FORM 6-K

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Report of Foreign Issuer

Pursuant to Rule 13a-16 or 15d-16 of

the Securities Exchange Act of 1934

For the month of February 2024

Commission File Number: 001-11960

AstraZeneca PLC

1 Francis Crick Avenue

Cambridge Biomedical Campus

Cambridge CB2 0AA

United Kingdom

Indicate by check mark whether the registrant files or will file annual reports under cover of Form 20-F or Form 40-F.

Form 20-F X Form 40-F __

Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(1):

Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(7): ______

Indicate by check mark whether the registrant by furnishing the information contained in this Form is also thereby furnishing the information to the Commission pursuant to Rule 12g3-2(b) under the Securities Exchange Act of 1934.

Yes __ No X

If “Yes” is marked, indicate below the file number assigned to the Registrant in connection with Rule 12g3-2(b): 82-_____________

AstraZeneca PLC

INDEX TO EXHIBITS

1. Final Results

AstraZeneca

8 February 2024

FY and Q4 2023 results

Strong growth and pipeline momentum with three new medicines approved since the third quarter

Revenue and EPS summary

		FY 2023			Q4 2023
		% Change			% Change
	$m	Actual	CER[1]	$m	Actual	CER
- Product Sales	43,789	2	4	11,323	5	5
- Alliance Revenue[2]	1,428	89	89	424	69	67
- Collaboration Revenue2	594	(1)	(1)	277	75	74
Total Revenue	45,811	3	6	12,024	7	8
Total Revenue ex COVID-19	45,488	13	15	12,036	16	16
Reported EPS	$3.84	81	96	$0.62	7	5
Core[3] EPS	$7.26	9	15	$1.45	5	7

Financial performance for full year 2023 (Growthnumbers at CER)

‒    Total Revenue $45,811m, up 6% despite a decline of $3,736m from COVID-19 medicines[4]

‒    Excluding COVID-19 medicines, Total Revenue increased 15% and Product Sales increased 14%

‒    Double-digit Total Revenue growth from Oncology 21%, CVRM 18%, R&I 10%, and Rare Disease 12%

‒    Core Product Sales Gross Margin[5] of 82%, up two percentage points, reflecting the decline in sales of lower margin COVID-19 medicines

‒    Core Operating Margin of 32% increased by two percentage points including the previously announced gain from an update to the contractual relationships for Beyfortus, totalling $712m and recorded as Core Other operating income. In the quarter, higher SG&A expense drove lower operating margins, partly due to phasing of expenses and increased investment in launches for Airsupra, Wainua and Truqap

‒    The Core Tax Rate for the year was 17%. In the fourth quarter, the tax rate was negatively impacted by reviews by tax authorities, administrative appeal processes and other adjustments, offset by a routine intragroup reorganisation of IP, leading to a tax rate of 10% in the quarter

‒    Core EPS increased 15% to $7.26

‒    Second interim dividend declared of $1.97 per share, making a total dividend declared for FY 2023 of $2.90 per share

‒    Total Revenue and Core EPS in FY 2024 are each expected to increase by a low double-digit to low teens percentage at CER

Pascal Soriot, Chief Executive Officer, AstraZeneca, said:

 "As AstraZeneca celebrates its 25th anniversary, we are pleased to report another year of strong financial performance and scientific progress, with double-digit earnings growth, and investment in exciting areas of science, including antibody drug conjugates and cell therapies, that lay the foundations for long-term success.

We expect another year of strong growth in 2024, driven by continued adoption of our medicines across geographies. Our differentiated and growing portfolio of approved medicines, global reach and rich R&D pipeline give us confidence that we will continue to deliver industry-leading growth."

Key milestones achieved since the prior results announcement

‒    Three first approvals for new molecular entities: Truqap (capivasertib), Wainua (eplontersen), Voydeya (danicopan)

‒    US approvals for Truqap plus Faslodex in HR-positive, HER2-negative advanced breast cancer with biomarker alterations (CAPItello-291), and Wainua for ATTRv-PN (NEURO-TTRansform). China approvals for Imfinzi in mBTC (TOPAZ-1) and Beyfortus for prevention of RSV in infants (MEDLEY/MELODY). First approval, in Japan, for Voydeya, as an add-on therapy to Ultomiris or Soliris for PNH with EVH (ALPHA)

‒   Enhertu granted Priority Review in the US for patients with metastatic HER2-positive solid tumours

Guidance

The Company issues its Total Revenue and Core EPS guidance for FY 2024 at CER, based on the average foreign exchange rates through 2023.

Total Revenue is expected to increase by a low double-digit to low teens percentage

Core EPS is expected to increase by a low double-digit to low teens percentage

‒    Collaboration Revenue is expected to increase substantially, driven by success-based milestones and certain anticipated transactions

‒    Other operating income is expected to decrease substantially (FY 2023 included a $241m gain on the disposal of Pulmicort Flexhaler US rights, and a $712m one-time gain relating to updates to contractual arrangements for Beyfortus)

‒    The Core Tax rate is expected to be between 18-22%

The Company is unable to provide guidance on a Reported basis because it cannot reliably forecast material elements of the Reported results, including any fair value adjustments arising on acquisition-related liabilities, intangible asset impairment charges and legal settlement provisions. Please refer to the cautionary statements section regarding forward-looking statements at the end of this announcement.

Currency impact

If foreign exchange rates for February 2024 to December 2024 were to remain at the average rates seen in January 2024, it is anticipated that both FY 2024 Total Revenue and Core EPS would incur a low single-digit adverse impact versus the performance at CER. The Company's foreign exchange rate sensitivity analysis is provided in Table 19.

Investor Day

AstraZeneca will host an Investor Day on 21 May 2024.

For more information, see www.astrazeneca.com/investor-relations.html .

Table1: Key elements of Total Revenue performance in Q4 2023

% Change 

Revenue type	$m	Actual %	CER %
Product Sales	11,323	5	5	∗ Excluding COVID-19 medicines, Q4 2023 Product Sales increased by 14%
Alliance Revenue	424	69	67	∗ $281m for Enhertu (Q4 2022: $188m) ∗ $80m for Tezspire (Q4 2022: $37m) ∗ $41m for Beyfortus (Q4 2022: $nil)
Collaboration Revenue	277	75	74	∗ $245m Lynparza regulatory milestone (Q4 2022: $105m) ∗ $27m Beyfortus sales milestone (Q4 2022: $nil)
Total Revenue	12,024	7	8	∗ Excluding COVID-19 medicines, Q4 2023 Total Revenue increased by 16%
Therapy areas	$m	Actual %	CER %
Oncology	4,989	23	24	∗ Strong performance across all key medicines and regions
CVRM	2,702	18	18	∗ Farxiga up 36% (35% at CER),Lokelma up 38%, roxadustat up 27%, Brilinta declined 5% (4% at CER)
R&I	1,675	13	13	∗ Fasenra up 10% (9% CER), Breztri up 72%. Saphnelo and Tezspire also continue to grow rapidly, partially offset by a 16% decline in Symbicort following entry of a generic competitor in the US in the third quarter
V&I	413	(64)	(66)	∗ $6m revenue from COVID-19 mAbs and -$17m for Vaxzevria, both resulting from historic contracts (Q4 2022: $734m and $95m respectively) ∗ Beyfortus $122m, including $41m of Alliance Revenue for AstraZeneca's share of gross profits outside US, $27m of Collaboration Revenue for a sales milestone and $54m of Product Sales from product supplied to Sanofi
Rare Disease	1,971	9	9	∗ Ultomiris up 39% (38% at CER), partially offset by decline in Soliris of 15% (13% at CER) ∗ Strensiq up 12% (13% at CER) and Koselugo up 46% (48% at CER) reflecting strong patient demand
Other Medicines	274	(33)	(32)	∗ Nexium generic competition in Japan
Total Revenue	12,024	7	8
Regions inc. COVID-19	$m	Actual %	CER %
US	5,101	7	6
Emerging Markets	2,783	2	8
- China	1,382	16	16
- Ex-China Emerging Markets	1,401	(9)	2
Europe	2,880	25	17
Established RoW	1,259	(9)	(6)
Total Revenue inc. COVID-19	12,024	7	8	∗ Growth rates impacted by lower sales ofCOVID---19 medicines (see table below)
Regions ex. COVID-19	$m	Actual %	CER %
US	5,101	12	12
Emerging Markets	2,791	15	22
- China	1,382	16	16
- Ex-China Emerging Markets	1,409	14	27
Europe	2,884	33	25
Established RoW	1,259	4	8
Total Revenue ex. COVID-19	12,036	16	16

Table2: Key elements of financial performance in Q4 2023

Metric	Reported	Reported change	Core	Corechange	Comments[6]
Total Revenue	$12,024m	7% Actual      8% CER	$12,024m	7% Actual      8% CER	∗ Excluding COVID-19 medicines, Q4 2023 Total Revenue increased by 16% ∗ See Table 1 and the Total Revenue section of this document for further details
Product Sales Gross Margin	80%	+6pp Actual      +6pp CER	80%	+3pp Actual      +2pp CER	+  In the prior year period, gross margins were reduced due to inventory write-downs and manufacturing contract terminations for Evusheld ∗ Variations in Product Sales Gross Margin can be expected between periods due to product seasonality, foreign exchange fluctuations and other effects
R&D expense	$3,073m	17% Actual      15% CER	$2,914m	15% Actual      14% CER	+  Increased investment in the pipeline ∗ Core R&D-to-Total Revenue ratio of 24%(Q4 2022: 23%) +  Quarterly phasing impact
SG&A expense	$5,371m	16% Actual      16% CER	$4,034m	13% Actual      12% CER	+  Market development for recent launches and pre-launch activities ∗ Core SG&A-to-Total Revenue ratio of 34%(Q4 2022: 32%) +  Quarterly phasing impact
Other operating income and expense[7]	$107m	-43% Actual      -42% CER	$107m	-17% Actual      -15% CER	‒   Discontinuation of brazikumab development
Operating Margin	10%	+1pp Actual      +1pp CER	23%	Stable	∗ See Product Sales Gross Margin, expenses and Other operating income and expense commentary above
Net finance expense	$337m	7% Actual      3% CER	$259m	5% Actual      1% CER	+  Higher rates on floating debt and bond issuances +  Increased Interest expense on income tax balances ‒   Higher interest received on cash and short-term investments
Tax rate	-7%	+9pp Actual      +13pp CER	10%	Stable	‒   Intragroup purchase of intellectual property +  Reviews by tax authorities, administrative appeals and changes to certain deferred tax balances ∗ Variations in the tax rate can be expected between periods
EPS	$0.62	7% Actual      5% CER	$1.45	5% Actual      7% CER	∗ Further details of differences between Reported and Core are shown in Table 14

Table3: Pipeline highlights since prior results announcement

Event	Medicine	Indication / Trial	Event
Regulatory approvals and other regulatory actions	Truqap	HR-positive HER2-negative advanced breast cancer with biomarker alterations (CAPItello-291)	Regulatory approval (US)
	Imfinzi	Biliary tract cancer (TOPAZ-1)	Regulatory approval (CN)
	Wainua	ATTRv-PN (NEURO-TTRansform)	Regulatory approval (US)
	Beyfortus	RSV (MELODY-MEDLEY)	Regulatory approval (CN)
	Voydeya	PNH with EVH (ALPHA)	Regulatory approval (JP)
Regulatory submissionsor acceptances*	Lynparza	gBRCA breast cancer (adjuvant) (OlympiA)	Regulatory submission (CN)
	Lynparza + Imfinzi	Endometrial cancer (1st-line) (DUO-E)	Regulatory submission (US, EU, JP)
	Enhertu	HER2-expressing tumours (DESTINY-PanTumor02, DESTINY-Lung01, DESTINY-CRC02)	Regulatory submission (US), Priority Review (US)
	Enhertu	HER2+/HER2-low gastric (1st-line) (DESTINY-Gastric01)	Regulatory submission (CN)
	Imfinzi + Imjudo	NSCLC (neoadjuvant) (AEGEAN)	Regulatory submission (EU)
	Wainua	ATTRv-PN (NEURO-TTRansform)	Regulatory submission (EU)
	Fasenra	EGPA (MANDARA)	Regulatory submission (US, EU, JP)
	Ultomiris	NMOSD (CHAMPION-NMOSD)	Regulatory submission (US)
	Ultomiris	gMG	Regulatory submission (CN)
Major Phase III data readouts and other developments	Imfinzi	NSCLC (unresectable, Stg. III) (PACIFIC-2)	Primary endpoint not met
	acoramidis [8]	ATTR-CM	Primary endpoint met

*US, EU and China regulatory submission denotes filing acceptance

Upcoming pipeline catalysts

For a table of anticipated timings of key trial readouts, please refer to page 3 of the Clinical Trials Appendix, available on www.astrazeneca.com/investor-relations.html.

Table4: Phase III trials started since 1 January 2023

Medicine	Trial name	Indication
datopotamab deruxtecan	AVANZAR	NSCLC (1st-line)
	TROPION-Lung07	Non-squamous NSCLC (1st-line)
	TROPION-Breast04	Neoadjuvant/adjuvant triple-negative or HR-low/HER2-negative breast cancer
	TROPION-Breast05	PD-L1-positive locally recurrent inoperable or metastatic TNBC
camizestrant	CAMBRIA-1	HR-positive/HER2-negative adjuvant breast cancer
	CAMBRIA-2	HR-positive/HER2-negative adjuvant breast cancer
Truqap	CAPItello-292	HR-positive/HER2-negative advanced breast cancer
volrustomig	eVOLVE-Cervical	High-risk locally advanced cervical cancer
	eVOLVE-Lung02	mNSCLC (1st-line) with PD-L1 <50%
	eVOLVE-Meso	Unresectable malignant pleural mesothelioma (1st-line)
	eVOLVE-HNSCC	Unresected, locally advanced HNSCC
rilvegostomig	ARTEMIDE-Biliary01	BTC with curative intent
saruparib	EvoPAR-PR01	HRRm and Non-HRRm mCSPC
zibo/dapa	ZENITH High Proteinuria	CKD with high proteinuria
Saphnelo	DAISY	Systemic sclerosis
baxdrostat	BaxHTN	Uncontrolled, including treatment-resistant, hypertension
Tezspire	CROSSING	Eosinophilic oesophagitis
Breztri	LITHOS	Mild to moderate asthma
	ATHLOS	COPD
pMDI portfolio	HFO1234ze + Breztri	COPD
	HFO1234ze	Mucociliary clearance in healthy volunteers
	HFO1234ze	Asthma
tozorakimab	MIRANDA	COPD
ipavibart (AZD3152)	SUPERNOVA	COVID-19 prophylaxis
Ultomiris	ARTEMIS	Cardiac surgery-associated acute kidney injury
ALXN2220	DepleTTR-CM	Transthyretin amyloid cardiomyopathy
efzimfotase alfa (ALXN1850)	HICKORY	Hypophosphatasia

Corporate and business development

In December 2023, AstraZeneca entered into a definitive agreement to acquire Icosavax, Inc (Icosavax). The acquisition strengthens AstraZeneca's late-stage pipeline with Icosavax's lead investigational vaccine candidate, IVX-A12, a potential first-in-class, Phase III-ready, combination VLP vaccine that targets both RSV and hMPV. RSV and hMPV are both leading causes of severe respiratory infection and hospitalisation in adults 60 years of age and older and those with chronic conditions such as cardiovascular, renal and respiratory disease. Subject to the satisfaction of the conditions in the merger agreement, the acquisition is expected to close in the first quarter of 2024.

In December 2023, AstraZeneca entered into a definitive agreement to acquire Gracell Biotechnologies Inc. (Gracell), a global clinical-stage biopharmaceutical company developing innovative cell therapies for the treatment of cancer and autoimmune diseases. The proposed acquisition will enrich AstraZeneca's growing pipeline of cell therapies with GC012F, a novel, clinical-stage FasTCAR-enabled BCMA and CD19 dual-targeting CAR-T therapy, a potential new treatment for multiple myeloma, as well as other haematologic malignancies and autoimmune diseases including systemic lupus erythematosus. The transaction is expected to close in the first quarter of 2024, subject to customary closing conditions, including regulatory clearances, and Gracell shareholder approval.

In February 2024, AstraZeneca announced that it is investing $300 million in a state-of-the-art facility in Rockville, Maryland to establish life-saving cell therapy platforms for critical cancer trials and future commercial supply. To align with clinical trial timelines, the site will initially focus on pivotal clinical trial manufacturing of CAR-T cell therapies to meet current clinical supply demand. More than 150 new highly skilled jobs will be created to initially focus on manufacturing T-cell therapies to enable clinical trials to be conducted around the world. Over time, the site may expand its focus to support other therapy areas.

Sustainability highlights

Through the Sustainable Markets Initiative Health Systems Task Force, AstraZeneca announced an industry-first renewable power agreement in China together with four global healthcare leaders and renewable energy company Envision Energy, resulting in potential annual emissions savings of approximately 120,000 tonnes, the equivalent of taking 25,000 cars off the road. See the Sustainability section in this document for further details.

Conference call

A conference call and webcast for investors and analysts will begin today, 8 February 2024, at 11:45 UK time. Details can be accessed via astrazeneca.com.

Reporting calendar

The Company intends to publish its Q1 2024 results on 25 April 2024.

Operating and financial review

All narrative on growth and results in this section is based on actual exchange rates, and financial figures are in US$ millions ($m), unless stated otherwise. Unless stated otherwise, the performance shown in this announcement covers the twelve-month period to 31 December 2023 ('the year' or 'FY 2023') compared to the twelve-month period to 31 December 2022 (FY 2022), or the three-month period to 31 December 2023 ('the quarter' or 'Q4 2023') compared to the three-month period to 31 December 2022 ('Q4 2022'). References to 'first quarter', 'second quarter', 'third quarter' and fourth quarter' refer to the respective quarters in FY 2023.

Core financial measures, EBITDA, Net debt, Product Sales Gross Margin (formerly termed as Gross Margin), Operating Margin and CER are non-GAAP financial measures because they cannot be derived directly from the Group's Condensed consolidated financial statements. Management believes that these non-GAAP financial measures, when provided in combination with Reported results, provide investors and analysts with helpful supplementary information to understand better the financial performance and position of the Group on a comparable basis from period to period. These non-GAAP financial measures are not a substitute for, or superior to, financial measures prepared in accordance with GAAP.

Core financial measures are adjusted to exclude certain significant items, such as:

‒    Charges and provisions related to restructuring programmes, which includes charges that relate to the impact of restructuring programmes on capitalised IT assets

‒    Amortisation and impairment of intangible assets, including impairment reversals but excluding any charges relating to IT assets

‒    Alexion acquisition-related items, primarily fair value adjustments on acquired inventories and fair value impact of replacement employee share awards

‒    Other specified items, principally the imputed finance charges and fair value movements relating to contingent consideration on business combinations, imputed finance charges and remeasurement adjustments on certain Other payables arising from intangible asset acquisitions, legal settlements and remeasurement adjustments relating to Other payables assumed from the Alexion acquisition

‒    The tax effects of the adjustments above are excluded from the Core Tax charge

Details on the nature of Core financial measures are provided on page 63 of the Annual Report and Form 20-F Information 2022.

Reference should be made to the Reconciliation of Reported to Core financial measures table included in the financial performance section in this announcement.

Product Sales Gross Margin (formerly termed Gross Margin) is calculated by dividing the difference between Product Sales and Cost of Sales by the Product Sales. The calculation of Reported and Core Product Sales Gross Margin excludes the impact of Alliance Revenue and Collaboration Revenue and any associated costs, thereby reflecting the underlying performance of Product Sales.

EBITDA is defined as Reported Profit before tax after adding back Net finance expense, results from Joint ventures and associates and charges for Depreciation, amortisation and impairment. Reference should be made to the Reconciliation of Reported Profit before tax to EBITDA included in the financial performance section in this announcement.

Operating margin is defined as Operating profit as a percentage of Total Revenue.

Net debt is defined as Interest-bearing loans and borrowings and Lease liabilities, net of Cash and cash equivalents, Other investments, and Net derivative financial instruments. Reference should be made to Note 3 'Net debt' included in the Notes to the Condensed consolidated financial statements in this announcement.

The Company strongly encourages investors and analysts not to rely on any single financial measure, but to review AstraZeneca's financial statements, including the Notes thereto, and other available Company reports, carefully and in their entirety.

Due to rounding, the sum of a number of dollar values and percentages in this announcement may not agree to totals.

Total Revenue

Table5: Therapy area and medicine performance - Product Sales and Total Revenue

	FY 2023				Q4 2023
			% Change				% Change
Product Sales	$m	% Total	Actual	CER	$m	% Total	Actual	CER
Oncology	17,145	37	17	20	4,453	37	19	19
- Tagrisso	5,799	13	7	9	1,419	12	6	6
- Imfinzi[9]	4,237	9	52	55	1,135	9	51	52
- Lynparza	2,811	6	7	9	741	6	8	8
- Calquence	2,514	5	22	23	675	6	15	14
- Enhertu	261	1	>3x	>3x	83	1	>2x	>3x
- Orpathys	44	-	34	42	11	-	n/m	n/m
- Truqap	6	-	n/m	n/m	6	-	n/m	n/m
- Zoladex	952	2	3	9	254	2	20	23
- Faslodex	297	1	(11)	(6)	79	1	7	7
- Others	224	-	(33)	(30)	50	-	(22)	(19)
BioPharmaceuticals: CVRM	10,585	23	15	18	2,698	22	18	18
- Farxiga	5,963	13	36	39	1,606	13	36	35
- Brilinta	1,324	3	(2)	(1)	329	3	(5)	(4)
- Lokelma	412	1	43	46	112	1	38	38
- roxadustat	271	1	38	45	63	1	28	28
- Andexxa	182	-	21	23	53	-	35	34
- Crestor	1,107	2	6	11	247	2	10	12
- Seloken/Toprol-XL	640	1	(26)	(20)	144	1	(8)	(3)
- Onglyza	227	-	(12)	(8)	47	-	(9)	(7)
- Bydureon	163	-	(42)	(42)	39	-	(46)	(47)
- Others	296	1	(19)	(17)	58	-	(30)	(31)
BioPharmaceuticals: R&I	6,107	13	6	8	1,590	13	10	10
- Symbicort	2,362	5	(7)	(4)	520	4	(16)	(16)
- Fasenra	1,553	3	11	12	420	3	10	9
- Breztri	677	1	70	73	199	2	72	72
- Saphnelo	280	1	>2x	>2x	89	1	86	86
- Tezspire	86	-	>10x	>10x	35	-	>9x	>8x
- Pulmicort	713	2	11	17	219	2	32	40
- Bevespi	58	-	-	-	15	-	6	4
- Daliresp/Daxas	54	-	(72)	(72)	13	-	(56)	(55)
- Others	324	1	(23)	(20)	80	1	13	14
BioPharmaceuticals: V&I	1,012	2	(79)	(78)	345	3	(69)	(70)
- COVID-19 mAbs	132	-	(94)	(93)	6	-	(99)	(99)
- Vaxzevria	12	-	(99)	(99)	(17)	-	n/m	n/m
- Beyfortus	106	-	n/m	n/m	54	-	n/m	n/m
- Synagis	546	1	(6)	(2)	164	1	(16)	(16)
- FluMist	216	-	24	17	138	1	20	11
Rare Disease	7,764	17	10	12	1,971	16	9	9
- Soliris	3,145	7	(16)	(14)	715	6	(15)	(13)
- Ultomiris	2,965	6	51	52	825	7	39	38
- Strensiq	1,152	3	20	21	305	3	12	13
- Koselugo	331	1	59	60	85	1	46	48
- Kanuma	171	-	7	8	41	-	(17)	(14)
Other medicines	1,176	3	(28)	(24)	266	2	(30)	(28)
- Nexium	945	2	(27)	(22)	209	2	(30)	(28)
- Others	231	1	(32)	(30)	57	-	(28)	(27)
Product Sales	43,789	96	2	4	11,323	94	5	5
Alliance Revenue	1,428	3	89	89	424	4	69	67
Collaboration Revenue	594	1	(1)	(1)	277	2	75	74
Total Revenue	45,811	100	3	6	12,024	100	7	8

Table 6: Alliance Revenue

	FY 2023				Q4 2023
			% Change				% Change
	$m	% Total	Actual	CER	$m	% Total	Actual	CER
Enhertu	1,022	72	95	95	281	66	50	47
Tezspire	259	18	>3x	>3x	80	19	>2x	>2x
Beyfortus	57	4	n/m	n/m	41	10	n/m	n/m
Vaxzevria: royalties	-	-	n/m	n/m	-	-	n/m	n/m
Other royalty income	81	6	18	18	21	5	25	27
Other Alliance Revenue	9	1	6	9	1	-	>3x	>3x
Total	1,428	100	89	89	424	100	69	67

Table 7: Collaboration Revenue

	FY 2023				Q4 2023
			% Change				% Change
	$m	% Total	Actual	CER	$m	% Total	Actual	CER
Lynparza: regulatory milestones	245	41	(31)	(31)	245	88	>2x	>2x
COVID-19 mAbs: licence fees	180	30	n/m	n/m	-	-	-	-
Farxiga: sales milestones	29	5	n/m	n/m	1	-	n/m	n/m
tralokinumab: sales milestones	20	3	(82)	(82)	-	-	-	-
Beyfortus: regulatory milestones	71	12	>2x	>2x	-	-	n/m	n/m
Beyfortus: sales milestone	27	5	n/m	n/m	27	10	n/m	n/m
Other Collaboration Revenue	22	4	(52)	(52)	4	1	(88)	(89)
Total	594	100	(1)	(1)	277	100	75	74

Table8: Total Revenue by therapy area

	FY 2023				Q4 2023
			% Change				% Change
	$m	% Total	Actual	CER	$m	% Total	Actual	CER
Oncology	18,447	40	19	21	4,989	41	23	24
BioPharmaceuticals	18,389	40	(8)	(6)	4,790	40	(3)	(3)
- CVRM	10,628	23	15	18	2,702	22	18	18
- R&I	6,404	14	7	10	1,675	14	13	13
- V&I	1,357	3	(72)	(71)	413	3	(64)	(66)
Rare Disease	7,764	17	10	12	1,971	16	9	9
Other Medicines	1,211	3	(31)	(27)	274	2	(33)	(32)
Total	45,811	100	3	6	12,024	100	7	8

Table9: Total Revenue by region

	FY 2023				Q4 2023
			% Change				% Change
	$m	% Total	Actual	CER	$m	% Total	Actual	CER
US	19,077	42	6	6	5,101	42	7	6
Emerging Markets	12,025	26	2	9	2,783	23	2	8
- China	5,876	13	1	7	1,382	11	16	16
- Ex-China	6,148	13	3	11	1,401	12	(9)	2
Europe	9,611	21	10	8	2,880	24	25	17
Established RoW	5,099	11	(14)	(8)	1,259	10	(9)	(6)
Total	45,811	100	3	6	12,024	100	7	8

Table10: Total Revenue by region - excluding COVID-19 medicines

	FY 2023				Q4 2023
			% Change				% Change
	$m	% Total	Actual	CER	$m	% Total	Actual	CER
US	19,077	42	14	14	5,101	42	12	12
Emerging Markets	11,830	26	12	20	2,791	23	15	22
- China	5,876	13	2	8	1,382	11	16	16
- Ex-China	5,953	13	24	35	1,409	12	14	27
Europe	9,597	21	19	17	2,884	24	33	25
Established RoW	4,985	11	1	8	1,259	10	4	8
Total	45,488	100	13	15	12,036	100	16	16

Oncology

Oncology Total Revenue of $18,447m in FY 2023 increased by 19% (21% at CER), representing 40% of overall Total Revenue (FY 2022: 35%). Lynparza Collaboration Revenue was $245m in FY 2023 (FY 2022: $355m) reflecting achievement of regulatory milestone for the US approval of PROpel and Enhertu Alliance Revenue was $1,022m (FY 2022: $523m). Product Sales increased by 17% (20% at CER) in FY 2023 to $17,145m, reflecting new launches and expanded reimbursement across key brands; partially offset by declines in legacy medicines.

Tagrisso

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	5,799	2,276	1,621	1,120	782
Actual change	7%	13%	3%	10%	(8%)
CER change	9%	13%	10%	8%	(1%)

Region	Drivers and commentary
Worldwide	∗ Increased global demand for Tagrisso in adjuvant (ADAURA) and 1st -line setting (FLAURA)
US	∗ Continued adjuvant and 1st-line demand growth
Emerging Markets	∗ Continued demand growth, partly offset by anticipated seasonality from hospital ordering dynamic in China
Europe	∗ Continued growth in 1st-line setting and increasing adjuvant demand
Established RoW	∗ Increased demand in adjuvant and 1st-line offset by continued impacts from HSR price reduction in Japan effective June 2023 and reclassification of Australian government rebates from Q4 2023

Imfinzi and Imjudo

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	4,237	2,317	360	758	802
Actual change	52%	49%	25%	39%	>2x
CER change	55%	49%	39%	36%	>2x

Region	Drivers and commentary
Worldwide	∗ Includes $218m of Total Revenue from Imjudo, which launched in Q4 2022 following approvals in the US for patients with unresectable HCC (HIMALAYA) and Stage IV NSCLC (POSEIDON)
US	∗ Continued demand growth from new launches in GI, including BTC (TOPAZ-1) and HCC
Emerging Markets	∗ Increased demand for new launches including BTC as well as continued demand for legacy indications: Stage III unresectable NSCLC (PACIFIC), SCLC (CASPIAN)
Europe	∗ Competitive share gain in SCLC and expanded reimbursement for BTC, HCC, Stage IV NSCLC and SCLC
Established RoW	∗ Growth driven by launch of BTC, HCC and Stage IV NSCLC in Japan

Lynparza

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	3,056	1,254	542	979	281
Actual change	2%	2%	11%	(3%)	5%
CER change	4%	2%	21%	(4%)	12%

Product Sales	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	2,811	1,254	542	734	281
Actual change	7%	2%	11%	12%	5%
CER change	9%	2%	21%	10%	12%

Region	Drivers and commentary
Worldwide	∗ Lynparza remains the leading medicine in the PARP inhibitor class globally across four tumour types (ovarian, breast, prostate, pancreatic), as measured by total prescription volume ∗ Following achievement of the regulatory approval for Lynparza PROpel in the US, AstraZeneca recognised $245m in milestone-related income from MSD in Q4 2023
US	∗ Continued share growth within PARP inhibitor class, offset by declining class use following the label restriction in 2nd-line ovarian cancer effective September 2023
Emerging Markets	∗ Increased demand, offset by price reduction in China associated with NRDL renewal that took effect March 2023 for ovarian cancer indications (PSR and BRCAm 1st-line maintenance) and new NRDL enlistment in prostate cancer (PROfound)
Europe	∗ Demand growth from increased uptake and new launches in 1st-line HRD-positive ovarian cancer (PAOLA-1), gBRCAm HER2-negative early breast cancer (OlympiA) and mCRPC (PROpel), offset by reduced use in 2nd-line ovarian cancer and pricing
Established RoW	∗ Growth driven by increased uptake in biomarker testing and use in 1st-line HRD-positive ovarian cancer, partially offset by market expansion re-pricing in Japan from November 2023

Enhertu

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	1,283	702	254	296	32
Actual change	>2x	73%	>3x	>2x	>4x
CER change	>2x	73%	>3x	>2x	>4x

Region	Drivers and commentary
Worldwide	∗ Combined sales of Enhertu, recorded by Daiichi Sankyo Company Limited (Daiichi Sankyo) and AstraZeneca, amounted to $2,566m in FY 2023 (FY 2022: $1,253m) ∗ AstraZeneca's Total Revenue of $1,283m in the period includes $1,022m of Alliance Revenue from its share of gross profits and royalties in territories where Daiichi Sankyo records product sales
US	∗ US in-market sales, recorded by Daiichi Sankyo, amounted to $1,472m in FY 2023 (FY 2022: $850m) ∗ Increased demand across launched indications offset by HER2-low bolus depletion in H2 2023
Emerging Markets	∗ Continued uptake driven by approvals and launches including strong demand growth in China following HER2-positive (DESTINY-Breast03) and HER2-low (DESTINY-Breast04) metastatic breast cancer launches
Europe	∗ Continued growth driven by increasing adoption in HER2-positive and HER2-low metastatic breast cancer
Established RoW	∗ AstraZeneca's Alliance Revenue includes a mid-single-digit percentage royalty on Daiichi Sankyo's sales in Japan

Calquence

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	2,514	1,815	98	493	108
Actual change	22%	10%	>2x	72%	58%
CER change	23%	10%	>2x	69%	65%

Region	Drivers and commentary
Worldwide	∗ Increased penetration globally; leading BTK inhibitor across key markets
US	∗ Sustained BTK inhibitor leadership across front-line and relapsed refractory CLL, partly offset by continued gross-to-net pressure within competitive class
Europe	∗ Continued growth supported by expanded access in key markets

Truqap

Truqap was approved in the US on 16 November 2023 in HR-positive HER2-negative metastatic breast cancer with one or more biomarker alterations (CAPItello-291) and regulatory submissions in other markets are ongoing. Strong initial launch demand resulted in $6m of Total Revenue in Q4 2023.

Other Oncology medicines

FY 2023 Change

Total Revenue	$m	Actual	CER
Zoladex	986	3%	9%	∗ Strong underlying growth in China and Emerging Markets offset by flat performance in EU and drop in Japan ∗ Australian government rebate reclassifications from Q4 2023
Faslodex	297	(11%)	(6%)	∗ Decline in China sales in fourth quarter due to supply issues, a consequence of short lead time of supply replenishment following VBP timeline changes
Orpathys	46	37%	44%	∗ Included in the NRDL in China from March 2023, for the treatment of patients with NSCLC with MET exon 14 skipping alterations
Other Oncology	224	(33%)	(30%)	∗ Generic competition

BioPharmaceuticals

BioPharmaceuticals Total Revenue decreased by 8% (6% at CER) in FY 2023 to $18,389m, representing 40% of overall Total Revenue (FY 2022: 45%). The decline was driven by COVID-19 medicines, partially offset by strong growth from Farxiga and R&I medicines.

BioPharmaceuticals - CVRM

CVRM Total Revenue increased by 15% (18% at CER) to $10,628m in FY 2023 and represented 23% of overall Total Revenue (FY 2022: 21%).

Farxiga

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	5,997	1,451	2,214	1,881	451
Actual change	37%	35%	33%	45%	28%
CER change	39%	35%	40%	42%	37%

Region	Drivers and commentary
Worldwide	∗ Farxiga volume is growing faster than the overall SGLT2 market in most major regions, fuelled by launches in heart failure and CKD ∗ Additional benefit from continued growth in the overall SGLT2 inhibitor class
US	∗ Growth driven by heart failure and CKD for patients with and without type 2 diabetes resulting in an increased market share. Favourable gross-to-net adjustment in Q4 2023
Emerging Markets	∗ Solid growth despite generic competition in some markets and strong momentum in Latin America, among other markets
Europe	∗ Benefited from the addition of cardiovascular outcomes trial data to the label and growth in HFrEF, CKD and the HFpEF approval in February 2023 ∗ ESC guidelines updated in August 2023 to also include treatment of patients with HFpEF
Established RoW	∗ In Japan, AstraZeneca sells to collaborator Ono Pharmaceutical Co., Ltd, which records in-market sales ∗ Continued volume growth driven by HF and CKD launches, largely offset by generic launches in Canada in Q3 2023

Brilinta

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	1,324	744	285	271	24
Actual change	(2%)	-	-	(4%)	(49%)
CER change	(1%)	-	10%	(5%)	(47%)

Region	Drivers and commentary
US	∗ Flat sales but with volume growth driven by longer duration of treatment
Emerging Markets	∗ Holding market position despite generics pressure
Europe	∗ Sales partly impacted by clawbacks
Established RoW	∗ Sales decline driven by generic entry in Canada

Lokelma

Lokelma Total Revenue increased 43% (46% at CER) to $412m with strong demand growth in all regions.

Roxadustat

Total Revenue increased 37% (44% at CER) to $276m, benefitting from increased demand in both the dialysis and non-dialysis-dependent populations. NRDL listing renewed.

Andexxa

AndexxaTotal Revenue increased 14% (15% at CER) to $182m.

Other CVRM medicines

FY 2023 Change

Total Revenue	$m	Actual	CER
Crestor	1,110	6%	12%	∗ Continued sales growth in Emerging Markets
Seloken/Toprol-XL	641	(26%)	(20%)	∗ Ongoing impact of China VBP implementation
Onglyza	227	(12%)	(8%)	∗ Continued decline for DPP-IV class
Bydureon	163	(42%)	(42%)	∗ Continued competitive pressures
Other CVRM	296	(19%)	(17%)

BioPharmaceuticals - R&I

Total Revenue of $6,404m from R&I medicines in FY 2023 increased 7% (10% at CER) and represented 14% of overall Total Revenue (FY 2022: 13%). This reflected growth in Fasenra, Tezspire, Breztri and Saphnelo, offsetting a decline in Symbicort.

Fasenra

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	1,553	992	64	355	142
Actual change	11%	9%	50%	16%	-
CER change	12%	9%	61%	14%	6%

Region	Drivers and commentary
Worldwide	∗ Continued asthma market share leadership in IL-5 class across major markets
US	∗ Maintained share of a growing market, leading to strong volume growth
Emerging Markets	∗ Continued strong demand growth driven by launch acceleration across key markets
Europe	∗ Expanded leadership in severe eosinophilic asthma
Established RoW	∗ Continued class leadership in Japan

Breztri

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	677	383	161	81	52
Actual change	70%	60%	75%	>2x	55%
CER change	73%	60%	85%	>2x	66%

Region	Drivers and commentary
Worldwide	∗ Fastest growing medicine within the growing FDC triple class across major markets
US	∗ Consistent share growth within the FDC triple class in new-to-brand[10]and the total market
Emerging Markets	∗ Maintained market share leadership in China with strong triple FDC class penetration
Europe	∗ Sustained growth across markets as new launches continue to progress
Established RoW	∗ Increased market share within COPD in Japan and strong launch in Canada

Tezspire

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	345	261	1	46	37
Actual change	>4x	>3x	>6x	>10x	>10x
CER change	>4x	>3x	>5x	>10x	>10x

Region	Drivers and commentary
Worldwide	∗ Combined sales of Tezspire, recorded by Amgen and AstraZeneca, amounted to $653m in FY 2023 (FY 2022: $174m) ∗ AstraZeneca's Total Revenue of $345m in the period includes $259m of Alliance Revenue from its share of gross profits in the US, where Amgen records product sales
US	∗ Maintained new-to-brand market share with majority of patients new to biologics ∗ Pre-filled pen approved in February 2023
Europe	∗ Achieved new-to-brand leadership in key markets ∗ Pre-filled pen approved in January 2023
Established RoW	∗ Japan maintained new-to-brand leadership

Saphnelo

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	280	260	2	8	10
Actual change	>2x	>2x	n/m	>4x	>2x
CER change	>2x	>2x	n/m	>4x	>3x

Region	Drivers and commentary
Worldwide	∗ Demand acceleration in the US, and additional growth driven by ongoing launches in Europe and Japan

Symbicort

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	2,362	726	753	549	334
Actual change	(7%)	(25%)	24%	(6%)	(11%)
CER change	(4%)	(25%)	33%	(7%)	(7%)

Region	Drivers and commentary
Worldwide	∗ Symbicort remained the global market leader within a stable ICS/LABA class
US	∗ Generic competition entered the US market in the third quarter of 2023
Emerging Markets	∗ Strong underlying demand for Symbicort in both China and Ex-China Emerging Markets, strengthened position as market leader in the region
Europe	∗ Continued price and volume erosion from generics and a slowing overall market
Established RoW	∗ Continued generic erosion in Japan

Other R&I medicines

FY 2023    Change

Total Revenue	$m	Actual	CER
Pulmicort	713	11%	17%	∗ >80% of revenues from Emerging Markets ∗ China market share has stabilised, with VBP having been in effect for over 12 months
Bevespi	58	-	-
Daliresp/Daxas	54	(72%)	(72%)	∗ Impacted by uptake of multiple generics following loss of exclusivity in the US
Other R&I	362	(33%)	(30%)	∗ Collaboration Revenue of $20m (FY 2022: $110m) ∗ Product Sales of $324m decreased 23% (20% at CER) due to generic competition

BioPharmaceuticals - V&I

Total Revenue from V&I medicines declined by 72% (71% at CER) to $1,357m (FY 2022: $4,836m) and represented 3% of overall Total Revenue (FY 2022: 11%). The decline was driven by COVID-19 medicines, which generated $323m of Total Revenue in FY 2023 (FY 2022: $4,059m).

COVID-19 mAbs

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	312	-	186	12	114
Actual change	(86%)	n/m	(55%)	(96%)	(72%)
CER change	(85%)	n/m	(55%)	(96%)	(68%)

Region	Drivers and commentary
Worldwide	∗ All Product Sales in FY 2023 were derived from sales of Evusheld
Emerging Markets	∗ $180m license fee from Serum Institute of India in Q2 2023 recorded as Collaboration Revenue

Vaxzevria

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	11	-	10	2	-
Actual change	(99%)	n/m	(99%)	n/m	n/m
CER change	(99%)	n/m	(99%)	(99%)	n/m

Other V&I medicines

FY 2023 Change

Total Revenue	$m	Actual	CER
Beyfortus	262	>10x	>10x	∗ In Q4 2023 AstraZeneca reported $54m of Product Sales, $41m of Alliance Revenue, and also $27m of Collaboration Revenue relating to a sales milestone ∗ Product Sales recognises AstraZeneca's sales of manufactured Beyfortus product to Sanofi ∗ Alliance Revenue recognises AstraZeneca's 50% share of gross profits on sales of Beyfortus in major markets outside the US ∗ AstraZeneca will recognise 25% of brand revenues in rest of world markets ∗ AstraZeneca has no participation in US profits or losses
Synagis	546	(6%)	(2%)	∗ Performance broadly in-line with prior year
FluMist	226	30%	22%	∗ $10m milestone received from Daiichi Sankyo in the second quarter of 2023 following FluMist approval in Japan

Rare Disease

Total Revenue from Rare Disease medicines increased by 10% (12% at CER) in FY 2023 to $7,764m, representing 17% of overall Total Revenue (FY 2022: 16%).

Ultomiris

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	2,965	1,750	71	668	476
Actual change	51%	54%	88%	39%	54%
CER change	52%	54%	89%	36%	65%

Region	Drivers and commentary
Worldwide	∗ Continued growth across gMG as well as expansion into new markets and continued conversion from Soliris ∗ Quarter-on-quarter variability in revenue growth can be expected due to Ultomiris every eight-week dosing schedule and lower average annual treatment cost compared to Soliris
US	∗ Growth in naïve patients in gMG as well as successful conversion from Soliris across shared indications
Emerging Markets	∗ Continued growth following launches in new markets
Europe	∗ Strong demand generation following launches in new markets, particularly in neurology indications, as well as accelerated conversion from Soliris in key markets, partially offset by  price reductions to secure reimbursement for new indications
Established RoW	∗ Continued conversion from Soliris and strong demand following new launches

Soliris

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	3,145	1,734	424	670	317
Actual change	(16%)	(20%)	41%	(17%)	(33%)
CER change	(14%)	(20%)	63%	(18%)	(29%)

Region	Drivers and commentary
US	∗ Decline driven by successful conversion of Soliris patients to Ultomiris in PNH, aHUS and gMG, partially offset by Soliris growth in NMOSD
Emerging Markets	∗ Growth driven by patient demand following launches in new markets
Europe	∗ Decline driven by successful conversion from Soliris to Ultomiris as well as biosimilar erosion in PNH
Est. RoW	∗ Decline driven by successful conversion from Soliris to Ultomiris

Strensiq

Total Revenue	Worldwide	US	Emerging Markets	Europe	Established RoW
FY 2023  $m	1,152	937	40	89	86
Actual change	20%	22%	15%	14%	13%
CER change	21%	22%	22%	11%	22%

Region	Drivers and commentary
Worldwide	∗ Growth driven by strong patient demand

Other Rare Disease medicines

FY 2023 Change

Total Revenue	$m	Actual	CER	Commentary
Koselugo	331	59%	60%	∗ Driven by patient demand and expansion in new markets
Kanuma	171	7%	8%	∗ Continued demand growth in ex-US markets

Other medicines (outside the main therapy areas)

FY 2023 Change

Total Revenue	$m	Actual	CER	Commentary
Nexium	962	(30%)	(26%)	∗ Generic launches in Japan in the latter part of 2022
Others	249	(35%)	(33%)	∗ Continued impact of generic competition

Financial performance

Table11: Reported Profit and Loss

FY 2023 FY 2022 % Change  Q4 2023 Q4 2022 % Change

	$m	$m	Actual	CER	$m	$m	Actual	CER
Total Revenue	45,811	44,351	3	6	12,024	11,207	7	8
- Product Sales	43,789	42,998	2	4	11,323	10,798	5	5
- Alliance Revenue	1,428	755	89	89	424	251	69	67
- Collaboration Revenue	594	598	(1)	(1)	277	158	75	74
Cost of sales	(8,268)	(12,391)	(33)	(34)	(2,308)	(2,900)	(20)	(18)
Gross profit	37,543	31,960	17	21	9,716	8,307	17	16
Product Sales Gross Margin	81.1%	71.2%	+10pp	+10pp	79.6%	73.1%	+6pp	+6pp
Distribution expense	(539)	(536)	1	2	(145)	(156)	(7)	(8)
% Total Revenue	1.2%	1.2%	-	-	1.2%	1.4%	-	-
R&D expense	(10,935)	(9,762)	12	13	(3,073)	(2,625)	17	15
% Total Revenue	23.9%	22.0%	-2pp	-2pp	25.6%	23.4%	-2pp	-2pp
SG&A expense	(19,216)	(18,419)	4	6	(5,371)	(4,621)	16	16
% Total Revenue	41.9%	41.5%	-	-	44.7%	41.2%	-3pp	-3pp
Other operating income & expense	1,340	514	>2x	>2x	107	189	(43)	(42)
% Total Revenue	2.9%	1.2%	+2pp	+2pp	0.9%	1.7%	-1pp	-1pp
Operating profit	8,193	3,757	>2x	>2x	1,234	1,094	13	14
Operating Margin	17.9%	8.5%	+9pp	+10pp	10.3%	9.8%	+1pp	+1pp
Net finance expense	(1,282)	(1,251)	2	1	(337)	(315)	7	3
Joint ventures and associates	(12)	(5)	>2x	>2x	-	(1)	(99)	(99)
Profit before tax	6,899	2,501	>2x	>2x	897	778	15	18
Taxation	(938)	792	n/m	n/m	62	124	(51)	(67)
Tax rate	14%	-32%			-7%	-16%
Profit after tax	5,961	3,293	81	96	959	902	6	4
Earnings per share	$3.84	$2.12	81	96	$0.62	$0.58	7	5

Table12: Reconciliation of Reported Profit before tax to EBITDA

FY 2023 FY 2022 % Change Q4 2023 Q4 2022 % Change

	$m	$m	Actual	CER	$m	$m	Actual	CER
Reported Profit before tax	6,899	2,501	>2x	>2x	897	778	15	18
Net finance expense	1,282	1,251	2	1	337	315	7	3
Joint ventures and associates	12	5	>2x	>2x	-	1	(99)	(99)
Depreciation, amortisation and impairment	5,387	5,480	(2)	(1)	1,327	1,480	(10)	(11)
EBITDA	13,580	9,237	47	55	2,561	2,574	(1)	-

EBITDA for the comparative FY 2022 was negatively impacted by $3,484m unwind of inventory fair value recognised on the acquisition of Alexion. EBITDA for the comparative Q4 2022 was negatively impacted by $309m unwind of inventory fair value uplift recognised on the acquisition of Alexion. This unwind had a $114m negative impact on EBITDA in FY 2023 and a $36m negative impact on EBITDA in Q4 2023.

Table13: Reconciliation of Reported to Core financial measures: FY 2023

FY 2023 Reported Restructuring Intangible Asset Amortisation & Impairments Acquisitionof Alexion Other[11] Core Core % Change

	$m	$m	$m	$m	$m	$m	Actual	CER
Gross profit	37,543	109	32	119	(3)	37,800	6	9
Product Sales Gross Margin	81.1%					81.7%	+2pp	+2pp
Distribution expense	(539)	-	-	-	-	(539)	1	2
R&D expense	(10,935)	212	447	7	2	(10,267)	8	9
SG&A expense	(19,216)	207	3,801	11	1,458	(13,739)	7	9
Total operating expense	(30,690)	419	4,248	18	1,460	(24,545)	7	9
Other operating income & expense	1,340	(61)	-	-	-	1,279	>2x	>2x
Operating profit	8,193	467	4,280	137	1,457	14,534	9	14
Operating Margin	17.9%					31.7%	+2pp	+2pp
Net finance expense	(1,282)	-	-	-	298	(984)	1	(1)
Taxation	(938)	(107)	(809)	(32)	(405)	(2,291)	11	17
EPS	$3.84	$0.23	$2.24	$0.07	$0.88	$7.26	9	15

Table14: Reconciliation of Reported to Core financial measures: Q4 2023

Q4 2023 Reported Restructuring Intangible Asset Amortisation & Impairments Acquisitionof Alexion Other Core Core % Change

	$m	$m	$m	$m	$m	$m	Actual	CER
Gross profit	9,716	(24)	8	37	1	9,738	11	11
Product Sales Gross Margin	79.6%					79.8%	+3pp	+2pp
Distribution expense	(145)	-	-	-	-	(145)	(7)	(9)
R&D expense	(3,073)	95	61	2	1	(2,914)	15	14
SG&A expense	(5,371)	44	938	4	351	(4,034)	13	12
Total operating expense	(8,589)	139	999	6	352	(7,093)	13	12
Other operating income & expense	107	-	-	-	-	107	(17)	(15)
Operating profit	1,234	115	1,007	43	353	2,752	5	6
Operating Margin	10.3%					22.9%	-	-
Net finance expense	(337)	-	-	-	78	(259)	5	1
Taxation	62	(26)	(192)	(10)	(76)	(242)	7	4
EPS	$0.62	$0.06	$0.53	$0.02	$0.22	$1.45	5	7

Profit and Loss drivers

Gross profit

‒    The calculation of Reported and Core Product Sales Gross Margin excludes the impact of Alliance Revenue and Collaboration Revenue

‒    The change in Product Sales Gross Margin (Reported and Core) in FY 2023 was impacted by:

‒    Positive effects from product mix. The increased contribution from Rare Disease and Oncology medicines had a positive impact on the Product Sales Gross Margin. Sales of Vaxzevria and Evusheld, which were dilutive to Product Sales Gross Margin in 2022, declined substantially in 2023

‒    Dilutive effects from product mix. The rising contribution of Product Sales with profit sharing arrangements (Lynparza, Enhertu, Tezspire, Koselugo) has a negative impact on Product Sales Gross Margin because AstraZeneca records product revenues in certain markets and pays away a share of the gross profits to its collaboration partners. The growth in Beyfortus also has a dilutive impact on Product Sales Gross Margin, as AstraZeneca is responsible for manufacturing and records its sales of goods to Sanofi as Product Sales - these sales generate a much lower gross margin than the Company average

‒    Dilutive effects from geographic mix. Emerging Markets, where Product Sales Gross Margin tends to be below the Company average, grew as a proportion of Total Revenue excluding COVID-19 medicines

‒    In FY 2022, the Reported Product Sales Gross Margin was impacted by $3,484m from the unwind of the inventory fair value uplift recognised on the acquisition of Alexion. In FY 2023, this effect had reduced to $114m

‒    Variations in Product Sales Gross Margin performance between periods can continue to be expected due to product seasonality, foreign exchange fluctuations, and other effects

R&D expense

‒    The change in R&D expense (Reported and Core) in the period was impacted by:

‒    Recent positive data read-outs for several high priority medicines that have ungated late-stage trials

‒    Investment in platforms, new technology and capabilities to enhance R&D productivity

‒    Reported R&D expense was also impacted by intangible asset impairments

SG&A expense

‒    The change in SG&A expense (Reported and Core) in the period was driven primarily by market development activities for launches

‒    Reported SG&A expense was also impacted by amortisation of intangible assets related to the Alexion acquisition and other acquisitions and collaborations

‒    Reported SG&A expense was also impacted by a $510m charge to provisions relating to a legal settlement with Bristol-Myers Squibb and Ono Pharmaceutical, and a $425m charge to provisions for product liability litigations related to Nexium and Prilosec. The prior year was impacted by a $775m legal settlement with Chugai Pharmaceutical Co. Ltd

Other operating income and expense

‒    Reported and Core Other operating income and expense in the year included a $712m gain resulting from an update to the contractual relationships for Beyfortus (nirsevimab), a $241m gain on the disposal of the US rights to PulmicortFlexhaler, and other disposal proceeds on the sale of tangible assets, and royalties on certain medicines

Net finance expense

‒    Reported Net finance expense was impacted by the discount unwind on acquisition-related liabilities. Core Net finance expense increased 2% (1% at CER) with higher interest received on cash and short-term investments, higher rates on floating debt and bond issuances, partially offset by higher rates on floating debt and bond issuances

Taxation

‒    The effective Reported Tax rate for the twelve months to 31 December 2023 was 14% (FY 2022: -32%) and the effective Core Tax rate was 17% (FY 2022: 17%); both included a favourable adjustment of $828m to deferred taxes arising from a UK group company undertaking a routine intragroup purchase of certain intellectual property which was offset by updates to tax liabilities following progress of reviews by tax authorities and administrative appeal processes and changes to certain deferred tax balances

‒    The FY 2022 effective Reported Tax rate was lower as it included a favourable adjustment of $883m relating to deferred taxes arising from an internal reorganisation to integrate the Alexion business

‒    The cash tax paid for the twelve months to 31 December 2023 was $2,366m (FY 2022: $1,623m), representing 34% of Reported Profit before tax (FY 2022: 65%)

‒    On 11 July 2023, Finance (No.2) Act 2023 was enacted in the UK, introducing a global minimum effective tax rate of 15%. The legislation implements a domestic top-up tax and a multinational top-up tax, effective for accounting periods starting on or after 31 December 2023. AstraZeneca is continuing to monitor potential impacts as further guidance is published by the OECD and territories implement legislation to enact the rules. Management has performed an assessment of the impact of the UK's Pillar 2 rules based on our 2023 data and no Pillar 2 Income Taxes are expected to arise for most jurisdictions in which the Group operates. It is anticipated that AstraZeneca may, in some jurisdictions, incur additional tax liabilities, but the effect on the Reported Tax rate is reasonably estimated to be immaterial

Dividends

‒    A second interim dividend of $1.97 per share (156.0 pence, 20.65 SEK) has been declared, resulting in a full-year dividend per share of $2.90 (227.8 pence, 30.29 SEK)

‒    Dividend payments are normally paid as follows:

‒    First interim dividend - announced with half-year and second-quarter results and paid in September

‒    Second interim dividend - announced with full-year and fourth-quarter results and paid in March

‒    Provisional dates for the 2023 second interim dividend: ex-dividend 22 February 2024, record date 23 February 2024, payable on 25 March 2024.

Table15: Cash Flow summary

	FY 2023	FY 2022	Change
	$m	$m	$m
Reported Operating profit	8,193	3,757	4,436
Depreciation, amortisation and impairment	5,387	5,480	(93)
Decrease in working capital and short-term provisions	300	3,757	(3,457)
Gains on disposal of intangible assets	(251)	(104)	(147)
Fair value movements on contingent consideration arising from business combinations	549	82	467
Non-cash and other movements	(386)	(692)	306
Interest paid	(1,081)	(849)	(232)
Taxation paid	(2,366)	(1,623)	(743)
Net cash inflow from operating activities	10,345	9,808	537
Net cash inflow before financing activities	6,281	6,848	(567)
Net cash outflow from financing activities	(6,567)	(6,823)	256

In FY 2022, the Reported Operating profit of $3,757m included a negative impact of $3,484m relating to the unwind of the inventory fair value uplift recognised on the acquisition of Alexion. This was offset by a corresponding item (positive impact of $3,484m) in Decrease in working capital and short-term provisions. Overall, the unwind of the fair value uplift had no impact on Net cash inflow from operating activities. This unwind had $114m negative impact on FY 2023 Reported Operating profit and offsetting positive impact on working capital movements. As a result of the update to the contractual relationships between AstraZeneca, Swedish Orphan Biovitrum AB (Sobi) and Sanofi relating to the future sales of Beyfortus (nirsevimab) in the US, a gain of $712m has been recorded in Non-cash and other movements, with no overall net impact on the Net cash inflow from operating activities.

Included within Net cash inflow before financing activities is a Movement in the profit-participation liability of $190m, including a cash receipt from Sobi in Q1 2023 after achievement of a regulatory milestone. The associated cash flow is presented within investing activities.

The decrease in Net cash outflow from financing activities of $256m is primarily driven by the increase in Issue of loans and borrowings of $3,816m, offset by the increase in Repayment of loans and borrowings of $3,671m.

Capital expenditure

Capital expenditure amounted to $1,361m in the twelve months to 31 December 2023 (FY 2022: $1,091m).

Capital expenditure is expected to increase substantially in 2024, driven by investment in several major manufacturing projects and continued investment in technology upgrades.

Table16: Net debt summary

	At 31   Dec 2023	At 31  Dec 2022
	$m	$m
Cash and cash equivalents	5,840	6,166
Other investments	122	239
Cash and investments	5,962	6,405
Overdrafts and short-term borrowings	(515)	(350)
Lease liabilities	(1,128)	(953)
Current instalments of loans	(4,614)	(4,964)
Non-current instalments of loans	(22,365)	(22,965)
Interest-bearing loans and borrowings (Gross debt)	(28,622)	(29,232)
Net derivatives	150	(96)
Net debt	(22,510)	(22,923)

Net debt decreased by $413m in the twelve months to 31 December 2023 to $22,510m. Details of the committed undrawn bank facilities are disclosed within the going concern section of Note 1. Details of the Company's solicited credit ratings and further details on Net debt are disclosed in Note 3.

Capital allocation

The Board's aim is to continue to strike a balance between the interests of the business, financial creditors and the Company's shareholders. The Company's capital allocation priorities include: investing in the business and pipeline; maintaining a strong, investment-grade credit rating; potential value-enhancing business development opportunities; and supporting the progressive dividend policy.

In approving the declaration of dividends, the Board considers both the liquidity of the company and the level of reserves legally available for distribution. Dividends are paid to shareholders from AstraZeneca PLC, a Group holding company with no direct operations. The ability of AstraZeneca PLC to make shareholder distributions is dependent on the creation of profits for distribution and the receipt of funds from subsidiary companies. The consolidated Group reserves set out in the Condensed consolidated statement of financial position do not reflect the profit available for distribution to the shareholders of AstraZeneca PLC.

Summarised financial information for guarantee of securities of subsidiaries

AstraZeneca Finance LLC ("AstraZeneca Finance") is the issuer of 0.700% Notes due 2024, 1.200% Notes due 2026, 4.875% Notes due 2028, 1.750% Notes due 2028, 4.900% Notes due 2030, 2.250% Notes due 2031 and 4.875% Notes due 2033 (the "AstraZeneca Finance Notes"). Each series of AstraZeneca Finance Notes has been fully and unconditionally guaranteed by AstraZeneca PLC. AstraZeneca Finance is 100% owned by AstraZeneca PLC and each of the guarantees issued by AstraZeneca PLC is full and unconditional and joint and several.

The AstraZeneca Finance Notes are senior unsecured obligations of AstraZeneca Finance and rank equally with all of AstraZeneca Finance's existing and future senior unsecured and unsubordinated indebtedness. The guarantee by AstraZeneca PLC of the AstraZeneca Finance Notes is the senior unsecured obligation of AstraZeneca PLC and ranks equally with all of AstraZeneca PLC's existing and future senior unsecured and unsubordinated indebtedness. Each guarantee by AstraZeneca PLC is effectively subordinated to any secured indebtedness of AstraZeneca PLC to the extent of the value of the assets securing such indebtedness. The AstraZeneca Finance Notes are structurally subordinated to indebtedness and other liabilities of the subsidiaries of AstraZeneca PLC, none of which guarantee the AstraZeneca Finance Notes.

AstraZeneca PLC manages substantially all of its operations through divisions, branches and/or investments in subsidiaries and affiliates. Accordingly, the ability of AstraZeneca PLC to service its debt and guarantee obligations is also dependent upon the earnings of its subsidiaries, affiliates, branches and divisions, whether by dividends, distributions, loans or otherwise.

Please refer to the Consolidated financial statements of AstraZeneca PLC in our Annual Report on Form 20-F and reports on Form 6-K with our quarterly financial results as filed or furnished with the SEC for further financial information regarding AstraZeneca PLC and its consolidated subsidiaries. For further details, terms and conditions of the AstraZeneca Finance Notes please refer to AstraZeneca PLC's reports on Form 6-K furnished to the SEC on 3 March 2023 and 28 May 2021.

Pursuant to Rule 13-01 and Rule 3-10 of Regulation S-X under the Securities Act of 1933, as amended (the "Securities Act"), we present below the summary financial information for AstraZeneca PLC, as Guarantor, excluding its consolidated subsidiaries, and AstraZeneca Finance, as the issuer, excluding its consolidated subsidiaries. The following summary financial information of AstraZeneca PLC and AstraZeneca Finance is presented on a combined basis and transactions between the combining entities have been eliminated. Financial information for non-guarantor entities has been excluded. Intercompany balances and transactions between the obligor group and the non-obligor subsidiaries are presented on separate lines.

Table17: Obligor group summarised Statement of comprehensive income

	FY 2023	FY 2022
	$m	$m
Total Revenue	-	-
Gross profit	-	-
Operating loss	(34)	(27)
Loss for the period	(976)	(687)
Transactions with subsidiaries that are not issuers or guarantors	15,660	1,071

Table18: Obligor group summarised Statement of financial position

	At 31 Dec 2023	At 31 Dec 2022
	$m	$m
Current assets	5	4
Non-current assets	-	-
Current liabilities	(4,856)	(2,839)
Non-current liabilities	(22,239)	(22,797)
Amounts due from subsidiaries that are not issuers or guarantors	18,421	7,806
Amounts due to subsidiaries that are not issuers or guarantors	-	(293)

Foreign exchange

The Company's transactional currency exposures on working capital balances, which typically extend for up to three months, are hedged where practicable using forward foreign exchange contracts against the individual companies' reporting currency. Foreign exchange gains and losses on forward contracts transacted for transactional hedging are taken to profit or to Other comprehensive income if the contract is in a designated cashflow hedge. In addition, the Company's external dividend payments, paid principally in pound sterling and Swedish krona, are fully hedged from announcement to payment date.

Table19: Currency sensitivities

The Company provides the following currency-sensitivity information:

Average rates vs. USD Annual impact ($m) of 5% strengthening (FY 2024 average rate vs. FY 2023 average)[12]

Currency	Primary Relevance	FY    2023[13]	YTD   2024[14]	Change  (%)	Total Revenue	Core Operating Profit
EUR	Total Revenue	0.92	0.92	1	397	179
CNY	Total Revenue	7.09	7.18	(1)	322	182
JPY	Total Revenue	140.60	145.97	(4)	177	119
Other[15]					453	227
GBP	Operating expense	0.80	0.79	2	60	(126)
SEK	Operating expense	10.61	10.34	3	9	(63)

Sustainability

Since the last quarterly report, AstraZeneca:

Access to healthcare

−Continued to make a high-level contribution to thePartnership for Health System Sustainability and Resilience(PHSSR), providing a valuable platform for dialogue with policymakers and other health system stakeholders:

‒   The PHSSREU expert advisory grouplaunched itsinaugural non-communicable disease (NCD) policy report, 'A stitch in time', on early intervention to tackle Europe's NCD crisis at an event in the European Parliament with more than 100 stakeholders from government, academia, advocacy, policy and industry groups

‒    National initiatives and policy improvements to strengthen health systems continued in countries including Brazil, Canada, Saudi Arabia, Greece, the Netherlands, Italy and Japan

‒    Through Healthy Heart Africa (HHA), trained more than 11,390 healthcare workers, conducted 47.95 million blood pressure screenings cumulatively since launching in 2014 and identified 9.64 million people with elevated blood pressure as of the end of December 2023. HHA has conducted one million screenings per month since February 2023. The programme is on track to achieve its ambition to reach 10 million people with elevated blood pressure by 2025

‒    Through the Young Health Programme (YHP), continued to be recognised for achievements in reaching millions of young people with information on NCD risk behaviours. YHP directly reached six million young people in 2023, an increase of 110% from 2022, and trained 385,000 people across 40 countries. More than 4,400 AstraZeneca employees volunteered time to YHP community projects in 2023

Environmental protection

‒    Joined global health and climate leaders at COP28, as part of the first official Health Day at the UN Climate Change Conference, to highlight the urgency of the climate-health crisis and share scalable solutions to decarbonise and adapt health systems. The Company convened cross-sector stakeholders for a Reuters panel discussion on tackling the impact of the climate crisis on lung health, and CEO Pascal Soriot hosted a session through the Sustainable Markets Initiative (SMI) Health Systems Task Force on accelerating the transition to net zero health systems

‒    Through the SMI Health Systems Task Force, announced an industry-first renewable power agreement in China together with four global healthcare leaders and renewable energy company Envision Energy, resulting in potential annual emissions savings of approximately 120,000 tonnes, the equivalent of taking 25,000 cars off the road

‒    Through AZ Forest, AstraZeneca's global reforestation and biodiversity initiative, planted 20 million trees together with partners, as part of the Company's $400 million commitment to plant and maintain 200 million trees by 2030. In December, the Company pledged to plant up to six million trees in western Kenya as part of AZ Forest, building on African reforestation initiatives in Ghana and Rwanda

Ethics and transparency

‒    Marked Global Ethics Day in October 2023, following the launch of Code of Ethics training focused on living the AZ Values and the role of ethics in everyday activities and decisions. The Company also launched its 2023 Ethics Survey alongside the training, to provide valuable insights into employee perspectives on AstraZeneca's ethical culture

‒    Appeared on the Forbes list of World's Best Employers for the fourth consecutive year and the World's Top Companies for Women, for the third consecutive year, as well as the FT Diversity Leaders 2024 for the fifth consecutive year, demonstrating the progress being made on the Company's People strategy and AstraZeneca's position as a Great Place to Work

Research and development

This section covers R&D events and milestones that have occurred since the prior results announcement on 9 November 2023, up to and including events on 7 February 2024.

A comprehensive view of AstraZeneca's pipeline of medicines in human trials can be found in the latest Clinical Trials Appendix, available on www.astrazeneca.com/investor-relations. The Clinical Trials Appendix includes tables with details of the ongoing clinical trials for AstraZeneca medicines and new molecular entities in the pipeline.

Oncology

AstraZeneca presented new data across its diverse portfolio of cancer medicines at four major medical congresses since the prior results announcement: the San Antonio Breast Cancer Congress (SABCS) in December 2023, the 65th American Society of Haematology Annual Meeting and Exposition (ASH) in December 2023, the American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO GI) in January 2024 and the American Society of Clinical Oncology Genitourinary Cancers (ASCO GU) in January 2024.

Imfinzi and Imjudo

Event		Commentary
Approval	China	For the 1st-line treatment of adult patients with locally advanced or metastatic BTC in combination with chemotherapy (gemcitabine and cisplatin). (TOPAZ-1, November 2023)
Trial update	PACIFIC-2	PACIFIC-2 Phase III trial for Imfinzi concurrently administered with chemoradiotherapy did not achieve statistical significance for the primary endpoint of PFS versus chemoradiotherapy alone for the treatment of patients with unresectable, Stage III NSCLC. (November 2023)
Presentation: ASCO GI	EMERALD-1	Imfinzi plus TACE and bevacizumab reduced the risk of disease progression or death by 23% compared to TACE alone (HR 0.77; 95% CI 0.61-0.98; p=0.032) with median PFS of 15 months in patients treated with the Imfinzi combination versus 8.2 months with TACE. (January 2024)

Enhertu

Event		Commentary
Priority Review	US	For the treatment of adult patients with unresectable or metastatic HER2-positive (immunohistochemistry IHC 3+) solid tumours who have received prior treatment or who have no satisfactory alternative treatment options. (DESTINY-PanTumor02, DESTINY-Lung01, DESTINY-CRC02, January 2024)

Truqap

Event		Commentary
Approval	US	In combination with Faslodex for the treatment of adult patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer with one or more biomarker alterations (PIK3CA, AKT1 or PTEN) that have progressed on at least one endocrine-based regimen in the metastatic setting or experienced recurrence on or within 12 months of completing adjuvant therapy. (CAPItello-291, November 2023)

BioPharmaceuticals - CVRM

Lokelma

Event	Commentary
Termination	STABILIZE-CKD and DIALIZE-Outcomes Phase III evidence trials discontinued. Decision was made due to substantially increased enrolment timelines and low event rates, respectively, which made it prohibitive to deliver study results within a timeframe to meaningfully advance clinical practice. (December 2023)

Wainua

Event		Commentary
Approval	US	Treatment of the polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults, commonly referred to as ATTRv-PN. (NEURO-TTRansform, December 2023)

Rare Disease

Alexion, AstraZeneca Rare Disease presented new real-world and clinical data at the 65th American Society of Haematology (ASH) , across PNH, AL amyloidosis, aHUS and haematopoietic stem cell transplant-associated thrombotic microangiopathy (HSCT-TMA).

Voydeya

Event		Commentary
Approval	JP	Treatment of patients with PNH with clinically significant EVH while treated with Ultomiris or Soliris. (ALPHA, January 2024)
Presentation: ASH	LTE ALPHA Phase III trial	New results from the 24-week and long-term extension period from the pivotal ALPHA Phase III trial reinforce the potential for Voydeya add-on therapy to address clinically significant EVH in the small subset of PNH patients who experience this condition while treated with C5 inhibitor therapy, allowing them to maintain control of intravascular haemolysis through standard-of-care treatment with Ultomiris or Soliris. (December 2023)

acoramidis

Event		Commentary
Phase III data readout	ATTRibute-CM (BridgeBio)	Positive high-level results from the Japan Phase III trial of acoramidis in adults with ATTR-CM showed consistency to those in the global BridgeBio Pharma, Inc. (BridgeBio) ATTRibute-CM Phase III trial, including survival, cardiac-related hospitalisations and other measures of improved functions at 30 months. (February 2024)

Condensed consolidated financial statements

Table20: Condensed consolidated statement of comprehensive income: FY 2023

For the twelve months ended 31 December	2023	2022
	$m	$m
Total Revenue[16]	45,811	44,351
Product Sales	43,789	42,998
Alliance Revenue	1,428	755
Collaboration Revenue	594	598
Cost of sales	(8,268)	(12,391)
Gross profit	37,543	31,960
Distribution expense	(539)	(536)
Research and development expense	(10,935)	(9,762)
Selling, general and administrative expense	(19,216)	(18,419)