David Elkins
Executive Vice President and Chief Financial Officer at Bristol-Myers Squibb
Thank you, Giovanni. I'm recognizing this is another busy day for all of you. Thanks again for joining our first quarter earnings call. Turning to Slide 8. Let's discuss our top line performance. Unless otherwise stated, all comparisons are made for the same period in 2022, and sales growth rates will be discussed on an underlying basis, which excludes the impact of foreign exchange. Total company sales in the quarter topped $11.3 billion, driven by strong double-digit sales of our in-line and new product portfolio, offset by [Indecipherable] loss of exclusivity. Sales in the U.S. grew 4%, driven primarily by volume, while international sales were impacted by the annualization of loss of exclusivity for Revlimid. Let's delve deeper into the strong performance of the new product portfolio on Slide nine.
As Giovanni mentioned, the new product portfolio generated over $720 million in sales, which more than doubled versus prior year and grew over 11% sequentially. This strong performance in the quarter was driven primarily by demand for Opdualag, Abecma and Reblozyl, which I will touch on further in a moment, and provides us confidence in the growth potential for our increasingly derisked and diversified new product portfolio. Moving to our solid tumor performance on Slide 10. Global Opdivo sales were strong, growing double digit versus prior year, primarily driven by continued demand for our newly launched and core indications. In the U.S., Opdivo grew 17%, primarily driven by demand in first-line lung, upper GI indications and adjuvant bladder cancer.
Outside the U.S., first quarter revenues increased 18%, primarily driven by demand for recently launched indications and expanded access. The strong execution in the first quarter gives us confidence in the continued growth expected for Opdivo. Now turning to the robust launch of Opdualag. Sales in the quarter were $117 million, growing double digit versus prior quarter. We are very pleased with the launch of Opdualag in first-line melanoma with market share now over 20%, primarily being sourced from PD-1 monotherapy. Now turning to our expanded cardiovascular portfolio on Slide 11. And starting with Eliquis, which generated over $3.4 billion globally, largely driven by the U.S. In the U.S., sales grew strongly, up 19%, driven primarily by robust demand. Internationally, sales were impacted primarily by generic entries in Canada and the U.K. and pricing measures we mentioned in the past. Moving now to our first-in-class myosin inhibitor, Camzyos.
We continue to be pleased with the progress we are making to bring Camzyos to more patients. Camzyos generated sales of $29 million in the first quarter. Now with approximately 2,700 patients in our hub, of which 1,500 patients on commercial drug at the end of the quarter. We continue to build momentum with considerable growth expected in the quarter-over-quarter. We look forward to our upcoming PDUFA date for Valor in June, which will reinforce the strong profile of Camzyos as well as the expected European approval having just received a positive CHMP opinion. Now turning to our hematology portfolio on Slide 12. Starting with Revlimid. Global sales in the quarter were approximately $1.8 billion, impacted by generic entry. As we expected, the favorability seen last year reversed in the first quarter. And we continue to expect quarter-to-quarter variability. Now on to POMALYST, global sales grew 2% versus prior year. In the U.S., longer duration of first-line treatments impacted new prescription volumes.
Internationally, revenues grew 12%, driven largely demand for triplet-based regimens as well as some buying patterns. Turning to Reblozyl, which generated revenues of $206 million in the quarter. Sales were strong, up 33%, largely driven by demand. In the U.S., revenues grew 18%, primarily driven by continued total prescription share growth. Internationally, Reblozyl more than doubled as we continue to secure reimbursement in additional countries, including being placed on China's national reimbursement drug list. We are now launched in 25 countries outside the U.S. and expect to launch in additional markets this year. We look forward to presenting the COMMANDS data in an oral presentation at ASCO and EHA to further accelerate the brand by bringing this first-in-class product to first-line ESA-naive MDS patients upon approval. Transitioning to our first-in-class and best-in-class cell therapy products of Abecma and Breyanzi.
We continue to make progress at expanding capacity, which has enabled robust sales growth driven by strong demand. With sales of $147 million in the quarter, we more than doubled our revenue for Abecma versus prior year and grew 16% sequentially. We continue to be pleased with the feedback from physicians on the reproducibility of efficacy and safety in the real world and reliability of our manufacturing capabilities. As Giovanni mentioned, KarMMa-3 and triple-class exposed myeloma patients is now under review in the EU, the U.S. and Japan, and we look forward to bringing Abecma to earlier [Indecipherable] line patients around the globe. Turning to Breyanzi. Sales in the quarter were $71 million, growing 66% versus prior year and 27% sequentially. Sales were driven by demand in second and third-line plus large B-cell lymphoma.
With the broadest label in second-line large B-cell lymphoma and differentiated safety profile, feedback from physicians has been very strong, and we are pleased with the strong demand for Breyanzi. We look forward to bringing Breyanzi to earlier line patients in the EU in the coming months, with the recent CHMP positive opinion. Let's now move to our immunology portfolio on Slide 13. Starting with Zeposia. Global sales in the quarter were $78 million, more than doubling compared to prior year. In the U.S., growth was primarily driven by demand in multiple sclerosis and expanding contribution from ulcerative colitis. Internationally, sales increased primarily to demand in multiple sclerosis and securing reimbursement in additional countries. Lastly, turning to a strong launch of our first-in-class TYK2 inhibitor, SOTYKTU. We're extremely pleased with the launch so far.
Just six months into the launch, we have over 9,500 script equivalents across bridge and commercial drug. SOTYKTU's share of the oral market is now in the mid-30s, sourcing business from systematic naive patients as well as Otezla and biologic experience patients. Internationally, we are very pleased with the strong launch performance in Japan and recent approval in Europe and look forward to working with individual countries on securing reimbursement through 2023 and beyond. We are very excited about SOTYKTU with nonrisk-adjusted revenue potential of $4-plus billion based on exciting opportunities ahead and moderate-to-severe psoriasis, cirrhotic arthritis and in lupus. Moving to our first quarter P&L on Slide 14. I will focus my remarks on a few non-key line items just covered -- as I just covered sales performance. In the quarter, as expected, gross margin was impacted by product mix. This was partially offset by favorable foreign exchange and related hedging settlements that will not repeat in the second quarter.
Operating expenses, excluding acquired in-process R&D remained largely consistent with prior year. MS&A declined 4%, primarily due to timing of spend which we expect to reverse going into the second quarter as we continue to invest in our new launches. Acquired in-process R&D in the quarter was $75 million, which was partially offset by $43 million of licensing income. Overall, first quarter earnings per share was $2.05, growing approximately 5%. Turning to the balance sheet and capital allocation on Slide 15. Cash flow generation and our balance sheet remains strong. Cash flow from operations in the quarter was approximately $3 billion, with over $9 billion in cash and marketable securities on hand as of March 31. As it relates to capital allocation, our priorities remain unchanged, with BD continuing to be our top priority and a focus on balance sheet strength as well as returning capital to shareholders. In the quarter, we repaid $1.6 billion in debt with an additional $2.3 billion maturing this year, and we remain opportunistic about share repurchases in the future with approximately $7 billion remaining in our share repurchase authorization.
Lastly, turning to our 2023 non-GAAP guidance on Slide 16. Based on upon performance to date, we are reaffirming our non-GAAP guidance. We expect 2023 revenues to grow approximately 2% on a reported and constant currency basis, which reflects that our in-line and new product portfolio will more than offset recent LOEs. Revlimid's sales expectations remain at approximately $6.5 billion, and we will continue to monitor variability from generics and other market dynamics through the year. We remain excited about the promise of our new product portfolio and expect the portfolio to roughly double versus prior year. As we continue to launch these assets around the globe, we expect growth to be more back half weighted as we build momentum during the year. We continue to expect gross margin to be approximately 77%, which reflects a shift in product mix.
Accounting for the FX favorability in the first quarter, we expect gross margin for the first half of the year to be approximately 77%. Excluding the impact of acquired in-process R&D and our operating expense, guidance remains unchanged and expected decline in the low single-digit range, reflecting efficiency initiatives in MS&A as we continue to up invest in our launch brands. As I mentioned during the results for the quarter, we expect MS&A to increase in the second quarter as we continue to invest in our launches. The operating expenses are expected to be approximately $4.2 billion in the second quarter. Our tax guidance of 17% remains unchanged, and we continue to expect earnings per share to be in the range of $7.95 and $8.25. Before we move to Q&A, I just want to acknowledge the work of our colleagues across the globe for the relentless commitment and execution to transform this company into a younger and more diversified business.
I'll now turn the call back over to Tim and Giovanni for Q&A.
