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. Starting with our top line performance on slide 8, we had yet another strong quarter with third quarter revenues growing double digits versus prior year, primarily due to increased demand for our in line brands but as well as our new product portfolio. So let me shed some light on some of our product performance starting with Eliquis on slide 9.
Eliquis continues to perform very strong with global sales up 15% versus prior year. In U.S., sales grew 18% versus prior year. Demand growth continues to be strong with total prescription growth of 14% versus last year driven by Eliquis market share gains and growth in new-to-brand volumes. Sequentially, as usual, sales were impacted by the expected coverage gap liability that occurs in the third and fourth quarters each year. We expect strong new-to-brand share growth to further translate to overall total prescription growth. Internationally sales grew 12% versus prior year primarily due to demand. Shares continue to increase across all key geographies and continues to rank as the number one OAC in multiple markets with additional room to grow. We remain really pleased with Eliquis's execution around the world and expect to continue to grow Eliquis's share within a growing class.
Now moving to Opdivo's performance on slide 10. We are pleased with the continued momentum for the brand with sales growth of 7% versus prior year. In the U.S., sales grew 4% versus last year, primarily driven by uptake in first-line lung cancer and our multiple other new launches this year. And sequentially, we had demand growth of 5%, which was offset by work-down of $40 million in inventory build we noted in the second quarter. Our commercial teams continue to execute well. We've retained strong positions in core indications such as melanoma and renal, and are very pleased with the performance of our newer indications.
Outside the U.S., we had another strong quarter with sales up 11% versus last year. Growth was primarily driven by demand for new indications of expanded access in Latin America, Turkey, and Russia. We continue to see strong uptake from our new launches in lung and renal cancer in Germany and Japan with pricing and reimbursement discussions ongoing in other key markets. These launches, together with recent approvals of first-line gastric and adjuvant esophageal cancer, are expected to contribute to further growth internationally. Based on positive momentum from our current launches and future potential launches, including first-line esophageal in May of next year as well as expansion opportunities from clinical trials that will read out over the next few years, the promise for Opdivo's continued growth is high.
Turning to our in line multiple myeloma portfolio on slide 11. Revlimid was up 11% globally, primarily driven by demand for triplet-based therapies and increasing treatment duration. Pomalyst global sales are up 10% driven by continued demand for triplet-based therapies and use in earlier lines.
Now moving to our new products on slide 12, we continue to be very pleased with our new products which generated sales of $344 million in the third quarter. This new diversified portfolio is already annualizing close to $1.5 billion run rate giving us great confidence that we are on our way to renewing our business with products that are much earlier in their life cycle. So let's start with Reblozyl, which generated strong sales of $160 million in the third quarter, up 67% versus prior year. Sales growth in the U.S. was primarily driven by continued demand in the ESA refractory MDS patients as well as a $20 million to $25 million inventory build. We are very encouraged by the recent NCCN guideline update that now recommends evaluating ESA response sooner at six to eight weeks instead their previously recommended 12 to 16 weeks. This supports the need to monitor and potentially treat new patients earlier in their treatment journey. Additionally, we remain focused on ensuring they receive the most appropriate dose for sustained benefit.
Outside the U.S., uptake continues to be strong in countries where Reblozyl is launched. Sales were impacted by the usual price review one year after launch in Germany. We expect to launch in Italy and the Netherlands in Q4 pending reimbursement discussions and in more countries in 2022 to drive additional growth for the brand.
Moving to our cell therapies, Abecma and Breyanzi. Demand for Abecma, our first-in-class BCMA CAR T, remains robust. We generated $71 million in the third quarter versus $24 million in the second quarter. Remember that 2Q revenues consisted of only 1.5 months of sales having launched in mid-May. So performance this quarter reflects a full quarter of sales. Demand continues to exceed supply, and we expect Q4 revenues to be largely similar to Q3.
Now moving to our CD19 CAR T, Breyanzi, sales in the quarter were $30 million versus $17 million in the prior quarter. Sales increased due to patient demand with physicians recognizing Breyanzi's best-in-class profile. We're extremely pleased to have clinically meaningful EFS data in second-line large B-cell lymphoma and look forward to presenting the data at ASH and bringing this treatment to earlier line patients in 2022.
Turning to Zeposia. Global revenues were $40 million in the quarter driven by multiple sclerosis launch and one-time inventory build in the U.S. The MS launch continues to progress well where Zeposia remains the S1P of choice in terms of written prescriptions. We continue to focus on establishing Zeposia as not only the S1P of choice but also the oral treatment of choice in MS. Our launch in UC is also progressing well in the U.S. We are encouraged by the initial uptake and growth in the number of new trialers since launch in June. Our focus is building on volume, establishing demand for this oral biologic-like medicine, while broadening access over time. We're also very pleased to have just received CHMP positive opinion in Europe and look forward to making Zeposia available to patients living with UC as soon as possible.
Lastly, we're making progress on establishing Onureg in first-line maintenance in AML patients. Onureg generated sales of $21 million in the quarter, primarily driven by increased demand as well as inventory build versus prior quarter. We continue to focus on shaping the new maintenance segment and increasing adoption and patient adherence.
Now let's turn our attention over to P&L on slide 13. We've already covered our strong sales for the quarter, so let me walk you through a few other non-GAAP key line items. Gross margin increased versus prior year primarily due to lower royalty payments. Operating expenses were higher than last year particularly in R&D due to COVID recovery but also slightly in MS&A due to investments supporting our launch and pre-launch activities. MS&A versus prior quarter did experience some softness due to timing of investments that have shifted to the fourth quarter. Our effective tax rate of 14.9% was primarily driven by earnings mix. Overall, non-GAAP EPS increased 23% year-over-year.
Now moving to our balance sheet and capital allocation on slide 14. Our liquidity position remained strong with almost $16 billion in cash and marketable securities and a strong cash flow from operations of $5.3 billion in the quarter. Our capital allocation priorities remain unchanged with significant financial flexibility to support a balanced approach to capital allocation. Our priorities are to continue to renew and diversify our portfolio through business development, paying down our debt, and returning capital to shareholders. We've executed several business development deals this year bringing in differentiated early-stage assets. Business development remains a top priority as a leading innovation-based company.
We have paid down $6 billion in debt year to date and are committed to maintaining our strong investment grade rating. As it relates to returning capital to shareholders, we're committed to growing our dividend subject to board approval and remain opportunistic about share repurchases. We have already purchased 3.5 billion of shares to date, and we currently have, approximately, $3 billion remaining in our authorization program.
Now turning to our guidance on slide 15. Based on the strong performance in the quarter, we're reaffirming full-year sales and raising the lower end of our non-GAAP EPS guidance. We continue to expect revenues to increase at the higher end of our guidance and gross margin be, approximately, 80%. Moving to operating expenses, we are maintaining our MS&A and R&D guidance for the year. As I mentioned earlier, MS&A, we are expecting higher expenses in the fourth quarter due to timing of investments that shifted by a quarter. Additionally, we're updating our tax rate guidance to, approximately, 16.5%, primarily due to earnings mix.
All-in-all, I'm pleased with our performance. We had another remarkable quarter for the company and continue to execute well against our plans and to diversify and renew our portfolio. This performance could not have been achieved without the passion and dedication of our employees around the world, and I look forward to providing you future updates on our progress.
With that, I'll now turn it back over to Tim and Giovanni for Q&A.
