be at least as effective as yours where do we need to be careful trying to compare quite different endpoints. And could you do the same thing, could you accelerate your Phase III and have data in the same sort of timelines or is the reason is yours might take a bit longer? And the second question was just a clarification on daprodustat and so it was already mentioned our Boxer had a tough AdCom although they had non-inferiority headline on the safety the point estimate that worst assays and I didn't go very well at the AdCom but it sounds like you very confident in your product. So can you just confirm that's because you also differentiated from and then your point estimate or may safety does actually better.

Dame Emma Walmsley -- Chief Executive Officer

Hal while you take you take both of and Roger, if you want to add anything on the broader RSP perspective, come back to you. Hal?

Hal Barron -- Chief Scientific Officer and President, R&D

Thanks James. But I'm not going to make too many comments on the announcement of Pfizer. But let me just highlight a few things about what we know about our project and why we're so excited about it. First of all, just to anchor everyone, of course RSV in older adults is an enormous unmet medical need with just in the United States alone over 180,000 people hospitalized and as many as 14,000 of those unfortunately die. Our Phase II as I was alluding to this earlier, really does show pretty robust boost our response with neutralizing titers that are, that are very comfortably in the range where we expect significant efficacy. I'm personally very pleased that this data, that the pre-fusion antigen is the right one as evidenced by our data as well as now with prices, so that's exciting. It's also important to remember that our program has this ASO one adjuvant which I explained earlier, provides this T-cell immune response, which we think will actually increased efficacy like we saw with RSV, but also maybe potentially duration, et cetera. So it's differentiated vaccine combination, if you will, with the pre-F antigen as well as the very effective proprietary ASO one adjuvant. I think it's also important, if I understood it correctly that while we are very confident that the immune response will be mounted effectively in the 18 to 50 roles. This is again the older adults is an older population where again we need to be ensuring we have the most robust immune response to protect them as their immune systems are different. And as I said earlier, the the T-cell immune response wasn't normal in an unadjuvanted RSV vaccine and that's why we chose to use the adjuvant because the T-cell response became much closer actually almost identical to young adults. In terms of the timelines and speed, it's important to remember that as we said, we're choosing this older adult population where we think the greatest unmet medical need is, and the timing of these studies are difficult to predict because, first of all, have a lot to do with the size of your trial, our study is very robust. We're enrolling 25,000 patient to make sure that we understand the safety and efficacy profile and potentially do subgroup analyses where, of course, the number of events determine how long the trial last, of course, the enrollment rate has a strong impact on that as well as the treatment effect of the drug. So I can tell you that we're very confident that this is one of the most important projects in our pipeline and we're doing everything we can to, excuse me, expedite it as fast as we can and we're optimistic that we will complete this in a very timely manner. So as far as daprodustat, I'm not again going to comment on the rocks AdCom although what you stated I think was pretty clear from the discussion we we any data from the central so would be an appropriately for me like today just to comment directly on on that, the point estimate and confidence intervals. I will say, however, that recent. Yes. You said the recent advisory committee meetings have disclosed I think pretty clear that the FDA wanted to see a non-inferiority margin of 1.25. I think that was pretty clear from the meeting and stated many times. We have previously said that our design clinical studies were done with input from from regulators and agreement from regulators. So you know I don't want to say more than that, but I'm very excited about the fact that we had five Phase 3 studies that were positive and that this robust program really was, I think it's going to be a very robust package for the regulators to review.

Dame Emma Walmsley -- Chief Executive Officer

Thank you, Hal. Next question please.

Operator

Thank you. The next question is from the line of Kerry Holford of Berenberg. Please go ahead.

Kerry Holford -- Berenberg -- Analyst

Thank you, two questions please. Firstly on the COVID antibody. I wonder if you're willing to give of us an idea and would you look at the effective price per dose that you've secured for the dose orders you secured to date and in what timeframe you should orders to be delivered? And then on the flu vaccine following the recent news you are going to ship 50 million doses in the US. In fact, conclude that that the sales of flu vaccine in this year should slightly exceed the 2020 figure around GBP730 million. Is that fair? Thank you. Thanks, Kerry. Well, I'm going to ask Iain because I think he should have a question Iain to talk about the flu outlet and we'll come back to Luke on the timing. I would say the short answer to are we going to give you the precise pricing about contracts will be no, but let's go to Iain first and then come over to Luke.

Iain Mackay -- Chief Financial Officer

Don't feel compelled....

Dame Emma Walmsley -- Chief Executive Officer

And Brian is available as well.

Iain Mackay -- Chief Financial Officer

So, Kerry, on a volume, on a volume basis, we would expect numbers to be broadly similar to last year. However, you'll recall from our commentary in the 4th quarter last year results, which we did in early February that we had a very significant RAR adjustment in flu last year and so netting out that RAR adjustment which we clearly won't to see the benefit of again, I think volumes will, we expect to be broadly similar but in dollar terms or Sterling terms rather will be slightly less.

Dame Emma Walmsley -- Chief Executive Officer

Yeah. And I would say that in the outlook of the 4% to 6% beyond guidance EPS that include the recent contract?

Iain Mackay -- Chief Financial Officer

It does indeed, yes.

Dame Emma Walmsley -- Chief Executive Officer

It does. So that's worth noting. Luke, you mentioned before, is anything else you want to add on that delivery?

Luke Miels -- President, Global Pharmaceuticals

Yeah, yeah, I mean I think what we now need to do. We've got this overarching contract to approach the 16 countries, which include all of the major European countries and sign up volumes and we've also got a number of other countries outside Europe that we've got contracts also I'm hoping in Q3, we can give you a lot more granularity, because we'll have those in hand. In terms of pricing, the only price that was given publicly is 2100 WACC in the US where we're selling a small number commercially. For Europe, you should just assume it's in the range of industry pricing.

Dame Emma Walmsley -- Chief Executive Officer

Next question please.

Operator

Thank you. Next question is from the line of Geoffrey Porges of SVB Leerink. Please go ahead.

Geoffrey Porges -- SVB Leerink -- Analyst

Thank you very much. On a couple of questions for Hal. First, just on the IO portfolio, you've highlighted the CD226 portfolio many times. I'm just wondering if you could give us a sense of when we could see the first clinical proof of concept for your combinations, the different combinations there for that whole strategy. And then secondly on, again the daprodustat, do you believe that we should expect class labeling for daprodustat for infection risk, thrombosis risk, and seizure risk given the imbalances seen in your competitors trials. As you know, the FDA has been extraordinarily cautious about labeling in the CKD population Yes it is. And so, would that be prudent on our part. Thanks.

Dame Emma Walmsley -- Chief Executive Officer

Hal?

Hal Barron -- Chief Scientific Officer and President, R&D

Thanks, Geoff, yeah, thanks Geoff. The IO portfolio is actually quite robust now and the CD226 axis I think is well covered with both the now anti-TIGIT from ITOs with CD96 inhibitor most advanced in our collaboration with 23 and the furthest behind, but also exciting is the anti-PVRIG which should get into the clinic next year was a deal with surface oncology recently. All of those, of course, can be combined with each other as well as with dostarlimab, so the four-drug combos are quite complicated and there'll be a lot of dose ranging that's needed indication ranging if you will, and we will be getting data from [Indecipherable] 96 and dostarlimab first. So that will be the first readout, that should occur in 2022. We should be able to get some PVRIG data probably in 2022 as well. The TIGIT combinations with dostarlimab will be seeing in 2022, hopefully some data at all, of course, depends on how robust the data is and what the, what do we see activity at various doses. The triplet will take a little longer, just because we have to get through all the dose-ranging and safety, but that should come following the observation of of proof of concepts with those combinations, so exciting opportunity we think to take the field beyond the PD1 era and enter into a CD226 year a possibly a doublet or maybe even a triplet if, if it's the cards fall appropriately and we can make a triplet. That would be profoundly beneficial for patients. That was the case. So excited about that opportunity. In terms of dapro, I really don't want to comment on discussions that we haven't yet even started with regulators. The data that I mentioned that we are very excited by was the primary endpoint, we haven't done any of the subgroup analyses and other sensitivity analyses that are going to be of course needed will be doing those very soon. We should have that data and hopefully be able to present that later this year. Of course, then that's followed by discussions with regulators, digestion of the classes, you say, and I think it would be premature to have any speculation on what anyone else's labels might show for sure and ours will of course follow the data. Thanks for the question, Geoff.

Dame Emma Walmsley -- Chief Executive Officer

Thanks, Hal. Next question please.

Operator

Thank you. The next question is from the line of Keyur Parekh of Goldman Sachs. Please go ahead.

Keyur Parekh -- Goldman Sachs -- Analyst

Good afternoon. Two questions please, one on commercial opportunity for Blenrep. Luke, I noticed that Bristol kind of reported first quarter revenues for their BCMA CAR T or $24 million that's roughly similar to the GBP21 million you reported for BLenrep. So, just give us a sense for where kind of Bristol is taking shared and how confident you are for growth of Blenrep even without the additional studies kind of reading out and then separately for Brian, Brian congratulations on kind of the CEO Designate not surprising that at all. But your slide talks about e-commerce being 7% of sales for the consumer healthcare business, up 30% for the quarter. Just wondering if you can kind of give us a sense for how that 7% stacks relative to your peer group. What was this corresponding number last year. So just give us a sense for how big you think e-commerce might be for the Glaxo consumer health business going forward.

Dame Emma Walmsley -- Chief Executive Officer

Thanks, Keyur. So, Luke?

Luke Miels -- President, Global Pharmaceuticals

So, I mean I think Keyur, just like this out. I mean it's, right now we have about a quarter of patients in the US who are fifth line in terms of patients on drug, but about a third of them are now now it's about a quarter a 5th line the rest 6% line but one in three new patients coming on the fifth line. So we are starting to move up there. I think there has been a bit of pressure in that fourth line setting. It's a relatively small number of patients is a lot of competition for them with studies such as decreased demand the bi-specifics. In terms of the CAR T, I mean, let's see, there is some ordering patterns, probably there. Again, it's concentrated in academic centers where we are now seeing our growth is in the community, which is a natural progression. I mean in the end though, we need to, we need to address the dosing and is how that line is a lot of activities to do that to penetrate the earlier lines of treatment where the vast majority of the opportunity for this product exists. We're less concerned around the lifestyle[Phonetic]. Again, I think that is being used in in the EMD population and some of the talks around him, and it's impacting [Indecipherable]. So I think we've got more work to do to capture those fourth line patients in the community, and we're working very hard to do it.

Dame Emma Walmsley -- Chief Executive Officer

Thank you. Brian?

Brian McNamara -- Chief Executive Officer

Yes, good question and thanks for the congratulations also. As you said, our e-commerce as a percent of sales is 7%, up 30%. Last year, we were at 6% of sales. We continue to see progression. As far as how that compares to competitors, it really is dependent on, quite dependent on portfolio. If you look across our portfolio, it's an oral care we are over-developed, where we have higher shares in many of our brands online versus offline. In OTC, we're pretty much in line but skewed toward again being over developed so slightly better than I would say the competitive set, and on VMS actually is an area we're catching up. So we were under-developed on the VMS, as there is many more digital native brands in that space, but we're growing in that area very aggressively and we're seeing really good progression in that area. So I continue to believe this is an area that's going to continue to grow really healthy. We've seen a massive shift in these categories to online shopping as part of the behavior that came with the pandemic. And we see that consumer that behavior can continuing and I feel really great about where we're at and our capabilities in this area to continue to win in the space.

Dame Emma Walmsley -- Chief Executive Officer

Thanks, Brian. And I would also like to add to my very public congratulations and pride in your, on your appointment.

Brian McNamara -- Chief Executive Officer

Thank you, Emma [Multiple Speakers]. And the other then I would just overlays, it's not only the brand power on digital, it's also the geographic mix where because of our strong presence in consumer in both the US and China, which are very e-commerce friendly regions that also helps drive both our capability and best on that. Next question please.

Operator

Thank you. The next question is from the line of Emmanuel Papadakis of Deutsche Bank. Please go ahead.

Dame Emma Walmsley -- Chief Executive Officer

Hi, Emmanuel.

Emmanuel Papadakis -- Deutsche Bank -- Analyst

Hi, thank you for taking the question. I'll make it to Brian actually. So if I look at your first question on margins, please you reiterate mid high 20s for next year, I think, but obviously that's as part of the current business, not as a stand-alone. I know there's been some discussion of what additional stand-alone costs you would incur. So any insight you can offer us the stage in terms of the step down on margins would likely to see a stand-alone business and it's not now even anything but not now when we not going to get that number and then maybe a question on the R&D side you reported in this Moonstone, perhaps you could give us some comments on the units at missed the the target you're overall. What does that imply if anything for clinical program for the. I don't actually think would do you any pivotal or proof-of-concept basis points for the rest of this year or even next. But we just waiting for that [Indecipherable] makes sense, but in 2024. The other things we should be thinking about looking at for you're considering. Thank you.

Dame Emma Walmsley -- Chief Executive Officer

Thanks so much, Emmanuel. Maybe I will go into. I would say, how the, first of all, Brian, do you want to comment on when it will be shared?

Brian McNamara -- Chief Executive Officer

Yeah. As Emma mentioned, we'll be doing a Capital Markets Day in the first half of next year, we haven't identified that date yet but at that time is when we would share much more detail around the business in a lot of areas around our cash flow and our our margin progression and included in that would be any of the off costs. So you would expect to hear about that next year before before separation.

Dame Emma Walmsley -- Chief Executive Officer

Thank you. Hal? Moonstone and implication?

Hal Barron -- Chief Scientific Officer and President, R&D

I mean could you just, a part of Emmanuel's question dropped out. Could you just repeat it briefly.

Emmanuel Papadakis -- Deutsche Bank -- Analyst

I can repeat it, if you can hear me.

Hal Barron -- Chief Scientific Officer and President, R&D

Oh, it is Emmanuel.

Emmanuel Papadakis -- Deutsche Bank -- Analyst

You are welcome. So it was just a question on the miss in Moonstone. What does that imply the clinical development and next data points we should be looking for thinking about.

Hal Barron -- Chief Scientific Officer and President, R&D

Thank you, that was what I thought, just want to confirm. You're correct, Moonstone has been stopped, I think it's important to point out Moonstone was a single-arm open label Phase II study where we were looking at response rate. It was in the most patients with ovarian cancer to treat the so-called platinum resistant ovarian cancer patient populations, who actually do not very well even with chemo and bevacizumab but these are second line those who failed bevacizumab, so very resistant population but was based on some very small numbers of patients that suggested maybe the combination of of a PD one plus PARP would be beneficial. So we had a very high bar and the the study where we looked at the response rates didn't suggest that it was going to achieve the bar we have. Now, the study that we have always been more optimistic about because again Moonstone was in the treatment setting where frankly PARPs the data for PARPs in the treatment setting has been [Indecipherable] in terms of efficacy. In the maintenance setting is where you really see the benefit and the study that we thought would most definitively identify an opportunity for the combination of a par plus one was the so-called first clinical the first trial, which is as patients who received chemo with dostarlimab and niraparib versus standard of care platinum based regimen, and that is enrolling well and we should see data for it before the next opportunity to have a direct read through for this synergistic potential synergistic impact. We're also, as you mentioned, committed to other combinations of niraparib with dostarlimab with the Phase III will be Part II section where we're comparing dostarlimab in combination with niraparib for patients with endometrial cancer and of course we have the zest and zeal, both of which could be transformational for patients zeal being in the front line lung cancer setting. That's being a novel novel study designed for patients who are surgically -- women with breast cancer who were surgically treated for the intent of cure but who's who have evidence through tumor measurements in the blood. The cell-free DNA from the tumor being evident as a biomarker, that we're using to start treating people to potentially prevent the disease from recurring. So two innovative and I think exciting trials in addition to first will add hopefully a lot to patient benefit into the life cycles of niraparib.

Dame Emma Walmsley -- Chief Executive Officer

Thanks, Hal.

Unidentified Speaker

We have time for one more question and then we'll wrap it up, if there is one more question.

Operator

Thank you. The next question is from the line of Graham Parry of BOA. Please go ahead.

Graham Parry -- Bank of America Merrill Lynch -- Analyst

Great, thanks for taking questions. Just firstly on Shingrix. I was just wondering if you could just help us kind of square the circle of the, the different commentary. So the guidance is a little cautious, but you still talking confidence in strong recovery into H. So are you still expecting a very strong 2022 I think consensus is looking for 25% year-on-year growth, does that sit within the range of your outcomes internally. And then secondly just following up on the question on Pfizer's RSV vaccine timing that suggests perhaps they might be expecting more on RSV events coming this season if they think they can get a data readout in Q1. So is it also the case that perhaps the RSV incidence is picking up relative to what, when you originally planned, your studies, meaning your data could also come earlier. Thank you.

Dame Emma Walmsley -- Chief Executive Officer

So, Hal, you will come back again to the RSV study and just on Shingrix, yes, we do see a significant step up '22 into to still commenting on versus specific answer the guidance on that one, Graham, but Hal would you like to comment on, on the RSV study.

Hal Barron -- Chief Scientific Officer and President, R&D

Yeah, I think yeah, just to reiterate, we. There's a lot of assumptions that go into determining how long a trial will take. Of course, as I mentioned before, and has a lot to do a sample size, so we are enrolling 25,000 people that enrollment is going very well. It does have a lot to do with the number of events, which is actually related to some extent to the treatment effect, and there is some reason to believe that the events might be higher than anticipated based on the fact that in 2020, there was very limited RSV and sometimes there is without the prior season immunity, sometimes there is more clinically significant cases, but again we're all estimating these things and it would be probably more like a class effect, if you will, that if there is more events, it's going to, we'll be seeing that in any trials in RSV will be obviously unique to us or Pfizer or anybody else. So, we just have to wait and see and of course anything is possible, but the idea that maybe there is more RSV because of the 2020 low levels. There is some data suggest that might be the case, we'll just have to wait and see.

Dame Emma Walmsley -- Chief Executive Officer

Thank you very much. And with that, everybody, we will finish today's call and look forward to catching up with you in the in the coming days. For those that we don't get to speak to, I hope, whether it's for you get some kind of bright outlook forward to catching up against soon. Thank you. Goodbye. [Operator Closing Remarks]

Duration: 77 minutes

Call participants:

Iain Mackay -- Chief Financial Officer

Dame Emma Walmsley -- Chief Executive Officer

Deborah Waterhouse -- Chief Executive Officer

Hal Barron -- Chief Scientific Officer and President, R&D

Brian McNamara -- Chief Executive Officer

Luke Miels -- President, Global Pharmaceuticals

Roger Connor -- President, Global Vaccines

Unidentified Speaker

Andrew Baum -- Citigroup -- Analyst

Unidentified Participant

Laura Sutcliffe -- UBS -- Analyst

Jo Walton -- Credit Suisse -- Analyst

James Gordon -- JP Morgan -- Analyst

Kerry Holford -- Berenberg -- Analyst

Geoffrey Porges -- SVB Leerink -- Analyst

Keyur Parekh -- Goldman Sachs -- Analyst

Emmanuel Papadakis -- Deutsche Bank -- Analyst

Graham Parry -- Bank of America Merrill Lynch -- Analyst

More GSK analysis

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