Galderma Stock

Good day, and thank you for standing by. Welcome to Galderma's conference call. [Operator Instructions] Please be advised that today's conference is being recorded.

I would now like to hand the conference over to Emil Ivanov, Head of Strategy, Investor Relations and ESG, to introduce the call. Emil, please go ahead.

Thank you, Sarah. Welcome to Galderma's Half Year 2026 Financial Results Call. The press release, along with Galderma's financial statements were published at 7:00 a.m. Central European Summer Time today and can be consulted on our corporate website at any time. Today's presentation slides as well as a recording of the webcast will be made available on our website after the call.

Please be advised that today's presentation contains forward-looking statements, which should be treated with appropriate level of caution as detailed on the slide. Let me now introduce today's half year 2026 financial results webcast. Dr. Flemming Ornskov, CEO of Galderma; and Luigi La Corte, CFO, will provide a performance update and discuss the financial results and outlook for the full year. After the presentation, Flemming and Luigi will be available to answer questions from financial analysts before Flemming provides his final remarks to close the webcast. With this, I would like to invite Flemming to start the Galderma's highlights for the first half of 2026.

Flemming, over to you.

Thank you, Emil. Good morning, good afternoon, and welcome to Galderma's First Half 2026 Financial Results Webcast. I'm pleased to be here today to discuss Galderma's continued strong growth trajectory. Capitalizing on another year of opportunities, we're progressing on our ambition to become the undisputed dermatology powerhouse.

I would like to thank our teams around the world for their dedication, hard work and relentless commitment to strengthening our leadership in dermatology and continuing to outperform the market. Galderma is on a highly attractive growth journey. And as many of you know, we were recently selected for inclusion in the Swiss Market Index. Expected to become effective in September, the inclusion in Switzerland's leading blue-chip equity index marks another important milestone in our journey as a publicly listed company.

For the first half of the year, Galderma delivered record net sales, surpassing USD 3 billion for the first time in the first 6 months of the year. Net sales year-on-year growth was 24.6% at constant currency with double-digit growth across all product categories and geographies. With a core EBITDA margin of 25.6%, margin expansion was ahead of initial expectations. Core EPS growth was also significant, up 68.5% year-on-year. We are raising our net sales guidance for the full year based on this stronger-than-anticipated trajectory, especially in Dermatological Skincare, Therapeutic Dermatology and neuromodulators.

We now expect 19% to 21% net sales growth year-on-year at constant currency. We are also confirming our core EBITDA margin guidance for the full year of approximately 26% at constant currency with the intent to continue investing behind growth opportunities in the second half of the year.

Let's now look at our net sales performance in more detail. For the first half of 2026, Galderma delivered USD 3.1 billion in net sales. Growth was predominantly volume-driven, complemented by favorable mix effects, despite a competitive market environment. The business delivered a positive price contribution during the period, excluding the anticipated gross to net impact from Nemluvio. Growth was broad-based with all our top 10 markets growing, of which 9 grew double digits.

Our market performance and outperformance continues to be driven by commercial excellence, innovation and deeper penetration across global markets. International, our larger reporting geography, grew 19% at constant currency with double-digit growth in each product category. Our momentum remains strong and highly attractive and largely under-penetrated markets. The U.S., up 32.3% at constant currency, delivered net sales growth across all product categories. This growth momentum was particularly strong in Injectable Aesthetics and Therapeutic Dermatology driven by Nemluvio. With that, let's turn to the performance and key highlights of each of our product categories.

In Injectable Aesthetics, with net sales of USD 1.4 billion, up 12.1% at constant currency, we continue to outpace the market across geographies in both neuromodulators and in Fillers and Biostimulators. The U.S. phasing effect favorable in the first quarter unwound in the second quarter. Neuromodulators delivered net sales of USD 826 million, up 13.4% at constant currency. U.S. shipment phasing specific to the second quarter is expected to benefit the third quarter of the year. Fillers and Biostimulators achieved net sales of USD 611 million, representing growth of 10.5% year-on-year at constant currency despite continued softness in the Fillers market. Sculptra meanwhile, continued to grow double digits in both international markets and in the U.S.

Executing on our neuromodulator portfolio strategy, we continue to gain market share in both the U.S. and international markets. Dysport continued to grow in the U.S. and in all top international markets with particularly strong performance across Asia and Latin America. Local investments in health care professional engagement and education continue to drive market share gains with outstanding performance in the second quarter in China and in South Korea. In addition, in Europe, including markets where Relfydess has already launched, Dysport sustained double-digit growth. Meanwhile, Relfydess continued to build momentum in international markets, for which health care professional feedback continues to be very supportive. The second quarter saw launches in three additional markets, including in Hong Kong, our first Asian markets. We continue to advance regulatory reviews as we steadily build the broadest and most innovative portfolio in Injectable Aesthetics, supported by one of the industry's most extensive global commercial and educational footprints.

Our strategic ambition is crystal clear to become the global leader in Injectable Aesthetics. Neuromodulators are an important part of that strategy. Over the past several years, we have invested significantly in both R&D and in manufacturing capabilities in this area. Relfydess is an internally discovered and developed innovation and is already approved in 33 markets with additional regulatory filings underway. As announced on July 1, Galderma received a complete response letter from the U.S. FDA, addressing remaining observations on our manufacturing site and on analytical method organization and optimization.

This is not uncommon for complex biologics and manufacturing facilities in this space. Approval time lines in the U.S. for neuromodulators have generally become longer over recent years. Since 2018, every new Botulinum toxin product reviewed by the FDA has received at least one complete response letter, be it newcomers or the industry's most experienced players. I want to reiterate that these observations do not relate to the safety or the efficacy of the product. Looking ahead, we remain fully committed to resolving these topics promptly and to continue working constructively with the FDA.

Advancing RelabotulinumtoxinA in the U.S. remains a top priority for us. Meanwhile, we continue to drive strong growth and market share gains with Dysport in the U.S. We're excited to be pioneering the next generation of neuromodulation. We remain confident in the underlying science and the long-term strategic importance of Relfydess to our Injectable Aesthetics portfolio. In light of our strong momentum from neuromodulators in both international markets and in the U.S., we do not expect the U.S. complete response letter to impact our ability to deliver on our midterm guidance as updated earlier in March.

In fillers and biostimulators, we continue to advance our portfolio and geographic expansion, supporting ongoing market share gains in international markets and in the U.S. First, we keep scaling recent launches. This includes Sculptra in China, which continues to significantly outpace a fast-growing market. For Restylane, this includes investments in education and training to drive further adoption. For example, behind new indications in the U.S. for the chin and for temples. Second, we keep rolling out new technologies in our fillers portfolio. This includes the further expansion of our Restylane SkinBooster SmartClick syringe now launched in China and it's third approval for Restylane Shaype now approved in Thailand for skin -- for chin augmentation.

Third, we keep expanding our biostimulators portfolio in new markets. This includes launching Sculptra in Indonesia, approval to launch in India later this quarter as well as a further approval for body indications in Australia. Beyond our global leadership position with Sculptra, we keep investing in innovation and have made progress with two clinical stage biostimulator assets for our long-term growth. We keep advancing our clinical development programs while also exploring external opportunities to further extend our leadership in Aesthetics.

Moving to Dermatological Skincare. We maintained our strong growth momentum across our flagship brands, Cetaphil and Alastin. With net sales of USD 848 million, up 16.4% at constant currency, we significantly outpaced the market. As anticipated, growth in the first half was strong, benefiting from a lower comparable base in the period. We continue to grow in both the U.S. and international markets with double-digit growth for Cetaphil in fast-growing international markets and for Alastin in both geographies.

E-commerce remains the fastest-growing channel, supported by our digital-first execution. We are also capturing growth opportunities globally through focused execution through innovation and through portfolio synergies. Our momentum remains particularly strong in fast-growing international markets, especially in Asia. On this slide, we are showcasing Cetaphil in China as it continues to deliver outstanding growth. We had the largest online share gains for the beginning of the year among top dermatological skincare brands. We also capitalized on local shopping events to outperform the market online.

In the second quarter, this included a highly successful 618 campaign with a particular focus on expanding our presence in the face segment where we have historically been underpenetrated. We also continue to scale our innovations globally, extending their reach and impact across markets.

In the U.S., this includes Cetaphil Skin Activator, one of the two largest U.S. launches in the hand and body segment among Dermatological Skincare brands. Alastin, which continues to outperform the physician-dispense market, including the strong uptake of its two recent launches with TriHex Technology plus new great technology.

In international markets, among many, these include Cetaphil Baby in India, where we are building leadership in the premium baby care segment, driving significant growth. Alastin also continues its international expansion, which now includes launches in Japan and in Taiwan. Alastin is a great example of a strategic bolt-on M&A. We'll continue to build on that success while also exploring other potential external opportunities.

Moving now to Therapeutic Dermatology. Net sales were USD 848 million, up 67.9% at constant currency. Growth remained very strong, driven by the ramp-up of Nemluvio, which continues on its successful global launch trajectory. Nemluvio net sales for the first half of the year were USD 433 million. For the first time, Nemluvio contributed more than half of Therapeutic Dermatology's net sales overall. The U.S. continues to represent the vast majority of sales, which we'll discuss shortly.

In international markets, the launch trajectory continues to be even stronger. At the same time, regulatory reviews and approvals for Nemluvio continue to progress, including recent approval in Brazil for both atopic dermatitis and prurigo nodularis. We've also secured additional reimbursement wins in key international markets that support broader patient access. Performance was complemented by higher-than-expected growth from the mature Therapeutic Dermatology portfolio globally, up 10% at constant currency for the period. We saw positive growth from geographic expansion and life cycle management of molecules with benefits also from delayed generic entries.

Nemluvio is on a strong global trajectory for which the U.S. remains our largest opportunity. In the U.S., Nemluvio's market share in paid new patients start, known as NBRx, was trending at about 42% in prurigo nodularis and about 9% in atopic dermatitis from mid-June to early July. Underlying demand remains strong. In the second quarter, the majority of U.S. patients initiating treatment continue to be new to biologics across both indications. To support growth, we keep investing behind health care professional engagement and supporting efforts for strong reimbursement access. This represents a strong achievement, and we look to our internal and external opportunities to further complement our growth trajectory in this segment.

In the U.S., we also launched different Epiduo Acne gel over-the-counter. This milestone represents yet another example of Galderma's unique integrated dermatology strategy. Here, we leveraged our consumer go-to-market expertise to support this prescription to over-the-counter transition in Acne care. Driven by strong science and execution, including support from major retailers, the uptake was stronger than we initially expected. The examples I've highlighted across our three product categories once again demonstrate the breadth of our growth opportunities and the significant potential we have to continue outperforming in our markets.

With that, I'm pleased to hand over to Luigi, who is now fully on board to provide more detail on our financial performance and on our outlook.

Thank you, Flemming, and good morning, good afternoon, everyone. It's a real privilege to have joined Galderma at this exciting time with the company rolling out significant innovation and on a high-growth trajectory. And clearly, I'm very pleased to have the opportunity today to comment on a strong set of financial results for the first 6 months of the year. And equally strong full year outlook, as we continue to make great progress towards our objective of becoming the undisputed dermatology powerhouse.

As you can see from our financial scorecard for the first half of 2026, Galderma delivered record performance across the board, both across top line and bottom line with EBITDA and net income growth significantly outpacing revenue and with a strong balance sheet lending leverage at the end of June at 1.2x EBITDA. Flemming has already covered our strong top line performance in detail. So let me just add that I'm absolutely impressed by the company's consistent ability to drive growth across geographies and product categories on the back of one of the most exciting and broadest portfolios in the sector. And to do that whilst continuing to drive margin expansion and achieving a marked improvement in key financial metrics.

So looking at our financial results, Galderma delivered significant core EBITDA margin expansion with operating leverage more than offsetting the gross margin impact of product mix as well as the anticipated gross to net evolution and higher royalty rates on Nemluvio, as it continues its very strong growth trajectory. Core EBITDA was USD 802 million, up 42.8%, significantly outpacing net sales growth. Core EBITDA margin expanded to 25.6% of revenue, representing a significant 328 basis point improvement at constant currency compared to the first half of 2025. This performance slightly exceeded our initial expectations for the period, reflecting strong net sales growth, some phasing in operating expenses and the benefit of a small onetime tariff refund.

Growth was even greater in core net income and core EPS, reflecting both the strong core EBITDA growth and lower financing costs following successful refinancing executed in the first part of the year. For the first half of 2026, core net income was USD 547 million, up 66.3% and core EPS was USD 2.34, up 68.5% with EPS growth also reflecting the slight positive effect of share repurchases.

And as shown on Slide 17, our strong operating cash flow, combined with the strong core EBITDA growth, reduced net leverage to 1.2x at the end of June '26, down from 1.5x at the end of 2025 despite increased dividend payments and share repurchases done in the period. Net cash generated by operations was USD 572 million, driven by strong core EBITDA with some working capital absorption driven by the high growth of the business.

This cash generation enabled us to return capital to shareholders while maintaining a disciplined balance sheet. During the first half, we paid dividend totaling USD 104 million and repurchased USD 302 million of shares as part of the final accelerated book build offering by the equity led consortium in Q1. And with that, we now have a total of just over 4.7 million shares held in treasury. This all results in a very strong investment-grade balance sheet profile, which reduces our financing expenses and gives the group optionality, allowing us to actively consider inorganic growth opportunities across our three product categories to further complement our very attractive organic growth outlook.

Reflecting our strong performance in the first half as Flemming has anticipated, we are raising our full year net sales growth guidance for the year. We now expect constant currency net sales growth of 19% to 21% for 2026. We continue to expect to outpace the market in each of our product categories while comparing to a higher base in the second half of '25 with incremental growth expectations versus the guidance that was provided at the beginning of the year, driven by Dermatological Skincare, Therapeutic Dermatology and Neuromodulators. In terms of phasing, we expect Neuromodulators growth in the third quarter to be particularly strong, also supported by U.S. phasing benefits from Q2 into Q3. This will offset within injectable aesthetics franchise, somewhat softer growth for fillers and biosimulators in Q3, which we expect in the low single digits in the quarter in a soft fillers market and against a high comparable base following the launch of Sculptra in China last year.

You may recall that last year did not follow a typical seasonality pattern with greater net sales in the third quarter higher than in the fourth quarter for this subcategory. We still expect Dermatological Skincare growth to be lower in the second half, normalizing against a higher comparative base in the previous year. And for mature Therapeutic Dermatology portfolio with now generics in the market and new ones expecting to enter and against a higher comparative base, growth is still expected to be negative in the second half of the year, while Nemluvio net sales are likely to pass the USD 1 billion mark for the year.

In terms of profitability, we are confirming a core EBITDA margin of approximately 26% constant currency for the full year, delivering significant margin expansion versus 2025 while absorbing inflationary headwinds and continuing to invest behind the growth opportunities that we have. A reminder that our full year guidance factors in manageable exposure to announced U.S. tariffs and potential effects from recent related proclamations, along with the ability to absorb potential consumer demand deterioration in the second half of '26 given the volatile political and macroeconomic environment.

Following receipt of the recent complete response letter from the FDA for RelabotulinumtoxinA and pending further discussion with FDA on completion of the necessary mediation towards the resubmission, we now plan to communicate an extended midterm guidance, one that goes beyond '27, in the first quarter of next year. As Flemming has already said, we don't expect the U.S. CRL to impact our ability to deliver on our midterm guidance through 2027 as updated already earlier in March.

And from my perspective, having seen firsthand the strength of our integrated dermatology strategy and execution and the breadth of our growth momentum, I'm confident in the opportunities ahead and our ability to continue outpacing the market. And finally, just as a reminder, you will find, as usual, in the appendix, our updated modeling metrics as well as our foreign exchange exposure. Based on June spot rates, we still expect a positive impact on reported figures with higher uplift on sales than on core EBITDA, resulting in a slightly negative impact on reported core EBITDA margin for the full year.

Thank you, Flemming, and thank you, Luigi, for the introductory remarks. We'll proceed with questions and answers from our analysts. When it comes to the brevity of the questions, we appreciate if you keep it to one question each so that we can fit as many of you as possible. With this, I would like to hand it back to Sarah, our operator today, to open the line for questions.

[Operator Instructions] Our first question today is from the line of Ben Jackson from Jefferies.

I'll start with one and then jump back in the queue. I'm going to start with the margin expectation for the full year 2026 and also the performance for the first half this year. Obviously, it's a great result on the expansion during that first half, but you did call out that it was ahead of your own expectations. Are you able to give us more color on how much of this was down to the cost phasing? And then for the proportion which you're indicating that you'll reinvest in the second half of the year, are there any particular focus areas that you see are highest priority for that?

Yes. Thanks, Ben. I'll take the first part, and then I'll pass on to Luigi. Yes, we are a very high-growth company. You've seen the growth. We delivered 24.6%. We're in very competitive categories. We achieved 25.6% EBITDA in the first half. It's a -- many different things driven by the strong growth of our products, their contribution. We also keep a very tight ship on the cost. And -- but the main thing for me is we have to invest to continue to grow the business. And that's the message you're getting. You're getting no under -- and it's a simple message. It's a high-growth business, high growth required investment, and that's why we're keeping it stable, and that's exactly what we plan to do in the second half.

Thank you, Ben. From my side, really, the key driver is the operating leverage, the very strong growth that we saw across the business over the first 6 months. Yes, there was a little bit of phasing on cost and a really minor impact from this onetime tariff refund, but it was really the sales growth that drives it. In terms of focus for investment, we really see opportunities across the three areas. And so we'll look to continue driving the growth that we see, as both in terms of driving greater penetration, winning share and continuing to launch and expand the portfolio in new markets. So it's really across the spectrum.

We'll now take our next question. This is from Victor Floch from BNP Paribas.

I will stick to one as well. So maybe one on Nemluvio's pipeline. You've just announced plans to submit in the pediatric atopic dermatitis patient population. So maybe can you walk us through this opportunity? What makes you excited, whether you can discuss a little bit the data that has been reported so far and whether you can confirm if it's captured by your current $4 billion guidance for the product? And finally, just can you confirm whether we should expect the CPU Phase II top line by year-end?

Well, the short answer, there's nothing I'm not excited about when I talk about Nemluvio. It was launched at #6. It's now almost a par in its trajectory to Dupixent. I've been involved in 5 or 6 blockbusters in my career. I've never seen anything like this. So the team is just phenomenal. Yes, any blockbuster like that. It's in the guidance 4 plus that we've already given. The most important for me is that we delivered great results in CPU, and we'll update you when we are ready to tell you when the data are there. Study is ongoing.

We have a smaller indication we're also looking at that's also enrolling. And yes, I think we all know the importance of the pediatric indication. And again, there, we will update you when we are filing for that. So there's nothing not to be excited about when it comes to Nemluvio. But when I wake up in the morning and go to bed, I'm more focused right now on driving the phenomenal opportunity. You see the number of opportunities we have actually in being the first-line biologic for many patients. If you see the phenomenal access we have in the commercial plans, the market share we've already achieved in PN and the very strong market share we accrete in a very, very competitive AD market.

So I think we still have a lot of work to do. I'm sure you're focused on the U.S. But if I look at the market share the teams have achieved outside the U.S., Germany, you see, some of them are even higher than the U.S. So I'm extremely proud of the team, but we are at the beginning. We may hopefully hit $1 billion this year, but we still have a few to go, and there's a lot of opportunity with this compound.

We will now take our next question. This is from Shyam Kotadia from Goldman Sachs.

So on your injectable aesthetics midterm guide for '22 to '27 of 10% to 12%, you mentioned it's still in place regardless of the Rofi delay. So I was wondering if you could provide a bit more color on what could influence where in the range you sit. I know Rofi at the earliest it seems like it won't come in until maybe second half '27 if you refile by year-end. So -- and you mentioned your current Neuromodulator portfolio is performing better than expected. So is that a suitable offset? Just how should we think about this now?

Well, I have to complement it on a very sophisticated question that was trying to get me to answer when we are planning to file. So the answer -- we do not know, okay? We just received the complete response letter. There has been no news since we received that letter. We are working through it. We worked very closely with the FDA, both during the inspection of Uppsala, during the various technical CMC-related issues, methodology-related issues. I think the team is making excellent progress.

As you probably know from all your experience, once you get a complete response letter, you are granted an audition with the FDA, where you basically first in writing and then during the meeting, present your mediation plans. Once that meeting has taken place sometime in the autumn, we will have a better idea both on are we on track and what would be the timing. I'm very confident. I've seen what the team has done. We started off with a large list of issues. We're dwindling it down to a small list of issues. Of course, there's still issues we need to address, but I'm very confident in the team, and I'm very confident in a very productive interaction with the FDA. And I know it's a priority for you, but you can imagine it's also a priority for me to get this product approved in the U.S.

We will now move to our next question. And this is from James Gordon from Barclays.

Also on the Relfydess CRL, so you've had a little bit more time to digest it. How does it compare to the first CRL in terms of is it as many things to do? Or is it more benign? And some people had thought there would be a CMD this year, and we now have clarity that it's going to be in Q1. So assuming that is a little bit of a pushout, is that because potentially you'd like to have Relfydess refiled ahead of the CMD and that's why the push out? Or is the push out for other potential reasons? And would the exact timing of when you get the approval in the U.S. for Relfydess make a big difference to the new guide anyway, in that I assume you would guide all the way up to 2030. So if it was a bit earlier or a bit later, how much of a swing factor would U.S. Relfydess be in the group's overall outlook to 2030?

Yes, James, thanks a lot for one question with a lot of sub-questions. So we'll try to answer that. I think the overarching thing is against regarding the complete response letter. I think you would expect -- I would expect -- the team is expecting that as you work through the list of issues become smaller. But other than that, I have no other comments on this. We will work with the FDA. We will -- and have started all the work that is necessary. To have a Capital Markets Day when you're in the midst of sorting out an important launch product in the U.S. makes to me very little sense. We know you look for guidance. We've already stated in the e-mail today that -- or in the letter today that you will get that along with our outlook for '27.

So I think we'll meet that requirement. And hopefully, by that time, we can provide more color to the outlook, the timing -- is that the only determining factor for our guidance? Of course, not. I think you can look at our performance with Dysport around the world, that speaks for itself. The fact that we have already told you that our guidance from '23 to '27 will remain unaffected by this. I think that speaks to the opportunities we have. The good news about having a portfolio also Neuromodulators is that you can shift a little bit resources between one and the other, and this is a time where you see the benefit of that.

Maybe I'll just add from my side, James, we just -- we're already at the beginning of this year, tightened guidance for the '23, '27 period. We've just upgraded guidance for 2026. We reiterated that the CRL will not impact our ability to meet that midterm guidance. So we just think allowing us the time to work through with the FDA their response and our plan way forward will give a better basis for having that discussion around the midterm early in the new year.

We'll now take the next question. This is from Alek Ebbeling from UBS.

It's on the Nemo net price. So in your guidance, what have you assumed for additional Medicare plan coverage? And if you continue to get access through medical exemption, are you less likely to pursue full access with PBMs at a discount?

No, let me take that question. It's obvious that we are rather successful with our exemption strategy for Medicare. As you know, that's more important for PN than it is for AD. AD is largely covered by commercial plans. We have 90-plus coverage. We continue to monitor the situation. We have 1 out of 5 we have contracted with. We're in discussions with the other ones. But I think it's too early to predict whether we will close further, but we are engaging with all of these relevant players that we are not engaged with today or that we don't have contracts with today.

But I think you can see that we've been rather successful with what we have done so far. But at some point, we probably will have to add to the coverage that we have in Medicare, but we'll update you then.

We now take our next question. This is from Joffrey Bellicha Meller from Bank of America Securities.

The question I have is, I would like to understand or if you could discuss what are the current trends you are seeing in the Neuromodulator market in the U.S. underlying, i.e., beyond your market share gains? Are you seeing an acceleration in the market? Or do you have any data points pointing to a potential acceleration in that market that could be supportive into the rest of the year?

And related to that, Luigi, you made some very clear comments, I think, on the third quarter for both Neuromodulators and Fillers and Biosimulators. Should we think that the balance of both would lead to Q3 Injectable Aesthetics to be in line with the second quarter or maybe slightly above?

Maybe I'll take the second question. I mean we try and give some direction, but please accept we won't give such precise. I think we're very confident with the momentum that we see in Neuromodulators and very confident that, that strong momentum will continue. Where precisely we're not going to provide. you want to take...

Yes. I think the -- well, first of all, I think it's very important to realize that we're one of the few companies with a portfolio in Neuromodulators. I think we've shown internationally that we have very strong growth of Dysport, Azzalure or Alluzience as the various products are called despite at the same time launching Relfydess. So I think that speaks to the fact that we are clearly winning new accounts, penetrating more and doing a really good job with the portfolio. In the U.S., I think you've seen a trend break. We are getting stronger and stronger. This is all about market share gains.

What are the dynamics in the market? Yes, we know and we've seen that, that patients prefer or have a strong preference for Neuromodulator treatment. We've also seen that products like Sculptra is high on their preference when they choose the treatment, but we are seeing a stabilization of a fillers also in the U.S. market shifted between Q1 and Q2. And I think that's also driven a bit by what you see with the rapid penetration of GLP-1 usage. So the trends are good. The competition is heating up. It's quite clear that we have some very formidable competitors, but I think we continue to take share, and I'm really proud of the team.

And the next question is from Emily Tedbury from Citi.

I just wanted to ask a big picture question on the strength that we've seen in China. Can you talk to the duration of growth you expect to see there? Is the strength that we've been seeing sort of representative end consumer demand? Or is it more sort of ramping up in different distribution channels, which perhaps we might expect to reach some kind of steady state or normalize in due course?

Well, Emily, did you want me to say that the growth is eternal or that we -- every single day environment, -- the growth is driven by a phenomenal performance by a team, particularly in the e-commerce channel. You see all the awards they win, how they're perceiving. Remember, we entered late in China, whether it was with the aesthetics business or the consumer business. We focused on e-commerce execution. And I think what I see is the team continues to do extremely well. There are certain events every year, given a very e-commerce savvy population that also are driving various sales boost. So on the consumer side or on dermatological skin care, I see very strong growth, and then we will soon be also hoping seeing impact of Alastin.

What we've seen in a very, very competitive aesthetics market is that if you launch something, I think when we launched Sculptra, there was five competitions on the market. There's 12 now, maybe it's even 13 since yesterday, who knows. And it shows again that we continue to do extremely well. So I think we have a small imprint when you compare to AbbVie, but we have lots of opportunity, both on the consumer side, but not least on the aesthetic side.

We will now take the next question. This is from Sophia Graeff Buhl Nielsen from JPMorgan.

Just on Sculptra and international, are you seeing any competitive impact from the use of polynucleotides ex U.S.? Or are you seeing more complementary use in clinics? Is this an area where Galderma might consider BD given the high growth of this market amongst smaller private players? Or are there any other areas of high interest for some of the inorganic opportunities you're talking about?

Well, Sophia, I have to compliment you because it's also some observations I'm making myself that polynucleotides is starting to get a place in the aesthetic armamentarium. It seems to me that it is nascent. I speak to a number of doctors that are using polynucleotides. Experience are mostly positive, but it's quite clear that along with skin quality, biostimulation that they probably will play a role. So we continue to observe that market. There are multiple players, as you know. And in Asia, there are even more players. We continue to watch the market. And like anything that is so attractive by the aesthetics market, there's constantly new innovation. And we, of course, as a leader, have to continue to watch that innovation.

I think Sophia, from my side, as we've said during the call, certainly, our priority #1, 2 and 3 is continue to drive the organic growth opportunities that we see in the business, but we're very much also looking at opportunities to complement that with business development and certainly, our balance sheet gives us the flexibility to do that.

And the next question today is from Harry Sephton from RBC.

So just to your comments that Dysport grew double digit in markets where Relfydess is launched. I just want to get a sense of has Relfydess been entirely additive to growth in those markets, effectively enabling you to gain share with the broader portfolio? Or has there been some modest cannibalization for the double-digit growth for Dysport simply shows the strength of those markets?

Yes. Of course, I cannot exclude that there is some cannibalization, but with the growth of Dysport and the growth that we have of Relfydess, that can only be a minor factor. What we are seeing is, and I've been in the field multiple times, that certain clinics have patients that prefer to try something new. Others are more conservative and either want to stay on Botox or on Dysport. So it's probably a certain segment of doctors, kind of early adopters and certain segment of customers that may be wanting to try a new product. But for us, we are selling a portfolio. So we want to make sure that we grow all of the Neuromodulators to the extent possible.

But I think some of the market shares that have been achieved in a very fast situation like in Spain and others, I must say it's also taking share, but also getting new patients into the market.

We have two more questions remaining. Next question is from Henrietta Boeg from Deutsche Bank.

Yes, I've got a question on Nemluvio, please. We saw a little uptick in NBRx for AD up to -- I think it was 8% -- 9% actually. And it would be good to know a bit about what you think is driving this and maybe how you think this is going to evolve in the remainder of the year?

I think as you probably have seen when you look over the year, in the first part of the year, there's always a little bit of ups and downs because when you have some coverage of Medicare, but you're also relying on individual patient exemptions, then before the system kicks in for the next year, that creates a little bit up and down in the NBRxs. But I would say, overall, we see an upward trend. We see we continue to gain share. It's getting more competitive, but I've seen the execution of the team. I'm very confident that this will continue to tick up. And I think there is a good chance that we could hit $1 billion this year in sales with Nemluvio in the U.S. alone.

We have one more question. Last question is from Victor Floch from BNP Paribas.

Just a quick question on the Injectable Aesthetics pipeline. I think you've mentioned that you are moving two biostimulator assets to clinical stage. So just wondering whether you can discuss how those products differ from Sculptra? And when should we expect them to hit the market?

Yes, we have multiple candidates. I would still characterize them at early stage. Biostimulation and fillers are two categories that we're constantly trying to innovate in, whether it's with new modalities or new ways of injecting and new indications. So yes, it's quite clear that one of our focus areas of interest is in biostimulation and those relatively early-stage compounds are still in that field. And I can assure you, once we have data, we will publish the data and show you. But early stage, interesting, but it's early stage.

Thank you, Flemming. Thank you, everyone, for the good questions. Before we close the call, I'll hand over to Flemming for his final remarks.

Well, thanks a lot, Emil, and thank you, everybody, online for your time and of course, your questions. I think you realized that '26 is another exciting year of opportunities for Galderma with continued execution of our proven growth-driven integrated dermatology strategy. For the first half of the year, we delivered record net sales. We surpassed USD 3 billion for the first time in a 6-month period of the year. It was a broad-based growth, double-digit across geographies and across product categories.

We achieved significant core EBITDA margin expansion of 328 basis points at constant currency. clearly ahead of expectations. With strong cash generation, we strengthened our financial profile, and I think we clearly demonstrated our commitment to superior shareholder returns along with, of course, delivering significant growth in core earnings per share. So our confidence in Galderma's growth trajectory remains very strong. And based on our performance for the first half of the year, we are raising our full year net sales guidance to 19% to 21% at constant currency, and we're also confirming full year core EBITDA margin of approximately 26% at constant currency, while, of course, targeting growth reinvestment in the second half.

So with these closing remarks, I want to thank you for joining our call today.

Thank you. This concludes today's conference call. Thank you for participating, and you may now disconnect.

Good day, and thank you for standing by. Welcome to Galderma's Q1 2026 Trading Update Conference Call. [indiscernible] Please be advised that today's conference is being recorded. I would now like to turn the conference over to Emil Ivanov, Head of Strategy, Investor Relations and ESG, to introduce the call. Emil, please go ahead.

Thank you. Welcome to Galderma's 2026 First Quarter Trading Update Call, which is planned for 45 minutes. As customary, the press release was published at 7:00 a.m. Central European Standard Time today and can be viewed on our corporate website at any time. Today's presentation slides as well as a recording of the webcast will be made available on our website after the call. Please be advised that today's presentation contains forward-looking statements, which should be treated with the appropriate level of caution as detailed on the slide. Let me now introduce today's trading update webcast. Dr. Flemming Ornskov, CEO of Galderma, will provide performance highlights for the first quarter.

Thomas Dittrich, CFO, will then present the trading update and the financial outlook for the full year. Both Flemming and Thomas will be available to answer questions from financial analysts before Flemming provides his final remarks to close the webcast. With this, I would like to invite Flemming to start with highlights for 2026 Q1. Flemming, over to you.

Thank you, Emil. Good morning, good afternoon, and welcome to Galderma's First Quarter 2026 Trading Update. I'm pleased to say that Galderma is off to a strong start with impressive commercial and innovation momentum across our portfolio. Building on a strong foundation, 2026 is another year of opportunities for us to drive growth. We remain focused with 5 clear priorities. First, we're in our second year of ramping up significant launches and geographic expansion. With opportunities across the portfolio, this includes the strong uptake of Nemluvio and of Relfydess, both with blockbuster potential.

It also includes the geographic expansion of Restylane and Sculptra as well as ongoing innovation in dermatological skin care. Second, global market share gains remain a major opportunity. Above all, we're doubling down on growth-focused execution in the U.S. and behind our momentum in underpenetrated fast-growing international markets. Third, we continue to strengthen our financial profile as evidenced by our improved investment-grade ratings with the recent upgrade from Fitch, BBB stable to BBB positive, now in line with S&P's rating. So far, we have replaced our revolving credit facility and already fully repaid our term loan with the proceeds from our recent Eurobond issuance. We also continue to demonstrate our commitment to superior shareholder returns, complementing our share performance with a dividend payment and share repurchases.

The final accelerated book build offering, which took place in March marked the full divestment by the EQT-led consortium of investors, emphasizing Galderma's reliable performance and attractive outlook as a stand-alone company, it is the largest fully monetized capital gain from a single fund in the history of global private equity. Fourth, we are increasing our focus on long-term growth. more strategic optionality, we can invest in further developing our extensive internal pipeline while, of course, exploring external opportunities with a strong strategic fit. Fifth, we maintain a dynamic approach to commercial investments to drive results. This marks our model and it's resilient with the ability to leverage our broad portfolio and geographic reach in order to navigate market volatility and capture opportunities. I look forward to working with our engaged colleagues around the world on this next phase of growth.

Galderma's strong first quarter performance reflects the continued execution of our unique growth-driven integrated dermatology strategy. For the first 3 months, Galderma delivered net sales of USD 1.473 billion. Net sales growth was up 25.5% year-on-year at constant currency. As expected, the results were strong with double-digit growth across geographies and across product categories. The first quarter of '26 represents a very good start to the year, including the expected phasing dynamics with stronger growth in the first half of the year. In addition, even under normal circumstances, it is difficult to extrapolate for the year based on the first quarter.

In the current macroeconomic and geopolitical environment that clearly qualifies as extraordinary, we confirm our full year guidance for 2026. Based on the strong growth trajectory across the portfolio and especially dermatological skin care's overperformance, the guidance is increasingly being derisked with confidence to navigate a volatile environment. We'll continue to do what we are best at, focusing on execution and delivering on already well-defined high growth goals with attractive net sales growth and significant margin expansion for the year. Looking at the results of the first quarter, Galderma achieved double-digit net sales growth across product categories and across geographies. As anticipated, net sales growth was particularly high in the first quarter.

This was driven by the strong ramp-up of Nemluvio against a low comparative base combined with a strong commercial performance across the rest of the portfolio. In particular, dermatological skin care delivered a strong quarter ahead of expectations. This performance demonstrates our ability to outpace the market across product categories through commercial excellence, innovation and global expansion. Let's look at some performance highlights by product category for 2026 so far. In injectable aesthetics, we continue to drive superior growth. Supporting this were investments in execution and innovation across the broadest portfolio in the industry as well as in market-leading education and services. Starting with the portfolio.

In neuromodulators, we progressed the execution of our portfolio strategy, driving continued growth of Dysport while ramping up Relfydess. We also advanced Relfydess regulatory reviews in additional markets. In fillers, we continue to strengthen our broad Restylane portfolio with a focus on growing our differentiated offering in a soft market. Key recent highlights include the U.S. FDA approval of Resty lane Contour for the correction of Temple Hollowing and the global Wake Up to Restylane campaign, positioning Restylane as an everyday natural beauty ally. In biostimulator, Sculptura maintained its growth momentum as we strengthened our leading position in regenerative aesthetics.

We also continue to invest behind ongoing launches, including in China. Looking at our value-adding services, we progressed the scientific leadership of our portfolio, which includes recent interim data showing and showcasing Restylane and Sculptura's role in addressing aesthetic changes associated with medication-driven weight loss and with menopause. We had a leading presence at medical conferences. This included recognition from AMWC, the Aesthetic and Anti-Aging Medicine World Congress with top awards for Relfydess and Restylane KIT. We organized numerous proprietary education and training events as part of GAIN, our Galderma aesthetic injector network. This included a very well-received GAIN event in South Korea, which combined with strong commercial execution, helped support outstanding local performance.

We also took steps to strengthen the ASPIRE loyalty program in the U.S., including adjustments to support positive pricing impact. In dermatological skin care, we delivered particularly strong growth across our flagship brands, driven by focused execution ongoing innovation and portfolio synergies. Looking at Cetaphil, we continue to support our core portfolio while launching differentiated innovation. We maintain investments behind prior launches, along with supporting the recent introduction of our AM/PM antioxidant serum launched across many top markets. These serums represent a breakthrough daily system with proprietary Gallic-AOX power to help defend against oxidative stress. Proven to be more effective than vitamin C, it is clinically designed to defend skin by day and support accelerated repair by night for sensitive skin.

Commercial execution also remains strong in fast-growing international markets. This included outstanding growth once again in China, supported by focused omnichannel activation, especially around Chinese New Year and impactful celebrity campaigns. As a result, Cetaphil started 2026 as the #1 brand online and dermatological skin care sales in China. Looking at Alastin. In the U.S., we just launched regenerative Skin Nectar with TriHex+™ technology. With our proprietary Octapeptide 45, the new formulation helps reinforce skin structure, restore skin barrier and support long-term skin longevity. Alastin also strengthened partnership with leading aesthetic clinics in the U.S. through Alastin Signature practices, a premium in-office experience designed to elevate regenerative periprocedural skin care.

In therapeutic dermatology, growth remains driven by Nemluvio's strong trajectory, especially in the U.S. Nemluvio's market share in paid new patient start known as NBRx was trending at about 39% in rurigo nodularis and about 8% in atopic dermatitis from the beginning of February to mid-March 2026. Across both indications, the majority of U.S. patients initiating treatment continue to be -- yes, continue to be new to biologics. We also continue to expand our local health care professional engagement to support Ne mluvio's uptake. We see positive response from our real-world experience data to reinforce Nemluvio's efficacy on skin clearance, complementing its position as the itch treatment and relief treatment of choice.

At AAD, the American Academy of Dermatology, we also presented late-breaking Phase II data demonstrating clinically meaningful benefits for children with moderate to severe atopic dermatitis. In terms of coverage, we remain engaged with the 3 remaining major U.S. Medicare payers to secure access and, of course, broaden coverage. In international markets, which represents only a small portion of today's Nemluvio sales, the launch trajectory remains even stronger. We are also advancing regulatory reviews in additional top markets. Before I invite Thomas to cover the next section, I would like to sincerely thank him on behalf of all Galderma for his significant contributions and great collaboration since October 2019.

In just over 6 years, he has been instrumental in setting up a stand-alone company and shaping Galderma into the dermatology category leader it is today, now publicly listed with a very strong EPS growth trajectory. Now with our incoming CFO, Luigi La Corte, I look forward to continuing to shape our strong journey underpinned by the ambition to become the world's undisputed dermatology powerhouse. With his deep financial leadership experience across the health care and across consumer industries, we are very happy to have Luigi as part of the team. As communicated previously, Luigi will take over as CFO effective May 1. For the last time, I would now like to hand over to Thomas to cover our sales performance in more detail and the outlook for the year.

Thank you, Flemming. The past 2 years with you at Galderma have been the most impactful transformation and growth journey of my career. I would like to express my sincere gratitude to all of Galderma's highly talented and motivated colleagues around the world. It has been a true pleasure working with you all, and I'm confident leaving you in the capable hands of Luigi to continue on the exciting trajectory ahead. It's now my pleasure to comment on Galderma's first quarter trading update and full year outlook. For the first quarter, Galderma achieved net sales of USD 1.473 billion. Net sales growth for the period was 25.5% in constant currency.

As anticipated, net sales growth was particularly high. This was driven by the strong ramp-up of Nemluvio against the low comparative base, combined with strong performance across the rest of the portfolio. Dermatological skin care, in particular, delivered ahead of expectations against a lower comparative base. Growth was widespread across geographies and product categories, outperforming the market in each product category. Growth was driven predominantly by volume, complemented by positive price and mix effects. Injectable aesthetics net sales for the first quarter was USD 648 million with year-on-year growth of 13.1% at constant currency. Neuromodulators delivered net sales of USD 364 million, up 12.5% year-on-year at constant currency.

Performance was broad-based and particularly high in Europe and Asia Pacific, with the U.S. also benefiting from some favorable phasing. Galderma outpaced the market in neuromodulators in both the U.S. and international markets. Fillearnings release and biosimulators achieved net sales of USD 284 million, up 14.0% year-on-year at constant currency. Growth continued to be driven by Sculptra with double-digit growth momentum in both geographies, while Restylane grew in a soft market. Fillers and biosimulators outpaced the market in both the U.S. and international markets with particularly strong growth in the U.S., which benefited from some favorable phasing as well as in China from the continued strong ramp-up of Sculptra.

As a recall, the introduction of Sculptra in China has been a major growth driver for fillers and biosimulators since the second quarter of 2025, which is expected to impact the comparable growth rate for the remaining quarters of the year. Dermatological skincare net sales for the first quarter were USD 441 million with year-on-year growth of 17.0% at constant currency. Both dermatological skin care flagship brands Cetaphil and Alastin maintained strong growth momentum. As expected, dermatological skin care growth for the first half of the year is benefiting from a lower comparable base for the period. Growth was positive in both geographies with e-commerce continuing to be the fastest-growing channel.

Cetaphil outperformed, especially in fast-growing international markets and there, in particular, in China, while Alastin strengthened its improved position as the fourth largest physician dispensed brand in the United States. Therapeutic Dermatology net sales in the first quarter reached USD 385 million, up 71.3% year-on-year at constant currency. Growth was driven by Nemluvio's continued strong launch trajectories in both the U.S. and international markets, benefiting from a low comparable base. Growth in the period was also complemented by moderate growth in constant currency from the mature therapeutic dermatology portfolio in international markets, which more than offset the decline of the mature portfolio in the U.S.

As anticipated, the mature therapeutic dermatology portfolio benefited from a low comparable base in the first half of the year. Nemluvio net sales for the quarter were USD 185 million. The vast majority of sales came from the U.S. with a greater contribution from atopic dermatitis than The vast majority of sales came from the U.S. with a greater contribution from atopic dermatitis than prurigo nodularis. Galderma is confirming its full year guidance for 2026 with net sales growth of 17% to 20% at constant currency and a core EBITDA margin of approximately 26% at constant currency. The strong start into the year and in particular, dermatological skin care delivery ahead of expectations, the guidance for the full year is increasingly being derisked with confidence to navigate a volatile environment.

With guidance at constant currency and despite the evolution of the exchange rate, it is worth noting that the current FX exposure is simulated to have a positive impact on reported net sales and core EBITDA dollars, yet a negative impact on reported core EBITDA margin for the full year. The evolution of the simulated foreign exchange impact from February to March is available in the appendix. On U.S. tariffs, our exposure is expected to remain manageable for the year. Currently, Galderma's main exposure is a 10% U.S. tariff on the import value of Sculptra and Restylane. We are assuming this could increase to 15% based on recent communication from the U.S. administration, which was already factored into our full year guidance as communicated at the beginning of the year.

Furthermore, considering the additional U.S. administration proclamation on the imports of pharmaceuticals and pharmaceutical ingredients, the Section 232, the guidance also now factors in a 15% tariff on the import value of the remaining U.S. portfolio with several notable exceptions. We continue to assume that Dysport, which is produced in the U.K. as well as Cetaphil and the mature therapeutic dermatology portfolio produced in Canada in the USMCA compliant plant would remain exempt from U.S. tariffs. As a reminder, on the import value itself, only a portion of the in-market net sales price is exposed to tariffs. And recall that Nemluvio is imported as a semi-finished product into the U.S. with the import value being only a fraction of the net sales price.

Specifically for the injectable aesthetics market overall, recall also that more than 90% of all products sold in the U.S. are being imported, whether from the European Union, the U.K. or South Korea. 2026 is well on track as a key year to expand opportunities and drive growth with margin expansion.

Thank you, Thomas. Thank you, Flemming, for your introductory remarks. This concludes the first portion of our call. Before the final remarks that Flemming is going to provide, we would like to hand over back to the operator to open the call for analyst questions. [Operator Instructions] Operator, please invite the first question.

[Operator Instructions] We are now going to proceed with our first question. The questions come from the line of Victor Floch from BNP Paribas.

So maybe I would just stick to one on tariffs. So you've indicated that your latest guidance now incorporates tariff assumption for your pharma portfolio. So I was just wondering whether you can confirm if those tariffs are already being applied? Or are they scheduled to take effect later this year? And also considering your pledge to expand U.S. manufacturing, how confident are you that you could, at some point, strike a settlement with the U.S. administration and maybe later before the end of the year?

Thanks for your question. I think it's important to understand that we are currently exposed to the U.S. tariff of the level of 10%. That will go to 15%. That's what we're exposed to. The rest is speculative at this time and also any negotiations with any government.

We Are now going to proceed with our next question. And the questions come from the line of Benjamin Jackson from Jefferies.

Clearly, outperforming the market still in injectable aesthetics. But perhaps could you just touch on and give us an idea on the sense of the U.S. phasing for both toxins and fillers and biostimulators. Is there any way that you could perhaps quantify this? Or if not willing to put a number to it, is it something that you're expecting to net even out over between 1Q and 2Q? Any kind of directional indication of that would be super useful for us to understand the underlying growth rate there.

Yes. Maybe I take that, Benjamin. Thank you for the question. So first off, on Q1 injectable aesthetics growth, Injectable aesthetics remains on a growth -- strong growth trajectory in both neuromodulators and fillers and biosimulators, outpacing the market in both international and the U.S. As we said, Q1 benefited from some favorable phasing in the U.S. And recall, that is not unusual given we have concentrated shipments with one large logistics, you call it 4PL partner in the U.S. We maintain our full year expectation in injectable aesthetics of approximately 12% to 13% year-on-year growth at constant currency, which we communicated at the beginning of the year, with typically the strongest growth occurring in Q4 following our typical quarterly seasonality.

And specifically on neuromodulators, we continue to expect strong growth for the full year against a high comparable base. With the annualization of the 2025 Relfydess launches as of Q1, you have to keep that in mind because Relfydess only came in, in Q1 and now last year. So now the base goes up. Fillers and biosimulators, that's expected to grow low double digits for the full year based on continued strong momentum. We commented on that, and that includes Sculptra, the launches there. China, we mentioned launches and activations. And beyond the phasing dynamics here, it's important to recall that the introduction of Sculptra in China has been a major growth driver for fillers and biosimulators since its launch in the second quarter last year. And of course, that will impact the comparable growth rate for the remaining quarters of the year in fillers and biosimulators. Hopefully, that's useful, Benjamin.

We are now going to proceed with our next question. And the questions come from the line of Shyam Kotadia from Goldman Sachs.

I've got one on Derm Skin Care. So you mentioned this delivered ahead of expectations. Were there any one-offs in there at all? And also, I believe you previously mentioned for full year '26 that the growth rate will maintain the 12.6% exit rate seen in 4Q '25. Does the strength of the performance in 1Q '26 change this?

Thanks for the question. Maybe if I just also take that one. No, you said it really well. We would confirm again that we continue to expect Derm Skin Care growth to nearly maintain the exit 2025 growth rate that we called out in not too long ago in the full year call on March 5, and that growth rate was 12.6% and also, please remember that for the product category, we expect the growth rate to be higher in the first half of the year compared to the second half due to the comparable base from very strong performance, which we have seen in the second half of 2025. And now yes, we are tracking slightly ahead. I mean we have started to build really nice momentum in dermatological skin care in the second half last year. that's carrying through. And that's all there is to say. So yes, very strong performance in that category.

We are now going to proceed with our next question. And the question comes from the line of James Gordon from Barclays.

James Gordon from Barclays. The first question was on Nemluvio. So I saw the comment on the majority of patients starting treatment is new to biologics, which implies quite significant upfront use in AD. So is the majority of the growth now coming from upfront use in AD, people who haven't already used Dupixent? And if so, how is it trending in terms of people who haven't used Dupixent already? Are any of them using Nemluvio upfront for the speed of onset and it benefit but then transitioning to Dupixent for better skin clearance? Or are you keeping all the patients that are naive question -- naive patients and no transition? That's the first question.

The second question is business development, so really strong growth right now. But what is the appetite to diversify to while going is good? Could you end up bolting anything on or doing deals? And if so, would therapeutic derm be the category where you might add even more growth? How to think about BD.

I think -- thanks for the question. The important to understand is that now most of the sales is coming from AD. As you know, the strategy was first to secure a very strong share position in BD, which we have. We have 39% there. We are 8% at AD. It has also the advantage that AD is covered by commercial plans where we have 80-plus coverage. We have one out of multiple in the Medicare, where we have about 15% coverage in Medicare. But the most important is that, I would say, we continue to grow, and we initially was also maybe a bit surprised that we get so many naive patients, but I think people are seeing that it offers excellent relief on itch, but also get skin clearance and the longer it takes, we have shown continued clearance beyond what other products have shown.

So yes, then there's more switches from Dupi to us than the other way around. But as you can see, we get a lot of new to category, new to biologics patients, which I think is a lot speaking to the profile of the product, the convenience, the opportunity to be Q4, Q8, the ability with a fast onset and the fact that it really is working fast on itch, but also has a continued strong clearance. So I think the doctors are showing what their choice is in that situation.

And the drop-off rate is also trending for us ahead of what you would expect as industry benchmarks. And that's another point that one could add on this one.

On business development, we are not dependent on business development. Yes, we generate a lot of cash now and debt has been rapidly paid down, but we have so many organic opportunities that, that is our focus currently. And we don't have a preference as we have an integrated model, whether it's in aesthetics, whether it's in dermatological skin care and where it's in therapeutic dermatology, we look at the opportunity. And I think if you look at the very impressive growth of Alastin, we take our time. We reposition the brand. We upgrade it, we made it even a bit more luxury. And I think if you look at those growth rates and we do it international, that's a more solid model than just jumping from one deal to the other, even in an environment like yet -- like now where a lot of deals are happening.

And the question comes from the line of Joffrey Bellicha Meller from Bank of America.

Before I kick off, Thomas, congratulations on your tenure at Galderma. It was a tremendous pleasure working with you over the last 2 years. Then to the question about the consumer sentiment. Have you heard or seen from your injectors any risk on consumer sentiment deterioration on the back of the current Middle Eastern conflict? And related to that as well, if higher oil prices were to remain higher for longer, how should we think about the impact on costs for the business, if any? Would you be able to pass it through to customers through pricing? Or are there any other mitigation opportunities within the company?

Well, when we wake up in the morning, we think about how we can gain market share. And I think we've shown in the first quarter, that's what we do. The environment has it's ups and downs. It's, of course, a very challenging situation in the Middle East. Our people there are safe, and that's our main concern. It's 2% of our overall business. If there would be a decline there, we can compensate that. But I think for me, our colleagues are going to the office. They are equally ambitious of developing both UAE and KSA or Saudi Arabia. So for us, mid- to long term is very important, even if there is some subdued sales now also in some of the distribution markets in that region. We have not yet seen cost impact from this conflict. But of course, it may come, but I think we have mitigated a lot of things here and we'll continue to mitigate this.

We have a growth also in dermatologic skin care, which has been driven by volume, a little bit of mix and a little bit of a positive price effect, but we don't think that price is where we are going to have to win. We'll have to win by taking market share. And I think around the world and the fact we're #1 in China, I think, shows a little bit that this only happened through focused execution and focused on gaining market share. That's our main situation.

And if I can just say thank you, Joffrey, for your kind words, of course, but it's always the team that deserves the accolades. And just keep in mind one other point. Our factories are basically running 100% on renewable energy by now. So we did a lot of work back there. So that's on a lot of the other contracts we have, we have longer-term contracts and also hedges in place for that. plus is a growing business. We are focused, as Flemming said, on driving opportunities and driving cost savings. So if one thing goes up, then we'll have to find savings elsewhere. We have done that in the past, and we did not lose a beat when COVID happened, et cetera, et cetera. So we're pretty dynamic in looking for opportunities and please keep that in mind. And of course, on top of that, as you have seen also in the first quarter, and then we have also pricing power, but that combined with how we manage the cost base, I think, leaves us in a good position.

And we're still also -- if you also were inclined with your consumer question and sentiment question. We've not seen any spillover to our growth rate in aesthetics. We've actually had a very, very strong start to the year in aesthetics. Remember, this is also typically in our clientele, a little bit older population with higher disposable income, so probably not the first one that is going to be affected by petrol prices and other things. So just keep that in mind.

The questions come from the line of Thibault from Morgan Stanley.

My question is just on the filler market. So obviously, for Galderma, very strong performance with Sculptra, very differentiated products within bio stimulators, but it's been some quarters that you've made comments on the softness of the filler market. I'm just wondering if we should assume that in the filler market, that softness is not structural and it's related to consumer preferences, maybe competitive dynamics and so the acceleration of your fill and biosimulator franchise is mostly going to be about Sultra going forward? Or if you think that we could see a wake-up of the filler market at some point beyond biosimulators?

I think it's important to realize that in more and more countries, including in the U.S. when you are thinking about an aesthetic treatment, you probably get your information online. So if your online media is full of negativity about fillers, it may impact what your choice is. But what you are seeing is that, that negativity appears to have bottomed out. It will cause overdone dramatically. You will not be able to achieve the aesthetic results you want without using fillers. And I think we're seeing that. I think doctors and practitioners and nurses in this field are reinforcing that fact. And as we are seeing a significant growth in facial stacking and others based on people taking GLP-1s, if you want to compensate for some of that, you will need Sculptra, but you also need a filler.

So I think for us, it's -- we're well positioned. And we also just launched after a major survey into menopause where also fillers also to secure hydration is very important. Our product SkinBooster is ideal position for that along with Sculptra. So I think we continue to play where we are best at execution with a unique broadest-in-class portfolio in aesthetic medicine.

A Question come from the line of Sophia Graeff Buhl Nielsen from JPMorgan.

Just on neuromodulators, could you give any additional color on market share evolution for neuromodulators in Europe, particularly with respect to the relative split now between Relfydess and Dysport?

Yes. We've seen a number of interesting phenomenon, which we congratulate ourselves on because this was a strategy from the beginning that we sell a portfolio. So that means you don't just focus on Relfydess. Relfydess has had in many countries, what I would call a phenomenal uptake, top 3, top 2 and 5-plus market share. So we're really pleased with that. But my consistent message, our team's consistent message, we have great products in Azzalure or Dysport. We have great product in Alluzience and we sell a portfolio. And what we've actually seen in those products in most countries grow at the same time as we grow Relfydess, we grab overall market share. So I think our overall share of the aesthetics market in neuromodulators is growing, and we're performing well on all our products also because we focus on our products and execution.

We are now going to proceed with the next question. The questions come from the line of Emily Tedbury from Citi.

I was wondering if you could just update us on what you're seeing in terms of biologic penetration in the atopic dermatitis market and perhaps where you think this could grow to?

Well, I think if you -- I didn't have a time to detail and analyze what Sanofi presented today, but I saw that Dupixent has some really strong data. I've seen some of the, I think, 38% growth or something like that. I've also seen that the market continues to perform really well, both in prurigo nodularis and in atopic dermatitis. I think I don't know what the penetration is today, mid-teens. So there's significant opportunity to still grow.

And what it could become to -- I mean, there, maybe a proxy could be psoriasis and there -- I mean that's a much -- PSO is a much more established market. And there, biologic penetration kept growing, kept growing. And it's now, I think, in the -- somewhere in the 30s, upper 30s even.

I'm not saying it will be the same, but just to dimensionalize it, if you're in the mid-teens and Innovative products expand the market and especially when it comes to biologics, they do that, and we are first to market with an IL-31. So I think.

And not only the market -- the products that are on the market, there's enormous amount of research effort in this category. If you spend 5 minutes at AAD, you see how important atopic dermatitis is. So I think, as Thomas said, higher penetration is almost a given. What rate it will get to is difficult to know. But it's clearly not at a peak right now, probably far from.

I think, operator, we have time for one last question.

We are now going to proceed with the last question. And the questions come from the line of Natalia Webster from RBC Capital Markets.

It's a follow-up on the fillers and biosimulators. Within the 14% growth you saw in Q1, are you able to further break down the contribution from the new Restylane launches and Sculptura? And then just on Sculptura and those tough comps for the remainder of the year, are you able to provide any further detail on how much China contributed to Q2 and the remainder of 2025, just so we have an idea of the potential impact there?

Yes, it may not be popular, but we report U.S. and international, and we don't break it down in individual countries, and we report fillers and biosimulators together, and we're not going to break that tradition at this meeting today. But needless to say, that the stabilization and the growth that we have shown and the market share gains, particularly international, we show in fillers is, of course, a significant contributor and the Sculptra launch in China, one of the most successful and the [indiscernible] magnitude, of course, is a contributor, but we're not giving individual data for them.

Thank you very much for the questions. I'll just hand it over to Flemming to wrap up the meeting.

Well, thank you for the thoughtful questions and hope we provided the answers. In some cases, it was a little bit beyond what we normally provide answers to, so we didn't answer those, but don't take that as any hostility on our part. 2026, another year of opportunities to continue to drive growth, which I think is what we've shown we're really good at. And we've driven growth across our core portfolio, very differentiated innovation and geographic expansion. So the ingredients are the same. We're off to a very strong start, again, driven by execution, growth-driven, volume-driven, and we are absolutely sure that this is because we have a unique integrated dermatology strategy that is resilient even in times like these.

The good news is also it was not a single product, a single country. That's also the way we report things. We had both U.S. and international reporting very strong growth and all our product franchises had double-digit growth. So I think it's fair for us to say that growth was widespread across our product categories and geography and double-digit growth and not least outperforming the market. So market share gain is very key for us. A lot of work on strengthening our financial profile. And of course, I think we continue to show that we're committed to superior shareholder returns, both for existing shareholders or future shareholders. And I think we have just shown what kind of returns we delivered for EQT Consortium as they exited.

We're, of course, confirming our full year guidance. We think it's an attractive net sales growth and significant margin expansion, but we are just, at this time, clearly confirming with big conviction. It's an extraordinary macroeconomic and geopolitical environment we are. So confirming, we also think is a very strong message in this situation. Based on a very strong start overall and with dermatological skin care delivering ahead of expectations, of course, you can say our guidance is increasingly derisked and of course, also shows our ability to navigate in a volatile environment. And I know you had a lot of detailed questions, and thanks for those on U.S. tariffs, an area, of course, with I'm sure more news to come. But I can assure you that we feel what we can see with the line of sight we have, we think it's manageable for us for this year.

So with those closing remarks, thank you for joining the call today, and I know it's a busy call and busy day for you with many reporting out.

This concludes today's conference call. Thank you all for participating. You may now disconnect your lines. Thank you.

Good day, and thank you for standing by. Welcome to Galderma's conference call. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to Emil Ivanov, Head of Strategy, Investor Relations and ESG, to introduce the call. Emil, please go ahead.

Thank you, operator. Warm welcome to Galderma's Full Year 2025 Financial Results Webcast. The press release, along with Galderma's 2025 annual report were published today at 7:00 a.m. Central European Standard Time and can be consulted on our corporate website at any time. Today's presentation slides as well as a recording of this webcast will be made available on our website after the call.

Please be advised that today's presentation contains forward-looking statements, which should be treated with the appropriate level of caution as detailed on this slide. Let me now introduce today's full year financial results webcast. Dr. Flemming Ornskov, the CEO of Galderma; and Thomas Dittrich, CFO, will provide a performance update and discuss the financial results for the full year, followed by the outlook for both '26 and the midterm. After the presentation, both Flemming and Thomas will be available to answer questions from the financial analysts before Flemming provides his final remarks to close the webcast. With this, I'd like to invite Flemming to start the -- with Galderma's highlights for 2025. Flemming, over to you.

Thank you, Emil. Good morning, good afternoon, and welcome to Galderma's Full Year 2025 Financial Results webcast. It's an honor to be here today and to confirm yet another record performance for the company. 2025 was a year of opportunities, and thanks to our team's hard work, we made important progress towards our ambition of becoming the undisputed dermatology powerhouse. We now have a robust foundation to continue driving very attractive top and bottom line growth in 2026.

Our journey as a dermatology category leader did not start in 2025, but 6 years ago with a transformation guided by our growth-focused integrated dermatology strategy. In 2020, we started our first year as a stand-alone company owned by private equity. It was during that time that we set a strong foundation for the business. We refocused our execution centered around dermatologists, and we fixed commercial fundamentals.

We strengthened the portfolio and built a leading pipeline across our product categories. We established our integrated dermatology platform, including optimizing our distribution channels and vendors. And in a tightly managed environment, we also learned that we had to be focused to succeed. This is now embedded in our culture, especially in our commercial execution. It is one of Galderma's strength to be able to focus on a select number of key priorities and deliver on them consistently.

In 2024, we reset our capital structure as a newly listed company on the SIX Swiss Exchange. Over the following 2 years, we emerged as the dermatology category leader. With our focused commercial execution, we reignited broad-based growth across our 3 product categories, outperforming each market, respectively. We expanded the portfolio and fueled our growth momentum with differentiated innovation, including 2 launches with blockbuster potential.

Lastly, we strengthened our scale commercially by further penetrating key growth markets and operationally by expanding our in-house manufacturing. Capacity has been significantly increased at our manufacturing sites. This includes completing the build-out of our biologics sites in Uppsala, alongside our announcement to further invest in the U.S. through contract manufacturing partners.

For 2026 and the years ahead, we're set to advance on our growth journey. With our transformation now largely complete, we also entered the phase with a diversified long-term shareholder base. As part of this, we welcome L'Oreal's increased ownership now at 20% following the successful close of the previously announced transaction.

In this phase, our priorities are clear: execute as leaders in each of our product categories, continue to invest in sustainable growth by rolling out differentiated innovation, progressing our pipeline and exploring inorganic opportunities, further scale our footprint and penetration of attractive markets, maximizing opportunities in the U.S. and in international markets. It's an exciting time at Galderma. I'm grateful to enter this next stage of growth with our talented teams around the world without whom none of this would have been possible.

Looking closely at 2025, there were many highlights beyond our record performance. Let me share a few across the 3 pillars of our integrated dermatology strategy. Starting with our broad and innovative portfolio, we had launches across nearly all of our key brands, including some exciting differentiated products as well as expansion of our geographic reach. We also progressed and invested in our broad innovation pipeline. This includes attractive early-stage assets with promising commercial potential.

In injectable aesthetics, this included key submissions and approvals from the broadest clinical trial pipeline in the industry. In dermatological skin care, product introductions with breakthrough benefits in both our flagship brands and in therapeutic dermatology, new approvals as well as the initiation of 2 clinical trials to explore new potential indications for nemolizumab.

Next, looking at our global scale, all of our top 10 markets grew in 2025 with 8 delivering double-digit growth. We continue to expand our commercial operations to enhance our reach across all channels. We now have a sales force of over 2,500 globally as we continue to invest in many of our top markets. In dermatological skin care, our digital playbook continues to deliver with e-commerce being our fastest-growing channel with over 25% year-on-year net sales growth. Our digital-first execution with Cetaphil also continues to reach billions of consumers globally. We'll discuss several examples of that later in the presentation.

Last, but of course, not least, looking at our market-leading education and services. Our increased engagement reached over 290,000 health care professionals in 2025 through education, training and medical awareness activities. This included a prominent presence at key medical congresses and numerous proprietary educational events, including over 10,000 events with GAIN, our Galderma Aesthetic Injector Network. ASPIRE, our aesthetic loyalty program, expanded into Brazil, one of our top aesthetics markets. In the U.S., its membership grew double digit in the year with now over 4.8 million consumers. Together, these examples demonstrate our leadership in dermatology and the strategic drivers behind our market share gains across all product categories.

Moving to our financial highlights. Capitalizing on a year of opportunities, Galderma continued on its strong growth trajectory on both net sales and profitability. Galderma delivered record net sales, surpassing USD 5 billion in a year for the first time. Net sales year-on-year growth was 17.7% at constant currency with broad-based growth across geographies and product categories. Galderma delivered core EBITDA of USD 1.2 billion with a margin of 23.3%. This represents a year-on-year margin expansion at constant currency, which exceeded initial expectations in a year of major launches and reinvestments in our growth.

Core EPS grew to USD 3.69, up 76.7% year-on-year, driven by strong core EBITDA growth, reduced financing and tax expenses as well as share repurchases. We expect another year of strong opportunities in 2026 with very attractive double-digit growth and significant expansion of profitability. We are guiding to net sales growth of 17% to 20% at constant currency.

With our proven integrated dermatology strategy, growth will continue to be driven by a continued focus on execution, innovation with the ramp-up of key launches and further geographic penetration. We're guiding to a core EBITDA margin of approximately 26% at constant currency. This represents a significant margin expansion in another year of launches and growth investments. Overall, we're confident in Galderma's trajectory and our ability to outpace the market despite intensifying competition and a volatile external environment. As a result, we are specifying our midterm guidance within and above the previously stated ranges. More on that later.

Now let's turn to our performance update, including key highlights by product category. For the full year, Galderma delivered USD 5.2 billion. Net sales year-on-year growth for the full year was 17.7% at constant currency. Growth was widespread with double-digit growth in both geographies. We also outpaced the market in each of our categories where products we have.

In the fourth quarter, net sales growth accelerated to 25.2% year-on-year at constant currency, with growth accelerating across all product categories. Net sales growth overall was predominantly volume-driven with a favorable product mix offsetting pricing effects from the competitive environment. In injectable aesthetics, we remain on our strong growth trajectory, consistently outpacing the market across geographies and across subcategories.

Net sales growth continued to be driven by focused execution, new product launches and further geographic penetration. Net sales for the full year were USD 2.572 billion, up 11.5% year-on-year at constant currency. For neuromodulators, net sales were USD 1.471 billion, up 14.3% year-on-year at constant currency. Both geographies delivered double-digit net sales growth and continued to gain market share.

Dysport continued to outperform globally with strong growth in key markets. Relfydess enjoyed a strong year of launches, setting a high growth base for 2026, and our strong fourth quarter performance in neuromodulators, notably in key international markets more than offset the phasing benefits experienced in the third quarter. For fillers and biostimulators, net sales were USD 1.101 billion, up 8% year-on-year at constant currency. Both geographies continued to gain market share.

Fillers continue to be impacted by market softness and pricing pressure globally. This was a result of lower consumer demand and aggressive promotional activity from competitors, especially in the mid space. We continue to focus on our more differentiated offering with net sales growth, especially driven by the uptake of new launches, led by Restylane SHAYPE in Brazil and by our medication-driven weight loss activation.

In biostimulators, Sculptra accelerated its double-digit growth, remaining our fastest-growing injectable aesthetics brand. Net sales growth was particularly high in key international markets, especially in China, where we had an exceptionally strong first year of launch. We're excited for the future of neuromodulators as we reflect on our first full year with Relfydess, widely recognized for its superior profile, it is shaping the future of neuromodulation. It is gaining share by helping us further penetrate existing accounts and also win new accounts where we can also leverage Galderma's full portfolio.

It has also strengthened our confidence in our neuromodulator portfolio strategy with Dysport continuing to grow in markets where Relfydess was launched. Recent in-market surveys and our advisory Board confirm that Relfydess is perceived by both health care professionals and patients as benefiting from high satisfaction overall, rapid onset, long duration of action and ease of use. This is reflected in the very positive uptake in markets so far. While, of course, the ramp-up will be progressive, which is typically in this space, the trajectory is strong. Relfydess has already surpassed [indiscernible] in terms of sales, which was launched 3 years earlier.

While there's always a lag in injectable aesthetics data, the third quarter of the year suggests that Relfydess is already at least a top 5 brand in neuromodulator sales across European markets where launched. Looking at the third quarter data for the first 2 markets where we launched, which was Spain and Germany, we held double-digit market share and we were already ranked third after Dysport and Botox.

Meanwhile, we're also progressing with our global expansion plans. Relfydess is now approved in 23 international markets. This includes recent approvals in additional markets. We expect multiple more approvals to follow in '26. We have launches underway this month in multiple countries, including New Zealand. We were also in the progress of launching in the United Arab Emirates. But given the situation, our focus has now shifted to the safety and the well-being of our colleagues and customers. On February 2, we also announced that the U.S. FDA accepted our resubmission for Relfydess' BLA. With Relfydess, we're excited to be pioneering the next generation of neuromodulation and strengthening our leadership in injectable aesthetics.

In fillers and biostimulators, we are also making progress in preparing the next phase of growth. we continue to invest in our fillers portfolio, which is already the broadest on the market with innovative launches and demand generation activities. In the U.S., we received the approval of the chin indication for Restylane Lyft. This strengthens one of our top-selling Restylane products. In Japan, we saw the approval of Restylane Defyne and Refyne, a first step in expanding our currently limited portfolio in a major aesthetics market.

We also unveiled our new Restylane campaign, which aims to support health care professionals in advocating for the segment with patients, reinforcing fillers as an integral part of their aesthetic journey, Wake Up to Restylane reframes Restylane from a clinical procedure into an always-on natural beauty regimen backed by science.

In biostimulators, we continue to strengthen our leading position and expansion in regenerative aesthetics. The launch of Sculptra in China was very strong in '25. Sculptra is rapidly gaining market share and expanding its reach with over 30,000 health care professionals already trained. In addition, a new chapter opened for the brand as we expanded our Sculptra label in Europe to include 4 new body indications.

While perhaps a more niche segment than the face, the volumes injected to treat body indications are often significant. We're also shaping the aesthetic journey for patients undergoing medication-driven weight loss with leading education and training around our proven portfolio. Not only did we run and publish the first-of-its-kind clinical trial with Restylane and Sculptra, we published the first international consensus guideline for GLP-1 patients.

In the U.S., we saw results from our focused direct-to-consumer campaign to generate new demand for health care professionals. It has had promising initial uptake, leading to a high conversion of new patients starting on our portfolio. We also announced a new focus for '26 onwards around the aesthetic needs of perimenopausal patients. This is a historically underserved population with high unmet needs, and it's growing quickly, expected to impact 1.2 billion women by 2030.

There is an opportunity to serve these women with fillers and biostimulators, the most frequently considered treatment to address aesthetic concerns related to menopause. Galderma is very well positioned to capture this opportunity. Moving forward, menopausal status is being incorporated into all of our clinical trials. As you can see, there are a lot of drivers underpinning our recent net sales acceleration in fillers and biostimulators giving us confidence for the future.

Moving to dermatological skin care. Both Cetaphil and Alastin continued on their strong growth trajectories, outpacing their respective segments globally. Net sales for the full year were USD 1.449 billion, up 9.3% year-on-year at constant currency. Growth was very strong in international markets with Cetaphil gaining share and delivering exceptional performance in Asia. China and India continued to deliver outstanding net sales growth with particularly strong net sales from year-end activations.

In international markets, Alastin continue to ramp up. In the U.S., growth was driven by Alastin, growing double digits. Cetaphil in a year of constrained consumer demand had a strong fourth quarter from the uptake of recent launches and year-end activation. Dermatological skincare net sales growth continues to be driven by holistic execution and targeted innovation while leveraging synergies from Galderma's full portfolio.

E-commerce remains the fastest-growing channel, where we see strong results from Cetaphil's digital-first approach. Cetaphil is indeed gaining growth momentum. We saw strong results from our digital-first global activations to support engagement and growth. Earlier in 2025, we launched Cetaphil, now one of the world's largest skin care advocacy networks. After 6 months, it had over 2,100 content creators engaged and over 110 million organic video views. We are proud of the community, which has an engagement rate that is nearly 2x higher than the skin care category average.

We also launched DermONTour, a global tour offering free dermatology consultations. The immersive science-driven pop-up experience has been hosted already by 4 U.S. cities with a social media reach of over 100 million views. I would be remiss to not mention China, which had another outstanding performance in the fourth quarter of last year. This included another record-breaking Double 11 season, selling 600,000 units in only 20 seconds, yes, 20 seconds in collaboration with the #1 Chinese live streamer. For the full year, Cetaphil outperformed the skin care market online during the period compared to skin care sales from the top e-commerce platforms and top dermatological skin care brands. It also included a record campaign centered around the [indiscernible] movie with over USD 50 million in sales in just 1 week.

This strong fourth quarter net sales momentum sets the stage for 2026. I'm happy to share that our China team is already off to a great start with good traction behind recent Chinese New Year activities. In dermatological skin care, we have many expansion opportunities ahead. With Cetaphil, we've successfully launched differentiated innovation. This includes a number of new products launched first in the U.S. with the opportunity to now expand in international markets. In '25, this included the international rollout of Cetaphil's Bright Healthy Radiance and Gentle Exfoliating lines. Looking ahead, we're excited about rolling out Cetaphil's skin activator hydrating and firming line and the nourishing oil to foam cleanser.

Both deliver breakthrough benefits and created entirely new categories with strong results in the U.S. so far. Looking at the skin activator specifically, it is the #2 new product innovation in the U.S. hand and body lotion segment across dermatological skin care brands following its launch in September 2025.

Alastin has expansion opportunities globally with its continued rollout in international markets and further penetration in the U.S. where it is performing very strongly. In 2025, Alastin went up 1 position in the U.S. and is now ranked #4 in sales among physician dispensed health skin care brands. It continues to be the fastest-growing of the top 5 physician-dispensed skin care brands in the U.S. and the only one growing double digits in sales last year.

With its physician-first approach, Alastin is strengthening its leading position as the preferred peri-procedure skin care brand. The launch performance has also been very strong for Alastin's Restorative Skin Complex featuring our next-generation TriHex Technology. This formula is proven to support the skin's own regenerative abilities, which pairs very well with our injectable aesthetics portfolio. Here again, there are many reasons to be excited for accelerated momentum in dermatological skin care.

Moving to therapeutic dermatology. Growth was very strong, driven by an outstanding launch trajectory from Nemluvio in prurigo nodularis and atopic dermatitis. This growth more than offset the anticipated decline in the category's mature portfolio, especially in the U.S. Net sales for therapeutic dermatology were USD 1.185 billion, up 50.2% year-on-year at constant currency. For the year, Nemluvio contributed USD 452 million in net sales. The vast majority of the Nemluvio sales were recorded in the U.S., which we'll discuss further shortly.

Overall, for the full year, Nemluvio sales were split almost evenly between prurigo nodularis and atopic dermatitis with the share of the latter increasing quickly. While international sales are only a small portion of total Nemluvio sales, the launch trajectory has been even stronger there. In Germany, the first international markets where we launched, we've gained even greater market share in total prescriptions than in the U.S.

Meanwhile, the launch in other markets looks very promising. This includes the U.K., where our teams have done an excellent job securing access to formularies and are significantly outperforming sales forecast. In the U.S., which is our largest opportunity for Nemluvio, the launch trajectory has been outstanding. Its significant market share gains are underpinned by its differentiated profile as well as by our team's effort to expand the sales force, deliver market-leading education, and enhance market access.

In the U.S., Nemluvio's market share in paid new patient starts, also known as NBRx' was trending at about 35% in prurigo nodularis and about 8% in atopic dermatitis from the end of December '25 to the end of January of this year. Across both indications, the majority of U.S. patients initiated treatment continue to be new to biologics, yes, new to biologics. Galderma has broad access in commercial plans for Nemluvio in the U.S. as a first-line biologic treatment, which has been further increased by approximately 85% currently.

We also secured our first major access win in Medicare as of January 2026. One of the 4 major Medicare payers have now granted Nemluvio first-line formulary access, and we're engaging with the others to broaden coverage. As mentioned, the real-world experience for Nemluvio has been greater than initially expected. While itch relief remains the main reason to prescribe Nemluvio, physician experience with the product also provides conviction on skin clearing.

On this slide, you can see the results of our latest survey with health care professionals in the U.S. on the brand attributes for moderate to severe atopic dermatitis. The attributes are ordered by importance and rated by prescribers with the results split in 2 on the slide. On the left are prescribers with low or limited experience with Nemluvio and on the right are adopters with greater experience with Nemluvio. The most important first attribute are itch-related. And Nemluvio in dark purple, is perceived ahead of the leading brand among all prescribers. This is perhaps not surprising given Nemluvio's strong clinical differentiation and recognition as the therapy of choice for itch.

In the remaining 2 attributes, Nemluvio adoptors perceive its superior benefits. The difference is particularly important when looking at skin clearance, where Nemluvio moves from being perceived significantly worse than the leading brand to being perceived as better than the competitor based on real-world experience. We're confident in Nemluvio and the meaningful impact it can have on patients' lives.

It drives our teams to improve our reach and gain buy-in from more and more prescribers. This is what also drives our conviction in the raised peak sales potential of the treatment, which we will discuss later in the presentation. Looking at our geographies. Net sales for both international markets and the U.S. grew double digits in the year. Growth was broad-based with all of our top 10 markets growing.

International, our larger reporting geography, sustained its strong net sales growth momentum in highly attractive, largely underpenetrated market. Overall, in international markets, injectable aesthetics delivered double-digit net sales growth and outpaced the market in both neuromodulators and fillers and biosimulators. Despite a soft filler market, each brand delivered growth with market share gains in most key markets.

Dermatological skincare also delivered double-digit net sales growth with particularly outstanding growth in India and China. Therapeutic dermatology net sales growth was mainly driven by Nemluvio with strong launch trajectories in its first European markets, while the mature portfolio delivered modest growth.

The U.S. delivered net sales growth in each product category and was especially strong for neuromodulators and therapeutic dermatology, thanks for Nemluvio. Injectable aesthetics outgrew a soft market and gained share in both neuromodulators and fillers and biostimulators. Fillers continue to be impacted by market softness, while neuromodulators and biosttimulators net sales grew double digits.

Dermatological skincare growth was mainly driven by Alastin growing double digits, while Cetaphil had a strong fourth quarter from the ramp-up of recent launches and year-end activations. Therapeutic dermatology had outstanding growth driven by Nemluvio's strong trajectory, which more than offset the anticipated decline in the mature portfolio.

As part of our growth journey, we continue to advance our ESG agenda as an integral part of our strategy. In 2025, we revisited our focus areas following a detailed double materiality assessment, the results of which we have shared in our 2025 annual report. We continue to make progress across all the highlighted areas on this page with particular focus on sustainable products and production and medical education and training, which are closely linked to our strategy.

In addition to driving our ESG agenda, we challenged ourselves to enhance our disclosure and have, for the first time, obtained limited assurance on 9 nonfinancial indicators. Finally, I'm pleased to share that our ESG agenda has gained external recognition through improvements in key ESG ratings, including an AA rating from MSCI in 2025. With these business highlights complete, I would now like to hand over to Thomas to provide more details on Galderma's financials.

Thank you, Flemming. It is my pleasure to comment on Galderma's full year financial results. Here is the financial scorecard for the full year 2025. It shows Galderma delivered record performance across the board. Flemming just presented the top line growth. So let's now look at the rest of the scorecard in some more detail on the next slide.

Core EBITDA grew to USD 1.211 billion, up 18.9% year-on-year at constant currency. Core EBITDA grew ahead of net sales, exceeding initial expectations in a year of major launches and reinvestments to drive growth. The reported core EBITDA margin was 23.3%, representing a margin expansion of 24 basis points at constant currency compared to 2024. This was possible due to ongoing operating leverage as well as a reduced adverse P&L impact from nemolizumab as a result of its greater sales. Improvements in operating expenses also offset the impact of pricing effects and unfavorable product mix on gross margin.

Core net income grew even more meaningfully to USD 871 million, up 75.4% year-on-year. This was driven by strong core EBITDA growth as well as reduced financing and tax expenses, which I'll cover later on. This translates to core EPS of USD 3.69, up 76.7%, benefiting from the drivers I just mentioned for core net income and on top, the share repurchases we executed in 2025.

Here, on the next slide, you see that Galderma's integrated dermatology platform provides operating leverage for the group. This is showcased in the year-on-year improvement in underlying profitability, defined as our core EBITDA margin, excluding the core EBITDA impact from nemolizumab. For 2025, it grew to 28.7% despite a year of significant launches and reinvestments into growth drivers in a competitive environment.

Recall, we started showing this evolution a few years ago, given the important investments in nemolizumab prior to having any sales. Please note that we no longer plan to disclose this view going forward now that Nemluvio has been in the market for over a year and given that we expect Nemluvio to break even on a contribution basis later this year. We'll get into this topic a little bit more in a minute.

Here, the strong cash generation in the year supported our deleveraging trajectory as well as shareholder value creation in the form of a dividend and share repurchases. Let's look at the key movements between our cash position beginning of January to end of December '25. On cash generated from operations, Galderma drove very strong cash generation for the year, driven by significant core EBITDA growth and favorable net working capital movements. Net working capital positions improved significantly behind effective net working capital management, structural improvements driven by shifts in market and product mix as well as phasing benefits.

Looking ahead, while expecting the structural net working capital improvements to stick, we expect other parts to normalize, reflecting our fast growth trajectory. All of this is reflected in our additional modeling metrics, which you'll find in the appendix of our press release and appendix of this presentation. On interest and taxes, interest payments were lower in 2025 than the previous year, reflecting the benefits from our deleveraging and refinancing activities.

Our tax expenses were also lower, predominantly as a result of a onetime noncash benefit from recognizing deferred tax assets on past tax losses in Switzerland. On CapEx and milestones, the movements reflected what was shared in our financial results for the first half of 2025. Core CapEx improved, benefiting from phasing of project spend with some now falling into outer years as well as continued focus on spend efficiencies and site operating performance.

CapEx as a percentage of sales also benefited from the high net sales growth. Meanwhile, the last expected milestone payment for nemolizumab was paid for a total of $23 million. Finally, on financing cash flow and foreign exchange, our strong cash generation enabled us to repay USD 240 million of debt early to repurchase shares for a total of USD 363 million and to make a dividend payment of $41 million.

Reflecting all the activities we just discussed and our ambitious deleveraging trajectory, I am pleased to report that net leverage came down to 1.5 turns at the end of December. This was driven by very strong cash generation in 2025, as you can see from this slide, while also delivering significant shareholder returns over the period.

Let me also highlight the substantial progress we achieved in refinancing our IPO-related term loan for a total of USD 1.26 billion in 2025. To do so, we issued several bonds benefiting from 2 investment-grade credit ratings, BBB positive by S&P, and BBB stable by Fitch. In February 2026, we also successfully refinanced our revolving credit facility at more advantageous terms and increased its size to USD 1 billion.

Moving on to capital allocation. Our capital allocation priorities remain focused with priority on organic growth. As we strengthen our financial profile, we also increased our strategic optionality. If we look at our key achievements for 2025, first and foremost, we maintained Galderma on a strong sales growth trajectory despite an uncertain environment with appropriate investments and focused execution to outpace the market.

In terms of business development and licensing, we completed our final milestone payment for nemolizumab. Given our rapid deleveraging trajectory, we reached our midterm target for net leverage to be below 2 turns early. Going forward, we will focus on maintaining our solid investment-grade rating. And in terms of shareholder returns, in addition to the share repurchases already mentioned, we are proposing a dividend of CHF 0.35 per share, an increase of more than 230% versus the dividend per share paid out last year.

Subject to approval at the upcoming Annual General Meeting, the dividend payout represents approximately 16% of the reported net income for 2025. We have just received the confirmation from the Swiss Federal tax authority on the tax treatment of the proposed dividend payment. I am pleased to confirm that the proposed dividend payment in 2026, which is paid out from reserves from capital contributions will be 100% exempt from Swiss withholding tax. 2025 was a year of outstanding performance with many achievements that all our Galderma colleagues and teams can be proud of. Now as we look ahead, I would like to invite Flemming to share our attractive outlook for 2026 and the midterm.

Building on a strong year, 2026 is another year of opportunities for us to drive growth. We remain focused with 5 clear priorities. First, we're now in our second year of ramping up significant launches. This includes Nemluvio and Relfydess, our 2 biologics with blockbuster potential as well as Sculptra in China and Restylane SHAYPE globally. We have additional Restylane launches planned, including our recently approved next-generation syringe and as usual, ongoing innovation in dermatological skin care with particularly exciting opportunities internationally.

Second, global market share gains remain a major opportunity. We have multiple opportunities internationally, building on our strong momentum in underpenetrated and fast-growing market. And in the U.S., we're doubling down on growth-focused execution. Third, we continue to strengthen our financial profile. For 2026, the focus is on maintaining an investment-grade balance sheet, completing our refinancing journey and continuing to deliver robust cash generation.

Fourth, we're increasing our focus on long-term growth. With more strategic optionality, we can invest in further developing our pipeline. Internally, we continue to invest in new indications and SKUs. We also have the option to explore external opportunities where we see a strong strategic fit. Fifth, we continue a dynamic approach to commercial investments to drive results. This makes our model resilient and the ability to leverage our broad portfolio and geographic reach in order to navigate market volatility and capture opportunities.

Building on this strong foundation, I look forward to leading the company through this next phase of growth. Based on our strong momentum and confidence behind very visible growth drivers, we're guiding to net sales growth of 17% to 20% at constant currency and a core EBITDA margin of approximately 26% at constant currency for the full year. We're confident in our ability to deliver despite existing uncertainties.

Beyond a volatile market and geopolitical environment, we see continued business pressures across our portfolio, especially in injectable aesthetics. And in the U.S., we expect competitor launches and continued pricing pressures. We're also awaiting decisions on regulatory approvals from the U.S. FDA. In that context, there's even greater value to the resilience and the flexibility provided by our dynamic approach to commercial investments. Let me hand over to Thomas again to provide some additional commentary on expectations for the year ahead.

Thanks, Flemming. Let's now look at sales by product category. We expect each product category to outgrow their respective markets. Injectable aesthetics is expected to grow approximately 12% to 13% year-on-year at constant currency. This includes strong growth for neuromodulators on a high comparable base with the annualization of many 2025 well fitted launches. Fillers and biostimulators are expected to grow low double digits based on continued strong momentum.

The injectable aesthetics product category is expected to follow its typical quarterly seasonality, including softer growth in the first quarter due to multiple launches in the same period a year ago and then strongest growth in the fourth quarter. Dermatological skincare is expected to carry the strong year-end growth momentum forward, nearly maintaining the fourth quarter 2025 growth rate at constant currency for the full year 2026.

Growth for the product category is expected to be higher in the first half of the year compared to the second half due to a high comparable base from outstanding performance in the second half of 2025. Therapeutic dermatology growth is expected to continue to be driven by Nemluvio. Nemluvio's launch trajectory in the first quarter is expected to reflect typical U.S. pharma seasonality, including January insurance renewals, plus the effect of expanded access within government channels and of recent winter weather in parts of the U.S.

As a result, we expect Nemluvio sales in the first quarter of this year to be slightly below the sales level from the fourth quarter of 2025. Importantly, we expect these effects to be transitional and not be reflective of underlying demand for the year. Nemluvio remains on a strong growth trajectory and is expected to continue its rapid ramp-up towards blockbuster sales run rate in the third quarter of 2026. In other words, approaching approximately USD 250 million in net sales in the third quarter.

The mature therapeutic dermatology portfolio is expected to slightly improve compared to the previous year, but is not expected to contribute to growth in the midterm. Growth of the mature portfolio in 2026 is expected to be positive in the first half compared to a particularly low base last year. In the second half, we expect to see an impact from a generic entry in select international markets. As for core EBITDA, it will be driven by Nemluvio's contribution and continued operating leverage while allocating appropriate levels of investment into growth drivers in a competitive environment.

Core EBITDA margin expansion against the full year 2025 base is expected to be greater in the second half of the year following typical seasonality patterns and the growing contributions from the strong Nemluvio trajectory, which, as mentioned before, is expected to breakeven on a contribution basis in 2026.

With guidance at constant currency, it is important to note that based on foreign exchange rates as of the end of February '26, the U.S. dollar depreciation is expected to have a positive impact on reported net sales and a negative impact on reported core EBITDA margin. This is due to our headquarter costs being denominated mainly in Swiss francs. A table with Galderma's exposure to key foreign exchange currency pairs is available in the appendix of the press release and in the appendix of this presentation. In regard to tariffs, our exposure remains manageable with our guidance assuming a 15% U.S. tariff on the import value of Restylane and Sculptra. Before I hand over to Flemming again, please note that we have also provided additional modeling metrics in the appendix. Flemming?

Thank you, Thomas. So we are raising our expectations for Nemluvio following a stronger-than-anticipated first year on the market. We are now confident in greater potential for the product, especially with the high demand and positive real-world experience we discussed earlier. We are raising our peak sales expectations in prurigo nodularis and atopic dermatitis from about USD 2 billion to about USD 4 billion. We expect Nemluvio to break even in 2026, 1 year ahead of initial expectation. And as mentioned, we now expect to approach a quarterly blockbuster sales run rate in the third quarter of this year.

Based on greater expectations for Nemluvio and confidence in our broad-based growth trajectory, we're specifying our 2023 to '27 midterm guidance. Our expectations are all within or above the previously stated ranges. On the top line, we expect to continue to outperform the markets we compete in. We expect a net sales CAGR for '23 to '27 at constant currency as follows: For the group, 15% to 17% above previous expectation, especially driven by the expected upside for Nemluvio. For injectable aesthetics, 10% to 12%. This includes continued strong neuromodulator momentum and normalization of the fillers and biostimulators growth rate in '27 after many impactful launches in '25 and '26 in our top 3 markets.

For dermatological skin care, 8.5% to 10.5% with continued above-market growth momentum for Cetaphil and for Alastin. For therapeutic dermatology, above 30%. This includes Nemluvio's strong trajectory, as we just discussed. Recall that we do not expect the mature therapeutic dermatology portfolio to contribute to growth over the midterm.

In terms of bottom line, we expect a margin expansion of 450 to 550 basis points at constant currency for '27 compared to a margin of 23.1% in '26. The raised margin expansion guidance reflects Nemluvio's margin drop-through as well as our continued reinvestment in growth. In order to continue to outperform the market in each product category, it is key that we maintain appropriate investment levels. Please note that our midterm guidance is subject to the same tariff assumptions and foreign exchange impact, as mentioned by Thomas.

We will be hosting a Capital Markets Day in the second half of the year, where we will extend our midterm guidance horizon. It also provides time for our incoming Chief Financial Officer, Luigi La Corte to join our team. As communicated previously, Luigi will join on April 1 and will take over as CFO effective May 1. Thomas will remain with the company through Q2 '26 to ensure a seamless transition before pursuing another senior executive opportunity outside the company. We're happy to have Luigi with us soon with his deep financial leadership experience across the health care and consumer industry. Driven by the ambition to be the undisputed dermatology powerhouse, we have an exciting trajectory ahead. With that, I pass over to Emil.

Thank you, Flemming and Thomas. This concludes the introductory remarks of Galderma's financial results webcast. Before final remarks, of course, I would like to hand back to Sandra, our operator today, to open the call for analyst questions. [Operator Instructions] With this, Sandra, can you please open the line?

[Operator Instructions] We will now take the first question from the line of Ben Jackson from Jefferies.

Thank you for the granularity on all of the outlook both in '26 and 2027. It's much appreciated. I guess you made an interesting comment on the ex-U.S. Nemluvio side, talking about the initial traction you've seen there. So perhaps could you remind us what is the upcoming launch and reimbursement cadence going forward for new countries? And when should we expect the relative contribution to begin increasing from that ex U.S. segment for the drug?

Yes. So I would say I'm really proud of what the team has achieved just by any experience I've had with launching multiple blockbusters and biologics, the fact that we are well underway in Germany, which has even a stronger market share performance than the U.S. We are doing extremely well in the U.K., got access much earlier at a better terms than we expected.

We have multiple countries, including now Spain coming online. We had Canada coming online. We have the Nordics, we have South Korea, and we have Italy. So yes, we have a whole host of countries. I would also say what -- it has been a bit hard, of course, with negotiating access, but the team has done really well. And we would not launch in any country we just discussed, for instance, Spain without feeling that it's financially is attractive for us.

And yes, it will take some time just given the phenomenal performance in the U.S. before you will see, I think, meaningful contribution. But as all of these countries accumulate, as their performance is really strong, as we learn from some of the best launches we've had, I think you will see continued very strong performance. And in countries where we didn't expect such a strong performance, we've really seen very strong performance. I think Germany will probably be something to raise that as really outstanding, but most of the European countries where we launched have done really well.

We will now take the next question from the line of Victor Floch from BNP Paribas.

Victor Floch from BNP Paribas. Maybe one on GLP-1 because the feedback we've been getting from the U.S. is that GLP-1s are already seen as a material tailwind to dermatologist practices in the U.S. And I believe last time you've updated us on GLP-1, you've made it clear that it was still relatively immaterial at the group level. So can you comment on whether you've seen any notable changes since then and whether you expect this tailwind to more meaningfully crystallize in the U.S. this year?

Yes. We basically took a little bit of gaining the evidence first. So we did a scientific publication. We then did multiple proprietary symposium. We presented the data at major symposium. We did a consensus paper. And so we've done -- it doesn't help that the patient shows up if the physician is not prepared. So we spent an enormous amount of time and energy as you can see with all our educational events on making sure that the physicians knew which protocol to follow, what was the evidence, what did the publication show.

So we probably spent a year or so on that around the world, starting off in the Middle East, where the idea actually more or less originated from to, now a big focus on the U.S. But we also realized to the point you raised, that without some consumer incentives or consumer awareness, you would not be successful. So we launched in the latter part of this year, we launched a campaign in the U.S., which was a consumer-directed campaign which was basically going out and highlighting with Lyft and Sculpt is the name what we could do. And we saw really attractive uptake. So we'll continue that campaign.

So a little bit early to give quantitative, but I would say education first, training, science and then now rolling out the consumer, I think, has been a smart strategy. But the proof will be in the pudding. But what we hear from our doctors is more and more patients are coming in and many are still not getting the appropriate treatment. We think what we have shown with Sculptra and with the fillers, we have a very appropriate science-based treatment.

We will now take the next question from the line of hyam Kotadia from Goldman Sachs.

Just a quick one on the 2026 top line guidance. So you provided a range of 17% to 20%. And on the release, I can say that it says the guidance reflects existing uncertainties. Does this relate to the U.S. approval of Relfydess? And is there any other uncertainties within there? Because I'm just trying to gauge exactly what's factored in here and influencing where in the range you may fall. And I guess, if there is potential scope for upside should these uncertainties move in a favorable direction.

Yes. I think it's appropriate to have a broader range because we both externally have more changes that I think anyone has seen in a long period of time. The Middle East is one. I think there is tariffs is another economic situation in the U.S. So there's multiple things that can affect us one way or the other. We also see, of course, we have significant opportunities. So I'm not just focusing on the risk. But in terms of the internal risks or opportunities, yes, Relfydess, whether it gets approved or not in the U.S. is, of course, a factor. Will it change our guidance? No. Are there other factors that could change it? No. If Nemluvio continues on a very good trajectory, the guidance gives us a broad range for what would be the end results for Nemluvio. So I think we've given both you and us an appropriate ambitions, but also realistic target from what we can see of today.

We will now take the next question from the line of Thibault Boutherin from Morgan Stanley.

My question is on further Medicare access for Nemluvio. So you secured one payer. Do you have some visibility on where you could unlock the rest? Could we see this year? And what's included in your -- the comments you made for the Nemluvio trajectory in 2026?

Yes. As you know, we have phenomenal commercial access that was secured over a very short period of time, 83% or so. The number is, of course, dramatically lower. It is double digit, but it's significantly lower when you have one out of, what is it, 5 major plans in the U.S. for Medicare and Medicaid. And anything in life, it's a negotiation. We've just started it off. And I'm optimistic based on what I can see in the pipeline that we should be able to close more. But one, I don't want to put the team under undue pressure so that they would do deals that doesn't really long term make sense. But I'm optimistic.

The other thing that is very important is our ability to get exemptions has been really strong. So that means that the doctors really want the product for their patients. So you know there's the opportunity when you're not covered to ask for medical exception. And all of these exemptions, we have a very high success rate. You don't get that unless the physician really feels this is a product that is worthwhile and that they want to take the time. So of course, this we can bridge for a period of time, even a long time. We did it for quite some time in '25. But I think going forward, of course, we will be focused on closing more deals. But I want to do it on the right terms for us, of course, also the right terms for the payers. But it comes when it comes, and we will clearly update you. But given our track record with the commercial plans, I think you can stay rather optimistic.

And I would just add to what Flemming said, it point to two things, within the government side, our success rate of getting prior authorizations approved, that's the key one for that part. But then big picture for AD, that market is mainly a commercial market and not a government reimbursement market. And AD is as a market opportunity 10x bigger than PN. So also keep that in mind. And just keep that in mind and with those things, we have factored that appropriately into our guidance ranges, and we are very robust there.

We will now take the next question from the line of Joffrey Bellicha Meller from Bank of America Securities.

I would like to talk a little bit about the Chinese market in injectable aesthetics. Are you already seeing the benefits from Sculptra's launch on the wider injectable aesthetics portfolio? Or is this an opportunity for incremental growth in 2026? Or is it coming beyond 2026?

Yes. I think it's important to realize just we haven't been a long time in China. I think we had one filler when I started in 2019, and that was not very successful. It was initially successful and then it was neglected. So that we now have a good chunk of our portfolio, and we want to put the rest of our portfolio there is huge progress. I think that China is extremely successful by any stretch. But they have a very interesting way of being successful, not by corporate mandate or by mandate by me, but by their ingenuity.

So in Cetaphil, they focus on one or a few SKUs. The focus on the digital channel, as you saw, the recent Double 11 and all that phenomenal success, very focused strategy going to channels where we can be successful. We also have done a lot of the same as we launched the aesthetics portfolio. And we knew that Sculptra, even though there were 4 other products or so in the market, would provide a great opportunity for us. So I think it's 30,000 people that have been trained on it right now. We had a phenomenal launch meeting. Order rates are really impressive.

So yes, this will, of course, drive not only our reach and also spill over to our rest of our portfolio because if you sell Sculptra, you get access. And if they're interested in Sculptra, they may take a look at our other parts of the portfolio. So your answer is yes, but I can't give you a number at this stage. But I'm absolutely sure that Sculptra will show up. You already see it in the growth rate as this continues because it's a huge market opportunity. And I think we will capture not only with Sculptra, but also with the rest of our aesthetics portfolio just outside.

We will now take the next question from the line of Harry Sephton from UBS.

Just could you touch on the cadence of some of the new SKU launches you have for the Restylane portfolios through this year? And also what you're expecting in terms of potentially expanding that Sculptra body outside of Europe and into other markets?

Thank you very much for the question. So again, here, if we talk outside the U.S., for instance, Restylane SHAYPE, we started off in Canada, now Brazil, and we will roll that out in a number of other markets. So we try to focus on a few and maximize what we do with them. In a number of opportunities, we also realized there was a significant need for a new syringe. So we recently got a new syringe approved, which will also facilitate and drive more customers to our portfolio because it's really attractive economically and develop with physicians themselves.

And then in the U.S., of course, we got one approved end of last year. We have a number with the FDA. It's fair to say the FDA, you may have a few rounds. We've had that with multiple before you get them approved, but I'm sure that we have the opportunity whether it's SHAYPE or skin booster that either this year or next year, we should have an opportunity to get them approved. But the bar is high, particularly in the U.S., but the fact that we continue to deliver innovation to them and many of our products before they saw the light of the market had a round or two with the FDA. So we'll see, but we're very confident.

We will now take the next question from the line of Sophia Graeff Buhl Nielsen from JPMorgan.

You mentioned that Galderma continues to make market share gains in the U.S. and international in neuromodulators. Maybe could you expand on the market dynamics you're seeing for neuromodulators in both of these regions and what you've assumed in your midterm guide?

Yes. I think that this is a very dynamic market. I think that the opportunity we have is, of course, we have significantly expanded our reach and the frequency we have. I think if you look in many countries outside the U.S., we are now #1. If you look at the fact that where we have launched Relfydess, we mentioned that here, we've actually also seen the rest of the portfolio grow. We're the only one with a really strong portfolio.

And what is also very important, in my opinion, is that in the U.S., yes, we've had a little bit AbbVie, maybe a bit distracted and which has given us a great opportunity to continue to gain share. But we still have a big share gap in the U.S. to Botox. So there's a lot of opportunity there, which is like we really would like at some point to get Relfydess approved because that would help us.

But what are the lessons learned we have? One, that having a portfolio is really beneficial, bringing innovation, true innovation like we've seen with Relfydess in terms of onset convenience, duration, that is really helpful. And I also want to say we've had a continued strong year with our partner, Ipsen. We've had basically very few or no stock-outs. I know there's a lot of noise in the marketplace about Ipsen. I think it's very important. We have an excellent collaboration with Ipsen. I know there was a readout of another arbitration recently. It's also important. I've seen a lot of the press around that, that pertains to an agreement that was made in 2014, which was basically related to early-stage research and development.

So the fact that you can say Ipsen, one, it allows them to develop the product in additional phases, Phase II and Phase III, but the exclusive distributor rights for us for neuromodulators for aesthetic indication doesn't change. It stays totally unchanged by this. So when it comes to commercialization, Ipsen would not be able to infringe those exclusive rights either themselves or through a partner.

So I think it's important just to keep things in perspective. But let me just take a stage here. Ipsen is a great partner. We have, I think, done extremely well that we've had some clarification issues with 2 arbitrations, I think, shouldn't cloud for the fact. And yes, we'll see what the data for the land are. We clearly will raise our hand if they're attractive, we think we will be the best partner, but time will tell.

We will now take the next question from the line of Natalia Webster from RBC.

It's on the Nemluvio P&L impact. You mentioned that you're expecting it to break even in 2026. Are you able to provide a bit more details on the timing here, whether you still expect a negative impact in H1? And then any color on how you expect this to contribute to margin into 2027 and the ongoing investments needed here...

Even if you press Thomas hard, I don't think he's going to give you a date would be my sense...

Let's take that question. Natalia, your -- thank you for your question. But I think Flemming gave you kind of the frame, and that's, of course, the correct one. I mean, let's step back. We were guiding to Nemluvio potentially breaking even sometime in 2027. Now we're updating that and say it will happen this year. So really good news on the back of the stronger real-world evidence that doctors and patients experience the product is selling really well, and that, of course, drives margin drop-through.

Some of that, we need to reinvest to drive growth because that growth doesn't come automatically. I think we highlighted that also. So we are already saying that we expect the brand to reach blockbuster -- quarterly blockbuster sales run rate, call it, $250 million a quarter and approach that level in Q3. Now any specificity on contribution margin or contribution that would be false precision because we have to drive the reinvestments, and I mean competition doesn't tell us early what they are planning to do or not to do. So please let me -- I don't want to be coy about it, but I just want to be realistic that this would be a false precision we would be giving you. But the big picture answer is one year early. And yes, to your '27 and beyond question, when you break even one year early roughly, then your margin drop-through goes only up, up and up for the group level, and that's the good news I want to leave you with.

We will now take the next question from the line of Gian-Marco Werro from ZKB.

One question also on your Nemluvio guidance, peak sales over USD 4 billion. To reconcile this new midterm guidance, could you share with us at least some key assumptions? Just as an example, what could be in your base assumption, the share of PN and AD or for example, also in PN, what could be the penetration in Medicare? And what is the potential sales also of other applications besides PN and AD?

Yes, that sounds like excellent modeling questions, and I can assure you we've done those modelings internal, but we have no plans to publish that externally. So the the guidance is what we think we can appropriately do in PN and in AD and how many markets we will get into. Of course, it would assume that we continue, even though as Thomas mentioned, Medicare and Medicaid is more for PN, we, of course, would assume that we get better penetrated than we are now. Also remember, this is the first year when we can go there.

So we're not going to give guidance. I think we've given more than enough guidance about what the peak sales can be. And we have also given the guidance what sales were -- or you can see what sales were in '25. And I think it should be easy to calculate what it would be assumed range in '26. Thomas, anything you want to add?

Yes, Gian-Marco, just to be sure because I'm not sure -- your voice came through a little bit crackly, I just want to be sure we got this right or you got that right that the guidance we're giving here, the guidance upgrade is for AD and PN globally. So there's no additional indications in there. I wasn't sure whether you had inferred that, that was included. So I just want to make sure the guidance upgrade is apples-to-apples. It was AD, PN before, it's AD, PN now, above 2 becomes above 4. So that's the first one.

And then what Flemming said is absolutely right. But if you step back, we're already competing for #2 in NBRx' in a hugely competitive market in AD. So we're -- yes, so that's -- you see we are already on a very strong position. And then also the slide that Flemming shared on the real-world evidence versus what we thought everybody else thought looking at our clinical trials, that's the main driver behind it. And then the rest, yes, we should not get really into. But thank you so much for your question and your interest in Nemluvio.

We will now take the next question from the line of Victor Floch from BNP Paribas.

I was just wondering whether you can -- I mean, like discuss a little bit the dynamics between Dysport and Relfydess because I think in your PR this morning, you said that they were both growing in markets where Relfydess has been launched. So I mean, I was just wondering whether you can explain whether we should assume that Relfydess is actually like opening a new segment in the market. And this is mainly down to its liquid formulation, which is particularly resonating in certain segments or rather driven by its long-acting profile driving potentially new patients to the toxin business? And final question whether you can say whether it further increased your enthusiasm for the potential U.S. launch this year.

Yes. I think what we have learned, we mentioned also in the presentation that we've done a lot of market research and survey. It is not one feature that people are particularly liking about Relfydess. It's convenience, onset, duration and multiple other attributes. I think what you are seeing is basically that as we are penetrating and becoming #1 in the more and more markets in neuromodulators that it's a differentiated market where there are different patients and doctors that prefer different modalities. And I think to be already #3 in some countries, 2 countries where we have launched or being #4, I think, across Europe, I think that is a high benchmark.

But also keep in mind, that it is not like in many other products that you may compare us to in other categories, AD and others. This is a product plus a service category. So the fact that doctors are starting to use a product is not just because it's available. They will require training, familiarity, multiple instructions. That's why you saw the 290-some thousand physicians we've trained. So it's very important.

A product by itself in whatever great the product is, particularly neuromodulator does not sell itself. You need the whole surround some and you need the whole infrastructure. And the fact that we continue to gain share, the fact that we can have a differentiated portfolio speaks also to the fact that we position these products really well. We don't ask doctors to switch. We say there's a new product. We go mainly to some accounts we were not in before so that we grow the overall pie and not just take share away from ourselves. So I think that's behind the question.

Last question is by James Gordon from Barclays, who sent it offline. Can you please comment on the health of the consumer? There was conflicting commentary received from peers with some concern on a slowdown, particularly in the U.S., but Galderma's performance seemed to accelerate in Q4.

Yes. I mean if the question is not their physical health, but what their outlook is, then I would say it's a very broad question. Situation is, of course, the consumers that we are looking at, whether they are in our consumer business or in our aesthetics business, we see they still want the same thing, and they're still willing to pay for the same thing.

If you come with science-backed true innovation and you are in the places where I want to shop, whether it's increasing the Amazon or whatever it is on the platforms in China and you bring me something new, ideally also like some of the influencer events we mentioned in China with good attractive discounts and opportunities, then you -- they will buy.

But it really means to talk about consumer in general, they make choices. So even if they have less available disposable income, they will make choices. And what we see in dermatology and dermatological skin care, if we focus on the right segments, if we focus on true innovation, if we realize that consumers are increasingly going to e-commerce and moving online, we still do fine.

And then we have another trick up our sleeves. I know many of you are super focused on the U.S., and I'm sure a lot of it was by our peers where what they think about the U.S. But the U.S. is much smaller for us than international. We have much more growth in China, India, increasingly in Europe. So that's the advantage of a model. And remember, in the U.S., we are repositioning Cetaphil to be, I would say, more offer end, whereas in many parts of the world, both price-wise and others, it's already seen as a dramatic premium product like in China. But it takes -- given decades of a different promotion in the U.S., it's going to take us some time.

Another great example is you couldn't call Alastin cheap. I also don't think it's luxury expensive, but it has a good price point. But we have rebranded the product. We have made it more luxurious. We have upgraded it. We have changed it. We have upgraded some of the ingredients, and we have phenomenal growth.

Why are we having that? Because the doctors and the patients like the look and the feel, the constant innovation, the new indication that they compared with their aesthetic procedures where we already are in with the aesthetics. So surround sound and the long-winded answer to your question is the health, meaning the outlook for the consumers is good. But to generalize and say whether it's -- we don't have so many products, we have to worry about that. We worry about two products. And for those two, we see pretty robust outlook.

Perfect. Thank you, Flemming. This was our last question in the queue. Thank you so much to our covering analysts for the good questions. Now before we wrap up the call, just to hand over to xeo for his final remarks. Flemming, over -- yes.

So first of all, thank you for your time and all of the excellent questions. So I think driven by Galderma's proven and growth-focused integrated dermatology strategy, we talked a lot about that in the questions. We accelerated our performance in '25. Net sales growth was widespread across both geographies and product categories with each category outpacing their respective markets.

Once again, we delivered record net sales exceeding USD 5 billion for the first time with strong growth mainly driven by volume. And core EBITDA grew ahead of net sales, and we delivered margin expansion at constant currency in a year where we also had major launches and reinvestment into growth. Core EPS growth, as you saw, was very strong and remained a high cash-generative company, which enabled us to significantly reduce our net leverage and obtain 2 investment-grade credit rating.

So looking to '26, we expect another year of significant opportunities for Galderma driven significant net sales growth and core EBITDA margin expansion. So in light of our greater expectations for Nemluvio with peak sales rates and continued confidence in our growth rate, we specified also our midterm guidance ranges. So with this exciting growth trajectory ahead, I look forward, like I'm sure you do, to 2026 and the years to follow. So now with these closing remarks, I would really like to thank you for joining the call today.

This concludes today's conference call. Thank you for participating. You may now disconnect.

Good day, and thank you for standing by. Welcome to Galderma's conference call. [Operator Instructions] Please be advised that this conference is being recorded.

I would now like to hand the conference over to Emil Ivanov, Head of Strategy, Investor Relations and ESG to introduce the call. Emil, please go ahead.

Thank you very much. Welcome to Galderma's 2025 Third Quarter Trading Update Call. As customary, the press release was published at 7 a.m. Central European standard time today and can be viewed on our corporate website at any time. Today's presentation slides as well as a recording of the webcast will be made available on our website after the call.

Please be advised that today's presentation contains forward-looking statements, which will be treated with the appropriate level of caution as advised on the slide.

Let me now introduce today's trading update webcast, Dr. Flemming Ornskov, CEO of Galderma will provide performance highlights for the third quarter, Thomas Dittrich, CFO, will then present the trading update and the financial outlook for the full financial year. Both Flemming and Thomas will be available to answer questions from financial analysts before Flemming provide his final remarks to close the webcast.

With this, I would like to invite Flemming to start Galderma's highlights for the third quarter of 2025. Flemming, over to you?

Thank you, Emil. Good morning, good afternoon, and welcome to Galderma's third quarter 2025 Trading Update webcast. In a year of opportunities, we delivered record net sales for the first 9 months along with strong commercial and innovation momentum across our portfolio. For the first nine months, Galderma delivered USD 3.7 billion in net sales. These results are ahead of expectation, driven by focused execution of both the existing portfolio and new innovation. Growth was driven primarily by volume, complemented by favorable mix.

For the period, net sales growth was up 15% year-on-year at constant currency. Growth for the third quarter was up 21% year-on-year at constant currency. This represents an acceleration across all geographies and product categories despite challenging market dynamics. The growth was especially strong for Nemluvio in the U.S. while neuromodulators benefit from some favorable phasing in the third quarter. Based on our strong growth trajectory across the portfolio and Nemluvio's performance, we are raising our full year guidance. For net sales growth, we expect to close the year between 17% and 17.7%. For core EBITDA, we expect a margin between 23.1% and 23.6%, both at constant currency. Our performance demonstrates our ability to deliver growth through commercial excellence, innovation and global expansion. Let's look at some highlights by product category on the next slide.

Galderma continues on its strong growth momentum with net sales growth acceleration in the third quarter across all product categories and geographies. Galderma achieved double-digit growth in both injectable aesthetics and therapeutic dermatology reflecting broad-based growth momentum and successful commercial execution for the first 9 months of the year. Dermatological skincare continued on a strong trajectory, especially in international markets. Globally, all 3 product categories outperform their respective markets. Both geographies delivered double-digit growth as did most of Galderma's top 10 markets. Our performance reflects focused commercial execution across our core business as well as incremental growth opportunities, as you'll see on the next slide.

Let's start with injectable aesthetics, focusing on our neuromodulator portfolio. Our next-generation neuromodulator, Relfydess, continues to ramp up well in the 17 markets where it was already launched. Feedback remains very positive, and we are progressively gaining market share mainly from competitors. I'm happy to share that we received 3 new approvals for Relfydess in Hong Kong, New Zealand and the United Arab Emirates. This last one arrived just in time for us to showcase Relfydess at the Aesthetic and Anti-Aging Medicine World Conference in Dubai. The conference took place in early October, and you can see some visuals on the right side of the slide. There was a lot of excitement. We look forward to the launch next year in a market where we currently do not have a neuromodulator offering.

We also completed multiple additional Relfydess submissions globally progressing in our plans to have the broadest neuromodulator portfolio globally.

The neuromodulator subcategories overall has been performing really well with market share gains in the U.S. and in international markets. If we focus on the European countries where Relfydess is launched, we see early signals demonstrating the strength of our neuromodulator portfolio strategy. Over the past 12 months, our neuromodulator portfolio gained 490 basis points of market share. And in the third quarter, the portfolio delivered double-digit growth with Dysport growing well and Relfydess continuing to ramp up.

Moving now to fillers and biostimulators, where we continue to invest for growth. We gained further market share in fillers and biostimulators in international markets and in the U.S. Restylane continued to be impacted by a soft filler market, while Sculptra maintained a very strong growth trajectory with double-digit growth across geographies. I would like to showcase 2 specific efforts, which are stimulating growth for this category.

First, global activities on our proven injectable treatments for improving facial appearance, after medication driven weight loss. We believe that we are best positioned in this space with our clinically proven portfolio of Sculptra and the full Restylane range. We provide leading education and training for health care professionals leveraging the first of its client clinical trial data focused on patients experiencing [ patient ] volume loss associated with the medication driven weight loss. We also commissioned clinical consensus guidelines which set a standard approach for identifying and managing the unique needs of this patient population. And in the U.S., we launched a significant direct-to-consumer campaign called Sculpt & Lift, targeting patients on GLP-1 treatment. We believe this is an important opportunity to increase demand for the category and for the Galderma offering as the campaign aims to bring medication driven weight loss patients to aesthetic practices. This includes patients who may not have been aesthetic users before.

Second, we continue to scale recently launched differentiated innovation. This includes the ramp-up of Restylane shape in Brazil, which created a total new segment as a bone-mimicking fillers, it offers an outcome, which could previously only be achieved with invasive plastic surgery. The launch continues to progress strongly with a positive halo effect on the rest of the portfolio of Restylane in the market.

The other significant launch was Sculptra in China which is on a very strong growth trajectory. Our Chinese team has been executing an exemplary omni launch strategy to increase awareness and penetration. Two of the achievements I find particularly impressive. Over 100,000 units were sold in the first 6 months of the launch. Sculptra is already the #1 searched brand in biostimulator [indiscernible] with over 200 million impressions.

Switching now to Dermatological skincare, we continue to focus on the core of our business, while also introducing new innovation to capture opportunities for further growth. Starting with Cetaphil. We further expanded its range to address white spaces. This included 2 totally transformative launches in the U.S., creating entirely new categories based on proven science.

First, the skin activate a hydrating and firming line. It marks an entirely new skincare category of advanced hydration and firming solutions this time specifically to improve the amperage of aging, thinning and fragile skin. This also marks our first step in strengthening our position in the faster-growing hands and body lotion segment, where we historically have been underrepresented in the U.S.

Second, the nourishing oil to foam cleanser represents a breakthrough in high-grading cleansers for sensitive skin. This first of its kind formula is designed to deeply cleanse while preserving hydration and supporting the sensitive skin's moisture barrier. As the essential first step in any skincare regime, it also removes sunscreen and makeup, making it ideal for double-cleansing or a stand-alone use.

In addition, Galderma continued to roll out recent innovation in international markets. This includes multiple Cetaphil lines, especially in the fast-growing Asian and Latin American markets. We're also using these to strengthen our position globally and capture local opportunities. For example, the gentle exfoliating SA line was launched in China, strengthening our offering in the face segment. For Alastin, the preferred periprocedural skincare brand in the U.S., we broadened our reach and leverage synergies with our injectable aesthetics portfolio. Following an exclusive launch for our partnering health care professionals, we initiated a broad consumer outreach for our restorative skin complex with next-generation TriHex Technology. This has been another successful launch turning the improved formula into one of Alastin's top-selling products. It also received Elle Magazine's Future of Beauty Award for top skin tightening cream, reinforcing its position for medication driven weight-loss patients.

Second, we continue to expand Alastin in international markets. For the launch of China, we're excited about to introduce Alastin to the second largest precision dispense market globally.

Turning to therapeutic dermatology. Nemluvio remains on a strong trajectory, especially in the U.S. Nemluvio continues to surpass expectations underpinned by growing demand and increased access. This is reflected in Nemluvio's growing share of total prescriptions and paid new patient starts. If we look at the 6-week rolling average of paid new patient start, also known as NBRx from September to early October. Nemluvio was trending at about 37% market share in prurigo nodularis and 7.3% in atopic dermatitis. As a result, atopic dermatitis sales became the larger contributor in the third quarter. Overall, the majority of patients starting on Nemluvio were new -- yes, new to advanced therapy. This demonstrates the value perceived from Nemluvio in these indications by health care professionals who have prescribed the product to their patients.

Last, but of course, not least, we continue to expand access for patients. The percentage of patients covered by commercial plans with broad access to reimbursement has surpassed 80%. For both indications, Nemluvio is reimbursed as a first-line biologic treatment with no need to first go through another therapy. Meanwhile, in international markets, Nemluvio's uptake continues to be strong in Germany. We have now launched Nemluvio in Austria, Switzerland, the United Kingdom and Denmark while progressing on price negotiations with multiple other markets where Nemluvio is already accrued. A number of additional regulatory submissions globally are also in profits.

As you can see, Galderma continues to perform strongly advancing our growth drivers across the portfolio and reinforcing our leadership in dermatology through new data presentations and world-class education programs.

I'd now like to hand over to Thomas to cover the sales performance in more detail as well as the outlook for the remainder of the year. Thomas?

Thank you, Flemming. It's my pleasure to comment on Galderma's Q3 2025 trading update and outlook, starting with an overview of net sales for the period. As mentioned by Flemming, Galderma continued on its strong momentum, achieving a record USD 3.737 billion in net sales for the first 9 months of the year, up 15% year-on-year at constant currency. For the third quarter, this represented an acceleration to 21% year-on-year growth at constant currency. This was higher than expected for the quarter based on strong performance across the portfolio and especially from Nemluvio's ramp up along with some favorable phasing in neuromodulators. Growth was broad-based and continues to be driven by volume, complemented by favorable mix which more than offset adverse price impact.

Looking now at injectable aesthetics, net sales were USD 1.871 billion, up 10.5% year-on-year at constant currency. Neuromodulator net sales were USD 1.053 billion, up 14.0% year-on-year at constant currency. Both the U.S. and international markets delivered double-digit growth, outperforming the market and gaining share. Growth was driven by strong performance of Dysport in both the U.S. and international markets, along with the ongoing ramp-up of Relfydess. Neuromodulator growth in the third quarter was 12.6% in constant currency, ahead of expectations, benefiting from strong execution as well as some favorable phasing between the third and the fourth quarter. Fillers and biostimulators net sales were USD 818 million, up 6.2% at constant currency for the first 9 months.

Again, Galderma grew faster than the market and gained share in both the U.S. and international markets. While fillers overall continue to be impacted by market softness, Galderma's performance was supported by the growth of differentiated products and especially new launches, including Restylane SHAYPE in Brazil, as Flemming presented earlier. Biostimulators maintained very strong momentum with outstanding double-digit growth in both geographies. Sculptra remains our fastest-growing injectable aesthetics brand. Growth was especially behind in the international markets with widespread performance and strong contribution from China, where we just launched the brand earlier this year.

Next, moving to dermatological skincare. Net sales for the first 9 months were USD 1.063 billion with year-on-year growth of 8.2% at constant currency. Galderma outgrew the market in dermatological skincare globally with the majority of our key markets gaining share despite some constrained consumer spending. Growth in dermatological skincare was led by international markets, our larger geographies, where both Cetaphil and Alastin grew double digit. I would also be remiss not to mention Cetaphil's continued outstanding trajectory in fast-growing Asian markets, especially in India and China. In the U.S., performance was impacted by constrained consumer spending. Nonetheless, Cetaphil in the U.S. saw positive responses late in the third quarter from multiple promotional activities. Meanwhile, Alastin continued to deliver double-digit growth in the U.S.

Now on to therapeutic dermatology. Net sales reached USD 804 million for the first 9 months of 2025, up 40.4% year-on-year in constant currency. Growth was driven by Nemluvio's continued outperformance, which more than offset the expected decline in the mature portfolio. Nemluvio's net sales for the first 9 months were USD 263 million, predominantly from the U.S. and prurigo nodularis. However, atopic dermatitis representing the larger market opportunity overtook prurigo nodularis sales in the third quarter for the first time. As formulary coverage for patient reimbursement increased significantly, the results for the third quarter reflect managed carry rebates resulting from securing commercial coverage. For the mature portfolio, excluding Nemluvio, performance was impacted by anticipated lower volumes and pricing pressures globally, especially in the U.S. Nonetheless, we also saw some positive momentum in international markets where we capitalized on our strong portfolio in acne and rosacea.

Now looking at net sales geographically for the first 9 months of the year. The majority of our top 10 markets grew double digits with particularly high performance in key international markets, such as India, China, Mexico, Germany and the U.K. and Ireland. Both reporting geographies accelerated their growth momentum, noting the U.S. growth was especially fueled by the Nemluvio ramp-up. International, which remains the larger of our 2 reporting geographies, continued its strong growth momentum with 13.2% net sales growth at constant currency. Injectable Aesthetics delivered double-digit growth in most key international markets, including in Europe, Latin America and Asia Pacific. Both neuromodulators and fillers and biostimulators grew double digits, outpacing the market and gaining share.

Neuromodulators saw growth across markets. Flemming already shared some highlights for Europe, which delivered the greatest growth contribution supported by the launch of Relfydess. Growth for neuromodulators in the third quarter also benefited as mentioned by some favorable phasing relative to the fourth quarter. For fillers and biostimulators, Restylane gained share in most key markets against a soft backdrop for fillers. As for Sculptra, we delivered strong growth and outstanding performance across international markets with some markets growing even triple digits. This includes markets where Sculptra is already well established especially in Latin America. Following the launch earlier this year, Sculptra continues its strong ramp up in China, the second largest injectable aesthetics market globally.

Dermatological skincare also delivered double-digit growth internationally, ahead of the market, driven especially by continued outstanding growth of Cetaphil in Asia, especially in China and India. Alastin also contributed to strong growth from the ongoing international expansion, albeit from a smaller base. Therapeutic Dermatology growth was primarily driven by the ongoing rollout of Nemluvio also internationally.

Moving now to the U.S. Net sales growth was 17.5% year-on-year at constant currency. The growth contribution was particularly strong from the ramp-up of Nemluvio, while injectable aesthetics and dermatological skincare grew modestly. Both neuromodulators and fillers and biostimulators outperformed the U.S. market and gained share. Growth was especially driven by Dysport and Sculptra, both growing double digit, while Restylane outperformed a declining filler market. Dysport in the U.S. also benefited from some favorable phasing between the third and fourth quarter.

In dermatological skincare, we navigated a constrained consumer spending environment in the U.S., especially impacting Cetaphil. Nevertheless, Cetaphil in the U.S. saw positive responses made in the third quarter from the multiple...

[Technical Difficulty]

Apologies for the disruption. We are trying to resume the call, bear with us. Thank you for that. Operator, could you please confirm that the sound is coming through?

Yes, it is all loud and clear.

Perfect. Thomas will resume his remarks. He is going to resume from his comments related to tariff exposure.

Happy to do that. So now moving on to tariff exposure in terms of the U.S., our exposure to tariffs that are already in effect is deemed manageable. Tariffs are mainly relevant for our U.S. fillers and biostimulator portfolio, which represents approximately 7% of our total Galderma net sales. Please recall that any tariff would be on the import value, thus exposing only a portion of the in-market net sales price to tariffs. Furthermore, it is important to remember that our in-market net sales price charge to health care professionals is typically only the smaller portion of the end consumer treatment price.

Also recall, more than 90% of all injectable aesthetics products currently sold in the U.S. are being imported. Our guidance fully factors in the exposure to all tariffs that are already in effect. Any further tariff announcement will be reviewed as to their potential impact during the remainder of the year, if any. Given the importance of the U.S. market, let me also remind you that we continue to expand our U.S. operations. Earlier this year, we announced our new U.S. headquarters in Miami, Florida, complementing our already established corporate and R&D hubs in 3 other U.S. states. We continue to provide significant health care professional education and training events across the country. We have committed to spend more than USD 650 million on U.S. manufacturing activities through the third-party manufacturers over the next 5 years. This includes ramping up final assembly and packaging for Nemluvio in Florida as well as the manufacturing of Alastin and select Cetaphil products with our contract manufacturing partners.

Also, Galderma and its partners have initiated additional technology transfers to the U.S. focusing on key growth drivers, including double sourcing Relfydess in the U.S.

Now on to guidance. We are raising our guidance for the full year, as Flemming already mentioned. This reflects our strong growth trajectory across the portfolio and especially of Nemluvio. We are raising net sales to 17.0% to 17.7% year-on-year growth at constant currency from previously 12% to 14%. On core EBITDA, we are raising the margin range to 23.1% to 23.6% at constant currency from previously approximately 23%. The guidance update especially reflects the significant ramp-up of Nemluvio which is driving growth in therapeutic dermatology. It also reflects the strong trajectory in injectable aesthetics with continued outperformance of the market in both neuromodulators and fillers and biostimulators.

In neuromodulators, the fourth quarter is expected to be impacted by phasing effects. Full year net sales growth for neuromodulators is expected to be in the low teens at constant currency. At the half year call, I translated low teens at 11% to 13%, as you recall. As we have now delivered a strong third quarter growth rate, our full year performance is largely derisked, and we expect growth towards the upper end of this 11% to 13% growth range.

In fillers and biostimulators, expectations for the fourth quarter are to maintain the recent growth momentum based on the strong trajectory of Sculptra, and from new launches.

Dermatological skincare is expected to accelerate its growth momentum to reach high single-digit growth at constant currency for the full year.

And finally, for the therapeutic dermatology mature portfolio, the Q3 year-to-date performance is indicative of our expected full year growth for this part of the business. The updated core EBITDA margin reflects reinvestments into growth for the group and to support Nemluvio's strong ramp-up. It also factors in the exposure to all U.S. tariffs that are currently in effect. Any further tariff announcements will be reviewed as to their potential impact during the remainder of the year. Please note that the updated guidance also has implications on the additional modeling metrics, which were previously provided in the financial results. In particular, the increased profitability is expected to positively impact the effective tax rate for the full year, putting it towards the lower end of the previously provided 23% to 25% range that we have provided at the half year call.

This concludes the introductory remarks of Galderma's trading update for the third quarter of 2025. Before we close the meeting with Flemming's final remarks, I would like to now hand back to the operator to open the call for questions. [Operator Instructions]

Operator, can you please now open the line?

[Operator Instructions] And now we're going to take our first question. And it comes to the line of Thibault Boutherin from Morgan Stanley.

A question is just on Nemluvio for the rest of the year. When we triangulate your comments on the business trends in Q4, it's clear to us that Nemluvio is the biggest moving part in the guidance. So if you could just tell us where you see the most viability here, is it the uptake in atopic dermatitis in the U.S.? Is it the excess uptake? Any sort of help you can give us on where you see the moving parts for Nemluvio in Q4 would be helpful.

Yes. I don't know if I agree with your analytics, First of all, thanks for the question. It's USD 263 million so far. You can see we have reported USD 3.737 billion. If I can do the math, that's not the majority. We had double-digit growth in injectable aesthetics. We have double-digit growth in therapeutic dermatology. We had 8.2% growth in dermatological skincare. So I think we have to be a little bit careful not to think that this is about Nemluvio. Nemluvio is in a very early stage of its trajectory. It's performing or outperforming any benchmark we've set.

We're at 7.2%, I think, share at this stage. If you look at NBRx for the AD market, and we're at 37%, if you look at PN, we are now north of 80% commercial coverage and next year, we'll enter most likely into the Medicare and Medicaid. But we have a lot of other things that are growing incredibly fast, and Nemluvio is important, but it's not the only thing. And if I think about the contributions of Cetaphil international. If I think about the contribution already of Relfydess, if I see the very strong performance of Dysport around the world, I think it was a little bit -- we need to moderate that sentiment.

Any further questions, Thibault?

Yes. No. I mean, I think the question was just on the moving parts in Q4 in particular, but that's fine. Thank you.

Yes. We don't manage the company with just one compound. We have -- we ship the resources. And I think we've seen -- we have brought growth in international and in the U.S., 17.5% growth in the U.S. 12-plus percent in international. And if you look at the portfolio, it's almost all products that are showing incredibly strong growth, not just Nemluvio.

[Operator Instructions] And the question comes line of Harry Sefton from UBS.

So in fillers and biostimulators, we saw another strong quarter against the backdrop of a weak, HA filler market. Should we think about the vast majority of that growth being driven by Sculptra? And how should we think about the growth going into 2026 for Sculptra given the push into GLP-1 patients do you think you'll be able to accelerate the growth of Sculptra next year? And then also thinking about Restylane growth going into next year given the launch of skin boosters in the U.S., and a couple of other SKUs?

No, a very insightful question. Thanks very much. Yes, sometimes one get lost in the minutia details. If you take a step back, your strategic comment is totally right. Over time, in the combined category of fillers and biostimulators. Sculptra, the biostimulator part is approaching half and will probably overtake it sometime next year. What we are seeing, but these are early signs. You should talk to all our competition. Is there a flattening on the negative trend with fillers, yes or no, your insights may be as good as ours. What we are seeing is that if you launch new and innovative fillers like what we've seen with Restylane SHAYPE, we have uptakes that matches some of the best launches like Restylane Kysse, Restylane Lift, we've had -- so I think it's a bit of a mixed bag. There's pricing pressure. There's commoditization.

But if you bring innovation to the market, you see that the unique advantage for us in one of the largest markets, we're going to be launching, I think, up to 6 new products, several of them being fillers next year. In the U.S., if all goes well. We are in the final stage of regulatory approvals for those. So that should give us a boost. But it is quite clear that the trend among consumers is yes, we all want a neuromodulator and now we also want a biostimulatory product. And then we add on a filler. But for treatment of some of the effects of significant weight loss with GLP-1s, you will need both a filler ad biostimulatory product. It's early days to say -- our growth is driving in certain parts of the world, if you go to the Middle East, it's a significant part, in the U.S., it's still early days.

And then I would only add when you -- and you asked about '26, and we're not going to comment on '26, Harry. But on the longer-term, when you think about the biostimulator opportunity, remember, we just launched in China and the biostimulator opportunity longer-term in China is so big. It's bigger than most -- the sizes of most injectable aesthetics markets in JPAC. So that's why we just start -- launched and then together with Flemming's comments, think of the longer-term secular trend that we have here, and that's really big and amazing.

[Operator Instructions] And the next question comes from the line of Shyam Kotadia from Goldman Sachs.

A quick one on Nemluvio. So in terms of the guidance going forward, you mentioned in the prior results that you're going to consider your greater than $2 billion peak sales guide for the drug. So given the ramp continues to be strong, do you have any update from that perspective? And also any update in terms of the breakeven assumptions, which I believe previously were 2027 and also your assumption to hit blockbuster run rate was also 2027. So any update in regards to that would be super helpful.

Yes. I don't think at this stage, we're going to give guidance on Nemluvio apart from what we've already said, it's $2 billion plus. When we look at the data, the uptake continues to be very strong. I think part of the success with the launch so far is we keep the head to the ground, and we focus on building out the sales force, making sure we get access, making sure we do well against that very tough competitive set and that we get as many doctors to experience the product so that they also can prescribe it to more patients. The -- there's a lot of change going on. We used to be mainly dependent on PN. Now we see that AD is a larger part in the third quarter. That was the largest part. So net-net, of course, with this strong uptick, if it continues to that way, we will, at some point, consider resetting the guidance for peak sales and, of course, also the profitability threshold guidance.

Yes. And on the profitability, I mean, let me just comment there on 2025 because this is the Q3 2025 call. Recall that we said that we expected in the H1 call we expected the adverse P&L impact from Nemluvio launch investments and other investments to be 60% in H1 and 40% in H2. Let me update that here with by saying that in H1, we have seen 75% of the adverse P&L impact, and it will be only 25% in H2, driven by the strong uptick. But also remember, strong uptake doesn't happen by itself. You need to reinvest some of those proceeds to make it happen in the following period. And that's what we have done very judiciously. So therefore, driving the strong uptake will bring the breakeven point in -- at a later stage when it's appropriate time. But we're on a very good trajectory here as you see also from a profitability standpoint.

Very, very sorry. It broke up a little bit when you said it will bring the breakeven point as -- can you just repeat that lastly on the breakeven point?

Yes. It will bring breakeven point in because the strong uptake delivers additional profitability. But we don't want to comment on that right now. We said it back today it's sometime in '27. So let's not get into any details. We will do that at the appropriate point in time.

[Operator Instructions] And the next question comes from the line of Benjamin Jackson from Jefferies.

Great. Thank You for the question. One on Relfydess, if I may. I think you've spoken fairly positively about it for a number of quarters now and the ongoing launches. But is there perhaps any more depth in the color that you can provide to us even around the relative size in terms of the entire neuromodulator number that you're putting out? And then thinking about your strategy and how you launch it, is there more color you can provide about the uptake, but also how you balance the commercialization process between Dysport and Relfydess and then how that matters for the U.S. too?

Yes. I think you have to take the background here. Since 2019, when we as a team took over, we have shown incredible growth of Dysport around the globe. So of course, we continue to support Dysport. It's an incredibly strong product. It competes well against BOTOX. We are launching it even in more and more countries. So for us, that's the most important product we have right now. We are now launching another product and the way we've launched that is we know that in the neuromodulator space, there are still...

[Technical Difficulty]

I'm not sure I caught any -- like three quarters of that due to the line breaking up. I don't know whether you could repeat it at all. Sorry about that. I'm not sure if it's just me.

Sorry about that. Yes. So we're really sorry about that. We seem to have some technical issues today.

[Technical Difficulty]

Yes. Please continue.

Okay. Good. Okay. So I apologize. Strong results, not so strong technical execution today. So I apologize for that. But do you want me to repeat the -- sorry, it was a bit long, but I'm happy to repeat it. Is that what you would like me to do?

Please, that'll be really useful if so, thank you.

I really apologize for these technical issues. So what I was saying is that the way we -- since 2019 have basically been strengthening the commercial execution for Dysport. I think the way we've gained market share. In some cases, we've gained leadership. It's a very strong product. I think you see in most geographies, including the U.S., we continue to gain significant market share also against BOTOX. So when we had the opportunity to launch Relfydess initially in some European countries, the focus was, of course, to maintain the strong momentum of Dysport. We know that there is room for additional optionality among doctors and patients. Relfydess offers certain benefits, of course, fast onset, it's liquid duration. And the doctors that have started using Relfydess, we see that they continue to have a strong preference for that, but we still need to keep in mind that the vast majority of our sales today is Dysport.

So what our key strategy is to continue to drive our overall share of the neuromodulator market and given we're now #1 in Europe, #1 in Australia, #1 in Brazil, honing in on the U.S. I think the strategy is working. And remember, our play in injectable aesthetics is a portfolio play. We have multiple opportunities for you to use fillers under the Restylane name, we have Sculptra. And now in many countries, we have 2 options for you if you want to use a neuromodulator. And we think one of the core strength of our gaining market share and holding in on leadership in aesthetics is because we have a broad portfolio approach.

[Operator Instructions] And then the question comes from line of Yihan Li from Barclays.

Yihan Li from Barclays. Congrats on the on the quarter. I guess I have a question on Nemluvio treatment dynamics. So I acknowledge nemo's launch is still at a very early stage. But I'm still wondering what is the average treatment duration so far in PN and also AD indication separately? So based on our research, it seems like the switch out rate for from Nemluvio remains at a very low level, but slightly increased a little bit in the third quarter versus second quarter. So just curious, any observations on discontinuation rate or like patient experiences so far?

Yes. There's one advantage of being the CEO and a physician is I interact with a lot of physicians. I just spent time yesterday with 2 of them. So they both have a very large number of patients on the product and I go together with my colleagues on many field visits. So what you're observing is also what we hear back from the physicians, and we're seeing in the market research, the dropout rate has been really low. We still see that every 4 week is the preferred duration, but we are now seeing the doctors and stable patients that have been itch-free slept well at night, that they're now thinking about going or have already started to go to every 8 weeks, which they see as a huge advantage. So what we're seeing is that the initial feedback from patients and physicians has been reconfirming the fast itch-release. It's reconfirmed the very positive impact on sleep and quality of life.

It also has been surprising for many physicians that they feel that the skin clearance is above what their expectations. They had strong expectations in PN, but maybe not so in AD, and they are in the patients they select to be on the product. So the fact that we also can be used first line, the fact that we have a very large portion of our patients being biological naive. It all probably speaks to the fact that for the moment, along with incredibly strong access, 80-plus percent in commercial plans, we see low dropout rates. Of course, like any IL-13 and IL-31, it's not going to be for everyone. The physicians have choices to make but the good news is a lot of physicians are starting to use Nemluvio as first-line given its safety profile, given what the fast itch relief but it's way too early to comment on that. And we just basically started to launch in certain parts of the world. We're building out the field force. We've just launched DTC. So it's way too early at this stage to make big bold projections on the brand.

The other part that helps a lot is the tolerability. Flemming mentioned the lack of side effects, so to speak. But the other part is just that it doesn't seem to sting as much because it's against the main competitor from a large French company. The volume is much, much lower. It's about a quarter. So therefore, the convenience of having to auto inject yourself. And that's also practice that physicians tell us that help people wanting to stay on the ground because it's just convenient. It's highly tolerable. It doesn't hurt as much. So that's some of the learnings we're getting there. Just complementing Flemming's comments.

But the most important is to realize, we're on a journey. We're basically well into the larger PN. We're basically now starting significantly the launch of AD. When you speak to physicians and what we see in market research, that the ones that started to use Nemluvio, particularly in PN initially, they had a lineup of patients that had been difficult to treat for them with other products that didn't want the JAK. So we probably got a pretty severe group of patients initially. Now we're moving into, I think, a broader group of patients and also first line in many cases. So we'll see where that takes us.

[Operator Instructions] And the next question comes from the line of Victor Floch from BNP Paribas Exane.

My question is on Relfydess, and I was wondering if you could comment on the timeline for securing the U.S. capacity and whether bringing this capacity online might shift your neuromodulator's product mix further towards Relfydess, considering that the rest of your toxin portfolio is still expected to be manufactured out of the U.K.

No. Our focus is still and Ipsen is doing an excellent job is to continue to manufacture in a reliable manner. In the history, we had some stock outs, but we've had a very good record now of delivery on time, and that's very important because of the very strong growth rate that we're seeing with Relfydess. We had a bit of subdued launch in Europe because we are new to the manufacturing of neuromodulators. We built a totally new manufacturing site in Sweden. So we were a little bit cautious that we would not run out of stock, and we have not done that. We prioritized which countries we were launching in.

The other thing that was very important and is still impacting a little bit of our launch trajectory for Relfydess is we have to run a lot of batches to prepare for the filing of the complete response letter in -- with the FDA. So we have choices to be made all the time between making sure we have supply for the products where we are -- in the countries where we're also launched and making sure we have batches enough for answering all the questions that we have to answer with the FDA. As I see right now because, remember, it's a lot of batches that have to be run and we have to do testing on these batches. Everything seems to be going in the right direction, whether it's going to be in December or flip into January, I do not know, but I think we're on track.

[Operator Instructions] And it comes the line of Richard Vosser from JPMorgan.

Question on Relfydess and the approval in the UAE. Obviously, as you said, Flemming, no presence there. So I'm just thinking how would you size the opportunity? And how you would attack that opportunity in other areas where you don't have Dysport under your control? And how we should think about the opportunity in those areas for Relfydess?

Well, the Middle East is a region that is near and dear in my heart as it is in the drug department. Because as we go through a lot of challenges in that region, we had just [Technical Difficulty] so we set out of a venture, which was not a easy venture through arbitration and a whole, in my case, a kind of lawsuit to fight and secure our ability to sell our products in the region. So first, we make really good progress with fillers, now with Sculptra, now comes the next stage, which is with Relfydess, we will be -- because Relfydess is approved in March at the beginning of the year. It's a region that continues to surprise me. I recently was at a conference, AMWC in Dubai. I heard that there will be 3,000 people at the conference. I think there were 6,000 people there. And I saw the interest in Relfydess, which we just got approved in time.

So I cannot quantify at this stage, but it's also coincides with the fact that this is one of the regions where there's also very significant treatment for GLP-1. It's almost OTC. So I think both what we're seeing for Sculptra and for fillers is very strong growth. And I imagine now having the full [Technical Difficulty] with Relfydess, should help us to secure more market share overall in injectable aesthetics. And as you know, a lot of people from different parts of Europe are gravitating towards now also putting their clinics in UAE. And the bigger market is, of course, at KSA or Saudi, so [Technical Difficulty] so I'm optimistic about it, but it's going to take a bit of time.

But let me just add from a profitability standpoint, Relfydess in the Middle East is super attractive because from the first unit onwards, it's royalty free. We don't have to pay any royalties to Ipsen. So that's also very attractive profitability-wise. And it is, of course, an added brand and over time will be a contributor to our profitability and margin expansion.

And now we're going to take our last question for today. And it comes from the line of Natalia Webster from RBC.

It's just a follow-up on what you mentioned around Relfydess in contribution to margins. Are you able to comment a bit more on when you expect this to be a meaningful driver to margins? Do we still need to see the U.S. approval? And then those royalty caps to be reached in major markets for this?

Yes. Thank you, Natalia. Yes, you're right. I mean, from an overall margin standpoint, think about what Flemming just said earlier. These ramps go slowly, steadily, but this is really sticky stuff. But it ramps slowly and remember, you'll never have a patent cliff either. So we really want to do it the right way that doctors like it, patients like it [Technical Difficulty] patient doctor discussions. So that's what it is. And then from a margin standpoint, I just said, look, there are some geographies like UAE and Middle East that are royalty free because we did not have the right to Dysport there. So that's really attractive.

So there, you have a contribution right from the get-go. And then other territories in which we have the right to Dysport, that's in various geographies. And there, you have to hit certain levels. Really in the U.S., once approved, we would get -- given the size of the growth of the market, we would get to that threshold quicker than in the other territories where we have to pay royalties. So there takes a little bit longer. But overall, a very good trajectory and the excitement from patients seeing that fast onset and health care professionals fast onset and the long duration, that's really what we should focus on. And profitability will follow and it's very attractive for us. So that will almost take care of itself.

Thank you very much for the question. Thank you, Thomas and Flemming for the answers. I will now pass over to Flemming to give his final remarks so that we can close the webcast.

First of all, thank you so much for your thoughtful questions and also for your patience. I think you'll recognize that we're good at commercial execution, maybe we need to be a little bit better at meeting execution, but we always strive to improve. The good news was, it happened on a day when we had strong results, so you couldn't accuse us of trying to hide something.

So as we highlighted today, we continue to be on a very strong trajectory, a very focused execution, both on our existing portfolio and new innovation. I can hear through the questions, you're very excited about a lot of new innovation, but don't forget, the vast majority of the growth is coming from our existing portfolio. We delivered USD 3.7 billion for the first 9 months, record, growing 15% at constant currency, widespread growth across product categories and geographies. Of course, you all honed in on Nemluvio, very strong growth in the U.S., but we also with neuromodulators that also showed very strong growth. We also had some benefit from some phasing in full transparency. A lot of questions from you U.S. tariffs. I think Thomas gave you a crystal clear answer with what we see today is factored into the 2025 guidance, but it is a bit of a moving target.

U.S., as you can see, is very important for us, neuromodulators, Cetaphil, now Nemluvio. And of course, we also will invest significantly in the U.S., USD 650 million, as you may have read, U.S. dollar up to 2030 because we clearly need to increase our manufacturing footprint there. And given the importance of a number of products, Alastin, Nemluvio and Cetaphil, that's a necessary investment. And I think, as you've seen, strong growth trajectory, Nemluvio strong performance. We've updated our full year guidance, I think, not by a small percent, but significantly, both on top and bottom line. And with that, again, thank you so much for your thoughtful questions today, and have a great rest of the day.

This concludes today's conference call. Thank you for participating. You may all disconnect. Have a nice day.