David Elkins
Executive Vice President and Chief Financial Officer at Bristol-Myers Squibb
Thank you, Giovanni, and thank you all for joining our call today. Let me start with our top-line performance on Slide 8. I'm very pleased to discuss our strong double-digit growth this quarter, driven by increased demand for our key medicines across the globe. Looking at the first half of the year which normalizes for most of the COVID-related buying patterns we experienced last year, commercial performance was strong, up 9% year-over-year or 7% excluding currency. This robust performance demonstrates both our strong execution of our commercial teams, as well as increased demand for our products.
I'll now provide additional color on the performance of our key brands and new launches starting with Eliquis on Slide 9. This was another strong quarter for Eliquis with global sales up 29% versus last year. Second quarter growth benefited from a favorable year-over-year comparison as prior year included the unwinding of COVID-related buying patterns. When looking at the first half to normalize for this dynamic, sales remained strong, up 18%. In the U.S., we saw strong demand with total prescription growth of 14% versus prior year driven by market share gains, which continue to expect strong new-to-brand share growth for further translate to overall total prescription growth.
As a reminder, when we look toward the third and fourth quarters, we expect similar dynamics from the Medicare coverage gap as seen in previous years. Internationally, we had very strong demand across all key geographies, as we further gain share as the number one OAC in multiple markets and we continue to see additional room to grow. Overall, we remain very pleased with the execution of Eliquis around the world and expect to continue to grow Eliquis share within a growing class.
Now turning to Opdivo on Slide 10, let me start by saying, we're very pleased to deliver return to growth this quarter, up 16% versus last year, while COVID recovery dynamics, as well as approximately $40 million in U.S. inventory build contributed this quarter's growth. The brand's performance is largely driven by strong demand for both our core and our newly launched indications. In the U.S., sales were up 13% year-over-year, as well as 14% sequentially, driven by launches in lung, RCC and our upper GI cancers, which are all going well, and lung shares in the low double-digits with positive momentum and we're seeing use across all histologies.
In RCC, our Opdivo plus Cabo launch continues to do well with Opdivo now the leading PD-1 in first-line renal across both available regimens. In upper GI, we saw very strong start with Opdivo plus chemo in first-line gastric cancer with CheckMate -649, which reached 25% to 30% share in just a few months based upon the strength of our data. The adjuvant esophageal launch, while still in early days is off to a great start. Overall, we see upper GI as an important opportunity for Opdivo based on the breadth of offered indications and the fact that Opdivo is the only PD therapy approved for HER-2 negative gastric cancer.
Outside the U.S., we had another strong quarter with sales up 13% excluding the impact of foreign currency versus last year. Growth was primarily driven by demand of our new launches in lung and renal cancer. Results also benefited from a favorable comparison due to COVID-related impact last year. All-in-all, we're very pleased with Opdivo's performance and future growth outlook based upon the positive momentum for our current launches, our future potential launches, including muscle-invasive bladder cancer and first-line esophageal, as well as potential expansion opportunities from clinical trials that we'll read out over time.
Now turning to Slide 11 regarding our in-line multiple myeloma portfolio. Revlimid was up globally, primarily driven by demand for triplet-based therapies and increasing treatment duration. In the U.S., we are encouraged to see prescriptions nearing pre-COVID levels. Pomalyst global sales were up 15%, driven by continued strong demand for triplet-based therapies and use in our earlier lines. Now moving to our recent launches on Slide 12, we continue to be very pleased with our new launches, beginning with Reblozyl, which generated $128 million in Q2 and increased 14% sequentially. As the bolus from the MDS launches continue to wind down, it's being replaced by underlying demand growth as expected. We continue to expect sustained growth in the second half of the year as we remain focused on treating new patients early in their treatment journey and ensuring they receive the most appropriate dose for sustained benefit.
Moving to Zeposia, which generated $28 million in the quarter. The MS launch continues to progress well, where Zeposia is the S1P of choice in terms of written prescriptions and where we continue to see high intent to prescribe metrics. We have also seen an acceleration in the conversion time from written prescriptions to commercially supplied product. Looking forward, we see -- we continue to focus on establishing Zeposia not only as the S1P of choice, but also the oral treatment of choice for MS. Beyond MS, we launched Zeposia and ulcerative colitis in the U.S. in early June. While early in the launch, we are very encouraged by physician receptivity to the product so far. Our plan is to focus on step-wise process of building volume by establishing demand for this differentiated oral like biologic like medicine, while maximizing access over time.
Turning to Onureg, the launch is also going well with double-digit demand growth over prior quarter. We continue to expand the user base with physicians recognizing Onureg as the first and only FDA-approved treatment for AML patients in first remission with a demonstrated OS benefit. Second quarter sales were impacted by reduced inventory, driven by our transition from bottles to blister cards. However, based upon the strength of underlying demand trends, we expect to see sales rebound in the second half of the year. Remember that this is a new treatment segment where it will take time to shape and establish Onureg as a maintenance treatment. Looking at each of these products internationally, we are encouraged to see how these launches are going and we look forward to driving growth through gaining access and reimbursement in additional markets over time.
Now I'd like to turn to Slide 13 and discuss cell therapy. Demand for our two new differentiated cell therapy products has been strong. Starting with Breyanzi, we are pleased with our launch progress with Q2 sales of $17 million, driven by strong execution and rapid site activation, with more than 65 sites activated to-date. Messages around our differentiated profile and outpatient utilization are resonating well with high awareness among CAR T treaters.
Next as it relates to Abecma, our first-in-class BCMA CAR T had sales of $24 million in the quarter led by very strong demand. We were able to leverage the site footprint of Breyanzi to accelerate site onboarding, an advantage of launching two CAR T medicine simultaneously. Based on the significant unmet demand and differentiated profile, we have seen robust demand for this product, beyond our current capacity and we are looking hard to increase capacity over time. Looking forward, we continue to see meaningful long-term potential with our cell therapy franchise across both Breyanzi and Abecma as evidenced by the recent demand we've seen.
Now turning to the next slide, a few points as we think about our launch portfolio overall. First, we are very encouraged with how each of these products are progressing at this point in the launch cycle. Together, they have already contributed $225 million this quarter and are approaching a $1 billion run rate. Importantly, we review these products as having significant future potential. This gives us great confidence in our ability to diversify and renew our portfolio as we look forward.
Now let me take you through a few line items on our P&L on Slide 15. Since we've already covered strong sales for the quarter, I'll focus on a couple of other key line items. First, gross margin decreased versus prior year, which is primarily due to foreign exchange and product mix. Operating expenses were higher than last year, particularly in MS&A due to higher launch and pre-launch investments across therapeutic areas, as well as foreign exchange, which were partially offset by our realized synergies. Remember that at the same time period last year, our spend levels were lower than normal through the initial wave of COVID. Effective tax rate was 16.9%, primarily driven by our earnings mix, and overall, non-GAAP EPS increased significantly year-over-year, primarily driven by our strong top-line performance.
Now switching gears to the balance sheet and our capital allocation on Slide 16, our liquidity position remains strong with over $13 billion in cash and marketable securities, and strong cash flow from operations of $3.1 billion in the quarter. Our capital allocation priorities remain unchanged. During the quarter, we continue to strengthen the balance sheet, while renewing and diversifying our portfolio through business development. As Giovanni mentioned, we executed two deals during the quarter that both complement, diversify our oncology portfolio with Agenus and Eisai.
As it relates to continued debt reduction, our $4 billion tender offer and additional $1.5 billion in maturities in the first half of the year demonstrate our commitment to strong investment-grade rating. As it relates to our share repurchases of the planned buyback to $3 billion to $4 billion this year, we have already bought back $3 billion to-date and will remain opportunistic as the year progresses.
Now turning to our 2021 guidance on Slide 17, following this quarter's performance, we are reaffirming our top and bottom line non-GAAP guidance for the year, which reflects significant growth over last year. From a full-year revenue perspective, we continue to expect growth in the high single-digits. In terms of phasing for the remainder of the year due to Eliquis's coverage gap and unwinding of Opdivo inventory that I noted earlier, we expect Q3 global revenues to be similar to Q2. However, we are encouraged by the strength in the business and expect full-year sales at the higher end of our guidance. We have updated our gross margin assumption to 80% for the full-year primarily due to product mix and the impact of foreign exchange.
Moving to operating expenses, we are maintaining our full-year guidance on MS&A of low single-digit increase and on R&D of mid single-digit increase. In terms of phasing for opex, we expect it to increase quarter-over-quarter at a similar pace to the first half of the year. Based on that and the strength of the business, we are reaffirming non-GAAP diluted EPS of $7.35 and $7.55 for 2021. This quarter we remain pleased not just with our performance, but also with the considerable progress we made in executing our launches and advancing our pipeline.
I'll now turn the call back over to Tim and Giovanni for Q&A.
