0000310158us-gaap:OperatingSegmentsMembermrk:ZepatierMembermrk:PharmaceuticalsegmentMembermrk:InternationalMember2020-01-012020-09-300000310158mrk:PharmaceuticalsegmentMemberus-gaap:OperatingSegmentsMembercountry:US2020-07-012020-09-30


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
 
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 20202021
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ______ to ______
Commission File No. 1-6571
Merck & Co., Inc.
(Exact name of registrant as specified in its charter)
New Jersey22-1918501
(State or other jurisdiction of incorporation)(I.R.SI.R.S. Employer Identification No.)
2000 Galloping Hill Road
KenilworthNew Jersey07033
(Address of principal executive offices) (zip code)
(Registrant’s telephone number, including area code) (908) 740-4000
Not Applicable
(Former name, former address and former fiscal year, if changed since last report.)
Securities Registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock ($0.50 par value)MRKNew York Stock Exchange
0.500% Notes due 2024MRK 24New York Stock Exchange
1.875% Notes due 2026MRK/26New York Stock Exchange
2.500% Notes due 2034MRK/34New York Stock Exchange
1.375% Notes due 2036MRK 36ANew York Stock Exchange

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes     No  
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).  Yes     No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one):
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes   No 
Securities Registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock ($0.50 par value)MRKNew York Stock Exchange
1.125% Notes due 2021MRK/21New York Stock Exchange
0.500% Notes due 2024MRK 24New York Stock Exchange
1.875% Notes due 2026MRK/26New York Stock Exchange
2.500% Notes due 2034MRK/34New York Stock Exchange
1.375% Notes due 2036MRK 36ANew York Stock Exchange
The number of shares of common stock outstanding as of the close of business on October 31, 2020: 2,530,034,4372021: 2,525,943,936





Table of Contents
Page No.
PART I
Item 1.
Item 2.
Item 3.
Item 4.
PART II
Item 1.
Item 1A.
Item 2.
Item 6.





Part I - Financial Information
Item 1. Financial Statements
MERCK & CO., INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENT OF INCOME
(Unaudited, $ in millions except per share amounts)
 
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
2020201920202019 2021202020212020
SalesSales$12,551 $12,397 $35,479 $34,972 Sales$13,154 $10,929 $35,183 $30,570 
Costs, Expenses and OtherCosts, Expenses and OtherCosts, Expenses and Other
Cost of salesCost of sales3,481 3,990 9,952 10,443 Cost of sales3,450 3,013 9,752 8,589 
Selling, general and administrativeSelling, general and administrative2,450 2,589 7,383 7,726 Selling, general and administrative2,336 2,060 6,804 6,336 
Research and developmentResearch and development3,390 3,204 7,721 7,324 Research and development2,445 3,349 9,177 7,609 
Restructuring costsRestructuring costs114 232 269 444 Restructuring costs107 113 487 265 
Other (income) expense, netOther (income) expense, net(312)35 (630)362 Other (income) expense, net(450)(312)(1,007)(637)
9,123 10,050 24,695 26,299  7,888 8,223 25,213 22,162 
Income Before Taxes3,428 2,347 10,784 8,673 
Taxes on Income483 440 1,611 1,259 
Income from Continuing Operations Before TaxesIncome from Continuing Operations Before Taxes5,266 2,706 9,970 8,408 
Taxes on Income from Continuing OperationsTaxes on Income from Continuing Operations695 380 1,436 1,271 
Net Income from Continuing OperationsNet Income from Continuing Operations4,571 2,326 8,534 7,137 
Less: Net Income Attributable to Noncontrolling InterestsLess: Net Income Attributable to Noncontrolling Interests
Net Income from Continuing Operations Attributable to Merck & Co., Inc.Net Income from Continuing Operations Attributable to Merck & Co., Inc.4,567 2,324 8,525 7,136 
Income from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling InterestsIncome from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling Interests— 617 766 2,025 
Net Income Attributable to Merck & Co. Inc.Net Income Attributable to Merck & Co. Inc.$4,567 $2,941 $9,291 $9,161 
Basic Earnings per Common Share Attributable to Merck & Co., Inc. Common Shareholders:Basic Earnings per Common Share Attributable to Merck & Co., Inc. Common Shareholders:
Income from Continuing OperationsIncome from Continuing Operations$1.81 $0.92 $3.37 $2.82 
Income from Discontinued OperationsIncome from Discontinued Operations— 0.24 0.30 0.80 
Net IncomeNet Income2,945 1,907 9,173 7,414 Net Income$1.81 $1.16 $3.67 $3.62 
Less: Net Income (Loss) Attributable to Noncontrolling Interests12 (73)
Net Income Attributable to Merck & Co., Inc.$2,941 $1,901 $9,161 $7,487 
Basic Earnings per Common Share Attributable to Merck & Co., Inc. Common Shareholders$1.16 $0.74 $3.62 $2.91 
Earnings per Common Share Assuming Dilution Attributable to Merck & Co., Inc. Common Shareholders$1.16 $0.74 $3.61 $2.89 
Earnings per Common Share Assuming Dilution Attributable to Merck & Co., Inc. Common Shareholders:Earnings per Common Share Assuming Dilution Attributable to Merck & Co., Inc. Common Shareholders:
Income from Continuing OperationsIncome from Continuing Operations$1.80 $0.92 $3.36 $2.81 
Income from Discontinued OperationsIncome from Discontinued Operations— 0.24 0.30 0.80 
Net IncomeNet Income$1.80 $1.16 $3.66 $3.61 
 
MERCK & CO., INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENT OF COMPREHENSIVE INCOME
(Unaudited, $ in millions)
 
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
2020201920202019 2021202020212020
Net Income Attributable to Merck & Co., Inc.Net Income Attributable to Merck & Co., Inc.$2,941 $1,901 $9,161 $7,487 Net Income Attributable to Merck & Co., Inc.$4,567 $2,941 $9,291 $9,161 
Other Comprehensive Income (Loss) Net of Taxes:Other Comprehensive Income (Loss) Net of Taxes:Other Comprehensive Income (Loss) Net of Taxes:
Net unrealized (loss) gain on derivatives, net of reclassifications(137)91 (153)(9)
Net unrealized (loss) gain on investments, net of reclassifications(17)(18)109 
Net unrealized gain (loss) on derivatives, net of reclassificationsNet unrealized gain (loss) on derivatives, net of reclassifications84 (137)324 (153)
Net unrealized loss on investments, net of reclassificationsNet unrealized loss on investments, net of reclassifications— — — (18)
Benefit plan net gain and prior service credit, net of amortizationBenefit plan net gain and prior service credit, net of amortization62 15 161 41 Benefit plan net gain and prior service credit, net of amortization38 62 1,522 161 
Cumulative translation adjustmentCumulative translation adjustment85 (117)(180)14 Cumulative translation adjustment(84)85 (251)(180)
10 (28)(190)155  38 10 1,595 (190)
Comprehensive Income Attributable to Merck & Co., Inc.Comprehensive Income Attributable to Merck & Co., Inc.$2,951 $1,873 $8,971 $7,642 Comprehensive Income Attributable to Merck & Co., Inc.$4,605 $2,951 $10,886 $8,971 
 The accompanying notes are an integral part of these condensed consolidated financial statements.
- 3 -



MERCK & CO., INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEET
(Unaudited, $ in millions except per share amounts)
 
September 30, 2020December 31, 2019September 30, 2021December 31, 2020
AssetsAssetsAssets
Current AssetsCurrent AssetsCurrent Assets
Cash and cash equivalentsCash and cash equivalents$7,356 $9,676 Cash and cash equivalents$10,016 $8,050 
Short-term investments774 
Accounts receivable (net of allowance for doubtful accounts of $89 in 2020
and $86 in 2019)
8,422 6,778 
Inventories (excludes inventories of $2,081 in 2020 and $1,480 in 2019
classified in Other assets - see Note 6)
6,128 5,978 
Accounts receivable (net of allowance for doubtful accounts of $69 in 2021
and $67 in 2020)
Accounts receivable (net of allowance for doubtful accounts of $69 in 2021
and $67 in 2020)
8,571 6,803 
Inventories (excludes inventories of $2,373 in 2021 and $2,070 in 2020
classified in Other assets - see Note 7)
Inventories (excludes inventories of $2,373 in 2021 and $2,070 in 2020
classified in Other assets - see Note 7)
5,603 5,554 
Other current assetsOther current assets4,671 4,277 Other current assets6,868 4,674 
Current assets of discontinued operationsCurrent assets of discontinued operations— 2,683 
Total current assetsTotal current assets26,577 27,483 Total current assets31,058 27,764 
InvestmentsInvestments1,372 1,469 Investments435 785 
Property, Plant and Equipment, at cost, net of accumulated depreciation of $18,572
in 2020 and $17,686 in 2019
16,919 15,053 
Property, Plant and Equipment, at cost, net of accumulated depreciation of $18,155
in 2021 and $18,162 in 2020
Property, Plant and Equipment, at cost, net of accumulated depreciation of $18,155
in 2021 and $18,162 in 2020
18,565 17,000 
GoodwillGoodwill20,248 19,425 Goodwill18,862 18,882 
Other Intangibles, NetOther Intangibles, Net16,677 14,196 Other Intangibles, Net13,384 14,101 
Other AssetsOther Assets8,007 6,771 Other Assets11,190 9,881 
Noncurrent Assets of Discontinued OperationsNoncurrent Assets of Discontinued Operations— 3,175 
$89,800 $84,397  $93,494 $91,588 
Liabilities and EquityLiabilities and EquityLiabilities and Equity
Current LiabilitiesCurrent LiabilitiesCurrent Liabilities
Loans payable and current portion of long-term debtLoans payable and current portion of long-term debt$2,420 $3,610 Loans payable and current portion of long-term debt$3,534 $6,431 
Trade accounts payableTrade accounts payable3,744 3,738 Trade accounts payable3,366 4,327 
Accrued and other current liabilitiesAccrued and other current liabilities11,690 12,549 Accrued and other current liabilities14,214 12,212 
Income taxes payableIncome taxes payable984 736 Income taxes payable954 1,597 
Dividends payableDividends payable1,567 1,587 Dividends payable1,660 1,674 
Current liabilities of discontinued operationsCurrent liabilities of discontinued operations— 1,086 
Total current liabilitiesTotal current liabilities20,405 22,220 Total current liabilities23,728 27,327 
Long-Term DebtLong-Term Debt26,321 22,736 Long-Term Debt22,907 25,360 
Deferred Income TaxesDeferred Income Taxes1,777 1,470 Deferred Income Taxes1,527 1,005 
Other Noncurrent LiabilitiesOther Noncurrent Liabilities12,027 11,970 Other Noncurrent Liabilities9,469 12,306 
Noncurrent Liabilities of Discontinued OperationsNoncurrent Liabilities of Discontinued Operations— 186 
Merck & Co., Inc. Stockholders’ EquityMerck & Co., Inc. Stockholders’ EquityMerck & Co., Inc. Stockholders’ Equity
Common stock, $0.50 par value
Authorized - 6,500,000,000 shares
Issued - 3,577,103,522 shares in 2020 and 2019
1,788 1,788 
Common stock, $0.50 par value
Authorized - 6,500,000,000 shares
Issued - 3,577,103,522 shares in 2021 and 2020
Common stock, $0.50 par value
Authorized - 6,500,000,000 shares
Issued - 3,577,103,522 shares in 2021 and 2020
1,788 1,788 
Other paid-in capitalOther paid-in capital39,489 39,660 Other paid-in capital44,149 39,588 
Retained earningsRetained earnings51,107 46,602 Retained earnings51,691 47,362 
Accumulated other comprehensive lossAccumulated other comprehensive loss(6,383)(6,193)Accumulated other comprehensive loss(4,590)(6,634)
86,001 81,857 93,038 82,104 
Less treasury stock, at cost:
1,047,343,390 shares in 2020 and 1,038,087,496 shares in 2019
56,815 55,950 
Less treasury stock, at cost:
1,051,780,149 shares in 2021 and 1,046,877,695 shares in 2020
Less treasury stock, at cost:
1,051,780,149 shares in 2021 and 1,046,877,695 shares in 2020
57,244 56,787 
Total Merck & Co., Inc. stockholders’ equityTotal Merck & Co., Inc. stockholders’ equity29,186 25,907 Total Merck & Co., Inc. stockholders’ equity35,794 25,317 
Noncontrolling InterestsNoncontrolling Interests84 94 Noncontrolling Interests69 87 
Total equityTotal equity29,270 26,001 Total equity35,863 25,404 
$89,800 $84,397  $93,494 $91,588 
The accompanying notes are an integral part of this condensed consolidated financial statement.
- 4 -



MERCK & CO., INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENT OF CASH FLOWS
(Unaudited, $ in millions)
 
Nine Months Ended
September 30,
Nine Months Ended
September 30,
20202019 20212020
Cash Flows from Operating ActivitiesCash Flows from Operating ActivitiesCash Flows from Operating Activities
Net income$9,173 $7,414 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization2,721 2,716 
Net income from continuing operationsNet income from continuing operations$8,534 $7,137 
Adjustments to reconcile net income from continuing operations to net cash provided by operating activities:Adjustments to reconcile net income from continuing operations to net cash provided by operating activities:
AmortizationAmortization1,231 1,393 
DepreciationDepreciation1,148 1,210 
Intangible asset impairment chargesIntangible asset impairment charges35 864 Intangible asset impairment charges— 35 
Charge for acquisition of Peloton Therapeutics, Inc.982 
Income from investments in equity securities, netIncome from investments in equity securities, net(1,535)(964)
Charge for the acquisition of Pandion Therapeutics, Inc.Charge for the acquisition of Pandion Therapeutics, Inc.1,556 — 
Deferred income taxesDeferred income taxes47 (386)Deferred income taxes28 32 
Share-based compensationShare-based compensation354 306 Share-based compensation360 329 
OtherOther(445)219 Other499 519 
Net changes in assets and liabilitiesNet changes in assets and liabilities(5,638)(3,469)Net changes in assets and liabilities(3,794)(5,484)
Net Cash Provided by Operating Activities6,247 8,646 
Net Cash Provided by Operating Activities from Continuing OperationsNet Cash Provided by Operating Activities from Continuing Operations8,027 4,207 
Cash Flows from Investing ActivitiesCash Flows from Investing ActivitiesCash Flows from Investing Activities
Capital expendituresCapital expenditures(3,170)(2,336)Capital expenditures(3,240)(2,998)
Purchases of securities and other investmentsPurchases of securities and other investments(78)(2,380)Purchases of securities and other investments(1)(78)
Proceeds from sales of securities and other investmentsProceeds from sales of securities and other investments1,894 7,459 Proceeds from sales of securities and other investments497 1,894 
Acquisition of Pandion Therapeutics, Inc. net of cash acquiredAcquisition of Pandion Therapeutics, Inc. net of cash acquired(1,554)— 
Acquisition of ArQule, Inc., net of cash acquiredAcquisition of ArQule, Inc., net of cash acquired(2,545)Acquisition of ArQule, Inc., net of cash acquired— (2,545)
Acquisition of Antelliq Corporation, net of cash acquired(3,620)
Acquisition of Peloton Therapeutics, Inc., net of cash acquired(1,040)
Other acquisitions, net of cash acquiredOther acquisitions, net of cash acquired(907)(269)Other acquisitions, net of cash acquired(89)(907)
OtherOther141 320 Other15 138 
Net Cash Used in Investing Activities(4,665)(1,866)
Net Cash Used in Investing Activities from Continuing OperationsNet Cash Used in Investing Activities from Continuing Operations(4,372)(4,496)
Cash Flows from Financing ActivitiesCash Flows from Financing ActivitiesCash Flows from Financing Activities
Net change in short-term borrowingsNet change in short-term borrowings(311)(3,892)Net change in short-term borrowings(3,983)(311)
Payments on debtPayments on debt(1,954)Payments on debt(1,153)(1,954)
Distribution from Organon & Co.Distribution from Organon & Co.9,000 — 
Proceeds from issuance of debtProceeds from issuance of debt4,419 4,958 Proceeds from issuance of debt— 4,419 
Purchases of treasury stockPurchases of treasury stock(1,281)(3,730)Purchases of treasury stock(822)(1,281)
Dividends paid to stockholdersDividends paid to stockholders(4,673)(4,290)Dividends paid to stockholders(4,967)(4,673)
Proceeds from exercise of stock optionsProceeds from exercise of stock options68 344 Proceeds from exercise of stock options68 68 
OtherOther(472)(240)Other(253)(472)
Net Cash Used in Financing Activities(4,204)(6,850)
Net Cash Used in Financing Activities from Continuing OperationsNet Cash Used in Financing Activities from Continuing Operations(2,110)(4,204)
Discontinued OperationsDiscontinued Operations
Net cash provided by operating activitiesNet cash provided by operating activities1,051 2,040 
Net cash used in investing activitiesNet cash used in investing activities(134)(169)
Net cash used in financing activitiesNet cash used in financing activities(504)— 
Net Cash Flows Provided by Discontinued OperationsNet Cash Flows Provided by Discontinued Operations413 1,871 
Effect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted CashEffect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted Cash89 (26)Effect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted Cash(65)89 
Net Decrease in Cash, Cash Equivalents and Restricted Cash(2,533)(96)
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes restricted
cash of $258 at January 1, 2020 included in Other Assets)
9,934 7,967 
Cash, Cash Equivalents and Restricted Cash at End of Period (includes restricted cash
of $45 at September 30, 2020 included in Other Assets)
$7,401 $7,871 
Net Increase (Decrease) in Cash, Cash Equivalents and Restricted CashNet Increase (Decrease) in Cash, Cash Equivalents and Restricted Cash1,893 (2,533)
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes restricted
cash of $103 at January 1, 2021 included in Other Assets)
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes restricted
cash of $103 at January 1, 2021 included in Other Assets)
8,153 9,934 
Cash, Cash Equivalents and Restricted Cash at End of Period (includes restricted cash
of $30 at September 30, 2021 included in Other Assets)
Cash, Cash Equivalents and Restricted Cash at End of Period (includes restricted cash
of $30 at September 30, 2021 included in Other Assets)
$10,046 $7,401 
The accompanying notes are an integral part of this condensed consolidated financial statement.
- 5 -

Notes to Condensed Consolidated Financial Statements (unaudited)

1.Basis of Presentation
The accompanying unaudited condensed consolidated financial statements of Merck & Co., Inc. (Merck or the Company) have been prepared pursuant to the rules and regulations for reporting on Form 10-Q. Accordingly, certain information and disclosures required by accounting principles generally accepted in the United States (U.S.) (GAAP) for complete consolidated financial statements are not included herein. These interim statements should be read in conjunction with the audited financial statements and notes thereto included in Merck’s Form 10-K filed on February 26, 2020.25, 2021.
The results of operations of any interim period are not necessarily indicative of the results of operations for the full year. In the Company’s opinion, all adjustments necessary for a fair statement of these interim statements have been included and are of a normal and recurring nature.
Planned Reclassifications — Certain reclassifications have been made to prior year amounts to conform to the current year presentation.
Spin-Off of Women’s Health, Biosimilars and Established Brands into New CompanyOrganon & Co.
In February 2020,On June 2, 2021, Merck announced its intention tocompleted the spin-off of products from its women’s health, biosimilars and established brands businesses into a new, independent, publicly traded company named Organon & Co. (Organon) through a distribution of Organon’s publicly traded stock to Company shareholders. The distribution is expected to qualify as tax-free to the Company and its shareholders for U.S. federal income tax purposes. The established brands included in the transaction consistconsisted of dermatology, non-opioid pain management, respiratory, and select cardiovascular products, including Zetia (ezetimibe) and Vytorin (ezetimibe and simvastatin), as well as the rest of Merck’s diversified brands franchise. Merck’s existing research pipeline programs will continue to be owned and developed within Merck as planned. Organon will have development capabilities initially focused on late-stage development and life-cycle management and is expected over time to develop research capabilities in selected therapeutic areas. The spin-off is expected to be completed in the second quarter of 2021, subject to market and certain other conditions. Subsequent to the spin-off, the historical results of the women’s health, biosimilars and established brands businesses will bethat were contributed to Organon in the spin-off have been reflected as discontinued operations in the Company’s consolidated financial statements.statements through the date of the spin-off (see Note 2).
Recently Adopted Accounting Standards
In June 2016,December 2019, the Financial Accounting Standards Board (FASB) issued new guidance on the accounting for credit losses on financial instruments. The new guidance introduces an expected loss model for estimating credit losses, replacing the incurred loss model. The new guidance also changes the impairment model for available-for-sale debt securities, requiring the use of an allowance to record estimated credit losses (and subsequent recoveries). The Company adopted the new guidance effective January 1, 2020. There was no impact to the Company’s consolidated financial statements upon adoption.
In November 2018, the FASB issued new guidance for collaborative arrangements intended to reduce diversity in practice by clarifying whether certain transactions between collaborative arrangement participants should be accounted for under revenue recognition guidance (ASC 606). The Company adopted the new guidance effective January 1, 2020, which resulted in minor changes to the presentation of information related to the Company’s collaborative arrangements.
Recently Issued Accounting Standards Not Yet Adopted
In December 2019, the FASB issued amended guidance on the accounting and reporting of income taxes. The guidance is intended to simplify the accounting for income taxes by:by removing exceptions related to certain intraperiod tax allocations and deferred tax liabilities;liabilities, clarifying guidance primarily related to evaluating the step-up tax basis for goodwill in a business combination;combination, and reflecting enacted changes in tax laws or rates in the annual effective tax rate. The amended guidance is effective for interim and annual periods in 2021. Early adoption is permitted. The amendments inCompany adopted the new guidance areeffective January 1, 2021. There was no impact to be applied on a retrospective basis, on a modified retrospective basis through a cumulative-effect adjustment to retained earnings or prospectively, depending on the amendment. The Company is currently evaluating the impact of adoption on itsCompany’s consolidated financial statements.statements upon adoption.
In January 2020, the FASB issued new guidance intended to clarify certain interactions between accounting standards related to equity securities, equity method investments and certain derivatives. The guidance addresses accounting for the transition into and out of the equity method of accounting and measuring certain purchased options and forward contracts to acquire investments. The Company adopted the new guidance is effective for interim and annual periods in 2021 and isJanuary 1, 2021. There was no impact to be applied prospectively. Early adoption is permitted. The Company is currently evaluating the impact of adoption on itsCompany’s consolidated financial statements.statements upon adoption.
Recently Issued Accounting Standards Not Yet Adopted
In March 2020, the FASB issued optional guidance to ease the potential burden in accounting for (or recognizing the effects of) reference rate reform on financial reporting.reporting and subsequently issued clarifying amendments. The guidance provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected bythat reference the London Interbank Offered Rate (LIBOR) or another reference rate expected to be discontinued because of reference rate reform. The optional guidance is effective upon issuance and can be applied on a prospective basis at any time between January 1, 2020 through December 31, 2022. The Company is currently evaluating the impact of adoption on its consolidated financial statements.
In August 2020, the FASB issued amended guidance on the accounting for convertible instruments and contracts in an entity’s own equity. The guidance removes the separation model for convertible debt instruments and preferred stock, amends requirements for conversion options to be classified in equity as well as amends diluted earnings per share (EPS) calculations for certain convertible debt instruments. The amended guidance is effective for interim and annual periods in 2022. Early adoption is permitted. The application of the amendments in the new guidance are to be applied either on a modified retrospective or a retrospective basis. The Company is currently evaluating the impact of adoption on its consolidated financial statements.
In October 2021, the FASB issued amended guidance that requires acquiring entities to recognize and measure contract assets and liabilities in a business combination in accordance with existing revenue recognition guidance. The amended guidance is effective for interim and annual periods in 2023 and is to be applied prospectively. Early adoption is permitted on a retrospective basis to the beginning of the fiscal year of adoption. The Company is currently evaluating the impact of adoption on its consolidated financial statements.
- 6 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
2. Spin-Off of Organon & Co.
On June 2, 2021, Merck completed the spin-off of Organon through a distribution of Organon’s publicly traded stock to Company shareholders. In connection with the spin-off, each Merck shareholder received one tenth of a share of Organon’s common stock for each share of Merck common stock held by such shareholder. The distribution is expected to qualify as tax free to Merck and its shareholders for U.S. federal income tax purposes. Indebtedness of $9.5 billion principal amount, consisting of term loans and senior notes, was issued in 2021 in connection with the spin-off and assumed by Organon. Merck is no longer the obligor of any Organon debt or financing arrangements. Cash proceeds of $9.0 billion were distributed by Organon to Merck in connection with the spin-off.
Also in connection with the spin-off, Merck and Organon entered into a separation and distribution agreement and also entered into various other agreements to effect the spin-off and provide a framework for the relationship between Merck and Organon after the spin-off, including a transition services agreement (TSA), manufacturing and supply agreements (MSAs), trademark license agreements, intellectual property license agreements, an employee matters agreement, a tax matters agreement and certain other commercial agreements. Under the TSA, Merck will provide Organon various services and, similarly, Organon will provide Merck various services. The provision of services under the TSA agreement generally will terminate within 25 months following the spin-off. Merck and Organon also entered into a series of interim operating agreements pursuant to which in various jurisdictions where Merck held licenses, permits and other rights in connection with marketing, import and/or distribution of Organon products prior to the separation, Merck will continue to market, import and distribute such products until such time as the relevant licenses and permits are transferred to Organon. Under such interim operating agreements and in accordance with the separation and distribution agreement, Merck will continue operations in the affected markets on behalf of Organon, with Organon receiving all of the economic benefits and burdens of such activities. Additionally, Merck and Organon entered into a number of MSAs pursuant to which Merck will (a) manufacture and supply certain active pharmaceutical ingredients for Organon, (b) toll manufacture and supply certain formulated pharmaceutical products for Organon, and (c) package and label certain finished pharmaceutical products for Organon. Similarly, Organon and Merck entered into a number of MSAs pursuant to which Organon will (a) manufacture and supply certain formulated pharmaceutical products for Merck, and (b) package and label certain finished pharmaceutical products for Merck. The terms of the MSAs range in initial duration from four years to ten years.
Amounts included in the condensed consolidated statement of income for the above agreements were immaterial in the third quarter and first nine months of 2021. The amount due from Organon under the above agreements was $1.4 billion at September 30, 2021 and is reflected in Other current assets. The amount due to Organon under these agreements was $930 million at September 30, 2021 and is included in Accrued and other current liabilities.
The results of the women’s health, biosimilars and established brands businesses (previously included in the Pharmaceutical segment) that were contributed to Organon in the spin-off, as well as interest expense related to the debt issuance in 2021, have been reflected as discontinued operations in the Company’s condensed consolidated statement of income as Income from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling Interests through June 2, 2021, the date of the spin-off. Prior periods have been recast to reflect this presentation. As a result of the spin-off of Organon, Merck incurred separation costs of $556 million in the nine months ended September 30, 2021, and $193 million and $483 million in the three and nine months ended September 30, 2020, respectively, which are also included in Income from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling Interests. These costs primarily relate to professional fees for separation activities within finance, tax, legal and information technology functions, as well as investment banking fees. As of December 31, 2020, the assets and liabilities associated with these businesses are classified as assets and liabilities of discontinued operations in the condensed consolidated balance sheet.

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Notes to Condensed Consolidated Financial Statements (unaudited)
Details of Income from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling Interests are as follows:
 Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)2020
2021 (1)
2020
Sales$1,622 $2,512 $4,911 
Costs, Expenses and Other
Cost of sales468 789 1,362 
Selling, general and administrative390 877 1,046 
Research and development41 103 113 
Restructuring costs
Other (income) expense, net— (15)
900 1,755 2,532 
Income from discontinued operations before taxes722 757 2,379 
Tax provision (benefit)103 (12)343 
Income from discontinued operations, net of taxes619 769 2,036 
Less: Income of discontinued operations attributable to noncontrolling interests11 
Income from discontinued operations, net of taxes and amounts attributable to noncontrolling interests$617 $766 $2,025 
(1)Reflects amounts through the June 2, 2021 spin-off date.
Details of assets and liabilities of discontinued operations are as follows: 
($ in millions)December 31, 2020
Cash and cash equivalents$12 
Accounts receivable, less allowance for doubtful accounts1,048 
Inventories756 
Other current assets867 
Current assets of discontinued operations$2,683 
Property, plant and equipment, net$986 
Goodwill1,356 
Other intangibles, net503 
Other assets330 
Noncurrent Assets of Discontinued Operations$3,175 
Trade accounts payable$267 
Accrued and other current liabilities841 
Income taxes payable(22)
Total current liabilities of discontinued operations$1,086 
Deferred income taxes$10 
Other noncurrent liabilities176 
Noncurrent Liabilities of Discontinued Operations$186 
As a result of the spin-off of Organon, Merck distributed net liabilities of $5.1 billion as of June 2, 2021 consisting of debt of $9.4 billion (described above), goodwill of $1.4 billion, property, plant and equipment of $981 million, cash of $929 million, inventory of $815 million, other intangibles, net, of $519 million and other net liabilities of $328 million. The spin-off also resulted in a net decrease to Accumulated other comprehensive loss (AOCL) of $449 million consisting of $421 million for the derecognition of net losses on foreign currency translation adjustments and $28 million associated with employee benefit plans. The distribution of the net liabilities and reduction to AOCL resulted in a net $4.6 billion increase to Other paid-in capital.
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Notes to Condensed Consolidated Financial Statements (unaudited)
The Company has share-based compensation plans under which the Company grants restricted stock units (RSUs) and performance share units (PSUs) to certain management level employees. In addition, employees and non-employee directors were granted options to purchase shares of Company common stock at the fair market value at the time of grant. In connection with the spin-off of Organon, all outstanding Merck stock options, RSUs and PSUs (whether vested or unvested) were converted into adjusted Merck awards for current and former Merck employees or Organon awards for Organon employees. Such adjusted awards preserved the same intrinsic value and general terms and conditions (including vesting) as were in place immediately prior to the adjustments. Approximately 1.3 million RSUs, 1.9 million stock options and 248 thousand PSUs were converted from Merck awards into Organon awards.
Expenses for curtailments, settlements and termination benefits provided to certain employees were incurred in connection with the spin-off. Additionally, the transfer of employees to Organon triggered remeasurements of some of the Company’s pension plans (see Note 11).
3.    Acquisitions, Research Collaborations and License Agreements
The Company continues to pursue acquisitions and the establishment of external alliances such as research collaborations and licensing agreements to complement its internal research capabilities. These arrangements often include upfront payments, as well as expense reimbursements or payments to the third party, and milestone, royalty or profit share arrangements, contingent upon the occurrence of certain future events linked to the success of the asset in development. The Company also reviews its marketed products and pipeline to examine candidates which may provide more value through out-licensing and, as part of its portfolio assessment process, may also divest certain assets. Pro forma financial information for acquired businesses is not presented if the historical financial results of the acquired entity are not significant when compared with the Company’s financial results.
In November 2020,September 2021, Merck and VelosBio,Acceleron Pharma Inc. (VelosBio) announced that the companies had(Acceleron), a publicly traded biopharmaceutical company, entered into a definitive agreement pursuantunder which Merck will acquire Acceleron for $180 per share in cash for an approximate total equity value of $11.5 billion. Acceleron is focused on harnessing the power of the transforming growth factor (TGF)-beta superfamily of proteins that is known to whichplay a central role in the regulation of cell growth, differentiation and repair. Acceleron’s lead therapeutic candidate, sotatercept, has a novel mechanism of action with the potential to improve short-term and/or long-term clinical outcomes in patients with pulmonary arterial hypertension (PAH). Sotatercept is in Phase 3 trials as add-on to current standard of care for the treatment of PAH. In addition to sotatercept, Acceleron’s portfolio includes Reblozyl (luspatercept-aamt), a first-in-class erythroid maturation recombinant fusion protein approved in the U.S., Europe, Canada and Australia for the treatment of anemia in certain rare blood disorders. Reblozyl is being developed and commercialized through a global collaboration with Bristol Myers Squibb. Under the terms of the acquisition agreement, Merck, through a subsidiary, willinitiated a tender offer to acquire all outstanding shares of VelosBio for $2.75 billion,Acceleron. The closing of the tender offer is subject to certain conditions, including the tender of shares representing at least a majority of the total number of Acceleron’s outstanding shares, receipt of applicable regulatory approvals, and other customary adjustments. VelosBioconditions. The acquisition agreement includes termination provisions providing that (i) in the event Acceleron terminates in order to enter into an agreement with respect to a superior proposal (as defined in the agreement), Acceleron will be required to pay a termination fee of $345 million, and (ii) in the event the acquisition is not consummated due to antitrust conditions, Merck will be required to pay Acceleron a reverse termination fee of $650 million to $750 million depending on the time of termination. The transaction is expected to close in the fourth quarter of 2021.
In April 2021, Merck acquired Pandion Therapeutics, Inc. (Pandion), a clinical-stage biotechnology company developing novel therapeutics designed to address the unmet needs of patients living with autoimmune diseases. Pandion is advancing a pipeline of precision immune modulators targeting critical immune control nodes. Total consideration paid of $1.9 billion included $147 million of transaction costs primarily comprised of share-based compensation payments to settle equity awards. The transaction was accounted for as an acquisition of an asset. Merck recorded net assets of $156 million (primarily cash) and Research and development expenses of $1.7 billion in the first nine months of 2021 related to the transaction. There are no future contingent payments associated with the acquisition.
In March 2021, Merck and Gilead Sciences, Inc. (Gilead) entered into an agreement to jointly develop and commercialize long-acting treatments in HIV that combine Merck’s investigational nucleoside reverse transcriptase translocation inhibitor, islatravir, and Gilead’s investigational capsid inhibitor, lenacapavir. The collaboration will initially focus on long-acting oral formulations and long-acting injectable formulations of these combination products, with other formulations potentially added to the collaboration as mutually agreed. There was no upfront payment made by either party upon entering into the agreement.
Under the terms of the agreement, Gilead and Merck will share operational responsibilities, as well as development, commercialization and marketing costs, and any future revenues. Global development and commercialization costs will be shared 60% Gilead and 40% Merck across the oral and injectable formulation programs. For long-acting oral products, Gilead
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Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
will lead commercialization in the U.S. and Merck will lead commercialization in the EU and the rest of the world. For long-acting injectable products, Merck will lead commercialization in the U.S. and Gilead will lead commercialization in the EU and the rest of the world. Gilead and Merck will co-promote in the U.S. and certain other major markets. Merck and Gilead will share global product revenues equally until product revenues surpass certain pre-agreed per formulation revenue tiers. Upon passing $2.0 billion a year in net product sales for the oral combination, the revenue split will adjust to 65% Gilead and 35% Merck for any revenues above the threshold. Upon passing $3.5 billion a year in net product sales for the injectable combination, the revenue split will adjust to 65% Gilead and 35% Merck for any revenues above the threshold.
Beyond the potential combinations of investigational lenacapavir and investigational islatravir, Gilead will have the option to license certain of Merck’s investigational oral integrase inhibitors to develop in combination with lenacapavir. Reciprocally, Merck will have the option to license certain of Gilead’s investigational oral integrase inhibitors to develop in combination with islatravir. Each company may exercise its option for an investigational oral integrase inhibitor of the other company following completion of the first Phase 1 clinical trial of that integrase inhibitor. Upon exercise of an option, the companies will split development costs and revenues, unless the non-exercising company decides to opt-out.
In January 2021, Merck entered into an exclusive license and research collaboration agreement with Artiva Biotherapeutics, Inc. (Artiva) to discover, develop and manufacture CAR-NK cells that target certain solid tumors using Artiva’s proprietary platform. Merck and Artiva agreed to engage in up to three different research programs, each covering a collaboration target. Merck has sole responsibility for all development and commercialization activities (including regulatory filing and approval). Under the terms of the agreement, Merck made an upfront payment of $30 million, which was included in Research and development expenses in the first nine months of 2021, for license and other rights for the first two collaboration targets and agreed to make another upfront payment of $15 million for license and other rights for the third collaboration target when it is selected by Merck and accepted by Artiva. In addition, Artiva is eligible to receive future contingent milestone payments (which span all three collaboration targets), aggregating up to: $217.5 million in developmental milestones, $570 million in regulatory milestones, and $1.05 billion in sales-based milestones. The agreement also provides for Merck to pay tiered royalties ranging from 7% to 14% on future sales.
In December 2020, Merck acquired OncoImmune, a privately held, clinical-stage biopharmaceutical company, committed to developing first-in-class cancer therapies targeting receptor tyrosine kinase-like orphan receptor 1 (ROR1). VelosBio’sfor an upfront payment of $423 million. OncoImmune’s lead investigationaltherapeutic candidate is VLS-101, an antibody-drug conjugate targeting ROR1 that is currentlyMK-7110 (formerly known as CD24Fc) was being evaluated in a Phase 1 and a Phase 2 clinical trial for the treatment of patients hospitalized with hematologic malignanciescoronavirus disease 2019 (COVID-19). The transaction was accounted for as an acquisition of an asset. Under the agreement, prior to the completion of the acquisition, OncoImmune spun-out certain rights and solid tumors, respectively. Theassets unrelated to the MK-7110 program to a new entity owned by the existing shareholders of OncoImmune. In connection with the closing of the transaction,acquisition, Merck invested $50 million for a 20% ownership interest in the new entity, which is subjectwas valued at $33 million resulting in a $17 million premium. Merck also recognized other net liabilities of $22 million. The Company recorded Research and development expenses of $462 million in 2020 related to approval underthis transaction. In 2021, Merck received feedback from the Hart-Scott-Rodino Antitrust Improvements ActU.S. Food and other customary conditions, is expected byDrug Administration (FDA) that additional data would be needed to support a potential Emergency Use Authorization application and therefore the endCompany did not expect MK-7110 would become available until the first half of 2020.2022. Given this timeline and the technical, clinical and regulatory uncertainties, the availability of a number of medicines for patients hospitalized with COVID-19, and the need to concentrate Merck’s resources on accelerating the development and manufacture of the most viable therapeutics and vaccines, Merck decided to discontinue development of MK-7110 for the treatment of COVID-19. Due to the discontinuation, the Company recorded charges of $207 million in the first nine months of 2021, which are reflected in Cost of sales and relate to fixed-asset and materials write-offs, as well as the recognition of liabilities for purchase commitments.
In September 2020, Merck and Seagen Inc. (Seagen, formerly known as Seattle Genetics, Inc.) announced an oncology collaboration to globally develop and commercialize Seagen’s ladiratuzumab vedotin (MK-6440), an investigational antibody-drug conjugate targeting LIV-1, which is currently in Phase 2 clinical trials for breast cancer and other solid tumors.trials. The collaboration will pursue a broad joint development program evaluating ladiratuzumab vedotin as monotherapy and in combination with Keytruda (pembrolizumab) in triple-negative breast cancer, hormone receptor-positive breast cancer and other LIV-1-expressing solid tumors. The companies will equally share profits worldwide. Under the terms of the agreement, Merck made an upfront payment of $600 million and a $1.0 billion equity investment in 5 million shares of Seagen common stock at a price of $200 per share. Merck recorded $622 million in Research and development expenses in the third quarter and first nine months of 2020 related to this transaction reflecting the upfront payment as well as a $22 million mark-to-market loss on the purchase commitment (forward contract) relating to the equity shares (calculated based on the closing price of Seagen common stock on September 30, 2020). The closing of the equity investment occurred in October 2020 and resulted in the recognition of a $6 million reduction to Research and development expenses based on the price of Seagen common stock on the closing date. Seagen is also eligible to receive future contingent milestone payments of up to $2.6 billion, including $850 million in development milestones and $1.75 billion in salessales-based milestones.
Concurrent with the above transaction, Seagen granted Merck an exclusive license to commercialize Tukysa (tucatinib), a small molecule tyrosine kinase inhibitor, for the treatment of HER2-positivehuman epidermal growth factor receptor 2 (HER2)-
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Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
positive cancers, in Asia, the Middle East and Latin America and other regions outside of the United States,U.S., Canada and Europe. Merck will be responsible for marketing applications seeking approval in its territories, supported by the positive results from the HER2CLIMB clinical trial. Merck will also co-fund a portion of the Tukysa global development plan, which encompasses several ongoing and planned trials across HER2-positive cancers, including breast, colorectal, gastric and other cancers set forth in a global product development plan. Merck will solely fund and conduct country-specific clinical trials necessary to support anticipated regulatory applications in its territories. Under the terms of the agreement, Merck made upfront payments aggregating $210 million, which were recorded as Research and development expenses in the third quarter and first nine months of 2020. Seagen is also eligible to receive future contingent regulatory approval milestones of up to $65 million and will receive tiered royalties ranging from 20% to 33% based on annual sales levels of Tukysa in Merck’s territories.
Additionally in September 2020, Merck acquired a biologics manufacturing facility located in Dunboyne, Ireland from Takeda Pharmaceutical Company Limited for €256 million ($302 million). The transaction was accounted for as an acquisition of an asset. Merck recorded property, plant and equipment of $289 million and other net assets of $13 million. There are no future contingent payments associated with the acquisition.
In July 2020, Merck acquired the U.S. rights to Sentinel Flavor Tabs and Sentinel Spectrum Chews from Virbac Corporation for $410 million. Sentinel products provide protection against common parasites in dogs. The transaction was accounted for as an acquisition of an asset. Merck recognized intangible assets of $401 million related to currently marketed products and inventory of $9 million at the acquisition date. The estimated fair values of the identifiable intangible assets related to currently marketed products were determined using an income approach. Actual cash flows are likely to be different than those assumed. The intangible assets related to currently marketed products will be amortized over their estimated useful lives of 15 years. There are no future contingent payments associated with the acquisition.
Also in July 2020, Merck and Ridgeback Biotherapeutics LP (Ridgeback Bio), a closely held biotechnology company, closed a collaboration agreement to develop molnupiravir (MK-4482, formerly known as (MK-4482/EIDD-2801), an orally
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Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
available antiviral candidate currently in clinical development for the treatment of patients with COVID-19. Merck gained exclusive worldwide rights to develop and commercialize molnupiravir and related molecules. Under the terms of the agreement, Ridgeback Bio received an upfront payment and also is eligible to receive future contingent payments dependent upon the achievement of certain developmental and regulatory approval milestones, as well as a share ofmilestones. Any profits from the net profits of molnupiravir and related molecules, if approved.collaboration will be split between the partners equally. Merck and Ridgeback Bio are committed to ensure that any medicines developed for SARS-CoV-2 (the causative agent of COVID-19) will be accessible and affordable globally.
In June 2020, Merck acquired privately held Themis Bioscience GmbH (Themis), a company focused on vaccines (including a COVID-19 vaccine candidate, V591) and immune-modulation therapies for infectious diseases and cancer for $366 million. The acquisition originally provided for Merck mayto make additional contingent payments of up to $740 million, including up to $80 million for development milestones, up to $260 million for regulatory approval milestones, and up to $400 million for commercial milestones. Themis has a broad pipeline of vaccine candidates and immune-modulatory therapies developed using its innovative measles virus vector platform based on a vector originally developed by scientists at the Institut Pasteur and licensed exclusively to Themis for select viral indications. The acquisition builds upon an ongoing collaboration between the two companies to develop vaccine candidates using the measles virus vector platform and is expected to accelerate the development of the COVID-19 vaccine candidate (V591), which is currently in Phase 1 clinical development.million. The transaction was accounted for as an acquisition of a business. The Company determined the fair value of the contingent consideration was $97$85 million at the acquisition date utilizing a probability-weighted estimated cash flow stream using an appropriate discount rate dependent on the nature and timing of the milestone payment.payments. Merck recognized intangible assets for in-process research and development (IPR&D) of $136$113 million, cash of $59 million, deferred tax assets of $71$72 million and other net liabilities of $32 million. The excess of the consideration transferred over the fair value of net assets acquired of $229$239 million was recorded as goodwill that was allocated to the Pharmaceutical segment and is not deductible for tax purposes. The fair values of the identifiable intangible assets related to IPR&D were determined using an income approach. Actual cash flows are likely to be different than those assumed. In connection withJanuary 2021, the transaction, Merck has entered intoCompany announced it was discontinuing development of V591. As a memorandumresult, in the fourth quarter of understanding that reflects2020, the parties’ commitmentsCompany recorded an IPR&D impairment charge of $90 million within Research and development expenses. The Company also recorded a reduction in Research and development expenses resulting from a decrease in the related liability for contingent consideration of $45 million since future contingent milestone payments have been reduced to address$450 million in the COVID-19 pandemic by developing, manufacturing and distributing the vaccine on a global basis and with pricing that makes the vaccine both available around the world and accessible to those who need it.
In May 2020, Merck and the International AIDS Vaccine Initiative, Inc. (IAVI), a nonprofit scientific research organization dedicated to addressing urgent, unmet global health challenges, announced a new collaboration to develop V590, an investigational vaccine against SARS-CoV-2 being studied for the prevention of COVID-19. This vaccine candidate will use the recombinant vesicular stomatitis virus (rVSV) technology that is the basis for Merck’s approved Ebola Zaire virus vaccine, Ervebo (Ebola Zaire Vaccine, Live), which was the first rVSV vaccine approved for use in humans. Under the terms of the agreement, Merck made an upfront payment of $6.5 million and may make additional contingent payments ofaggregate, including up to $100$60 million for sales-baseddevelopment milestones, as well as royalty payments. Merck has also signed an agreement with the Biomedical Advanced Researchup to $196 million for regulatory approval milestones, and Development Authority (BARDA), part of the office of the Assistant Secretaryup to $194 million for Preparedness and Response within an agency of the United States Department of Health and Human Services, to provide initial funding support for this effort. Under the agreement, IAVI and Merck will work together to advance the development and global clinical evaluation of a SARS-CoV-2 vaccine candidate designed and engineered by IAVI scientists. The vaccine candidate is currently in Phase 1 clinical development. Merck will lead regulatory filings globally. Both organizations will work together to develop the vaccine and make it accessible and affordable globally, if approved.commercial milestones.
In January 2020, Merck acquired ArQule, Inc. (ArQule), a publicly traded biopharmaceutical company focused on kinase inhibitor discovery and development for the treatment of patients with cancer and other diseases. Total consideration paid of $2.7 billion included $138 million of share-based compensation payments to settle equity awards attributable to precombination service and cash paid for transaction costs on behalf of ArQule. The Company incurred $95 million of transaction costs directly related to the acquisition of ArQule, consisting almost entirely of share-based compensation payments to settle non-vested equity awards attributable to postcombination service. These costs were included in Selling, general and administrative expenses in the first nine months of 2020. ArQule’s lead investigational candidate, MK-1026 (formerly known as ARQ 531), is a novel, oral Bruton’s tyrosine kinase (BTK) inhibitor currently being evaluated for the treatment of B-cell malignancies. The transaction was accounted for as an acquisition of a business.

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Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
The estimated fair value of assets acquired and liabilities assumed from ArQule is as follows:
($ in millions)January 16, 2020
Cash and cash equivalents$145 
IPR&D MK-1026 (formerly ARQ 531) (1)
2,280 
Licensing arrangement for ARQ 08780 
Deferred income tax liabilities(389)(361)
Other assets and liabilities, net34 
Total identifiable net assets2,1502,178 
Goodwill (2)
540512 
Consideration transferred$2,690 
(1)The estimated fair value of the identifiable intangible asset related to IPR&D was determined using an income approach. The future net cash flows were discounted to present value utilizing a discount rate of 12.5%. Actual cash flows are likely to be different than those assumed.
(2)The goodwill was allocated to the Pharmaceutical segment and is not deductible for tax purposes.
In July 2019, Merck acquired Peloton Therapeutics, Inc. (Peloton), a clinical-stage biopharmaceutical company focused on the development of novel small molecule therapeutic candidates targeting hypoxia-inducible factor-2α (HIF-2α) for the treatment of patients with cancer and other non-oncology diseases. Peloton’s lead candidate, MK-6482 (formerly known as PT2977), is a novel investigational oral HIF-2α inhibitor in late-stage development for renal cell carcinoma. Merck made an upfront payment of $1.2 billion; additionally, former Peloton shareholders will be eligible to receive $50 million upon U.S. regulatory approval, $50 million upon first commercial sale in the United States, and up to $1.05 billion of sales-based milestones. The transaction was accounted for as an acquisition of an asset. Merck recorded cash of $157 million, deferred tax liabilities of $64 million, and other net liabilities of $6 million at the acquisition date and Research and development expenses of $982 million in the third quarter and first nine months of 2019 related to the transaction.
On April 1, 2019, Merck acquired Antelliq Corporation (Antelliq), a leader in digital animal identification, traceability and monitoring solutions. These solutions help veterinarians, farmers and pet owners gather critical data to improve management, health and well-being of livestock and pets. Merck paid $2.3 billion to acquire all outstanding shares of Antelliq and spent $1.3 billion to repay Antelliq’s debt. The transaction was accounted for as an acquisition of a business.
The estimated fair value of assets acquired and liabilities assumed from Antelliq is as follows:
($ in millions)April 1, 2019
Cash and cash equivalents$31 
Accounts receivable73 
Inventories93 
Property, plant and equipment60 
Identifiable intangible assets (useful lives ranging from 18-24 years) (1)
2,689 
Deferred income tax liabilities(589)
Other assets and liabilities, net(82)
Total identifiable net assets2,275 
Goodwill (2)
1,376 
Consideration transferred$3,651 
(1)    The estimated fair values of identifiable intangible assets relate primarily to trade names and were determined using an income approach. The future net cash flows were discounted to present value utilizing a discount rate of 11.5%. Actual cash flows are likely to be different than those assumed.
(2)    The goodwill recognized is largely attributable to anticipated synergies expected to arise after the acquisition and was allocated to the Animal Health segment. The goodwill is not deductible for tax purposes.

The Company’s results for the first nine months of 2019 include five months of activity for Antelliq. The Company incurred $47 million of transaction costs directly related to the acquisition of Antelliq, consisting largely of advisory fees, which are reflected in Selling, general and administrative expenses in the first nine months of 2019.
Also in April 2019, Merck acquired Immune Design, a late-stage immunotherapy company employing next-generation in vivo approaches to enable the body’s immune system to fight disease, for $301 million in cash. The transaction was accounted for as an acquisition of a business. Merck recognized intangible assets of $156 million, cash of $83 million and other net assets of $42 million. The excess of the consideration transferred over the fair value of net assets acquired of $20
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Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
million was recorded as goodwill that was allocated to the Pharmaceutical segment and is not deductible for tax purposes. The fair values of the identifiable intangible assets related to IPR&D were determined using an income approach. Actual cash flows are likely to be different than those assumed.
3.4.    Collaborative Arrangements
Merck has entered into collaborative arrangements that provide the Company with varying rights to develop, produce and market products together with its collaborative partners. Both parties in these arrangements are active participants and exposed to significant risks and rewards dependent on the commercial success of the activities of the collaboration. Merck’s more significant collaborative arrangements are discussed below. For further details refer to Note 4 to the consolidated financial statements included in Merck’s 2020 Form 10‑K.
AstraZeneca
In July 2017, Merck and AstraZeneca PLC (AstraZeneca) entered into a global strategic oncology collaboration to co-develop and co-commercialize AstraZeneca’s Lynparza (olaparib) for multiple cancer types. Lynparza is an oral poly (ADP-ribose) polymerase (PARP) inhibitor currently approved for certain types of advanced ovarian, breast, pancreatic and prostate cancers. The companies are jointly developing and commercializing Lynparza, both as monotherapy and in combination trials with other potential medicines. Independently, Merck and AstraZeneca will develop and commercialize Lynparza in combinations with their respective PD-1 and PD-L1 medicines, Keytruda and Imfinzi. The companies willare also jointly developdeveloping and commercializecommercializing AstraZeneca’s Koselugo (selumetinib), an oral, selective inhibitor of MEK, part of the mitogen-activated protein kinase (MAPK) pathway, currently being developed for multiple indications. In April 2020, Koselugowas approved by the U.S. Food and Drug Administration (FDA) for the treatment of pediatric patients two years of age and older with neurofibromatosis type 1 who have symptomatic, inoperable plexiform neurofibromas. Under the terms of the agreement, AstraZeneca and Merck will share the development and commercialization costs for Lynparza and Koselugo monotherapy and non-PD-L1/PD-1 combination therapy opportunities.
Profits from Lynparza and Koselugo product sales generated through monotherapies or combination therapies are shared equally. Merck will fund all development and commercialization costs of Keytruda in combination with Lynparza or Koselugo. AstraZeneca will fund all development and commercialization costs of Imfinzi in combination with Lynparza or Koselugo. AstraZeneca is the principal on Lynparza and Koselugo sales transactions. Merck records its share of Lynparza and Koselugo product sales, net of cost of sales and commercialization costs, as alliance revenue and its share of development costs associated with the collaboration as part of Research and development expenses. Reimbursements received from AstraZeneca for research and development expenses are recognized as reductions to Research and development costs.
As part of the agreement, Merck made an upfront payment to AstraZeneca of $1.6 billion in 2017 and also made payments of $750 million over a multi-year period for certain license options. In addition, the agreement provides for additional contingent payments from Merck to AstraZeneca related to the successful achievement of sales-based and regulatory milestones.
In the second quarter As of 2020, Merck determined it was probable that sales of Lynparza in the future would trigger $400 million ofSeptember 30, 2021, sales-based milestone payments from Merck to AstraZeneca. Accordingly, Merck recorded aaccrued but not yet paid totaled $400 million liability and a corresponding increase to the intangible asset related to Lynparza. Prior to 2020, Merck accrued sales-based milestone payments aggregating $1.0 billion related to Lynparza, of which $200 million and $250 million was paid to AstraZeneca in 2019 and 2018, respectively, and $250 million was paid in the first nine months of 2020.million. Potential future sales-based milestone payments of $2.7 billion have not yet been accrued as they are not deemed by the Company to be probable at this time.
In the second quarter of 2020, Lynparza received regulatory approvals triggering capitalized milestone payments of $135 million from Merck to AstraZeneca. In 2019 and 2018, Lynparza received regulatory approvals triggering capitalized milestone payments of $60 million and $140 million, respectively, in the aggregate from Merck to AstraZeneca. Potential Additionally, potential future regulatory milestone payments of $1.4 billion remain under the agreement.
The intangible asset balance related to Lynparza (which includes capitalized sales-based and regulatory milestone payments) was $1.3$1.1 billion at September 30, 20202021 and is included in Other Intangibles, Net on the Consolidated Balance Sheet.. The amount is being amortized over its estimated useful life through 2028 as supported by projected future cash flows, subject to impairment testing.

- 1012 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Summarized financial information related to this collaboration is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)2020201920202019($ in millions)2021202020212020
Alliance revenue - LynparzaAlliance revenue - Lynparza$196 $123 $519 $313 Alliance revenue - Lynparza$246 $196 $721 $519 
Alliance revenue - KoselugoAlliance revenue - KoselugoAlliance revenue - Koselugo20 
Total alliance revenueTotal alliance revenue$199 $123 $522 $313 Total alliance revenue$252 $199 $741 $522 
Cost of sales (1)
Cost of sales (1)
41 28 205 120 
Cost of sales (1)
42 41 125 205 
Selling, general and administrativeSelling, general and administrative40 36 112 96 Selling, general and administrative44 40 127 112 
Research and developmentResearch and development20 44 93 122 Research and development27 20 87 93 
($ in millions)($ in millions)September 30, 2020December 31, 2019($ in millions)September 30, 2021December 31, 2020
Receivables from AstraZeneca included in Other current assets
Receivables from AstraZeneca included in Other current assets
$197 $128 
Receivables from AstraZeneca included in Other current assets
$248 $215 
Payables to AstraZeneca included in Accrued and other current liabilities (2)
Payables to AstraZeneca included in Accrued and other current liabilities (2)
309 577 
Payables to AstraZeneca included in Accrued and other current liabilities (2)
415 423 
Payables to AstraZeneca included in Other Noncurrent Liabilities (2)
400 
(1) Represents amortization of capitalized milestone payments.
(2) Includes accrued milestone payments.
Eisai
In March 2018, Merck and Eisai Co., Ltd. (Eisai) announced a strategic collaboration for the worldwide co-development and co-commercialization of Lenvima (lenvatinib), an orally available tyrosine kinase inhibitor discovered by Eisai. Lenvima is currently approved for the treatment of certain types of thyroid cancer, hepatocellular carcinoma, in combination with everolimus for certain patients with renal cell carcinoma, and in combination with Keytruda for the treatment of certain patients with endometrial carcinoma. Under the agreement, Merck and Eisai will develop and commercialize Lenvima jointly, both as monotherapy and in combination with Keytruda. Eisai records Lenvima product sales globally (Eisai is the principal on Lenvima sales transactions), and Merck and Eisai share applicable profits equally. Merck records its share of Lenvima product sales, net of cost of sales and commercialization costs, as alliance revenue. Expenses incurred during co-development including for studies evaluating Lenvima as monotherapy, are shared equally by the two companies in accordance with the collaboration agreement and reflected in Research and development expenses. Certain expenses incurred solely by Merck or Eisai are not shareable under the collaboration agreement, including costs incurred in excess of agreed upon caps and costs related to certain combination studies of Keytruda and Lenvima.
Under the agreement, Merck made an upfront payment to Eisai of $750 million and agreed to makealso made payments of up to $650 millionover a multi-year period for certain optionoptions rights through 2021 (of which $325 million was paid in March 2019, $200 million was paid in March 2020 andthe final $125 million is expected to be paidoption payment was made in March 2021). In addition, the agreement provides for additional contingent payments from Merck to Eisai related to the successful achievement of sales-based and regulatory milestones.
In the second quarter of 2020, Merck determined it was probable that sales of Lenvima in the future would triggermade sales-based milestone payments aggregating $370of $200 million from Merck to Eisai. Accordingly, Merck recorded a $370 million liability and a corresponding increase to the intangible asset related to Lenvima. Prior to 2020, Merck accrued sales-based milestone payments aggregating $950 million. Of these amounts, $50 million was paid to Eisai in 2019 and an additional $500 million was paid in the first nine months of 2020.2021. As of September 30, 2021, sales-based milestone payments accrued but not yet paid totaled $600 million. Potential future sales-based milestone payments of $2.7$2.6 billion have not yet been accrued as they are not deemed by the Company to be probable at this time.
In 2018,the third quarter of 2021, Lenvima received a regulatory approvalsapproval triggering a capitalized milestone paymentspayment of $250$75 million in the aggregate from Merck to Eisai. Potential future regulatory milestone payments of $135$50 million remain under the agreement.
The intangible asset balance related to Lenvima (which includes capitalized sales-based and regulatory milestone payments) was $1.1$1.0 billion at September 30, 20202021 and is included in Other Intangibles, Net on the Consolidated Balance Sheet.. The amount is being amortized over its estimated useful life through 2026 as supported by projected future cash flows, subject to impairment testing.

- 1113 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Summarized financial information related to this collaboration is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)2020201920202019($ in millions)2021202020212020
Alliance revenue - LenvimaAlliance revenue - Lenvima$142 $109 $421 $280 Alliance revenue - Lenvima$188 $142 $498 $421 
Cost of sales (1)
Cost of sales (1)
46 23 215 97 
Cost of sales (1)
49 46 143 215 
Selling, general and administrativeSelling, general and administrative18 21 48 59 Selling, general and administrative34 18 88 48 
Research and developmentResearch and development48 37 168 146 Research and development43 48 165 168 
($ in millions)($ in millions)September 30, 2020December 31, 2019($ in millions)September 30, 2021December 31, 2020
Receivables from Eisai included in Other current assets
Receivables from Eisai included in Other current assets
$170 $150 
Receivables from Eisai included in Other current assets
$223 $157 
Payables to Eisai included in Accrued and other current liabilities (2)
Payables to Eisai included in Accrued and other current liabilities (2)
325 700 
Payables to Eisai included in Accrued and other current liabilities (2)
600 335 
Payables to Eisai included in Other Noncurrent Liabilities (3)
Payables to Eisai included in Other Noncurrent Liabilities (3)
570 525 
Payables to Eisai included in Other Noncurrent Liabilities (3)
— 600 
(1) Represents amortization of capitalized milestone payments.
(2) Includes accrued milestone and future option payments.
(3) Includes accrued milestone payments.
Bayer AG
In 2014, the Company entered into a worldwide clinical development collaboration with Bayer AG (Bayer) to market and develop soluble guanylate cyclase (sGC) modulators including Bayer’s Adempas (riociguat), which is approved to treat pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.. The two companies have implemented a joint development and commercialization strategy. The collaboration also includes clinical development of Bayer’s vericiguat,Verquvo (vericiguat), which is in development for the potential treatment of worsening heart failure. Vericiguat is currently under review by regulatory authoritieswas approved in the United States,U.S. in January 2021, in Japan in June 2021 and in the EU and Japan.in July 2021. Under the agreement, Bayer leads commercialization ofcommercializes Adempas in the Americas, while Merck leads commercializationcommercializes in the rest of the world. For vericiguat, if approved,Verquvo, Merck commercializes in the U.S. and Bayer will lead commercializationcommercializes in the rest of world and Merck will lead in the Americas.world. Both companies share in development costs and profits on sales and have the right to co-promote in territories where they are not the lead.sales. Merck records sales of Adempas and Verquvo in its marketing territories, as well as alliance revenue. Alliance revenue which isrepresents Merck’s share of profits from the sale of Adempassales in Bayer’s marketing territories, which are product sales net of cost of sales and commercialization costs. Cost of sales includes Bayer’s share of profits from sales in Merck’s marketing territories.
In addition, the agreement provides for contingent payments from Merck to Bayer related to the successful achievement of sales-based milestones.
Prior to 2020, In the first quarter of 2021, following the approval of Verquvo noted above, Merck accrued $725 milliondetermined it was probable that sales of sales-based milestone payments for this collaboration, of which $350 million was paid to BayerAdempas and Verquvo in 2018. There is an additionalthe future would trigger the remaining $400 million potential future sales-based milestone payment that has not yet been accrued as it is not deemed bywas outstanding under this agreement. Accordingly, Merck recorded a liability of $400 million and a corresponding increase to the Companyintangible assets related to be probable at this time.collaboration. Merck also recognized $153 million of cumulative amortization expense related to the recognition of this milestone in the first nine months of 2021.
The intangible asset balance related to this collaborationAdempas (which includes the acquired intangible asset balance, as well as capitalized sales-based milestone payments)payments attributed to Adempas) was $838$869 million at September 30, 20202021 and is included in Other Intangibles, Net on the Consolidated Balance Sheet. The amount is being amortized over its estimated useful life through 2027 as supported by projected future cash flows, subject to impairment testing.
Summarized financial information The intangible asset balance related to this collaborationVerquvo (which reflects the portion of the final sales-based milestone payment that was attributed to Verquvo) was $72 million at September 30, 2021 and is being amortized over its estimated useful life through 2031 as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)2020201920202019
Alliance revenue - Adempas$83 $50 $216 $144 
Net sales of Adempas recorded by Merck55 57 167 158 
Total sales$138 $107 $383 $302 
Cost of sales (1)
29 28 85 86 
Selling, general and administrative19 12 42 31 
Research and development12 31 53 94 
($ in millions)September 30, 2020December 31, 2019
Receivables from Bayer included in Other current assets
$70 $49 
Payables to Bayer included in Other Noncurrent Liabilities (2)
375 375 
supported by projected future cash flows, subject to impairment testing.
(1) Includes amortization of intangible assets.
(2) Represents accrued milestone payment.
- 1214 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
4.Summarized financial information related to this collaboration is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)2021202020212020
Alliance revenue - Adempas/Verquvo$100 $83 $248 $216 
Net sales of Adempas recorded by Merck59 55 188 167 
Net sales of Verquvo recorded by Merck— — 
Total sales$161 $138 $439 $383 
Cost of sales (1)
53 81 328 229 
Selling, general and administrative31 12 84 32 
Research and development16 12 36 53 
($ in millions)September 30, 2021December 31, 2020
Receivables from Bayer included in Other current assets
$139 $65 
Payables to Bayer included in Accrued and other current liabilities (2)
467 — 
(1) Includes amortization of intangible assets. Amount in the first nine months of 2021 includes $153 million of cumulative amortization as noted above. In addition, cost of sales in all periods now includes Bayer’s share of profits from sales in Merck’s marketing territories.
(2) Includes accrued milestone payment.
5.    Restructuring
In early 2019, Merck approved a new global restructuring program (Restructuring Program) as part of a worldwide initiative focused on further optimizing the Company’s manufacturing and supply network, as well as reducing its global real estate footprint. This program is a continuation of the Company’s plant rationalization, builds on prior restructuring programs and does not include any actions associated with the planned spin-off of Organon. As the Company continues to evaluate its global footprint and overall operating model, it subsequently identified additional actions under the Restructuring Program, and could identify further actions over time. The actions currently contemplated under the Restructuring Program are expected to be substantially completed by the end of 2023, with the cumulative pretax costs to be incurred by the Company to implement the program estimated to be approximately $2.5$3.0 billion. The Company estimates that approximately 60%70% of the cumulative pretax costs will result in cash outlays, primarily related to employee separation expense and facility shut-down costs. Approximately 40%30% of the cumulative pretax costs will be non-cash, relating primarily to the accelerated depreciation of facilities to be closed or divested. The Company expects to record charges of approximately $800 million in 2020 related to the Restructuring Program. Actions under previous global restructuring programs have been substantially completed.
The Company recorded total pretax costs of $186$168 million and $296$185 million in the third quarter of 20202021 and 2019,2020, respectively, and $504$630 million and $642$500 million for the first nine months of 20202021 and 2019,2020, respectively, related to restructuring program activities. Since inception of the Restructuring Program through September 30, 2020,2021, Merck has recorded total pretax accumulated costs of approximately $1.4$2.4 billion. For the full year of 2021, the Company expects to record charges of approximately $700 million related to the Restructuring Program. For segment reporting, restructuring charges are unallocated expenses.
The following tables summarize the charges related to restructuring program activities by type of cost:
Three Months Ended September 30, 2020Nine Months Ended September 30, 2020 Three Months Ended September 30, 2021Nine Months Ended September 30, 2021
($ in millions)($ in millions)Separation
Costs
Accelerated
Depreciation
OtherTotalSeparation
Costs
Accelerated
Depreciation
OtherTotal($ in millions)Separation
Costs
Accelerated
Depreciation
OtherTotalSeparation
Costs
Accelerated
Depreciation
OtherTotal
Cost of salesCost of sales$$33 $$38 $$89 $42 $131 Cost of sales$— $11 $37 $48 $— $32 $81 $113 
Selling, general and administrativeSelling, general and administrative15 15 37 37 Selling, general and administrative— — 
Research and developmentResearch and development18 19 66 67 Research and development— — 20 21 
Restructuring costsRestructuring costs61 53 114 143 126 269 Restructuring costs17 — 90 107 310 — 177 487 
$61 $66 $59 $186 $143 $192 $169 $504 $17 $22 $129 $168 $310 $60 $260 $630 
Three Months Ended September 30, 2019Nine Months Ended September 30, 2019 Three Months Ended September 30, 2020Nine Months Ended September 30, 2020
($ in millions)($ in millions)Separation
Costs
Accelerated
Depreciation
OtherTotalSeparation
Costs
Accelerated
Depreciation
OtherTotal($ in millions)Separation
Costs
Accelerated
Depreciation
OtherTotalSeparation
Costs
Accelerated
Depreciation
OtherTotal
Cost of salesCost of sales$$41 $21 $62 $$139 $22 $161 Cost of sales$— $33 $$38 $— $89 $42 $131 
Selling, general and administrativeSelling, general and administrative33 33 Selling, general and administrative— 15 — 15 — 37 — 37 
Research and developmentResearch and development(1)Research and development— 18 19 — 66 67 
Restructuring costsRestructuring costs205 27 232 358 86 444 Restructuring costs61 — 52 113 143 — 122 265 
$205 $41 $50 $296 $358 $173 $111 $642 $61 $66 $58 $185 $143 $192 $165 $500 
- 15 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Separation costs are associated with actual headcount reductions, as well as those headcount reductions which were probable and could be reasonably estimated.
Accelerated depreciation costs primarily relate to manufacturing, research and administrative facilities and equipment to be sold or closed as part of the programs. Accelerated depreciation costs represent the difference between the depreciation expense to be recognized over the revised useful life of the asset, based upon the anticipated date the site will be closed or divested or the equipment disposed of, and depreciation expense as determined utilizing the useful life prior to the restructuring actions. All the sites have and will continue to operate up through the respective closure dates and, since future undiscounted cash flows are sufficient to recover the respective book values, Merck is recording accelerated depreciation over the revised useful life of the site assets. Anticipated site closure dates, particularly related to manufacturing locations, have been and may continue to be adjusted to reflect changes resulting from regulatory or other factors.
Other activity in 20202021 and 20192020 includes asset abandonment, facility shut-down and other related costs, as well as pretax gains and losses resulting from the sales of facilities and related assets. Additionally, other activity includes certain employee-related costs associated with pension and other postretirement benefit plans (see Note 12)11) and share-based compensation.

- 13 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
The following table summarizes the charges and spending relating to restructuring program activities for the nine months ended September 30, 2020:2021:
($ in millions)($ in millions)Separation
Costs
Accelerated
Depreciation
OtherTotal($ in millions)Separation
Costs
Accelerated
Depreciation
OtherTotal
Restructuring reserves January 1, 2020$690 $$69 $759 
Restructuring reserves January 1, 2021Restructuring reserves January 1, 2021$567 $— $19 $586 
ExpenseExpense143 192 169 504 Expense310 60 260 630 
(Payments) receipts, net(Payments) receipts, net(395)(237)(632)(Payments) receipts, net(305)— (155)(460)
Non-cash activityNon-cash activity(192)39 (153)Non-cash activity— (60)(84)(144)
Restructuring reserves September 30, 2020 (1)
$438 $$40 $478 
Restructuring reserves September 30, 2021 (1)
Restructuring reserves September 30, 2021 (1)
$572 $— $40 $612 
(1)The remaining cash outlays are expected to be substantially completed by the end of 2023.
5.6.    Financial Instruments
Derivative Instruments and Hedging Activities
The Company manages the impact of foreign exchange rate movements and interest rate movements on its earnings, cash flows and fair values of assets and liabilities through operational means and through the use of various financial instruments, including derivative instruments.
A significant portion of the Company’s revenues and earnings in foreign affiliates is exposed to changes in foreign exchange rates. The objectives and accounting related to the Company’s foreign currency risk management program, as well as its interest rate risk management activities are discussed below.
Foreign Currency Risk Management
The Company has established revenue hedging, balance sheet risk management and net investment hedging programs to protect against volatility of future foreign currency cash flows and changes in fair value caused by changes in foreign exchange rates.
The objective of the revenue hedging program is to reduce the variability caused by changes in foreign exchange rates that would affect the U.S. dollar value of future cash flows derived from foreign currency denominated sales, primarily the euro, Japanese yen and Chinese renminbi. To achieve this objective, the Company will hedge a portion of its forecasted foreign currency denominated third-party and intercompany distributor entity sales (forecasted sales) that are expected to occur over its planning cycle, typically no more than two years into the future. The Company will layer in hedges over time, increasing the portion of forecasted sales hedged as it gets closer to the expected date of the forecasted sales. The portion of forecasted sales hedged is based on assessments of cost-benefit profiles that consider natural offsetting exposures, revenue and exchange rate volatilities and correlations, and the cost of hedging instruments. The Company manages its anticipated transaction exposure principally with purchased local currency put options, forward contracts and purchased collar options.
The fair values of these derivative contracts are recorded as either assets (gain positions) or liabilities (loss positions) in the Condensed Consolidated Balance Sheet. Changes in the fair value of derivative contracts are recorded each period in either current earnings or Other comprehensive income (OCI), depending on whether the derivative is designated as part of a hedge transaction and, if so, the type of hedge transaction. For derivatives that are designated as cash flow hedges, the unrealized gains or losses on these contracts are recorded in Accumulated other comprehensive incomeAOCL (AOCI) and reclassified into Sales when the hedged anticipated revenue is recognized. For those derivatives which are not designated as cash flow hedges, but serve as economic hedges of forecasted sales, unrealized gains or losses are recorded in Sales each period. The cash flows from both designated and non-designatednon-
- 16 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
designated contracts are reported as operating activities in the Condensed Consolidated Statement of Cash Flows. The Company does not enter into derivatives for trading or speculative purposes.
The Company manages operating activities and net asset positions at each local subsidiary in order to mitigate the effects of exchange on monetary assets and liabilities. The Company also uses a balance sheet risk management program to mitigate the exposure of net monetary assets that are denominated in a currency other than a subsidiary’s functional currency from the effects of volatility in foreign exchange. In these instances, Merck principally utilizes forward exchange contracts to offset the effects of exchange on exposures denominated in developed country currencies, primarily the euro and Japanese yen. For exposures in developing country currencies, the Company will enter into forward contracts to partially offset the effects of exchange on exposures when it is deemed economical to do so based on a cost-benefit analysis that considers the magnitude of the exposure, the volatility of the exchange rate and the cost of the hedging instrument. The cash flows from these contracts are reported as operating activities in the Condensed Consolidated Statement of Cash Flows.
Monetary assets and liabilities denominated in a currency other than the functional currency of a given subsidiary are remeasured at spot rates in effect on the balance sheet date with the effects of changes in spot rates reported in Other (income) expense, net. The forward contracts are not designated as hedges and are marked to market through Other (income) expense, net. Accordingly, fair value changes in the forward contracts help mitigate the changes in the value of the remeasured
- 14 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
assets and liabilities attributable to changes in foreign currency exchange rates, except to the extent of the spot-forward differences. These differences are not significant due to the short-term nature of the contracts, which typically have average maturities at inception of less than one year.
The Company also uses forward exchange contracts to hedge a portion of its net investment in foreign operations against movements in exchange rates. The forward contracts are designated as hedges of the net investment in a foreign operation. The unrealized gains or losses on these contracts are recorded in foreign currency translation adjustment within OCI and remain in AOCIAOCL until either the sale or complete or substantially complete liquidation of the subsidiary. The Company excludes certain portions of the change in fair value of its derivative instruments from the assessment of hedge effectiveness (excluded components). Changes in fair value of the excluded components are recognized in OCI. The Company recognizes in earnings the initial value of the excluded components on a straight-line basis over the life of the derivative instrument, rather than using the mark-to-market approach. The cash flows from these contracts are reported as investing activities in the Condensed Consolidated Statement of Cash Flows.
Foreign exchange risk is also managed through the use of foreign currency debt. The Company’s senior unsecured euro-denominated notes have been designated as, and are effective as, economic hedges of the net investment in a foreign operation. Accordingly, foreign currency transaction gains or losses due to spot rate fluctuations on the euro-denominated debt instruments are included in foreign currency translation adjustment within OCI.
The effects of the Company’s net investment hedges on OCI and the Consolidated Statement of Income are shown below:
Amount of Pretax (Gain) Loss Recognized in Other Comprehensive Income (1)
Amount of Pretax (Gain) Loss Recognized in Other (income) expense, net for Amounts Excluded from Effectiveness Testing
Amount of Pretax (Gain) Loss Recognized in Other Comprehensive Income (1)
Amount of Pretax (Gain) Loss Recognized in Other (income) expense, net for Amounts Excluded from Effectiveness Testing
Three Months Ended September 30,Nine Months Ended September 30,Three Months Ended September 30,Nine Months Ended September 30,Three Months Ended September 30,Nine Months Ended September 30,Three Months Ended September 30,Nine Months Ended September 30,
($ in millions)($ in millions)20202019202020192020201920202019($ in millions)20212020202120202021202020212020
Net Investment Hedging RelationshipsNet Investment Hedging RelationshipsNet Investment Hedging Relationships
Foreign exchange contractsForeign exchange contracts$10 $$15 $$(4)$(8)$(15)$(23)Foreign exchange contracts$$10 $(27)$15 $(4)$(4)$(12)$(15)
Euro-denominated notesEuro-denominated notes162 (150)182 (152)Euro-denominated notes(77)162 (199)182 — — — — 
(1) No amounts were reclassified from AOCIAOCL into income related to the sale of a subsidiary.
Interest Rate Risk Management
The Company may use interest rate swap contracts on certain investing and borrowing transactions to manage its net exposure to interest rate changes and to reduce its overall cost of borrowing. The Company does not use leveraged swaps and, in general, does not leverage any of its investment activities that would put principal capital at risk.
In February 2020,January 2021, 5 interest rate swaps with a total notional amountsamount of $250 million each$1.15 billion matured. These swaps effectively converted the Company’s $1.25$1.15 billion, 1.85%3.875% fixed-rate notes due 20202021 to variable rate debt. At September 30, 2020,2021, the Company was a party to 149 pay-floating, receive-fixed interest rate swap contracts designated as fair value hedges of fixed-rate notes in which the notional amounts match the amount of the hedged fixed-rate notes as detailed in the table below.
September 30, 2020
($ in millions)Par Value of DebtNumber of Interest Rate Swaps HeldTotal Swap Notional Amount
3.875% notes due 2021$1,150 $1,150 
2.40% notes due 20221,000 1,000 
2.35% notes due 20221,250 1,250 
- 17 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
September 30, 2021
($ in millions)Par Value of DebtNumber of Interest Rate Swaps HeldTotal Swap Notional Amount
2.40% notes due 2022$1,000 $1,000 
2.35% notes due 20221,250 1,250 
The interest rate swap contracts are designated hedges of the fair value changes in the notes attributable to changes in the benchmark London Interbank Offered Rate (LIBOR)LIBOR swap rate. The fair value changes in the notes attributable to changes in the LIBOR swap rate are recorded in interest expense along with the offsetting fair value changes in the swap contracts. The cash flows from these contracts are reported as operating activities in the Condensed Consolidated Statement of Cash Flows.

- 15 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
The table below presents the location of amounts recorded on the Condensed Consolidated Balance Sheet related to cumulative basis adjustments for fair value hedges:
Carrying Amount of Hedged LiabilitiesCumulative Amount of Fair Value Hedging Adjustment Increase (Decrease) Included in the Carrying AmountCarrying Amount of Hedged LiabilitiesCumulative Amount of Fair Value Hedging Adjustment Increase (Decrease) Included in the Carrying Amount
($ in millions)($ in millions)September 30, 2020December 31, 2019September 30, 2020December 31, 2019($ in millions)September 30, 2021December 31, 2020September 30, 2021December 31, 2020
Balance Sheet Line Item in which Hedged Item is Included
Loans payable and current portion of long-term debtLoans payable and current portion of long-term debt$1,155 $1,249 $$(1)Loans payable and current portion of long-term debt$2,274 $1,150 $25 $— 
Long-Term DebtLong-Term Debt2,309 3,409 62 14 Long-Term Debt— 2,301 — 53 
Presented in the table below is the fair value of derivatives on a gross basis segregated between those derivatives that are designated as hedging instruments and those that are not designated as hedging instruments:
 September 30, 2020December 31, 2019  September 30, 2021December 31, 2020
 Fair Value of DerivativeU.S. Dollar
Notional
Fair Value of DerivativeU.S. Dollar
Notional
 Fair Value of DerivativeU.S. Dollar
Notional
Fair Value of DerivativeU.S. Dollar
Notional
($ in millions)($ in millions)Balance Sheet CaptionAssetLiabilityAssetLiability($ in millions)AssetLiabilityAssetLiability
Derivatives Designated as Hedging InstrumentsDerivatives Designated as Hedging InstrumentsDerivatives Designated as Hedging InstrumentsBalance Sheet Caption
Interest rate swap contractsOther current assets$$— $1,150 $$— $
Interest rate swap contractsInterest rate swap contractsOther Assets63 — 2,250 15 — 3,400 Interest rate swap contractsOther current assets$26 $— $2,250 $$— $1,150 
Interest rate swap contractsInterest rate swap contractsAccrued and other current liabilities— — 1,250 Interest rate swap contractsOther Assets— — — 54 — 2,250 
Foreign exchange contractsForeign exchange contractsOther current assets30 — 4,120 152 — 6,117 Foreign exchange contractsOther current assets224 — 7,138 12 — 3,183 
Foreign exchange contractsForeign exchange contractsOther Assets59 — 1,881 55 — 2,160 Foreign exchange contractsOther Assets45 — 1,469 45 — 2,030 
Foreign exchange contractsForeign exchange contractsAccrued and other current liabilities— 104 3,096 — 22 1,748 Foreign exchange contractsAccrued and other current liabilities— 15 1,601 — 217 5,049 
Foreign exchange contractsForeign exchange contractsOther Noncurrent Liabilities— 157 — 53 Foreign exchange contractsOther Noncurrent Liabilities— 145 — 52 
 $158 $105 $12,654 $222 $24 $14,728   $295 $16 $12,603 $112 $218 $13,714 
Derivatives Not Designated as Hedging InstrumentsDerivatives Not Designated as Hedging Instruments       Derivatives Not Designated as Hedging InstrumentsBalance Sheet Caption      
Foreign exchange contractsForeign exchange contractsOther current assets$81 $— $5,455 $66 $— $7,245 Foreign exchange contractsOther current assets$82 $— $6,333 $70 $— $7,260 
Foreign exchange contractsForeign exchange contractsAccrued and other current liabilities— 171 8,042 — 73 8,693 Foreign exchange contractsAccrued and other current liabilities— 117 9,522 — 307 11,810 
Forward contract related to Seagen common stockAccrued and other current liabilities— 22 1,000 — 
 $81 $193 $14,497 $66 $73 $15,938   $82 $117 $15,855 $70 $307 $19,070 
 $239 $298 $27,151 $288 $97 $30,666   $377 $133 $28,458 $182 $525 $32,784 
As noted above, the Company records its derivatives on a gross basis in the Condensed Consolidated Balance Sheet. The Company has master netting agreements with several of its financial institution counterparties (see Concentrations of Credit Risk below). The following table provides information on the Company’s derivative positions subject to these master netting arrangements as if they were presented on a net basis, allowing for the right of offset by counterparty and cash collateral exchanged per the master agreements and related credit support annexes:
September 30, 2020December 31, 2019 September 30, 2021December 31, 2020
($ in millions)($ in millions)AssetLiabilityAssetLiability($ in millions)AssetLiabilityAssetLiability
Gross amounts recognized in the condensed consolidated balance sheetGross amounts recognized in the condensed consolidated balance sheet$239 $298 $288 $97 Gross amounts recognized in the condensed consolidated balance sheet$377 $133 $182 $525 
Gross amounts subject to offset in master netting arrangements not offset in the condensed consolidated balance sheetGross amounts subject to offset in master netting arrangements not offset in the condensed consolidated balance sheet(140)(140)(84)(84)Gross amounts subject to offset in master netting arrangements not offset in the condensed consolidated balance sheet(120)(120)(156)(156)
Cash collateral received(34)
Cash collateral received/postedCash collateral received/posted(65)— — (36)
Net amountsNet amounts$99 $158 $170 $13 Net amounts$192 $13 $26 $333 

- 1618 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
The table below provides information regarding the location and amount of pretax (gains) losses of derivatives designated in fair value or cash flow hedging relationships:relationships (including amounts attributable to discontinued operations):
Sales
Other (income) expense, net (1)
Other comprehensive income (loss)Sales
Other (income) expense, net (1)
Other comprehensive income (loss)Sales
Other (income) expense, net (1)
Other comprehensive income (loss)Sales
Other (income) expense, net (1)
Other comprehensive income (loss)
Three Months Ended September 30,Three Months Ended September 30,Three Months Ended September 30,Nine Months Ended September 30,Nine Months Ended September 30,Nine Months Ended September 30,Three Months Ended September 30,Three Months Ended September 30,Three Months Ended September 30,Nine Months Ended September 30,Nine Months Ended September 30,Nine Months Ended September 30,
($ in millions)($ in millions)202020192020201920202019202020192020201920202019($ in millions)202120202021202020212020202120202021202020212020
Financial Statement Line Items in which Effects of Fair Value or Cash Flow Hedges are RecordedFinancial Statement Line Items in which Effects of Fair Value or Cash Flow Hedges are Recorded$12,551 $12,397 $(312)$35 $10 $(28)$35,479 $34,972 $(630)$362 $(190)$155 Financial Statement Line Items in which Effects of Fair Value or Cash Flow Hedges are Recorded$13,154 $10,929 $(450)$(312)$38 $10 $35,183 $30,570 $(1,007)$(637)$1,595 $(190)
(Gain) loss on fair value hedging relationships(Gain) loss on fair value hedging relationships(Gain) loss on fair value hedging relationships
Interest rate swap contractsInterest rate swap contractsInterest rate swap contracts
Hedged itemsHedged items— — (14)13 — — — — 54 101 — — Hedged items— — (9)(14)— — — — (29)54 — — 
Derivatives designated as hedging instrumentsDerivatives designated as hedging instruments— — (6)— — — — (76)(74)— — Derivatives designated as hedging instruments— — (1)— — — — — (1)(76)— — 
Impact of cash flow hedging relationshipsImpact of cash flow hedging relationshipsImpact of cash flow hedging relationships
Foreign exchange contractsForeign exchange contractsForeign exchange contracts
Amount of (loss) gain recognized in OCI on derivatives
— — — — (195)186 — — — — (126)183 
Increase (decrease) in Sales as a result of AOCI reclassifications
(23)70 — — 23 (70)65 189 — — (65)(189)
Amount of gain (loss) recognized in OCI on derivatives
Amount of gain (loss) recognized in OCI on derivatives
— — — — 72 (195)— — — — 193 (126)
(Decrease) increase in Sales as a result of AOCL reclassifications
(Decrease) increase in Sales as a result of AOCL reclassifications
(36)(23)— — 36 23 (219)65 — — 219 (65)
Interest rate contractsInterest rate contractsInterest rate contracts
Amount of gain recognized in Other (income) expense, net on derivatives
Amount of gain recognized in Other (income) expense, net on derivatives
— — (1)(1)— — — — (3)(3)— — 
Amount of gain recognized in Other (income) expense, net on derivatives
— — — (1)— — — — (2)(3)— — 
Amount of loss recognized in OCI on derivatives
Amount of loss recognized in OCI on derivatives
— — — — (1)(1)— — — — (3)(6)
Amount of loss recognized in OCI on derivatives
— — — — — (1)— — — — (2)(3)
(1) Interest expense is a component of Other (income) expense, net.
The table below provides information regarding the income statement effects of derivatives not designated as hedging instruments:instruments (including amounts attributable to discontinued operations):
Amount of Derivative Pretax (Gain) Loss Recognized in IncomeAmount of Derivative Pretax (Gain) Loss Recognized in Income
Three Months Ended
September 30,
Nine Months Ended September 30,Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)Income Statement Caption2020201920202019($ in millions)2021202020212020
Derivatives Not Designated as Hedging InstrumentsDerivatives Not Designated as Hedging InstrumentsDerivatives Not Designated as Hedging InstrumentsIncome Statement Caption
Foreign exchange contracts (1)
Foreign exchange contracts (1)
Other (income) expense, net$(7)$(8)$(138)$112 
Foreign exchange contracts (1)
Other (income) expense, net$18 $(7)$234 $(138)
Foreign exchange contracts (2)
Foreign exchange contracts (2)
Sales(11)(7)
Foreign exchange contracts (2)
Sales(4)
Interest rate contracts (3)
Interest rate contracts (3)
Other (income) expense, net
Interest rate contracts (3)
Other (income) expense, net— — — 
Forward contract related to Seagen common stockForward contract related to Seagen common stockResearch and development expenses22 22 Forward contract related to Seagen common stockResearch and development— 22 — 22 
(1) These derivative contracts primarily mitigate changes in the value of remeasured foreign currency denominated monetary assets and liabilities attributable to changes in foreign currency exchange rates. Amount in the first nine months of 2021 includes a loss on forward exchange contracts entered into in conjunction with the spin-off of Organon.
(2) These derivative contracts serve as economic hedges of forecasted transactions.
(3) These derivativesderivative contracts serve as economic hedges against rising treasury rates.
At September 30, 2020,2021, the Company estimates $155$55 million of pretax net unrealized lossesgains on derivatives maturing within the next 12 months that hedge foreign currency denominated sales over that same period will be reclassified from AOCIAOCL to Sales. The amount ultimately reclassified to Sales may differ as foreign exchange rates change. Realized gains and losses are ultimately determined by actual exchange rates at maturity.

- 1719 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Investments in Debt and Equity Securities
Information on investments in debt and equity securities is as follows:
September 30, 2020December 31, 2019 September 30, 2021December 31, 2020
Amortized
Cost
Gross UnrealizedFair
Value
Amortized
Cost
Gross UnrealizedFair
Value
Amortized
Cost
Gross UnrealizedFair
Value
Amortized
Cost
Gross UnrealizedFair
Value
($ in millions)($ in millions)GainsLossesGainsLosses($ in millions)GainsLossesGainsLosses
U.S. government and agency securitiesU.S. government and agency securities$74 $$$74 $266 $$$269 U.S. government and agency securities$83 $— $— $83 $84 $— $— $84 
Corporate notes and bondsCorporate notes and bonds— — — — — — 
Foreign government bondsForeign government bondsForeign government bonds— — — — 
Commercial paper668 668 
Corporate notes and bonds608 13 621 
Asset-backed securities226 227 
Total debt securitiesTotal debt securities$76 $$$76 $1,768 $17 $$1,785 Total debt securities$89 $— $— $89 $89 $— $— $89 
Publicly traded equity securities (1)
Publicly traded equity securities (1)
1,477 838 
Publicly traded equity securities (1)
1,915 1,787 
Total debt and publicly traded equity securitiesTotal debt and publicly traded equity securities$1,553 $2,623 Total debt and publicly traded equity securities$2,004 $1,876 
(1) Unrealized net (gains)gains of $90 million and unrealized net losses recognizedof $109 million were recorded in Other (income) expense, net on equity securities still held at September 30, 2021 in the third quarter and first nine months of 2021, respectively. Unrealized net gains recorded in Other (income) expense, net on equity securities still held at September 30, 2020 were $(43)$43 million and $(512)$512 million in the third quarter and first nine months of 2020, respectively. Unrealized net losses (gains) recognized in Other (income) expense, net on equity securities still held at September 30, 2019 were $25 million and $(41) million in the third quarter and first nine months of 2019, respectively.
At September 30, 20202021 and September 30, 2019,2020, the Company also had $508$578 million and $393$508 million, respectively, of equity investments without readily determinable fair values included in Other Assets. The Company recognizes unrealized gains on these equity investments based on favorable observable price changes from transactions involving similar investments of the same investee and recognizes unrealized losses based on unfavorable observable price changes. During the first nine monthsof 2020,2021, the Company recognizedrecorded unrealized gains of $104 million and unrealized losses of $1 million in Other (income) expense, net related to these equity investments held at September 30, 2021. During the first nine monthsof 2020, the Company recorded unrealized gains of $21 million and unrealized losses of $3 million in Other (income) expense, net related to these equity investments held at September 30, 2020. During the first nine months of 2019, the Company recognized unrealized gains of $4 million and unrealized losses of $12 million in Other (income) expense, net related to these investments held at September 30, 2019. Cumulative unrealized gains and cumulative unrealized losses based on observable prices changes for investments in equity investments without readily determinable fair values still held at September 30, 20202021 were $128$229 million and $24$7 million, respectively.
Fair Value Measurements
Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. The Company uses a fair value hierarchy which maximizes the use of observable inputs and minimizes the use of unobservable inputs when measuring fair value. There are three levels of inputs used to measure fair value with Level 1 having the highest priority and Level 3 having the lowest: Level 1 - Quoted prices (unadjusted) in active markets for identical assets or liabilities; Level 2 - Observable inputs other than Level 1 prices, such as quoted prices for similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities; Level 3 - Unobservable inputs that are supported by little or no market activity. Level 3 assets or liabilities are those whose values are determined using pricing models, discounted cash flow methodologies, or similar techniques with significant unobservable inputs, as well as assets or liabilities for which the determination of fair value requires significant judgment or estimation. If the inputs used to measure the financial assets and liabilities fall within more than one level described above, the categorization is based on the lowest level input that is significant to the fair value measurement of the instrument.

- 1820 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis
Financial assets and liabilities measured at fair value on a recurring basis are summarized below:
Fair Value Measurements UsingFair Value Measurements UsingFair Value Measurements UsingFair Value Measurements Using
Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
($ in millions)($ in millions)September 30, 2020December 31, 2019($ in millions)September 30, 2021December 31, 2020
AssetsAssetsAssets
InvestmentsInvestmentsInvestments
Foreign government bondsForeign government bonds$$$$$$$$Foreign government bonds$— $$— $$— $$— $
Commercial paper668 668 
Corporate notes and bonds621 621 
Asset-backed securities (1)
227 227 
U.S. government and agency securities209 209 
Publicly traded equity securitiesPublicly traded equity securities1,370 1,370 518 518 Publicly traded equity securities433 — — 433 780 — — 780 
1,370 1,372 518 1,725 2,243  433 — 435 780 — 785 
Other assets (2)
Other assets (1)
Other assets (1)
U.S. government and agency securitiesU.S. government and agency securities74 74 60 60 U.S. government and agency securities83 — — 83 84 — — 84 
Corporate notes and bondsCorporate notes and bonds— — — — — — 
Publicly traded equity securitiesPublicly traded equity securities107 107 320 320 Publicly traded equity securities1,482 — — 1,482 1,007 — — 1,007 
181 181 380 380 1,569 — — 1,569 1,091 — — 1,091 
Derivative assets (3)
Derivative assets (2)
Derivative assets (2)
Forward exchange contractsForward exchange contracts116 116 169 169 Forward exchange contracts— 230 — 230 — 90 — 90 
Purchased currency optionsPurchased currency options— 121 — 121 — 37 — 37 
Interest rate swapsInterest rate swaps69 69 15 15 Interest rate swaps— 26 — 26 — 55 — 55 
Purchased currency options54 54 104 104 
239 239 288 288  — 377 — 377 — 182 — 182 
Total assetsTotal assets$1,551 $241 $$1,792 $898 $2,013 $$2,911 Total assets$2,002 $379 $— $2,381 $1,871 $187 $— $2,058 
LiabilitiesLiabilitiesLiabilities
Other liabilitiesOther liabilitiesOther liabilities
Contingent considerationContingent consideration$$$829 $829 $$$767 $767 Contingent consideration$— $— $902 $902 $— $— $841 $841 
Derivative liabilities (3)
Derivative liabilities (2)
Derivative liabilities (2)
Forward exchange contractsForward exchange contracts275 275 95 95 Forward exchange contracts— 132 — 132 — 505 — 505 
Forward contract related to Seagen common stock22 22 
Written currency optionsWritten currency optionsWritten currency options— — — 20 — 20 
Interest rate swaps
298 298 97 97 — 133 — 133 — 525 — 525 
Total liabilitiesTotal liabilities$$298 $829 $1,127 $$97 $767 $864 Total liabilities$— $133 $902 $1,035 $— $525 $841 $1,366 
(1)Primarily all of the asset-backed securities were highly rated (Standard & Poor’s rating of AAA and Moody’s Investors Service rating of Aaa), secured primarily by auto loan, credit card and student loan receivables, with weighted-average lives of primarily 5 years or less.
(2)    Investments included in other assets are restricted as to use, including for the payment of benefits under employee benefit plans.
(3)(2)    The fair value determination of derivatives includes the impact of the credit risk of counterparties to the derivatives and the Company’s own credit risk, the effects of which were not significant.
As of September 30, 20202021 and December 31, 2019,2020, Cash and cash equivalents included $6.6$9.2 billion and $8.9$6.8 billion of cash equivalents, respectively (which would be considered Level 2 in the fair value hierarchy).
- 19 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Contingent Consideration
Summarized information about the changes in the fair value of liabilities for contingent consideration associated with business acquisitions is as follows:
Nine Months Ended September 30,Nine Months Ended September 30,
($ in millions)($ in millions)20202019($ in millions)20212020
Fair value January 1$767 $788 
January 1January 1$841 $767 
AdditionsAdditions97 Additions— 97 
Changes in estimated fair value (1)
Changes in estimated fair value (1)
71 52 
Changes in estimated fair value (1)
73 71 
PaymentsPayments(106)(85)Payments— (106)
Fair value September 30 (2)(3)
$829 $755 
OtherOther(12)— 
September 30 (2)(3)
September 30 (2)(3)
$902 $829 
(1) Recorded in Cost of sales, Research and development expenses, and Other (income) expense, net. Includes cumulative translation adjustments.
(2) Balance at September 30, 20202021 includes $140$289 million recorded as a current liability for amounts expected to be paid within the next 12 months.
(3) At September 30, 20202021 and December 31, 2019, $6372020, $747 million and $625$711 million, respectively, of the liabilities relate to the termination of the Sanofi-PasteurSanofi Pasteur MSD joint venture in 2016. As part of the termination, Merck recorded a liability for contingent future royalty payments of 11.5% on net sales of all Merck products that were previously sold by the joint venture through December 31, 2024. The fair value of this liability is determined utilizing the estimated amount and timing of projected cash flows using a risk-adjusted discount rate of 8% to present value the cash flows.
The additions to contingent consideration in 2020 relate to the acquisition of Themis (see Note 2)3). The payments of contingent consideration in both periods2020 relate to liabilities recorded in connection with the termination of the Sanofi-Pasteur MSD joint venture in 2016.
- 21 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Other Fair Value Measurements
Some of the Company’s financial instruments, such as cash and cash equivalents, receivables and payables, are reflected in the balance sheet at carrying value, which approximates fair value due to their short-term nature.
The estimated fair value of loans payable and long-term debt (including current portion) at September 30, 2020,2021, was $32.6$29.1 billion compared with a carrying value of $28.7$26.4 billion and at December 31, 2019,2020, was $28.8$36.0 billion compared with a carrying value of $26.3$31.8 billion. Fair value was estimated using recent observable market prices and would be considered Level 2 in the fair value hierarchy.
Concentrations of Credit Risk
On an ongoing basis, the Company monitors concentrations of credit risk associated with corporate and government issuers of securities and financial institutions with which it conducts business. Credit exposure limits are established to limit a concentration with any single issuer or institution. Cash and investments are placed in instruments that meet high credit quality standards as specified in the Company’s investment policy guidelines.
The majority of the Company’s accounts receivable arise from product sales in the United States,U.S., Europe and China and are primarily due from drug wholesalers and retailers, hospitals, government agencies, managed health care providers and pharmacy benefit managers. The Company monitors the financial performance and creditworthiness of its customers so that it can properly assess and respond to changes in their credit profile. The Company also continues to monitor global economic conditions, including the volatility associated with international sovereign economies, and associated impacts on the financial markets and its business.
The Company has accounts receivable factoring agreements with financial institutions in certain countries to sell accounts receivable. The Company factored $2.1$2.4 billion and $2.7$2.1 billion of accounts receivable in the third quarter ofat September 30, 2021 and December 31, 2020, and the fourth quarter of 2019, respectively, under these factoring arrangements, which reduced outstanding accounts receivable. The cash received from the financial institutions is reported within operating activities in the Consolidated Statement of Cash Flows. In certain of these factoring arrangements, for ease of administration, the Company will collect customer payments related to the factored receivables, which it then remits to the financial institutions. The net cash flows relating to these collections are reported as financing activities in the Consolidated Statement of Cash Flows. The cost of factoring such accounts receivable was de minimis.
Derivative financial instruments are executed under International Swaps and Derivatives Association master agreements. The master agreements with several of the Company’s financial institution counterparties also include credit support annexes. These annexes contain provisions that require collateral to be exchanged depending on the value of the derivative assets and liabilities, the Company’s credit rating, and the credit rating of the counterparty. Cash collateral received by the Company from various counterparties was $34$65 million at December 31, 2019.September 30, 2021. The obligation to return such collateral is recorded in Accrued and other current liabilities. NaN cashCash collateral was advanced by the Company to counterparties as of September 30, 2020 orwas $36 million at December 31, 2019.2020.
- 20 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
6.7.    Inventories
Inventories consisted of:
($ in millions)($ in millions)September 30, 2020December 31, 2019($ in millions)September 30, 2021December 31, 2020
Finished goodsFinished goods$2,038 $1,772 Finished goods$1,628 $1,610 
Raw materials and work in processRaw materials and work in process6,073 5,650 Raw materials and work in process6,135 5,949 
SuppliesSupplies197 207 Supplies190 146 
Total (approximates current cost)Total (approximates current cost)8,308 7,629 Total (approximates current cost)7,953 7,705 
Decrease to LIFO cost(99)(171)
Increase (decrease) to LIFO costIncrease (decrease) to LIFO cost23 (81)
$8,209 $7,458  $7,976 $7,624 
Recognized as:Recognized as:Recognized as:
InventoriesInventories$6,128 $5,978 Inventories$5,603 $5,554 
Other assetsOther assets2,081 1,480 Other assets2,373 2,070 
Amounts recognized as Other Assets are comprised almost entirely of raw materials and work in process inventories. At September 30, 20202021 and December 31, 2019,2020, these amounts included $1.8$1.9 billion and $1.3$1.8 billion, respectively, of inventories not expected to be sold within one year. In addition, these amounts included $288$519 million and $168$279 million at September 30, 20202021 and December 31, 2019,2020, respectively, of inventories produced in preparation for product launches.
- 22 -
7.    Other

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
8.    Goodwill and Intangibles
DuringIn connection with the third quarterspin-off of Organon (see Note 2), goodwill was reduced by $1.4 billion. Additionally, other intangibles, on a net basis, were reduced by $519 million, including products and first nine monthsproducts rights of 2019, the Company recorded $612$394 million and $693 million, respectively,licenses of intangible asset impairment charges related to marketed products within Cost of sales. During the third quarter of 2019, the Company recorded an impairment charge of $612 million related to Sivextro (tedizolid phosphate), a product for the treatment of acute bacterial skin and skin structure infections caused by susceptible isolates of certain Gram-positive microorganisms. As part of a reorganization and reprioritization of its internal sales force, the Company made the decision to cease promotion of Sivextro in the U.S. market by the end of 2019. This decision resulted in reduced cash flow projections for Sivextro, which indicated that the Sivextro intangible asset value was not fully recoverable on an undiscounted cash flows basis. The Company utilized market participant assumptions to determine its best estimate of the fair value of the intangible asset related to Sivextro that, when compared with its related carrying value, resulted in the impairment charge noted above.
8.    Long-Term Debt
In June 2020, the Company issued $4.5 billion principal amount of senior unsecured notes consisting of $1.0 billion of 0.75% notes due 2026, $1.25 billion of 1.45% notes due 2030, $1.0 billion of 2.35% notes due 2040 and $1.25 billion of 2.45% notes due 2050. Merck used the net proceeds from the offering for general corporate purposes, including without limitation the repayment of outstanding commercial paper borrowings and other indebtedness with upcoming maturities.$125 million.
9.    Contingencies
The Company is involved in various claims and legal proceedings of a nature considered normal to its business, including product liability, intellectual property, and commercial litigation, as well as certain additional matters including governmental and environmental matters. In the opinion of the Company, it is unlikely that the resolution of these matters will be material to the Company’s financial condition, results of operations or cash flows.
Given the nature of the litigation discussed below and the complexities involved in these matters, the Company is unable to reasonably estimate a possible loss or range of possible loss for such matters until the Company knows, among other factors, (i) what claims, if any, will survive dispositive motion practice, (ii) the extent of the claims, including the size of any potential class, particularly when damages are not specified or are indeterminate, (iii) how the discovery process will affect the litigation, (iv) the settlement posture of the other parties to the litigation and (v) any other factors that may have a material effect on the litigation.
The Company records accruals for contingencies when it is probable that a liability has been incurred and the amount can be reasonably estimated. These accruals are adjusted periodically as assessments change or additional information becomes available. For product liability claims, a portion of the overall accrual is actuarially determined and considers such factors as past experience, number of claims reported and estimates of claims incurred but not yet reported. Individually significant contingent losses are accrued when probable and reasonably estimable. Legal defense costs expected to be incurred in connection with a loss contingency are accrued when probable and reasonably estimable.
- 21 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
The Company’s decision to obtain insurance coverage is dependent on market conditions, including cost and availability, existing at the time such decisions are made. The Company has evaluated its risks and has determined that the cost of obtaining product liability insurance outweighs the likely benefits of the coverage that is available and, as such, has no insurance for most product liabilities.
Product Liability Litigation
Fosamax
As previously disclosed, Merck is a defendant in product liability lawsuits in the United StatesU.S. involving Fosamax (Fosamax Litigation). As of September 30, 2020,2021, approximately 3,5903,470 cases are pending against Merck in either a federal multidistrict litigation (Femur Fracture MDL) or state court. Plaintiffs in the vast majority of these cases generally allege that they sustained femur fractures and/or other bone injuries (Femur Fractures) in association with the use of Fosamax.
All federal cases involving allegations of Femur Fractures have been or will be transferred to a multidistrict litigation in the District of New Jersey (Femur Fracture MDL). In the only bellwether case tried to date in the Femur Fracture MDL, Glynn v. Merck, the jury returned a verdict in Merck’s favor. In addition, in June 2013, the Femur Fracture MDL court granted Merck’s motion for judgment as a matter of law in the Glynn case and held that the plaintiff’s failure to warn claim was preempted by federal law.
In August 2013, the Femur Fracture MDL court entered an order requiring plaintiffs in the Femur Fracture MDL to show cause why those cases asserting claims for a femur fracture injury that took place prior to September 14, 2010, should not be dismissed based on the court’s preemption decision in the Glynn case. Pursuant to the show cause order, in March 2014, the Femur Fracture MDL court dismissed with prejudice approximately 650 cases on preemption grounds. Plaintiffs in approximately 515 of those cases appealed that decision to the U.S. Court of Appeals for the Third Circuit (Third Circuit). In March 2017, the Third Circuit issued a decision reversing the Femur Fracture MDL court’s preemption ruling and remanding the appealed cases back to the Femur Fracture MDL court. In May 2019, the U.S. Supreme Court decided that the Third Circuit had incorrectly concluded that the issue of preemption should be resolved by a jury, and accordingly vacated the judgment of the Third Circuit and remanded the proceedings back to the Third Circuit to address the issue in a manner consistent with the Supreme Court’s opinion. In November 2019, the Third Circuit remanded the cases back to the District Court in order to allow that court to determine in the first instance whether the plaintiffs’ state law claims are preempted by federal law under the standards described by the Supreme Court in its opinion. Briefing on the issue is closed, and the parties await the decision of the District Court.
Accordingly, as of September 30, 2020, approximately 970 cases were actively pending in the Femur Fracture MDL.
As of September 30, 2020, approximately 2,340 cases alleging Femur Fractures have been filed in New Jersey state court and are pending before Judge James Hyland in Middlesex County. The parties selected an initial group of cases to be reviewed through fact discovery, and Merck has continued to select additional cases to be reviewed.
As of September 30, 2020, approximately 275 cases alleging Femur Fractures have been filed and are pending in California state court. All of the Femur Fracture cases filed in California state court have been coordinated before a single judge in Orange County, California.
Additionally, there are 4 Femur Fracture cases pending in other state courts.
Discovery is presently stayed in the Femur Fracture MDL and in the state court in California. As part of the spin-off of Organon, Organon is required to indemnify Merck intendsfor all liabilities relating to, defend against these lawsuits.arising from, or resulting from the Fosamax Litigation.
Januvia/Janumet
As previously disclosed, Merck is a defendant in product liability lawsuits in the United StatesU.S. involving Januvia and/or Janumet. As of September 30, 2020,2021, Merck is aware of approximately 1,465730 product users alleging that Januvia and/or Janumet caused the development of pancreatic cancer and other injuries.
Most claims have been filed in multidistrict litigation before the U.S. District Court for the Southern District of California (MDL). On March 9, 2021, the MDL Court issued an omnibus order granting defendants’ summary judgment motions based on preemption and failure to establish general causation, as well as granting defendants’ motions to exclude
- 23 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
plaintiffs’ expert witnesses. The plaintiffs appealed that order. Since that time, more than half of these claims have been dismissed with prejudice as to Merck, and on October 5, 2021, the U.S. Court of Appeals for the Ninth Circuit dismissed the appeal as to Merck and two of its codefendants.
Outside of the MDL, the majority of claims have been filed in coordinated proceedings before the Superior Court of California, County of Los Angeles (California State Court).
In November 2015, On April 6, 2021, the MDL andcourt in California State Court–in separate opinions–granted summary judgment to defendants on grounds of federal preemption.
Plaintiffs appealed in both forums. In November 2017, the U.S. Court of Appeals for the Ninth Circuit vacated the judgment and remanded for further discovery. In November 2018, the California state appellate court reversed and remanded on similar grounds. In March 2019, the parties in the MDL and the California coordinated proceedings agreed to coordinate and adopt a schedule for completing discovery on general causation and preemption issues and for renewing summary judgment
- 22 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
and Daubert motions. Under the stipulated case management schedule, the hearings for Daubert andissued an omnibus order granting defendants’ summary judgment motions took place on October 20, 2020.and also granting defendants’ motions to exclude plaintiffs’ expert witnesses.
As of September 30, 2020,2021, 6 product users have claims pending against Merck in state courts other than California, including Illinois. In June 2017, the Illinois trial court denied Merck’s motion for summary judgment based on federal preemption. Merck appealed, and the Illinois appellate court affirmed in December 2018. Merck filed a petition for leave to appeal to the Illinois Supreme Court in February 2019. In April 2019, the Illinois Supreme Court stayed consideration of the pending petition to appeal until the U.S. Supreme Court issued its opinion in Merck Sharp & Dohme Corp. v. Albrecht (relating to the Fosamax matter discussed above). Merck filed the opinion in Albrecht with the Illinois Supreme Court in June 2019. The petition for leave to appeal was decided in September 2019, in which the Illinois Supreme Court directed the intermediate appellate court to reconsider its earlier ruling. The Illinois Appellate Court issued a favorable decision concluding, consistent with Albrecht, that preemption presents a legal question to be resolved by the court. In May 2020, the Illinois Appellate Court issued a mandate to the state trial court, which, as of September 30, 2021, had not scheduled a case management conference or otherwise taken action.
In addition to the claims noted above, the Company has agreed to toll the statute of limitations for approximately 50 additional claims. The Company intends to continue defending against theseany remaining lawsuits.
Vioxx
As previously disclosed, Merck is a defendant in a lawsuit brought by the Attorney General of Utah alleging that Merck misrepresented the safety of Vioxx. The lawsuit is pending in Utah state court. Utah seeks damages and penalties under the Utah False Claims Act. A bench trial in this matter has been rescheduled for April 6, 2021.
Governmental Proceedings
As previously disclosed, the Company’s subsidiaries in China have received and may continue to receive inquiries regarding their operations from various Chinese governmental agencies. Some of these inquiries may be related to matters involving other multinational pharmaceutical companies, as well as Chinese entities doing business with such companies. The Company’s policy is to cooperate with these authorities and to provide responses as appropriate.
As previously disclosed, from time to time, the Company receives inquiries and is the subject of preliminary investigation activities from competition and other governmental authorities in markets outside the United States.U.S. These authorities may include regulators, administrative authorities, and law enforcement and other similar officials, and these preliminary investigation activities may include site visits, formal or informal requests or demands for documents or materials, inquiries or interviews and similar matters. Certain of these preliminary inquiries or activities may lead to the commencement of formal proceedings. Should those proceedings be determined adversely to the Company, monetary fines and/or remedial undertakings may be required.
Commercial and Other Litigation
Zetia Antitrust Litigation
As previously disclosed, Merck, MSD, Schering Corporation, Schering-Plough Corporation, and MSP Singapore Company LLC (collectively, the Merck Defendants) are defendants in putative class action and opt-out lawsuits filed in 2018 on behalf of direct and indirect purchasers of Zetia alleging violations of federal and state antitrust laws, as well as other state statutory and common law causes of action. The cases have been consolidated for pretrial purposes in a federal multidistrict litigation before Judge Rebecca Beach Smith in the Eastern District of Virginia. In December 2018, the court denied the Merck Defendants’ motions to dismiss or stay the direct purchaser putative class actions pending bilateral arbitration. In August 2019, the district court adopted in full the report and recommendation of the magistrate judge with respect to the Merck Defendants’ motions to dismiss on non-arbitration issues, thereby granting in part and denying in part Merck Defendants’ motions to dismiss. In addition, in June 2019, the representatives of the putative direct purchaser class filed an amended complaint, and in August 2019, retailer opt-out plaintiffs filed an amended complaint. The Merck Defendants moved to dismiss the new allegations in both complaints. In October 2019, the magistrate judge issued a report and recommendation recommending that the district judge grant the motions in their entirety. In December 2019, the district court adopted this report and recommendation in part. The district court granted the Merck Defendants’ motion to dismiss to the extent the motion sought dismissal of claims for overcharges paid by entities that purchased generic ezetimibe from Par Pharmaceutical, Inc. (Par Pharmaceutical) and dismissed any claims for such overcharges. In November 2019, the direct purchaser plaintiffs and the indirect purchaser plaintiffs filed motions for class certification. On June 18,In August 2020, the magistrate judge issued a report and recommendation recommending that the district judge grantcourt granted in part the direct purchasers’ motion for class certification and certifycertified a class of 35 direct purchasers. On August 21, 2020, the district court adopted the reportpurchasers and, recommendation in full, and on November 2, 2020, the U.S. Court of Appeals for the Fourth Circuit granted defendants’the Merck Defendants’ motion for permission to appeal the district court’s order. Also, onIn August 14, 2020,2021, the magistrate judge recommended thatFourth Circuit vacated the court grantdistrict court’s class certification order and remanded for further proceedings consistent with the court’s ruling. In September 2021, the direct purchaser plaintiffs filed a renewed motion for class certification filed by the putative indirect purchaser class. The Merck Defendants objected to this report and recommendation and are awaiting a decision from the district court.briefing regarding that motion is pending.
- 23 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
OnIn August 10, 2020, the Merck Defendants filed a motion for summary judgment and other motions, and plaintiffs filed a motion for partial summary judgment, and other motions. Those motions are now fully briefed, and the court will likelyhas heard
- 24 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
argument on certain of the motions. The court may hold a hearingadditional hearings on the competingother motions. Trial in this matter has been adjourned.
Also in August 2020, the magistrate judge recommended that the court grant the motion for class certification filed by the putative indirect purchaser class. The Merck Defendants objected to this report and recommendation. In August 2021, the district court overruled the Merck Defendants’ objections to the report and recommendation and granted certification of a class of indirect purchasers. In September 2021, the Merck Defendants petitioned to appeal the class certification decision to the Fourth Circuit. The Fourth Circuit denied that petition on September 30, 2021.
In September 2020, United Healthcare Services, Inc. filed a lawsuit in the U.S. District Court for the District of Minnesota against the Merck Defendants and others (the UHC Action). The UHC Action makes similar allegations as those made in the Zetia class action. In September 2020, the U.S. Judicial Panel on Multidistrict Litigation transferred the case to the Eastern District of Virginia to proceed with the multidistrict Zetia litigation already in progress. Defendants have filed a motion to dismiss.
In December 2020, Humana Inc. filed a lawsuit in the Superior Court of the State of California, County of San Francisco, against Merck and others, alleging defendants violated state antitrust laws in multiple states. Also, in December 2020, Centene Corporation and others filed a lawsuit in the Superior Court of the State of California, County of San Francisco, against the same defendants as Humana. Both lawsuits allege similar anticompetitive acts to those alleged in the Zetia class action. In July 2021, the California Court ruled on defendants’ Motion to Quash for lack of personal jurisdiction, granting the motion as to the out-of-state claims against defendants, and ordering limited jurisdictional discovery with regard to the California claims. In September 2021, the parties reached an agreement that Humana and Centene would file their claims in New Jersey federal court, seek a transfer of those claims to the multidistrict Zetia litigation already in progress, and subsequently dismiss the actions previously filed in California. The parties jointly sought a stay of the Superior Court action, pending filing of the federal action. The Superior Court granted the stay on September 17, 2021.
Also, on July 16, 2021, Humana and Centene filed actions against the Merck Defendants in New Jersey in the Bergen County Superior Court, re-asserting the claims that were dismissed in their California action. Those complaints have not yet been served, and Humana and Centene have agreed to dismiss those actions once they have filed their complaints in New Jersey federal court.
In June 2021, Kaiser Foundation Health Plan, Inc. similarly filed a lawsuit in the Superior Court of the State of California, County of San Francisco, against the same defendants as Humana and Centene. The Kaiser lawsuit alleges similar anticompetitive acts to those alleged in the Zetia class action. The Kaiser action was removed to the U.S. District Court for the Northern District of California on July 16, 2021. In September 2021, the U.S. Judicial Panel on Multidistrict Litigation transferred the case to the Eastern District of Virginia to proceed with the multidistrict Zetia litigation already in progress.
Patent Litigation
From time to time, generic manufacturers of pharmaceutical products file abbreviated New Drug Applications (NDAs) with the FDA seeking to market generic forms of the Company’s products prior to the expiration of relevant patents owned by the Company. To protect its patent rights, the Company may file patent infringement lawsuits against such generic companies. Similar lawsuits defending the Company’s patent rights may exist in other countries. The Company intends to vigorously defend its patents, which it believes are valid, against infringement by companies attempting to market products prior to the expiration of such patents. As with any litigation, there can be no assurance of the outcomes, which, if adverse, could result in significantly shortened periods of exclusivity for these products and, with respect to products acquired through acquisitions, potentially significant intangible asset impairment charges.
Bridion Between January and MarchNovember 2020, the Company received multiple Paragraph IV Certification Letters under the Hatch-Waxman Act notifying the Company that generic drug companies have filed applications to the FDA seeking pre-patent expiry approval to sell generic versions of Bridion (sugammadex) Injection. In March, April and AprilDecember 2020, the Company filed patent infringement lawsuits in the U.S. District Courts for the District of New Jersey and the Northern District of West Virginia against those generic companies. All actions in the District of New Jersey have been consolidated. These lawsuits, which assert one or more patents covering sugammadex and methods of using sugammadex, automatically stay FDA approval of the generic applications until June 2023 or until adverse court decisions, if any, whichever may occur earlier.
Mylan Pharmaceuticals Inc., Mylan API US LLC, and Mylan Inc. (Mylan) have filed motions to dismiss in the District of New Jersey for lack of venue and failure to state a claim against certain defendants, and in the Northern District of West Virginia for failure to state a claim against certain defendants. The New Jersey motion has not yet been decided, and the West Virginia action is stayed pending resolution of the New Jersey motion. All New Jersey actions against all defendants have been consolidated.
- 25 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
The Company has settled with 3 generic companies providing that these generic companies can bring their generic versions of Bridion to the market in January 2026 (which may be delayed by any applicable pediatric exclusivity) or earlier under certain circumstances.
Januvia, Janumet, Janumet XRAs previously disclosed, the FDA has granted pediatric exclusivity with respect to Januvia, Janumet, and Janumet XR, which provides a further six months of exclusivity in the U.S. beyond the expiration of all patents listed in the FDA’s Orange Book. Adding this exclusivity to the term of the key patent protection extends exclusivity on these products to January 2023. The Company anticipates that sales of Januvia and Janumet in the U.S. will decline significantly after this loss of market exclusivity. However, Januvia, Janumet, and Janumet XR contain sitagliptin phosphate monohydrate and the Company has another patent covering certain phosphate salt and polymorphic forms of sitagliptin (2027 salt/polymorph patent), which, if determined to be valid, would preclude generic manufacturers from making sitagliptin phosphate salt and polymorphic forms until 2027 with the expiration of that patent, plus pediatric exclusivity. In February 2019, Par Pharmaceutical filed suit against the Company in the U.S. District Court for the District of New Jersey, seeking a declaratory judgment of invalidity of a patent owned by the Company covering certain salt and polymorphic forms of sitagliptin that expires in 2026.2027 salt/polymorph patent. In response, the Company filed a patent infringement lawsuit in the U.S. District Court for the District of Delaware against Par Pharmaceutical and additional companies that also indicated an intent to market generic versions of Januvia, Janumet, and Janumet XR following expiration of key patent protection, in 2022, but prior to the expiration of the later-granted patent owned by the Company covering certain salt and polymorphic forms of sitagliptin that expires in 2026 (20262027 salt/polymorph patent),patent, and a later granted patent owned by the Company covering the Janumet formulation which expireswhere its term plus the pediatric exclusivity ends in 2028. Par Pharmaceutical dismissed its case in the U.S. District Court for the District of New Jersey against the2029. The Company and will litigate the action in the U.S. District Court for the District of Delaware. The Companyalso filed a patent infringement lawsuit against Mylan in the Northern District of West Virginia. The Judicial Panel ofon Multidistrict Litigation entered an order transferring the Company’s lawsuit against Mylan to the U.S. District Court for the District of Delaware for coordinated and consolidated pretrial proceedings with the other cases pending in that district. The
Prior to the beginning of the October 2021 trial in the U.S. District Court for the District of Delaware has scheduled the lawsuits for a single three-day trial on invalidity issues, the Company settled with all defendants scheduled to participate in October 2021. The Court will schedule separate one-day trials on infringement issues if necessary.that trial. In the Company’s case against Mylan, the U.S. District Court for the Northern District of West Virginia has conditionally scheduled a three-dayfive-day bench trial in December 2021 on all issues. 2021.
In February 2020,total, the Company amended its complaint against one defendant, Teva Pharmaceuticals USA, Inc., to add patent infringement claims related to a patent that expires in 2025 and covers certain processes for manufacturing sitagliptin. In July 2020, the Company amended its complaints against two defendants, Teva Pharmaceuticals USA, Inc. and Watson Laboratories, Inc., to add patent infringement claims related to a patent that also expires in 2026 and covers certain amorphous forms of sitagliptin.
The Company has settled with 516 generic companies suchproviding that these generic companies can bring their productsgeneric versions of Januvia and Janumet to the market in NovemberMay 2026 or earlier under certain circumstances, and their generic versions of Janumet XR to the market in July 2026 or earlier under certain circumstances.
In OctoberAdditionally, in 2019, Mylan filed a petition for Inter Partes Review (IPR) at the United StatesU.S. Patent and Trademark Office (USPTO) seeking invalidity of some, but not all, of the claims of the 20262027 salt/polymorph patent. The USPTO instituted IPR proceedings in May 2020, finding a reasonable likelihood that the challenged claims are not valid. A trial is scheduled forwas held in February 2021 and a final decision is expectedwas rendered in May 2021. After institution, 3 additional IPR petitions2021, holding that all of the challenged claims were not invalid. Mylan has appealed the USPTO’s decision to the U.S. Court of Appeals for the Federal Circuit.
On March 1, 2021, the Company filed by Tevaa patent infringement lawsuit in the U.S. District Court for the District of Delaware against Zydus Worldwide DMCC, Zydus Pharmaceuticals USA, Inc., Dr. Reddy’s Laboratories,(USA) Inc., and Sun Pharmaceutical IndustriesCadila Healthcare Ltd., as well as related entities, which requested joinder with Mylan’s IPR proceedings. If (collectively, Zydus).In that lawsuit, the challenges are successful, the unchallenged claimsCompany alleged infringement of the 20262027 salt/polymorph patent will remain valid, subject tobased on the court proceedings described above.
- 24 -

Notes to Condensed Consolidated Financial Statements (unaudited)filing of Zydus’s application seeking approval under 21 U.S.C. § 355(b)(2) of its sitagliptin tablets. (continued)
The U.S. District Court for the District of Delaware has set a three-day bench trial in this matter beginning on October 31, 2022.
In Germany, two generic companies have sought the revocation of the Supplementary Protection Certificate (SPC) for Janumet. If the generic companies are successful, Janumet could lose market exclusivity in Germany at the same time as early as Julythe expiry of Januvia pediatric market exclusivity in September 2022. A hearing was held in June 2021 and the court decided that the SPC for Janumet is invalid, which decision the Company has appealed. Challenges to the Janumet SPC have also occurred in the following European countries: Austria, Czech Republic, Finland, France, Hungary, Italy, Portugal, Romania, Slovakia, and Finland, and could occur in other European countries.Sweden.
Other Litigation
There are various other pending legal proceedings involving the Company, principally product liability and intellectual property lawsuits. While it is not feasible to predict the outcome of such proceedings, in the opinion of the Company, either the likelihood of loss is remote or any reasonably possible loss associated with the resolution of such proceedings is not expected to be material to the Company’s financial condition, results of operations or cash flows either individually or in the aggregate.
Legal Defense Reserves
Legal defense costs expected to be incurred in connection with a loss contingency are accrued when probable and reasonably estimable. Some of the significant factors considered in the review of these legal defense reserves are as follows: the actual costs incurred by the Company; the development of the Company’s legal defense strategy and structure in light of the
- 26 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
scope of its litigation; the number of cases being brought against the Company; the costs and outcomes of completed trials and the most current information regarding anticipated timing, progression, and related costs of pre-trial activities and trials in the associated litigation. The amount of legal defense reserves as of September 30, 20202021 and December 31, 20192020 of approximately $255$225 million and $240$235 million, respectively, represents the Company’s best estimate of the minimum amount of defense costs to be incurred in connection with its outstanding litigation; however, events such as additional trials and other events that could arise in the course of its litigation could affect the ultimate amount of legal defense costs to be incurred by the Company. The Company will continue to monitor its legal defense costs and review the adequacy of the associated reserves and may determine to increase the reserves at any time in the future if, based upon the factors set forth, it believes it would be appropriate to do so.

10.    Equity
Three Months Ended September 30,Three Months Ended September 30,
  
Common Stock
Other
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Comprehensive
Loss
 
Treasury Stock
Non-
controlling
Interests
Total
  
Common Stock
Other
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Comprehensive
Loss
 
Treasury Stock
Non-
controlling
Interests
Total
($ and shares in millions except per share amounts)($ and shares in millions except per share amounts)SharesPar ValueSharesCost($ and shares in millions except per share amounts)SharesPar ValueSharesCost
Balance at July 1, 20193,577 $1,788 $39,484 $45,295 $(5,362)1,010 $(53,570)$102 $27,737 
Net income attributable to Merck & Co., Inc.— — — 1,901 — — — — 1,901 
Other comprehensive loss, net of taxes— — — — (28)— — — (28)
Cash dividends declared on common stock ($0.55 per share)— — — (1,392)— — — — (1,392)
Treasury stock shares purchased— — — — — 17 (1,405)— (1,405)
Share-based compensation plans and other— — 77 — — (1)50 — 127 
Net income attributable to noncontrolling interests— — — — — — — 
Distributions attributable to noncontrolling interests— — — — — — — (21)(21)
Balance at September 30, 20193,577 $1,788 $39,561 $45,804 $(5,390)1,026 $(54,925)$87 $26,925 
Balance at July 1, 2020Balance at July 1, 20203,577 $1,788 $39,373 $49,724 $(6,393)1,048 $(56,850)$102 $27,744 Balance at July 1, 20203,577 $1,788 $39,373 $49,724 $(6,393)1,048 $(56,850)$102 $27,744 
Net income attributable to Merck & Co., Inc.Net income attributable to Merck & Co., Inc.— — — 2,941 — — — — 2,941 Net income attributable to Merck & Co., Inc.— — — 2,941 — — — — 2,941 
Other comprehensive income, net of taxesOther comprehensive income, net of taxes— — — — 10 — — — 10 Other comprehensive income, net of taxes— — — — 10 — — — 10 
Cash dividends declared on common stock ($0.61 per share)Cash dividends declared on common stock ($0.61 per share)— — — (1,558)— — — — (1,558)Cash dividends declared on common stock ($0.61 per share)— — — (1,558)— — — — (1,558)
Share-based compensation plans and otherShare-based compensation plans and other— — 116 — — (1)35 — 151 Share-based compensation plans and other— — 116 — — (1)35 — 151 
Net income attributable to noncontrolling interestsNet income attributable to noncontrolling interests— — — — — — — Net income attributable to noncontrolling interests— — — — — — — 
Distributions attributable to noncontrolling interestsDistributions attributable to noncontrolling interests— — — — — — — (22)(22)Distributions attributable to noncontrolling interests— — — — — — — (22)(22)
Balance at September 30, 2020Balance at September 30, 20203,577 $1,788 $39,489 $51,107 $(6,383)1,047 $(56,815)$84 $29,270 Balance at September 30, 20203,577 $1,788 $39,489 $51,107 $(6,383)1,047 $(56,815)$84 $29,270 
Balance at July 1, 2021Balance at July 1, 20213,577 $1,788 $44,039 $48,777 $(4,628)1,044 $(56,682)$94 $33,388 
Net income attributable to Merck & Co., Inc.Net income attributable to Merck & Co., Inc.— — — 4,567 — — — — 4,567 
Other comprehensive income, net of taxesOther comprehensive income, net of taxes— — — — 38 — — — 38 
Cash dividends declared on common stock ($0.65 per share)Cash dividends declared on common stock ($0.65 per share)— — — (1,653)— — — — (1,653)
Treasury stock shares purchasedTreasury stock shares purchased— — — — — (583)— (583)
Share-based compensation plans and otherShare-based compensation plans and other— — 110 — — — 21 — 131 
Net income attributable to noncontrolling interestsNet income attributable to noncontrolling interests— — — — — — — 
Distributions attributable to noncontrolling interestsDistributions attributable to noncontrolling interests— — — — — — — (29)(29)
Balance at September 30, 2021Balance at September 30, 20213,577 1,788 44,149 51,691 (4,590)1,052 (57,244)69 35,863 
- 2527 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Nine Months Ended September 30,Nine Months Ended September 30,
  
Common Stock
Other
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Comprehensive
Loss
 
Treasury Stock
Non-
controlling
Interests
Total
  
Common Stock
Other
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Comprehensive
Loss
 
Treasury Stock
Non-
controlling
Interests
Total
($ and shares in millions except per share amounts)($ and shares in millions except per share amounts)SharesPar ValueSharesCost($ and shares in millions except per share amounts)SharesPar ValueSharesCost
Balance at January 1, 20193,577 $1,788 $38,808 $42,579 $(5,545)985 $(50,929)$181 $26,882 
Net income attributable to Merck & Co., Inc.— — — 7,487 — — — — 7,487 
Other comprehensive income, net of taxes— — — — 155 — — — 155 
Cash dividends declared on common stock ($1.65 per share)— — — (4,262)— — — — (4,262)
Treasury stock shares purchased— — 1,000 — — 54 (4,730)— (3,730)
Share-based compensation plans and other— — (247)— — (13)734 — 487 
Net loss attributable to noncontrolling interests— — — — — — — (73)(73)
Distributions attributable to noncontrolling
interests
— — — — — — — (21)(21)
Balance at September 30, 20193,577 1,788 39,561 45,804 (5,390)1,026 (54,925)87 26,925 
Balance at January 1, 2020Balance at January 1, 20203,577 $1,788 $39,660 $46,602 $(6,193)1,038 $(55,950)$94 $26,001 Balance at January 1, 20203,577 $1,788 $39,660 $46,602 $(6,193)1,038 $(55,950)$94 $26,001 
Net income attributable to Merck & Co., Inc.Net income attributable to Merck & Co., Inc.— — — 9,161 — — — — 9,161 Net income attributable to Merck & Co., Inc.— — — 9,161 — — — — 9,161 
Other comprehensive loss, net of taxesOther comprehensive loss, net of taxes— — — — (190)— — — (190)Other comprehensive loss, net of taxes— — — — (190)— — — (190)
Cash dividends declared on common stock ($1.83 per share)Cash dividends declared on common stock ($1.83 per share)— — — (4,656)— — — — (4,656)Cash dividends declared on common stock ($1.83 per share)— — — (4,656)— — — — (4,656)
Treasury stock shares purchasedTreasury stock shares purchased— — — — — 16 (1,281)— (1,281)Treasury stock shares purchased— — — — — 16 (1,281)— (1,281)
Share-based compensation plans and otherShare-based compensation plans and other— — (171)— — (7)416 — 245 Share-based compensation plans and other— — (171)— — (7)416 — 245 
Net income attributable to noncontrolling interestsNet income attributable to noncontrolling interests— — — — — — — 12 12 Net income attributable to noncontrolling interests— — — — — — — 12 12 
Distributions attributable to noncontrolling
interests
Distributions attributable to noncontrolling
interests
— — — — — — — (22)(22)Distributions attributable to noncontrolling interests— — — — — — — (22)(22)
Balance at September 30, 2020Balance at September 30, 20203,577 $1,788 $39,489 $51,107 $(6,383)1,047 $(56,815)$84 $29,270 Balance at September 30, 20203,577 1,788 39,489 51,107 (6,383)1,047 (56,815)84 29,270 
Balance at January 1, 2021Balance at January 1, 20213,577 $1,788 $39,588 $47,362 $(6,634)1,047 $(56,787)$87 $25,404 
Net income attributable to Merck & Co., Inc.Net income attributable to Merck & Co., Inc.— — — 9,291 — — — — 9,291 
Other comprehensive income, net of taxesOther comprehensive income, net of taxes— — — — 1,595 — — — 1,595 
Cash dividends declared on common stock ($1.95 per share)Cash dividends declared on common stock ($1.95 per share)— — — (4,962)— — — — (4,962)
Treasury stock shares purchasedTreasury stock shares purchased— — — — — 11 (822)— (822)
Spin-off of Organon & Co.Spin-off of Organon & Co.— — 4,643 — 449 — — (1)5,091 
Share-based compensation plans and otherShare-based compensation plans and other— — (82)— — (6)365 — 283 
Net income attributable to noncontrolling interestsNet income attributable to noncontrolling interests— — — — — — — 12 12 
Distributions attributable to noncontrolling interestsDistributions attributable to noncontrolling interests— — — — — — — (29)(29)
Balance at September 30, 2021Balance at September 30, 20213,577 1,788 44,149 51,691 (4,590)1,052 (57,244)69 35,863 

11.    Share-Based Compensation Plans
The Company has share-based compensation plans under which the Company grants restricted stock units (RSUs) and performance share units (PSUs) to certain management level employees. In addition, employees and non-employee directors may be granted options to purchase shares of Company common stock at the fair market value at the time of grant.
The following table provides the amounts of share-based compensation cost recorded in the Condensed Consolidated Statement of Income:
 Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)2020201920202019
Pretax share-based compensation expense$126 $101 $354 $306 
Income tax benefit(17)(14)(48)(42)
Total share-based compensation expense, net of taxes$109 $87 $306 $264 
During the first nine months of 2020, the Company granted 7 million RSUs with a weighted-average grant date fair value of $77.83 per RSU and during the first ninemonths of 2019 granted 5 million RSUs with a weighted-average grant date fair value of $80.03 per RSU. During the first nine months of 2020, the Company granted 773 thousand PSUs with a weighted-average grant date fair value of $75.22 per PSU and during the first ninemonths of 2019 granted 609 thousand PSUs with a weighted-average grant date fair value of $90.50 per PSU.
During the first nine months of 2020, the Company granted 4 million stock options with a weighted-average exercise price of $77.67 per option and during the first nine months of 2019 granted 3 million stock options with a weighted-average exercise price of $80.05 per option. The weighted-average fair value of options granted during the first nine months of 2020 and 2019 was $9.93 and $10.63 per option, respectively, and was determined using the following assumptions:
- 26 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
  Nine Months Ended
September 30,
20202019
Expected dividend yield3.1 %3.2 %
Risk-free interest rate0.4 %2.4 %
Expected volatility22.1 %18.7 %
Expected life (years)5.85.9
At September 30, 2020, there was $800 million of total pretax unrecognized compensation expense related to nonvested stock options, RSU and PSU awards which will be recognized over a weighted-average period of 2.1 years. For segment reporting, share-based compensation costs are unallocated expenses.
12.    Pension and Other Postretirement Benefit Plans
The Company has defined benefit pension plans covering eligible employees in the United StatesU.S. and in certain of its international subsidiaries. The net periodic benefit cost of such plans (including certain costs reported as part of discontinued operations) consisted of the following components: 
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
20202019202020192021202020212020
($ in millions)($ in millions)U.S.InternationalU.S.InternationalU.S.InternationalU.S.International($ in millions)U.S.InternationalU.S.InternationalU.S.InternationalU.S.International
Service costService cost$96 $77 $76 $58 $270 $225 $221 $178 Service cost$104 $75 $96 $76 $302 $254 $270 $222 
Interest costInterest cost107 35 115 44 323 103 343 133 Interest cost102 33 107 35 305 92 323 102 
Expected return on plan assetsExpected return on plan assets(193)(104)(202)(106)(581)(310)(613)(320)Expected return on plan assets(188)(105)(193)(104)(568)(313)(581)(309)
Amortization of unrecognized prior service creditAmortization of unrecognized prior service credit(12)(3)(12)(3)(37)(9)(37)(9)Amortization of unrecognized prior service credit(9)(3)(12)(3)(29)(12)(37)(9)
Net loss amortizationNet loss amortization75 32 43 16 228 94 113 47 Net loss amortization75 32 75 32 218 110 228 94 
Termination benefitsTermination benefitsTermination benefits— 54 
CurtailmentsCurtailments(1)Curtailments(1)— — 15 (27)(1)
SettlementsSettlements11 Settlements139 — — 139 11 
$77 $38 $28 $$223 $106 $40 $30  $224 $32 $77 $37 $436 $109 $223 $103 
The Company anticipates that in 2020 it will contribute approximately $200 million and $375 million
- 28 -

Notes to its U.S. and international pension plans, respectively, of which $184 million and $123 million, respectively, was contributed in the first nine months of the year.Condensed Consolidated Financial Statements (unaudited) (continued)
The Company provides medical benefits, principally to its eligible U.S. retirees and similar benefits to their dependents, through its other postretirement benefit plans. The net credit of such plans consisted of the following components: 
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)2020201920202019($ in millions)2021202020212020
Service costService cost$13 $12 $39 $36 Service cost$11 $13 $37 $39 
Interest costInterest cost14 17 43 52 Interest cost12 14 34 43 
Expected return on plan assetsExpected return on plan assets(19)(18)(56)(54)Expected return on plan assets(20)(19)(59)(56)
Amortization of unrecognized prior service creditAmortization of unrecognized prior service credit(18)(20)(54)(59)Amortization of unrecognized prior service credit(16)(18)(48)(54)
Net gain amortizationNet gain amortization(5)(3)(13)(7)Net gain amortization(12)(5)(30)(13)
Termination benefitsTermination benefitsTermination benefits— — 37 — 
CurtailmentsCurtailments(3)(1)(4)Curtailments(1)— (29)(1)
$(15)$(14)$(42)$(35) $(26)$(15)$(58)$(42)
Net periodic benefit cost (credit) for pension and other postretirement benefit plans in the first nine months of 2021 includes expenses for curtailments, settlements and termination benefits provided to certain employees in connection with the spin-off of Organon.
In connection with restructuring actions (see Note 4)5), termination charges were recorded on pension plans related to expanded eligibility for certain employees exitingexiting Merck. Also, in connection with these restructuring actions, curtailments were recorded on pension and other postretirement benefit plans and settlements were recorded on certainpension plans. In addition, lump sum payments to U.S. and international pension plans as reflectedplan participants triggered a partial settlement resulting in a charge of approximately $125 million in the tables above.third quarter and first nine months of 2021. This partial settlement triggered a remeasurement of some of the Company’s U.S. pension plans. This remeasurement, which was calculated using discount rates and asset values as of September 30, 2021, resulted in a net increase of $160 million to net pension liabilities and also resulted in a related adjustment to AOCL.
The components of net periodic benefit cost (credit) other than the service cost component are included in Other (income) expense, net (see Note 13)12), with the exception of certain amounts for termination benefits, curtailments and
- 27 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
settlements, which are recorded in Restructuring costs if the event giving rise to the termination benefits, curtailment or settlement is related to restructuring actions or in Income from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling Interests if related to the spin-off of Organon (each as noted above.above).
The transfer of employees to Organon in connection with the spin-off triggered remeasurements of some of the Company’s pension plans. These remeasurements, which were calculated using discount rates and asset values as of the date of the spin-off, resulted in a $1.7 billion reduction to net pension liabilities primarily due to higher discount rates. In addition, $99 million of net pension liabilities were transferred to Organon. The remeasurements and plan transfers also resulted in a related adjustment to AOCL (see Note 15).
13.12.    Other (Income) Expense, Net
Other (income) expense, net, consisted of: 
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)2020201920202019($ in millions)2021202020212020
Interest incomeInterest income$(9)$(61)$(48)$(225)Interest income$(7)$(9)$(27)$(48)
Interest expenseInterest expense203 231 624 674 Interest expense196 203 597 624 
Exchange lossesExchange losses10 38 89 166 Exchange losses46 10 202 89 
Income from investments in equity securities, net (1)
Income from investments in equity securities, net (1)
(360)(16)(964)(50)
Income from investments in equity securities, net (1)
(683)(360)(1,535)(964)
Net periodic defined benefit plan (credit) cost other than service cost(88)(128)(259)(409)
Net periodic defined benefit plan cost (credit) other than service costNet periodic defined benefit plan cost (credit) other than service cost40 (88)(159)(259)
Other, netOther, net(68)(29)(72)206 Other, net(42)(68)(85)(79)
$(312)$35 $(630)$362  $(450)$(312)$(1,007)$(637)
(1)    Includes net realized and unrealized gains and losses from investments in equity securities either owned directly or through ownership interests in investment funds. Unrealized gains and losses from investments that are directly owned are determined at the end of the reporting period, while ownership interests in investment funds are accounted for on a one quarter lag.
The decline in interest incomeCompany estimates that gains of approximately $540 million will be recorded in the thirdfourth quarter and first nine months of 2020 reflects lower investments and lower interest rates. The lower exchange losses2021 from ownership interests in the first nine months of 2020 reflect losses on forward exchange contracts in 2019 related to the acquisition of Antelliq. The increase in income from investments in equity securities, net, in both the third quarter and first nine months of 2020 was driven primarily by the recognition of unrealized gains on certain investments, most of which relate to Moderna, Inc.
Other, net (as reflected in the table above) in the first nine months of 2019 includes $162 million of goodwill impairment charges related to certain businesses in the Healthcare Services segment.investment funds.
Interest paid for the nine months ended September 30, 2021 and 2020 was $570 million and 2019 was $605 million, and $629 million, respectively.
- 29 -
14.

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
13.    Taxes on Income
The effective income tax rates of 14.1%from continuing operations were 13.2% and 18.7%14.0% for the third quarter of 20202021 and 2019,2020, respectively, and 14.9%14.4% and 14.5%15.1% for the first nine months of 2021 and 2020, and 2019, respectively, reflect the impacts of acquisition and divestiture-related costs and restructuring costs, partially offset by the beneficial impact of foreign earnings.respectively. The effective income tax rates from continuing operations in the third quarter and first nine months of 2019 also2021 reflect the beneficial impact of the settlement of a foreign tax matter. The effective income tax rate from continuing operations for the first nine months of 2021 reflects the unfavorable impacteffect of a charge for the acquisition of PelotonPandion for which no tax benefit was recognized, and the favorable impact of product mix on the estimated 2019 full-year tax rate. In addition, the effective income tax rate for the first nine months of 2019 reflects the favorable impact ofas well as a $360 million net tax benefit of $207 million related to the settlement of certain federal income tax matters.matters as discussed below.
In the first quarter of 2019,2021, the Internal Revenue Service (IRS) concluded its examinations of Merck’s 2012-20142015-2016 U.S. federal income tax returns. As a result, the Company was required to make a payment of $107 million.$190 million (of which $172 million related to Merck continuing operations and $18 million related to Organon discontinued operations). The Company’s reserves for unrecognized tax benefits for the years under examination exceeded the adjustments relating to this examination period and therefore the Company recorded a $360$236 million net tax benefit in the first nine months of 2019.2021 (of which $207 million related to Merck continuing operations and $29 million related to Organon discontinued operations). This net benefit reflects reductions in reserves for unrecognized tax benefits and other related liabilities for tax positions relating to the years that were under examination, partially offset by additional reserves for tax positions not previously reserved for.examination.

- 28 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
15.14.    Earnings Per Share
The calculations of earnings per share are as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ and shares in millions except per share amounts)($ and shares in millions except per share amounts)2020201920202019($ and shares in millions except per share amounts)2021202020212020
Net income attributable to Merck & Co., Inc.$2,941 $1,901 $9,161 $7,487 
Net Income from Continuing Operations Attributable to Merck & Co., Inc.Net Income from Continuing Operations Attributable to Merck & Co., Inc.$4,567 $2,324 $8,525 $7,136 
Income from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling InterestsIncome from Discontinued Operations, Net of Taxes and Amounts Attributable to Noncontrolling Interests— 617 766 2,025 
Net Income Attributable to Merck & Co., Inc.Net Income Attributable to Merck & Co., Inc.$4,567 $2,941 $9,291 $9,161 
Average common shares outstandingAverage common shares outstanding2,529 2,558 2,530 2,572 Average common shares outstanding2,530 2,529 2,531 2,530 
Common shares issuable (1)
Common shares issuable (1)
14 11 15 
Common shares issuable (1)
11 
Average common shares outstanding assuming dilutionAverage common shares outstanding assuming dilution2,538 2,572 2,541 2,587 Average common shares outstanding assuming dilution2,536 2,538 2,539 2,541 
Basic earnings per common share attributable to Merck & Co., Inc. common shareholders$1.16 $0.74 $3.62 $2.91 
Earnings per common share assuming dilution attributable to Merck & Co., Inc. common shareholders$1.16 $0.74 $3.61 $2.89 
Basic Earnings per Common Share Attributable to Merck & Co., Inc. Common Shareholders:Basic Earnings per Common Share Attributable to Merck & Co., Inc. Common Shareholders:
Income from Continuing OperationsIncome from Continuing Operations$1.81 $0.92 $3.37 $2.82 
Income from Discontinued OperationsIncome from Discontinued Operations— 0.24 0.30 0.80 
Net IncomeNet Income$1.81 $1.16 $3.67 $3.62 
Earnings per Common Share Assuming Dilution Attributable to Merck & Co., Inc. Common Shareholders:Earnings per Common Share Assuming Dilution Attributable to Merck & Co., Inc. Common Shareholders:
Income from Continuing OperationsIncome from Continuing Operations$1.80 $0.92 $3.36 $2.81 
Income from Discontinued OperationsIncome from Discontinued Operations— 0.24 0.30 0.80 
Net IncomeNet Income$1.80 $1.16 $3.66 $3.61 
(1)Issuable primarily under share-based compensation plans.
For the third quarter of 2021 and 2020, and 2019, 58 million and 35 million, respectively, and for the first nine months of 2021 and 2020, and 2019, 510 million and 25 million, respectively, of common shares issuable under share-based compensation plans were excluded from the computation of earnings per common share assuming dilution because the effect would have been antidilutive.
16.    Other Comprehensive Income (Loss)
Changes in
AOCI by component are as follows:
Three Months Ended September 30,
($ in millions)DerivativesInvestmentsEmployee
Benefit
Plans
Cumulative
Translation
Adjustment
Accumulated Other
Comprehensive
Income (Loss)
Balance July 1, 2019, net of taxes$66 $48 $(3,530)$(1,946)$(5,362)
Other comprehensive income (loss) before reclassification adjustments, pretax186 (4)(84)106 
Tax(39)(33)(72)
Other comprehensive income (loss) before reclassification adjustments, net of taxes147 (4)(117)34 
Reclassification adjustments, pretax(71)(1)(25)(2)21 (3)(75)
Tax15 (2)13 
Reclassification adjustments, net of taxes(56)

(25)

19 

(62)
Other comprehensive income (loss), net of taxes91 (17)15 (117)(28)
Balance September 30, 2019, net of taxes$157 $31 $(3,515)$(2,063)$(5,390)
Balance July 1, 2020, net of taxes$15 $$(4,162)$(2,246)$(6,393)
Other comprehensive income (loss) before reclassification adjustments, pretax(195)50 (143)
Tax41 35 77 
Other comprehensive income (loss) before reclassification adjustments, net of taxes(154)85 (66)
Reclassification adjustments, pretax22 (1)72 (3)94 
Tax(5)(13)(18)
Reclassification adjustments, net of taxes17 


59 

76 
Other comprehensive income (loss), net of taxes(137)62 85 10 
Balance September 30, 2020, net of taxes$(122)$$(4,100)$(2,161)$(6,383)
- 2930 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Nine Months Ended September 30,
($ in millions)DerivativesInvestmentsEmployee
Benefit
Plans
Cumulative
Translation
Adjustment
Accumulated Other
Comprehensive
Income (Loss)
Balance January 1, 2019, net of taxes$166 $(78)$(3,556)$(2,077)$(5,545)
Other comprehensive income (loss) before reclassification adjustments, pretax183 139 (5)47 364 
Tax(38)(33)(65)
Other comprehensive income (loss) before reclassification adjustments, net of taxes145 139 14 299 
Reclassification adjustments, pretax(195)(1)(30)(2)49 (3)(176)
Tax41 (9)32 
Reclassification adjustments, net of taxes(154)(30)40 (144)
Other comprehensive income (loss), net of taxes(9)109 41 14 155 
Balance September 30, 2019, net of taxes$157 $31 $(3,515)$(2,063)$(5,390)
Balance January 1, 2020, net of taxes$31 $18 $(4,261)$(1,981)$(6,193)
Other comprehensive income (loss) before reclassification adjustments, pretax(126)(19)(220)(362)
Tax27 12 40 79 
Other comprehensive income (loss) before reclassification adjustments, net of taxes(99)(7)(180)(283)
Reclassification adjustments, pretax(68)(1)(21)(2)210 (3)121 
Tax14 (42)(28)
Reclassification adjustments, net of taxes(54)(21)168 93 
Other comprehensive income (loss), net of taxes(153)(18)161 (180)(190)
Balance September 30, 2020, net of taxes$(122)$$(4,100)$(2,161)$(6,383)
15.    Other Comprehensive Income (Loss)
Changes in each component of other comprehensive income (loss) are as follows:
Three Months Ended September 30,
($ in millions)DerivativesInvestmentsEmployee
Benefit
Plans
Foreign Currency
Translation
Adjustment
Accumulated Other
Comprehensive
Income (Loss)
Balance July 1, 2020, net of taxes$15 $— $(4,162)$(2,246)$(6,393)
Other comprehensive income (loss) before reclassification adjustments, pretax(195)— 50 (143)
Tax41 — 35 77 
Other comprehensive income (loss) before reclassification adjustments, net of taxes(154)— 85 (66)
Reclassification adjustments, pretax22 (1)— 72 (3)— 94 
Tax(5)— (13)— (18)
Reclassification adjustments, net of taxes17 

— 

59 

— 76 
Other comprehensive income (loss), net of taxes(137)— 62 85 10 
Balance September 30, 2020, net of taxes$(122)$— $(4,100)$(2,161)$(6,383)
Balance July 1, 2021, net of taxes$(26)$— $(3,028)$(1,574)$(4,628)
Other comprehensive income (loss) before reclassification adjustments, pretax72 — (24)(96)(48)
Tax(16)— 16 12 12 
Other comprehensive income (loss) before reclassification adjustments, net of taxes56 — (8)(84)(36)
Reclassification adjustments, pretax36 (1)— 68 (3)— 104 
Tax(8)— (22)— (30)
Reclassification adjustments, net of taxes28 

— 

46 

— 74 
Other comprehensive income (loss), net of taxes84 — 38 (84)38 
Balance September 30, 2021, net of taxes$58 $— $(2,990)$(1,658)$(4,590)
Nine Months Ended September 30,
($ in millions)DerivativesInvestmentsEmployee
Benefit
Plans
Foreign Currency
Translation
Adjustment
Accumulated Other
Comprehensive
Income (Loss)
Balance January 1, 2020, net of taxes$31 $18 $(4,261)$(1,981)$(6,193)
Other comprehensive income (loss) before reclassification adjustments, pretax(126)(19)(220)(362)
Tax27 — 12 40 79 
Other comprehensive income (loss) before reclassification adjustments, net of taxes(99)(7)(180)(283)
Reclassification adjustments, pretax(68)(1)(21)(2)210 (3)— 121 
Tax14 — (42)— (28)
Reclassification adjustments, net of taxes(54)(21)168 — 93 
Other comprehensive income (loss), net of taxes(153)(18)161 (180)(190)
Balance September 30, 2020, net of taxes$(122)$— $(4,100)$(2,161)$(6,383)
Balance January 1, 2021, net of taxes$(266)$— $(4,540)$(1,828)$(6,634)
Other comprehensive income (loss) before reclassification adjustments, pretax193 — 1,739 (167)1,765 
Tax(41)— (385)(84)(510)
Other comprehensive income (loss) before reclassification adjustments, net of taxes152 — 1,354 (251)1,255 
Reclassification adjustments, pretax218 (1)— 210 (3)— 428 
Tax(46)— (42)— (88)
Reclassification adjustments, net of taxes172 — 168 — 340 
Other comprehensive income (loss), net of taxes324 — 1,522 (251)1,595 
Spin-off of Organon (see Note 2)— — 28 421 449 
Balance September 30, 2021, net of taxes$58 $— $(2,990)$(1,658)$(4,590)
(1) RelatesPrimarily relates to foreign currency cash flow hedges that were reclassified from AOCIAOCL to Sales.
(2) Represents net realized (gains) lossesgains on the sales of available-for-sale debt securities that were reclassified from AOCIAOCL to Other (income) expense, net.
(3) Includes net amortization of prior service cost and actuarial gains and losses included in net periodic benefit cost (see Note 12)11).
- 31 -
17.

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
16.    Segment Reporting
The Company’s operations are principally managed on a products basis and include 32 operating segments, which are the Pharmaceutical Animal Health and Healthcare Services segments. The Pharmaceutical and Animal Health segments, both of which are the only reportable segments.
The Pharmaceutical segment includes human health pharmaceutical and vaccine products. Human health pharmaceutical products consist of therapeutic and preventive agents, generally sold by prescription, for the treatment of human disorders. The Company sells these human health pharmaceutical products primarily to drug wholesalers and retailers, hospitals, government agencies and managed health care providers such as health maintenance organizations, pharmacy benefit managers and other institutions. Human health vaccine products consist of preventive pediatric, adolescent and adult vaccines, primarily administered at physician offices. The Company sells these human health vaccines primarily to physicians, wholesalers, physician distributors and government entities. A large component of pediatric and adolescent vaccine sales are made to the U.S. Centers for Disease Control and Prevention Vaccines for Children program, which is funded by the U.S. government. Additionally, the Company sells vaccines to the Federal government for placement into vaccine stockpiles.
The Animal Health segment discovers, develops, manufactures and markets a wide range of veterinary pharmaceutical and vaccine products, as well as health management solutions and services, for the prevention, treatment and control of disease in all major livestock and companion animal species. The Company also offers an extensive suite of digitally connected identification, traceability and monitoring products. The Company sells its products to veterinarians, distributors and animal producers.
The Company previously had a Healthcare Services segment that provided services and solutions that focusfocused on engagement, health analytics and clinical services to improve the value of care delivered to patients. The Company has been indivested the process of divesting theremaining businesses in the Healthcare Services segment. The remaining businesses were divestedthis segment during the first quarter of 2020.

- 3032 -

Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Sales of the Company’s products were as follows:
Three Months Ended September 30,Nine Months Ended September 30,Three Months Ended September 30,Nine Months Ended September 30,
20202019202020192021202020212020
($ in millions) ($ in millions)U.S.Int’lTotalU.S.Int’lTotalU.S.Int’lTotalU.S.Int’lTotal ($ in millions)U.S.Int’lTotalU.S.Int’lTotalU.S.Int’lTotalU.S.Int’lTotal
Pharmaceutical:Pharmaceutical:Pharmaceutical:
OncologyOncologyOncology
KeytrudaKeytruda$2,157 $1,559 $3,715 $1,743 $1,327 $3,070 $6,106 $4,281 $10,387 $4,525 $3,448 $7,973 Keytruda$2,580 $1,954 $4,534 $2,157 $1,559 $3,715 $7,108 $5,501 $12,609 $6,106 $4,281 $10,387 
Alliance revenue - Lynparza (1)
Alliance revenue - Lynparza (1)
107 89 196 71 53 123 297 223 519 186 126 313 
Alliance revenue - Lynparza (1)
129 117 246 107 89 196 371 350 721 297 223 519 
Alliance revenue - Lenvima (1)
Alliance revenue - Lenvima (1)
82 60 142 65 44 109 270 152 421 169 112 280 
Alliance revenue - Lenvima (1)
114 74 188 82 60 142 287 211 498 270 152 421 
Emend31 39 42 56 98 18 96 115 173 163 336 
VaccinesVaccinesVaccines
Gardasil/Gardasil 9
Gardasil/Gardasil 9
579 608 1,187 761 558 1,320 1,209 1,732 2,941 1,579 1,464 3,044 
Gardasil/Gardasil 9
839 1,154 1,993 579 608 1,187 1,605 2,539 4,144 1,209 1,732 2,941 
ProQuad/M-M-R II/Varivax
ProQuad/M-M-R II/Varivax
437 139 576 482 141 623 1,033 356 1,390 1,325 469 1,794 
ProQuad/M-M-R II/Varivax
537 125 661 437 139 576 1,255 371 1,626 1,033 356 1,390 
Pneumovax 23
Pneumovax 23
276 99 375 179 58 237 478 270 748 428 164 592 
Pneumovax 23
181 97 277 276 99 375 354 247 600 478 270 748 
RotaTeqRotaTeq114 96 210 102 78 180 355 246 601 360 203 564 RotaTeq135 92 227 114 96 210 364 229 593 355 246 601 
VaqtaVaqta32 19 51 36 26 62 79 60 139 103 65 167 Vaqta32 16 48 32 19 51 80 58 138 79 60 139 
Hospital Acute CareHospital Acute CareHospital Acute Care
BridionBridion162 157 320 133 151 284 412 431 843 381 437 817 Bridion181 188 369 162 157 320 545 551 1,096 412 431 843 
PrevymisPrevymis39 57 96 32 46 77 111 159 270 87 113 200 
NoxafilNoxafil13 66 79 77 100 177 27 220 247 268 291 560 Noxafil19 45 64 13 66 79 48 149 197 27 220 247 
Prevymis32 46 77 22 23 45 87 113 200 60 55 115 
PrimaxinPrimaxin73 74 75 77 187 189 204 207 Primaxin— 69 70 73 74 — 194 194 187 189 
CancidasCancidas56 56 49 50 164 168 147 148 
InvanzInvanz50 51 (1)58 57 152 159 30 176 206 Invanz(2)55 53 50 51 (2)159 157 152 159 
Cancidas49 50 62 62 147 148 187 191 
Cubicin11 28 39 14 38 52 36 80 116 78 129 207 
ZerbaxaZerbaxa20 23 43 20 15 35 57 54 112 45 43 88 Zerbaxa(1)(1)(2)20 23 43 (5)(6)(11)57 54 112 
ImmunologyImmunologyImmunology
SimponiSimponi209 209 203 203 615 615 625 625 Simponi— 203 203 — 209 209 — 619 619 — 615 615 
RemicadeRemicade82 82 101 101 242 242 322 322 Remicade— 73 73 — 82 82 — 233 233 — 242 242 
NeuroscienceNeuroscienceNeuroscience
BelsomraBelsomra18 63 81 23 57 80 67 177 244 68 155 223 Belsomra23 58 81 18 63 81 56 183 238 67 177 244 
VirologyVirologyVirology
Isentress/Isentress HD
Isentress/Isentress HD
92 113 205 102 149 250 243 403 646 304 449 752 
Isentress/Isentress HD
77 112 189 92 113 205 222 368 590 243 403 646 
Zepatier22 28 24 59 83 38 83 122 96 208 304 
CardiovascularCardiovascularCardiovascular
Zetia(1)103 103 142 147 (4)389 384 11 432 443 
Vytorin44 47 52 57 130 139 11 219 231 
Atozet111 111 97 97 348 348 283 283 
Alliance revenue - Adempas (2)
78 83 48 50 200 16 216 137 144 
Alliance revenue-Adempas/Verquvo (2)
Alliance revenue-Adempas/Verquvo (2)
73 27 100 78 83 222 26 248 200 16 216 
AdempasAdempas55 55 57 57 167 167 158 158 Adempas— 59 59 — 55 55 — 188 188 — 167 167 
DiabetesDiabetesDiabetes
JanuviaJanuvia342 479 821 367 440 807 1,110 1,339 2,449 1,223 1,317 2,539 Januvia365 487 852 342 479 821 997 1,448 2,445 1,110 1,339 2,449 
JanumetJanumet105 400 506 129 375 503 361 1,138 1,499 462 1,105 1,567 Janumet86 401 487 105 400 506 244 1,205 1,449 361 1,138 1,499 
Women’s Health
Implanon/Nexplanon137 52 189 136 62 199 374 142 515 421 160 581 
NuvaRing24 34 58 202 39 241 85 98 184 593 107 700 
Diversified Brands
Singulair78 82 11 140 152 14 324 338 24 479 503 
Cozaar/Hyzaar86 91 110 116 17 275 292 16 313 329 
Arcoxia68 68 72 72 204 204 221 221 
Nasonex41 41 55 58 152 161 224 226 
Follistim AQ20 31 50 27 35 62 60 76 136 80 102 182 
Other pharmaceutical (3)
Other pharmaceutical (3)
352 834 1,186 343 804 1,149 1,144 2,334 3,478 1,037 2,394 3,431 
Other pharmaceutical (3)
262 308 572 193 333 526 745 957 1,704 706 969 1,675 
Total Pharmaceutical segment salesTotal Pharmaceutical segment sales5,218 6,102 11,320 5,180 5,914 11,095 14,202 17,452 31,654 14,202 17,016 31,218 Total Pharmaceutical segment sales5,670 5,826 11,496 4,842 4,872 9,714 14,611 16,103 30,714 13,108 13,690 26,797 
Animal Health:Animal Health:Animal Health:
LivestockLivestock164 594 758 144 582 726 448 1,697 2,145 406 1,601 2,007 Livestock190 675 864 165 593 758 508 1,996 2,503 448 1,697 2,145 
Companion AnimalsCompanion Animals234 228 462 193 203 396 676 714 1,390 560 704 1,264 Companion Animals277 276 553 234 228 462 855 948 1,804 676 714 1,390 
Total Animal Health segment salesTotal Animal Health segment sales398 822 1,220 337 785 1,122 1,124 2,411 3,535 966 2,305 3,271 Total Animal Health segment sales467 951 1,417 399 821 1,220 1,363 2,944 4,307 1,124 2,411 3,535 
Other segment sales (4)
Other segment sales (4)
46 46 23 23 133 133 
Other segment sales (4)
— — — — — — — — — 23 — 23 
Total segment salesTotal segment sales5,616 6,924 12,540 5,563 6,699 12,263 15,349 19,863 35,212 15,301 19,322 34,622 Total segment sales6,137 6,777 12,913 5,241 5,693 10,934 15,974 19,047 35,021 14,255 16,101 30,355 
Other (5)
Other (5)
11 10 125 134 47 221 267 19 330 350 
Other (5)
139 101 241 (14)(5)192 (30)162 46 168 215 
$5,625 $6,926 $12,551 $5,573 $6,824 $12,397 $15,396 $20,084 $35,479 $15,320 $19,652 $34,972  $6,276 $6,878 $13,154 $5,250 $5,679 $10,929 $16,166 $19,017 $35,183 $14,301 $16,269 $30,570 
U.S. plus international may not equal total due to rounding.
(1)    Alliance revenue represents Merck’s share of profits, which are product sales net of cost of sales and commercialization costs (see Note 3)4).
(2)    Alliance revenue represents Merck’s share of profits from sales in Bayer’s marketing territories, which are product sales net of cost of sales and commercialization costs (see Note 3)4).
(3)    Other pharmaceutical primarily reflects sales of other human health pharmaceutical products, including products within the franchises not listed separately.
(4)    Represents sales for the Healthcare Services segment. All the businesses in the Healthcare Services segment were fully divested asin the first quarter of March 31, 2020.
(5)    Other is primarily comprised of miscellaneous corporate revenues, including revenue hedging activities, as well as third-party manufacturing sales. Other for the three and nine months ended September 30, 2021 also includes $135 million and $185 million, respectively, related to the achievement of milestones for an out-licensed product that triggered contingent payments to Merck.
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Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Product sales are recorded net of the provision for discounts, including chargebacks, which are customer discounts that occur when a contracted customer purchases through an intermediary wholesale purchaser, and rebates that are owed based upon definitive contractual agreements or legal requirements with private sector and public sector (Medicaid and Medicare Part D) benefit providers, after the final dispensing of the product by a pharmacy to a benefit plan participant. These discounts, in the aggregate, reduced U.S. sales by $3.4$3.1 billion and $3.0$2.9 billion for the three months ended September 30, 20202021 and 2019,2020, respectively, and $9.6$9.1 billion and $8.6$8.3 billion for the nine months ended September 30, 20202021 and 2019,2020, respectively.
Consolidated sales by geographic area where derived are as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)2020201920202019($ in millions)2021202020212020
United StatesUnited States$5,625 $5,573 $15,396 $15,320 United States$6,276 $5,250 $16,166 $14,301 
Europe, Middle East and AfricaEurope, Middle East and Africa3,454 3,189 10,059 9,452 Europe, Middle East and Africa3,342 2,946 9,912 8,537 
ChinaChina1,016 914 2,715 2,423 China1,307 791 3,004 2,060 
JapanJapan828 919 2,506 2,639 Japan638 671 1,929 1,875 
Asia Pacific (other than China and Japan)Asia Pacific (other than China and Japan)735 756 2,129 2,217 Asia Pacific (other than China and Japan)613 545 1,782 1,560 
Latin AmericaLatin America604 671 1,670 1,889 Latin America599 499 1,631 1,374 
OtherOther289 375 1,004 1,032 Other379 227 759 863 
$12,551 $12,397 $35,479 $34,972  $13,154 $10,929 $35,183 $30,570 
A reconciliation of segment profits to Income before taxesfrom Continuing Operations Before Taxes is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)2020201920202019($ in millions)2021202020212020
Segment profits:Segment profits:Segment profits:
Pharmaceutical segmentPharmaceutical segment$7,974 $7,747 $22,010 $21,437 Pharmaceutical segment$8,606 $7,026 $22,450 $19,235 
Animal Health segmentAnimal Health segment451 423 1,336 1,243 Animal Health segment505 459 1,629 1,347 
Other segmentOther segment(1)(2)(2)Other segment— (1)— 
Total segment profitsTotal segment profits8,424 8,168 23,347 22,678 Total segment profits9,111 7,484 24,079 20,583 
Other profitsOther profits(12)101 188 226 Other profits141 (28)29 135 
Unallocated:Unallocated:Unallocated:
Interest incomeInterest income61 48 225 Interest income27 48 
Interest expenseInterest expense(203)(231)(624)(674)Interest expense(196)(203)(597)(624)
Depreciation and amortization(395)(382)(1,173)(1,169)
AmortizationAmortization(360)(406)(1,231)(1,393)
DepreciationDepreciation(358)(367)(1,031)(1,105)
Research and developmentResearch and development(3,272)(3,110)(7,364)(7,045)Research and development(2,312)(3,231)(8,775)(7,251)
Amortization of purchase accounting adjustments(285)(329)(879)(1,105)
Restructuring costsRestructuring costs(114)(232)(269)(444)Restructuring costs(107)(113)(487)(265)
Other unallocated, netOther unallocated, net(724)(1,699)(2,490)(4,019)Other unallocated, net(660)(439)(2,044)(1,720)
$3,428 $2,347 $10,784 $8,673  $5,266 $2,706 $9,970 $8,408 
Pharmaceutical segment profits are comprised of segment sales less standard costs, as well as selling, general and administrative expenses directly incurred by the segment. Animal Health segment profits are comprised of segment sales, less all cost of sales, as well as selling, general and administrative expenses and research and development costs directly incurred by the segment. For internal management reporting presented to the chief operating decision maker, Merck does not allocate the remaining cost of sales not included in segment profits as described above, research and development expenses incurred in Merck Research Laboratories, the Company’s research and development division that focuses on human health-related activities, or general and administrative expenses, nor the cost of financing these activities. Separate divisions maintain responsibility for monitoring and managing these costs, including depreciation related to fixed assets utilized by these divisions and, therefore, they are not included in segment profits. In addition, costs related to restructuring activities, as well as the amortization of intangible assets and purchase accounting adjustments are not allocated to segments.
Other profits are primarily comprised of miscellaneous corporate profits, as well as operating profits related to third-party manufacturing sales.
Other unallocated, net, includes expenses from corporate and manufacturing cost centers, goodwill and other intangible asset impairment charges, gains or losses on sales of businesses, expense or income related to changes in the estimated fair value measurement of liabilities for contingent consideration, and other miscellaneous income or expense items.
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Notes to Condensed Consolidated Financial Statements (unaudited) (continued)
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Planned Spin-Off of Women’s Health, Biosimilars and Established Brands into New CompanyOrganon & Co.
In February 2020,On June 2, 2021, Merck announced its intention tocompleted the spin-off of products from its women’s health, biosimilars and established brands businesses into a new, independent, publicly traded company named Organon & Co. (Organon) through a distribution of Organon’s publicly traded stock to Company shareholders. The distribution is expected to qualify as tax-free to the Company and its shareholders for U.S. federal income tax purposes. The established brands included in the transaction consistconsisted of dermatology, non-opioid pain management, respiratory, and select cardiovascular products, including Zetia (ezetimibe) and Vytorin (ezetimibe and simvastatin), as well as the rest of Merck’s diversified brands franchise. Merck’s existing research pipeline programs will continue to be owned and developed within Merck as planned. Organon will have development capabilities initially focused on late-stage development and life-cycle management and is expected over time to develop research capabilities in selected therapeutic areas. The spin-off is expected to be completed in the second quarter of 2021, subject to market and certain other conditions. Subsequent to the spin-off, the historical results of the women’s health, biosimilars and established brands businesses will bethat were contributed to Organon in the spin-off have been reflected as discontinued operations in the Company’s consolidated financial statements.statements through the date of the spin-off (see Note 2 to the condensed consolidated financial statements).
RecentOther Developments
Management
In October 2020, Merck announced that Dr. Roger M. Perlmutter will be retiring as Executive Vice President and President, Merck Research Laboratories (MRL). Dr. Perlmutter will be succeeded by Dr. Dean Y. Li, effective January 1, 2021. Dr. Perlmutter will remain as Non-Executive Chairman, MRL through June 30, 2021 to facilitate a seamless transition.
Business Developments
Below is a summary of significant 2020 business development activity.activity thus far in 2021. See Note 23 to the condensed consolidated financial statements for additional information.
In November 2020,January 2021, Merck entered into an exclusive license and research collaboration agreement with Artiva Biotherapeutics, Inc. (Artiva) to discover, develop and manufacture CAR-NK cells that target certain solid tumors using Artiva’s proprietary platform. Merck and VelosBio, Inc. (VelosBio) announced that the companies had entered intoArtiva agreed to engage in up to three different research programs, each covering a definitive agreement pursuant to whichcollaboration target. Merck through a subsidiary, will acquirehas sole responsibility for all outstanding shares of VelosBio for $2.75 billion, subject to certain customary adjustments. VelosBio is a privately held clinical-stage biopharmaceutical company committed to developing first-in-class cancer therapies targeting receptor tyrosine kinase-like orphan receptor 1 (ROR1). VelosBio’s lead investigational candidate is VLS-101, an antibody-drug conjugate targeting ROR1 that is currently being evaluated in a Phase 1development and a Phase 2 clinical trial for the treatment of patients with hematologic malignanciescommercialization activities (including regulatory filing and solid tumors, respectively. The closing of the transaction, which is subject to approval under the Hart-Scott-Rodino Antitrust Improvements Act and other customary conditions, is expected by the end of 2020.
In September 2020, Merck and Seagen Inc. (Seagen, formerly known as Seattle Genetics, Inc.) announced an oncology collaboration to globally develop and commercialize Seagen’s ladiratuzumab vedotin (MK-6440), an investigational antibody-drug conjugate targeting LIV-1, which is currently in Phase 2 clinical trials for breast cancer and other solid tumors. The companies will equally share profits worldwide.approval). Under the terms of the agreement, Merck made an upfront payment of $600$30 million, which was included in Research and a $1.0 billion equity investmentdevelopment expenses in 5the first nine months of 2021, for license and other rights for the first two collaboration targets and agreed to make another upfront payment of $15 million shares of Seagen common stock at a price of $200 per share. The closing offor license and other rights for the equity investment occurred in October 2020. Seagenthird collaboration target when it is alsoselected by Merck and accepted by Artiva. In addition, Artiva is eligible to receive future contingent milestone payments dependent upon the achievement of certain developmental and sales-based milestones.
Concurrent with the above transaction, Seagen granted Merck an exclusive license to commercialize Tukysa (tucatinib), a small molecule tyrosine kinase inhibitor, for the treatment of HER2-positive cancers, in Asia, the Middle East and Latin America and other regions outside of the United States, Canada and Europe. Under the terms of the agreement, Merck made upfront payments aggregating $210 million. Seagen is also eligible to receive future contingent regulatory approval milestones and will receive tiered royalties on sales of Tukysa in Merck’s territories.
Additionally in September 2020, Merck acquired a biologics manufacturing facility located in Dunboyne, Ireland from Takeda Pharmaceutical Company Limited for €256 million ($302 million).future sales.
In July 2020, Merck acquired the U.S. rights to Sentinel Flavor Tabs and Sentinel Spectrum Chews from Virbac Corporation for $410 million. Sentinel products provide protection against common parasites in dogs.
Also, in July 2020,March 2021, Merck and Ridgeback Biotherapeutics LP (Ridgeback Bio), a closely held biotechnology company, closed a collaborationGilead Sciences, Inc. (Gilead) entered into an agreement to develop molnupiravir (MK-4482, formerly known as EIDD-2801), an orally available antiviral candidate currently in clinical development for the treatment of patients with COVID-19. Merck gained exclusive worldwide rights tojointly develop and commercialize molnupiravirlong-acting treatments in HIV that combine Merck’s investigational nucleoside reverse transcriptase translocation inhibitor, islatravir, and related molecules. UnderGilead’s investigational capsid inhibitor, lenacapavir. The collaboration will initially focus on long-acting oral formulations and long-acting injectable formulations of these combination products, with other formulations potentially added to the terms of the agreement, Ridgeback Bio received ancollaboration as mutually agreed. There was no upfront payment and also is eligible to receive future contingent payments dependentmade by either party upon entering into the achievement of certain developmental and regulatory approval milestones, as well as a share of the net profits of molnupiravir and related molecules, if approved.
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agreement.
In June 2020,April 2021, Merck acquired privately held Themis Bioscience GmbH (Themis)Pandion Therapeutics, Inc. (Pandion), a clinical-stage biotechnology company focused on vaccines and immune-modulation therapiesdeveloping novel therapeutics designed to address the unmet needs of patients living with autoimmune diseases, for infectious diseases and cancer for $366 million. Merck may make additional contingent payments dependent upon the achievementtotal consideration of certain developmental, regulatory approval and commercial milestones. The acquisition builds upon an ongoing collaboration between the two companies to develop vaccine candidates using the measles virus vector platform and$1.9 billion. Pandion is expected to accelerate the developmentadvancing a pipeline of the COVID-19 vaccine candidate (V591), which is currently in Phase 1 clinical development.precision immune modulators targeting critical immune control nodes.
In May 2020,September 2021, Merck and the International AIDS Vaccine Initiative,Acceleron Pharma Inc. (IAVI), a nonprofit scientific research organization dedicated to addressing urgent, unmet global health challenges, announced a new collaboration to develop V590, an investigational vaccine against SARS-CoV-2 being studied for the prevention of COVID-19, which is currently in Phase 1 clinical development. Under the terms of the agreement, Merck made an upfront payment of $6.5 million and may make additional contingent payments dependent upon the achievement of certain sales-based milestones, as well as royalties.
In January 2020, Merck acquired ArQule, Inc. (ArQule)(Acceleron), a publicly traded biopharmaceutical company, entered into a definitive agreement under which Merck will acquire Acceleron for $180 per share in cash for an approximate total equity value of $11.5 billion. Acceleron is focused on kinase inhibitor discoveryharnessing the power of the transforming growth factor (TGF)-beta superfamily of proteins that is known to play a central role in the regulation of cell growth, differentiation and development forrepair. Under the treatmentterms of patients with cancerthe acquisition agreement, Merck, through a subsidiary, initiated a tender offer to acquire all outstanding shares of Acceleron. The closing of the tender offer is subject to certain conditions, including the tender of shares representing at least a majority of the total number of Acceleron’s outstanding shares, receipt of applicable regulatory approvals, and other diseases, for total considerationcustomary conditions. The transaction is expected to close in the fourth quarter of $2.7 billion. ArQule’s lead investigational candidate, MK-1026 (formerly known as ARQ 531), is a novel, oral Bruton’s tyrosine kinase (BTK) inhibitor currently being evaluated for the treatment of B-cell malignancies.2021.
Coronavirus Disease 2019 (COVID-19) Update
Overall, in response to the COVID-19 pandemic, Merck is focused on protecting the safety of its employees, ensuring that its supply of medicines and vaccines reaches its patients, contributing its scientific expertise to the development of vaccinean antiviral therapy, supporting efforts to expand manufacturing capacity and antiviral approaches,supply of SARS-CoV-2/COVID-19 medicines and vaccines (see below), and supporting health care providers and Merck’s communities. Although COVID-19-related disruptions to patients’ ability to access health care providers negatively affected results for the third quarter and first nine months of 2020,2021, Merck remains confident in the fundamentalcontinues to experience strong global underlying demand foracross its products and its prospects for long-term growth.business.
In the third quarter and first nine months of 2021, the estimated negative impact of the COVID-19 pandemic to Merck’s sales was approximately $350 million and $1.3 billion, respectively, all of which related to the Pharmaceutical segment. In the third quarter and first nine months of 2020, the estimated negative impact of the COVID-19 pandemic to Merck’s Pharmaceutical sales was estimated to be approximately $475 million. The negative impact to Animal Health sales was immaterial. The negative impact to sales in the first nine months$400 million and $1.7 billion, respectively. Roughly 75% of 2020 was approximately $2.0 billion for the Merck’s
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Pharmaceutical segment and $50 million for the Animal Health segment. Merck assumes that the majority of the negative impact from the COVID-19 pandemic occurred in the second quarter of 2020. However, the Company expects some residual negative impacts in the fourth quarter, largely in Europe and certain emerging markets. In addition, the phasing of the recovery of Gardasil 9 (Human Papillomavirus 9-valent Vaccine, Recombinant) demand is slower than originally anticipated, in particular in the United States due to lower back-to-school demand. Accordingly, for the full-year 2020, including the impact for the first nine months, Merck expects an unfavorable impact to sales of approximately $2.35 billion (excluding the impact of foreign exchange) due to the COVID-19 pandemic, comprised of approximately $2.3 billion for Pharmaceutical revenue and approximately $50 million for Animal Health revenue.
Roughly two-thirds of Merck’s Pharmaceutical revenue is comprised of physician-administered products, which, despite strong underlying demand, werehave been affected by social distancing measures and fewer well visitsvisits.
In April 2021, Merck announced it was discontinuing the development of MK-7110 (formerly known as CD24Fc) for the treatment of hospitalized patients with COVID-19 (see Note 3 to the condensed consolidated financial statements). This decision resulted in charges of $207 million to Cost of sales in the first nine months of 2021.
Operating expenses reflect a minor positive effect in the third quarter and delaysfirst nine months of 2021 as investments in elective surgeriesCOVID-19-related research programs largely offset the favorable impact of lower spending in other areas due to the COVID-19 pandemic. These impacts, as well as the prioritization of COVID-19 patients at health care providers, have resulted in reduced administration of many of the Company’s human health products, in particular for its vaccines, including Gardasil 9, as well as for Keytruda (pembrolizumab) and Implanon/Nexplanon (etonogestrel implant). Access to healthcare providers remains reduced, although improved from the second quarter. Merck anticipates reduced demand for its physician-administered products while pandemic-related access measures remain in place. In addition, declines in elective surgeries negatively affected the demand for Bridion (sugammadex) Injection in the year-to-date period. Sales of Pneumovax 23 (pneumococcal vaccine polyvalent) increased due to heightened awareness of pneumococcal vaccination during the COVID-19 pandemic and ahead of flu season.
Operating expenses were positively affected in the third quarter and first nine months of 2020 by approximately $115$100 million and $540$500 million, respectively, primarily driven by lower promotional and selling costs, as well as lower research and development expenses netdue to the COVID-19 pandemic.
Merck continues to believe that global health systems and patients have largely adapted to the impacts of investments in COVID-19-related antiviralthe COVID-19 pandemic, and vaccine research programs.that while certain negative impacts will persist, the trend will continue to improve. For the full-year 2020,full year of 2021, Merck expectsassumes a net favorableunfavorable impact to operating expensessales of approximately $625 million reflecting continued lower spendingless than 3% due to the COVID-19 pandemic, partially offsetall of which relates to the Pharmaceutical segment.
In November 2021, the Medicines and Healthcare products Regulatory Agency in the United Kingdom (U.K.) granted authorization for molnupiravir (MK-4482, EIDD-2801), an investigational oral antiviral medicine, for the treatment of mild-to-moderate COVID-19 in adults with a positive SARS-CoV-2 diagnostic test and who have at least one risk factor for developing severe illness. The authorization is based on positive results from a planned interim analysis from the Phase 3 MOVe-OUT clinical trial, which evaluated molnupiravir in non-hospitalized, unvaccinated adult patients with laboratory-confirmed mild-to-moderate COVID-19, symptom onset within five days of study randomization and at least one risk factor associated with poor disease outcomes. In the U.K., Lagevrio is the planned trademark for molnupiravir. In October 2021, Merck submitted an Emergency Use Authorization (EUA) application to the U.S. Food and Drug Administration (FDA) for molnupiravir for the treatment of mild-to-moderate COVID-19 in adults who are at risk for progressing to severe COVID-19 and/or hospitalization. The FDA subsequently announced a November 30, 2021 meeting of its Antimicrobial Drugs Advisory Committee to discuss the available data supporting the use of molnupiravir to treat mild-to-moderate COVID-19 in adults who have tested positive for COVID-19 and who are at high risk of progression to severe COVID-19, including hospitalization or death. Also in October 2021, the European Medicines Agency (EMA) initiated a rolling review for molnupiravir. Merck plans to work with the Committee for Medicinal Products for Human Use (CHMP) of the EMA to complete the rolling review process to facilitate initiating the formal review of the Marketing Authorization Application. Merck is developing molnupiravir in collaboration with Ridgeback Biotherapeutics LP (Ridgeback Bio). The companies are actively working with other regulatory agencies worldwide to submit applications for emergency use or marketing authorization in the coming months. In anticipation of the results from the MOVe-OUT trial and the potential for regulatory authorization or approval, Merck has been producing molnupiravir at risk. Merck expects to produce 10 million courses of treatment by spendingthe end of 2021, with at least 20 million additional courses expected to be produced in 2022. In June 2021, Merck announced a procurement agreement with the U.S. government under which Merck will supply approximately 1.7 million courses of molnupiravir to the U.S. government upon EUA or approval from the FDA, which will be delivered in scheduled increments. This procurement of molnupiravir will be supported in whole or in part with federal funds. Additionally, Merck has entered into supply and advance purchase commitments for molnupiravir with other governments worldwide, including Australia, South Korea and New Zealand pending regulatory authorization, as well as the U.K., and is currently in discussions with other governments. If approved, Merck will be the principal on COVID-19-related antiviralsales transactions, recognizing sales and vaccine research programs.related costs, with profit sharing amounts recorded within Cost of sales. Profits from the collaboration will be split equally between the partners.
Merck is committed to providing timely access to molnupiravir globally, if it is authorized or approved, and intends to implement a tiered pricing approach based on World Bank country income criteria to reflect countries’ relative ability to finance their health response to the pandemic. As part of its commitment to widespread global access, Merck has entered into non-exclusive voluntary licensing agreements for molnupiravir with established Indian generic manufacturers. Merck and the Medicines Patent Pool (MPP) also signed a voluntary licensing agreement to facilitate affordable global access for molnupiravir. Under the terms of the agreement, the MPP will be permitted to further license non-exclusive sublicenses to manufacturers and diversify the manufacturing base for the supply of quality-assured or WHO-prequalified molnupiravir to countries covered by the MPP license, subject to local regulatory authorization. Merck, Ridgeback Bio and Emory University will not receive royalties for sales of molnupiravir under this agreement (molnupiravir was invented at Emory University and licensed to Ridgeback Bio) for as long as COVID-19 remains classified as a Public Health Emergency of International Concern by the World Health Organization. These agreements will help expand access to molnupiravir in more than 100 low- and middle-income countries.
In March 2021, Merck announced it had entered into multiple agreements to support efforts to expand manufacturing capacity and supply of SARS-CoV-2/COVID-19 medicines and vaccines. The Biomedical Advanced Research and Development Authority (BARDA), a division of the Office of the Assistant Secretary for Preparedness and Response
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within the U.S. Department of Health and Human Services, will provide Merck with funding to adapt and make available a number of existing manufacturing facilities for the production of SARS-CoV-2/COVID-19 vaccines and medicines. Merck has also entered into agreements to support the manufacturing and supply of Johnson & Johnson’s SARS-CoV-2/COVID-19 vaccine. Merck will use its facilities in the U.S. to produce drug substance, formulate and fill vials of Johnson & Johnson’s vaccine.
Pricing
Global efforts toward health care cost containment continue to exert pressure on product pricing and market access worldwide. In the United States, pricing pressure continues on many of the Company’s products. Changes to the U.S. health care system as part of health care reform, as well as increased purchasing power of entities that negotiate on behalf of Medicare, Medicaid, and private sector beneficiaries, have contributed to pricing pressure. In several international markets, government-mandated pricing actions have reduced prices of generic and patented drugs. In addition, the Company’s revenue
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sales performance in the first nine months of 20202021 was negatively affected by other cost-reduction measures taken by governments and other third-partiesthird parties to lower health care costs. In the U.S., the Biden Administration and Congress continue to discuss legislation designed to control health care costs, including the cost of drugs. The Company anticipates all of these actions and additional actions in the future will continue to negatively affect revenuesales performance.
Operating Results
Sales
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($ in millions)($ in millions)20202019% Change20202019% Change($ in millions)20212020% Change20212020% Change
United StatesUnited States$5,625 $5,573 %%$15,396 $15,320 — %— %United States$6,276 $5,250 20 %20 %$16,166 $14,301 13 %13 %
InternationalInternational6,926 6,824 %%20,084 19,652 %%International6,878 5,679 21 %18 %19,017 16,269 17 %13 %
TotalTotal$12,551 $12,397 %%$35,479 $34,972 %%Total$13,154 $10,929 20 %19 %$35,183 $30,570 15 %13 %
U.S. plus international may not equal total due to rounding.

Worldwide sales were $12.6grew 20% to $13.2 billion and $35.5 billion forin the third quarter of 2021 and rose 15% to $35.2 billion in the first nine months of 2020, respectively, representing growth of 1% compared with the same prior year periods. Sales growth2021. Revenue performance in both periods was primarily driven byreflects higher sales in the oncology franchise reflectinglargely driven by strong growth of Keytruda, as well as (pembrolizumab) and increased alliance revenue from Lynparza (olaparib) and Lenvima (lenvatinib). Also contributing to revenue growth were, as well as higher sales of certainin the vaccines includingfranchise, primarily attributable to growth in PneumovaxGardasil 23,(Human Papillomavirus Quadrivalent [Types 6, 11, 16 and higher18] Vaccine, Recombinant)/Gardasil 9 (Human Papillomavirus 9-valent Vaccine, Recombinant), Varivax (Varicella Virus Vaccine Live) and ProQuad (Measles, Mumps, Rubella and Varicella Virus Vaccine Live). Higher sales of certain hospital acute care products, including Bridion (sugammadex) Injection and Prevymis (letermovir) and Bridion. Higher, as well as higher sales of Animal Health products also contributed todrove revenue growth in the third quarter and first nine months of 2020.
Sales growth in both periods was partially offset by the ongoing effects of generic competition for certain products including women’s health product NuvaRing (etonogestrel/ethinyl estradiol vaginal ring), hospital acute care product Noxafil (posaconazole), oncology products Emend (aprepitant)/Emend (fosaprepitant dimeglumine) for Injection, cardiovascular products Zetia and Vytorin, as well as products within the diversified brands franchise. The diversified brands franchise includes certain products that are approaching the expiration of their marketing exclusivity or that are no longer protected by patents in developed markets. Lower2021. Additionally, sales of certain vaccines including human papillomavirus (HPV) vaccines Gardasil (Human Papillomavirus Quadrivalent [Types 6,11,16 and 18] Vaccine, Recombinant)/Gardasil 9 and pediatric vaccines ProQuad (Measles, Mumps, Rubella and Varicella Virus Vaccine Live), M-M-R II (Measles, Mumps and Rubella Virus Vaccine Live) and Varivax (Varicella Virus Vaccine Live), as well as lower sales of virology products Zepatier (elbasvir and grazoprevir) and Isentress/IsentressHD (raltegravir) also partially offset revenue growth in the third quarter and first nine months of 2020.2021 also benefited from the achievement of milestones for an out-licensed product that triggered contingent payments to Merck. As discussed above, the COVID-19 pandemic unfavorably affected sales in the third quarter and first nine months of 2020.2021, but to a lesser extent than in the comparable periods of 2020 which benefited year-over-year sales growth.
Revenue growth in both periods was partially offset by lower sales of Pneumovax 23 (pneumococcal vaccine polyvalent) and the suspension of sales of hospital acute care product Zerbaxa (ceftolozane and tazobactam) for injection. Lower sales of diabetes product Janumet (sitagliptin/metformin HCl) also partially offset revenue growth in the first nine months of 2021.
See Note 1716 to the condensed consolidated financial statements for details on sales of the Company’s products. A discussion of performance for select products in the franchises follows.

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Pharmaceutical Segment
Oncology
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($ in millions)($ in millions)20202019% Change20202019% Change($ in millions)20212020% Change20212020% Change
KeytrudaKeytruda$3,715 $3,070 21 %21 %$10,387 $7,973 30 %31 %Keytruda$4,534 $3,715 22 %21 %$12,609 $10,387 21 %19 %
Alliance Revenue - Lynparza (1)
Alliance Revenue - Lynparza (1)
196 123 59 %58 %519 313 66 %67 %
Alliance Revenue - Lynparza (1)
246 196 25 %25 %721 519 39 %35 %
Alliance Revenue - Lenvima (1)
Alliance Revenue - Lenvima (1)
142 109 30 %29 %421 280 50 %50 %
Alliance Revenue - Lenvima (1)
188 142 32 %30 %498 421 18 %15 %
Emend39 98 (60)%(59)%115 336 (66)%(65)%
(1) Alliance revenue represents Merck’s share of profits, which are product sales net of cost of sales and commercialization costs (see Note 34 to the condensed consolidated financial statements).
Keytruda is an anti-PD-1 (programmed death receptor-1) therapy that has been approved as monotherapy for the treatment of certain patients with cervical cancer, classical Hodgkin lymphoma (cHL), cutaneous squamous cell carcinoma (cSCC), esophageal cancer, gastric or gastroesophageal junction adenocarcinoma, head and neck squamous cell carcinoma (HNSCC), hepatocellular carcinoma (HCC), non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), melanoma, Merkel cell carcinoma, microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) cancer including MSI-H/dMMR colorectal cancer, primary mediastinal large B-cell lymphoma, (PMBCL),tumor mutational burden-high (TMB-H) solid tumors, and urothelial carcinoma.carcinoma including non-muscle invasive bladder cancer. Keytruda is also approved for the treatment of certain patients in combination with chemotherapy for metastatic squamous and nonsquamous NSCLC, in combination with chemotherapy for esophageal cancer, in combination with chemotherapy for gastric cancer, in combination with chemotherapy for HNSCC, in combination with chemotherapy for triple-negative-breast cancer (TNBC), in combination with axitinib for renal cell carcinoma (RCC), and in combination with Lenvima for both endometrial
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carcinoma. carcinoma and RCC. The Keytruda clinical development program includes studies across a broad range of cancer types (seetypes. See “Research and Development” below).
In January 2020, the U.S. Food and Drug Administration (FDA) approved Keytruda as monotherapy for the treatment of certain patients with Bacillus Calmette-Guerin (BCG)-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) based on the results of the KEYNOTE-057 trial.
In April 2020, the FDA granted accelerated approval for an additional recommended dosage of 400 mg every six weeks (Q6W) for Keytrudaacross all adult indications, including monotherapy and combination therapy. This new dosage option is available in addition to the current dose of 200 mg every three weeks (Q3W).
In June 2020, the FDA granted accelerated approval for Keytruda as monotherapy for the treatment of adult and pediatric patients with unresectable or metastatic tumor mutational burden-high (TMB-H) (≥10 mutations/megabase) solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options based in part on the results of the KEYNOTE-158 trial.
Also in June 2020, the FDA approved Keytruda as monotherapy both for the treatment of patients with recurrent or metastatic cSCC that is not curable by surgery or radiation based on data from the Phase 2 KEYNOTE-629 trial and for the first-line treatment of patients with unresectable or metastatic MSI-H or mismatch repair deficient colorectal cancer based on results from the Phase 3 KEYNOTE-177 trial.
In October 2020, the FDA approved an expanded label for Keytruda as monotherapy for the treatment of adult patients with relapsed or refractory cHL. The approval is based on results from the Phase 3 KEYNOTE-204 trial in which Keytruda significantly reduced the risk of disease progression or death compared to brentuximab vedotin. The FDA also approved an updated pediatric indication for Keytruda for the treatment of pediatric patients with refractory cHL or cHL that has relapsed after two or more lines of therapy. Keytruda was previously approved under the FDA’s accelerated approval process for the treatment of adult and pediatric patients with refractory cHL, or who have relapsed after three or more prior lines of therapy based on data from the KEYNOTE-087 trial. In accordance with accelerated approval regulations, continued approval was contingent upon verification and description of clinical benefit; these accelerated approval requirements have been fulfilled with the data from KEYNOTE-204.
In June 2020, Keytruda was approved by the National Medical Products Administration (NMPA) in China as monotherapy for the second-line treatment of patients with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC) whose tumors express PD-L1 (Combined Positive Score [CPS] ≥10). This indication was granted based on the Phase 3 KEYNOTE-181 trial, including data from an extension of the global study in Chinese patients.
In August 2020, Keytruda was approved by the Japan Pharmaceuticals and Medical Devices Agency (PMDA) as monotherapy for the treatment of patients whose tumors are PD-L1-positive, and have radically unresectable, advanced or recurrent ESCC who have progressed after chemotherapy. The approval was based on results from the Phase 3 KEYNOTE-181 trial. Additionally, Keytruda was approved by the Japan PMDA for use at an additional recommended dosage of 400 mg Q6W, including monotherapy and combination therapy. This new dosage option is available in addition to the current dose of 200 mg Q3W.Development Update” below.
Global sales of Keytruda grew 21%22% and 30%21% in the third quarter and first nine months of 2020,2021, respectively. Sales growth in both periods was driven by higher demand as the Company continues to launch Keytruda with multiple new indications globally, although the COVID-19 pandemic had a dampening effect on growing demand.demand negatively affecting the number of new patients starting treatment. Sales in the United StatesU.S. continue to build across the multiple approved indications, in particular for the treatment of advanced NSCLC as monotherapy, and in combination with chemotherapy for both nonsquamous and squamous metastatic NSCLC, along with uptake in the RCC, adjuvant melanoma, HNSCC, bladderTNBC, MSI-H cancer, esophageal cancer and endometrial carcinomaHNSCC indications. Uptake of the Q6W dosing regimen in the United States benefited sales in 2020. Keytruda sales growth in international markets was driven by continued uptake in approvedpredominately for the NSCLC, HNSCC and RCC indications, particularly in the European Union (EU).Europe. Sales growth in the third quarter and first nine months of 20202021 was partially offset by declineslower pricing in Japan dueEurope, China and Japan.
In March 2021, the FDA approved Keytruda for the treatment of certain patients with locally advanced or metastatic esophageal or gastroesophageal junction carcinoma that is not amenable to pricing. Pursuant tosurgical resection or definitive chemoradiation in combination with chemotherapy. The approval was based on the results of the KEYNOTE-590 trial.
In May 2021, the FDA approved Keytruda in combination with chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic human epidermal growth factor receptor 2 (HER2) positive gastric or gastroesophageal junction adenocarcinoma based on the results of the KEYNOTE-811 trial. This indication is approved under accelerated approval based on tumor response rate and durability of response; continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.
In July 2021, the FDA approved Keytruda for the treatment of patients with high-risk, early-stage TNBC in combination with chemotherapy as neoadjuvant treatment and then continued as a re-pricing rule,single agent as adjuvant treatment after surgery, based on the Japanese government reducedKEYNOTE-522 trial. Additionally, the priceFDA converted the accelerated approval of Keytruda in combination with chemotherapy for the treatment of patients with locally recurrent unresectable or metastatic TNBC whose tumors express PD-L1 that was originally granted in 2020 to a full (regular) approval based on confirmatory data from KEYNOTE-522.
Also in July 2021, the FDA approved Keytruda as monotherapy for the treatment of patients with locally advanced cSCC that is not curable by 17.5% effective February 2020. surgery or radiation based on data from the KEYNOTE-629 trial.
Additionally, in July 2021, the FDA approved the combination of Keytruda plus Lenvima for the treatment of patients with advanced endometrial carcinoma that is not MSI-H or dMMR, who have disease progression following prior systemic therapy in any setting and are not candidates for curative surgery or radiation. The approval for this population is based on results from the KEYNOTE-775/Study 309 trial, which was the confirmatory trial for the accelerated approval by the FDA in 2019.
In August 2021, Merck announced a label update for Keytruda for its indication in first-line advanced urothelial carcinoma (bladder cancer) in the U.S. The FDA has converted this indication from an accelerated to a full (regular) approval.
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In addition, as part of the label update, this indication has been revised to be for the treatment of patients with locally advanced or metastatic urothelial carcinoma who are not eligible for any platinum-containing chemotherapy.
Also in August 2021, the FDA approved the combination of Keytruda and Lenvima for the first-line treatment of adult patients with advanced RCC based on results from the KEYNOTE-581 trial/Study 307 trial.
In October 2021, the FDA approved Keytruda in combination with chemotherapy, with or without bevacizumab, for the treatment of patients with persistent, recurrent or metastatic cervical cancer based on the KEYNOTE-826 trial. Additionally, the FDA converted the accelerated approval of Keytruda as a single agent for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy to a regular approval based on confirmatory data from KEYNOTE-826. This approval was originally granted in June 2018 based on results from the KEYNOTE-158 trial.
In March 2021, Merck announced it was voluntarily withdrawing the U.S. indication for Keytruda for the treatment of patients with metastatic SCLC with disease progression on or after platinum-based chemotherapy and at least one other prior line of therapy. The withdrawal of this indication was done in consultation with the FDA and does not affect other indications for Keytruda. Accelerated approval for this indication was granted in 2019 and was contingent upon completion of the post-marketing requirement establishing superiority of Keytruda as determined by overall survival (OS). As announced in January 2020, KEYNOTE-604, the confirmatory Phase 3 trial for this indication, met one of its dual primary endpoints of progression-free survival (PFS) but did not reach statistical significance for the other primary endpoint of OS.
In July 2021, Merck announced that it plans to voluntarily withdraw the U.S. accelerated approval indication for Keytruda for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma whose tumors express PD-L1, with disease progression on or after two or more prior lines of therapy. The decision was made in consultation with the FDA following the Oncologic Drugs Advisory Committee evaluation of this third-line gastric cancer indication for Keytruda as a monotherapy because it failed to meet its post-marketing requirement of demonstrating an OS benefit in a Phase 3 study. The withdrawal of this indication was done in consultation with the FDA and does not affect other indications for Keytruda. As agreed with the FDA, Merck will initiate the withdrawal in January 2022.
In January 2021, Keytruda was subject to another price reduction of 20.9%approved by the European Commission (EC) as a first-line treatment in April 2020 under a provisionadult patients with MSI-H or dMMR colorectal cancer based on the results of the Japanese pricing rules.KEYNOTE-177 study.
In March 2021, the EC approved an expanded label for Keytruda as monotherapy for the treatment of adult and pediatric patients aged 3 years and older with relapsed or refractory cHL who have failed autologous stem cell transplant (ASCT) or following at least two prior therapies when ASCT is not a treatment option. This approval is based on results from the KEYNOTE-204 and KEYNOTE-087 trials. This is the first pediatric approval for Keytruda in the European Union (EU).
In May 2021, the EC approved the addition of the 400 mg every six weeks (Q6W) dosing regimen to indications where Keytruda is administered in combination with other anticancer agents.
Also in May 2021, the EC approved an update to the European label for Keytruda to include data from KEYNOTE-361. In the EU, Keytruda is approved for the treatment of adult patients with advanced or metastatic urothelial carcinoma (bladder cancer) who are not eligible for cisplatin-containing chemotherapy and whose tumors express PD-L1. This approval was based on KEYNOTE-052; KEYNOTE-361 was conducted as part of a post-marketing commitment following the initial approval of Keytruda for these patients.
In June 2021, the EC approved Keytruda in combination with chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic carcinoma of the esophagus or HER2-negative gastroesophageal junction adenocarcinoma in adults whose tumors express PD-L1. This approval was based on results from the KEYNOTE-590 trial.
In October 2021, the EC approved Keytruda in combination with chemotherapy for the first-line treatment of locally recurrent unresectable or metastatic TNBC in adults whose tumors express PD-L1 and who have not received prior chemotherapy for metastatic disease based on the KEYNOTE-355 trial.
In August 2021, Keytruda received two new approvals from the Japan Pharmaceuticals and Medical Devices Agency: for the treatment of patients with PD-L1-positive, hormone receptor-negative and HER2-negative, inoperable or recurrent breast cancer, based on the results of the KEYNOTE-355 trial; and as a monotherapy for the treatment of patients with unresectable, advanced or recurrent MSI-H colorectal cancer, based on results of the KEYNOTE-177 trial.
In June 2021, Keytruda was approved by the China National Medical Products Administration (NMPA) as a first-line treatment in adult patients with MSI-H or dMMR colorectal cancer that is KRAS, NRAS and BRAF (all wild-type) based on the results of the KEYNOTE-177 study. In September 2021, Keytruda was approved by the China NMPA in combination with chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic carcinoma of the esophagus or gastroesophageal junction based on the KEYNOTE-590 trial.
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Lynparza is an oral poly (ADP-ribose) polymerase (PARP) inhibitor being developed as part of a collaboration with AstraZeneca PLC (AstraZeneca) (see Note 34 to the condensed consolidated financial statements),. Lynparza is approved for the treatment of certain types of advanced ovarian, breast, pancreatic and prostate cancers. Alliance revenue related to Lynparza increased 59%25% and 66%39% in the third quarter and first nine months of 2020,2021, respectively. Sales growth in both periods was largely driven by continued uptake across the multiple approved indications in the United States, the EUU.S. and China. In May 2020, the FDA approved LynparzaEurope. Higher demand in combination with bevacizumab as a first-line maintenance treatment of certain adult patients with advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial responseChina also contributed to first-line platinum-based chemotherapy based on the results from the Phase 3 PAOLA-1 trial. In November 2020, Lynparza was
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approvedsales growth in the EU for the maintenance treatment of adult patients with advanced high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or parital response following completion of first-line platinum-based chemotherapy in combination with bevacizumab and whose cancer is associated with homologous recombination deficiency (HRD)-positive status defined by either a breast cancer susceptibility gene 1/2 (BRCA1/2) mutation and/or genomic instability based on the results from the PAOLA-1 trial. Also in May 2020, the FDA approved Lynparza for the treatment of adult patients with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC) who have progressed following prior treatment with enzalutamide or abiraterone based on positive results from the Phase 3 PROfound trial.year-to-date period. In November 2020,June 2021, Lynparza was approvedgranted conditional approval in the EUChina as monotherapy for the treatment of adult patients with mCRPC and BRCA1/2 mutations (germline and/or somatic) who have progressed following a prior therapy that included a new hormonal agent based on the PROfound trial. In July 2020, Lynparza was approved in the EU as a monotherapy for the maintenance treatment ofcertain previously treated adult patients with germline or somatic BRCA1/2 mutations who have-mutated metastatic adenocarcinoma of the pancreas and have not progressed after a minimum of 16 weeks of platinum treatment within a first-line chemotherapy regimencastration-resistant prostate cancer based on the results fromof the Phase 3 POLOPROfound trial.
Lenvima is an oral receptor tyrosine kinase inhibitor being developed as part of a collaboration with Eisai Co., Ltd. (Eisai) (see Note 34 to the condensed consolidated financial statements),. Lenvima is approved for the treatment of certain types of thyroid cancer, RCC, HCC, in combination with everolimus for certain patients with RCC, in combination with Keytruda for the treatment of certain patients with endometrial carcinoma, and in combination with Keytruda for the treatment of certain patients with endometrial carcinoma.RCC. Alliance revenue related to Lenvima grew 30%32% and 50%18% in the third quarter and first nine months of 2020,2021, respectively. Sales growth in both periods was primarily due toreflects higher demand in the United States, China and the EU.U.S.
Global sales of Emend, for the prevention of chemotherapy-induced nausea and vomiting, declined 60% and 66%In June 2021, Koselugo (selumetinib) was granted conditional approval in the third quarter and first nine months of 2020, respectively. The sales declines were primarily driven by lower demand and pricing in the United States due to generic competition, including recent generic competition for Emend for Injection following U.S. patent expiry in September 2019. Also contributing to the sales declines in the third quarter and first nine months of 2020 was lower demand in the EU as a result of generic competition for the oral formulation of Emend following loss of market exclusivity in May 2019. U.S. market exclusivity for the oral formulation of Emend previously expired in 2015. Generic competition for Emend for Injection in Japan following loss of exclusivity also contributed to the sales declines in the third quarter and first nine months of 2020. Emend for Injection lost market exclusivity in major European markets in August 2020. The Company anticipates that sales of Emend for Injection in these markets will decline significantly in future periods.
In April 2020, the FDA approved Koselugo (selumetinib) for the treatment of pediatric patients twothree years of age and older with neurofibromatosis type 1 (NF1) who have symptomatic, inoperable plexiform neurofibromas (PN). The FDA approval is based on positive results from the National Cancer Institute (NCI) Cancer Therapy Evaluation Program (CTEP)-sponsored Phase 2Program-sponsored SPRINT Stratum 1 trial coordinatedtrial. Koselugo was approved by the NCI’s Center for Cancer Research, Pediatric Oncology Branch. ThisFDA in April 2020. Koselugo is part of the first regulatory approval of a medicinesame collaboration with AstraZeneca referenced above that includes Lynparza.
In August 2021, the FDA approved Welireg (belzutifan), an oral hypoxia-inducible factor-2 alpha (HIF-2α) inhibitor, for the treatment of NF1 PN, a rare and debilitating genetic condition. Koselugo is being jointly developed and commercializedadult patients with AstraZeneca globally (see Note 3von Hippel-Lindau (VHL) disease who require therapy for associated RCC, central nervous system hemangioblastomas, or pancreatic neuroendocrine tumors, not requiring immediate surgery. The approval was based on results from the open-label Study 004 trial. Welireg was obtained as part of Merck’s 2019 acquisition of Peloton Therapeutics, Inc. (Peloton). Pursuant to the condensed consolidated financial statements).acquisition agreement, Merck made a $50 million capitalized milestone payment to former Peloton shareholders upon first commercial sale of Welireg in the U.S.
Vaccines
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% Change
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($ in millions)($ in millions)20202019% Change20202019% Change($ in millions)20212020% Change20212020% Change
Gardasil/Gardasil 9Gardasil/Gardasil 9$1,187 $1,320 (10)%(10)%$2,941 $3,044 (3)%(2)%
Gardasil/Gardasil 9
$1,993 $1,187 68 %63 %$4,144 $2,941 41 %35 %
ProQuadProQuad218 232 (6)%(6)%507 588 (14)%(14)%ProQuad244 218 12 %12 %598 507 18 %17 %
M-M-R II
M-M-R II
115 121 (5)%(6)%287 443 (35)%(35)%
M-M-R II
127 115 11 %10 %295 287 %%
VarivaxVarivax243 270 (10)%(9)%595 763 (22)%(21)%Varivax290 243 19 %19 %733 595 23 %23 %
Pneumovax 23
Pneumovax 23
375 237 58 %58 %748 592 26 %27 %
Pneumovax 23
277 375 (26)%(26)%600 748 (20)%(21)%
RotaTeqRotaTeq227 210 %%593 601 (1)%(3)%
Worldwide sales of Gardasil/Gardasil 9, vaccines to help prevent certain cancers and other diseases caused by certain types of HPV, declined 10%human papillomavirus (HPV), grew 68% and 3%41% in the third quarter and first nine months of 2020, respectively,2021, respectively. Sales growth in both periods was driven primarily due to lowerby strong global demand, particularly in China which also benefited from increased supply, and in the United States and Hong Kong, SAR, PRC attributable toU.S. which also benefited from the COVID-19 pandemic, partially offset by higher volumestiming of public sector purchases. Higher pricing in China and in the EU.
The Company anticipates that in the fourth quarter of 2020 it will replenish the doses of Gardasil 9 borrowed from the U.S. Centers for Disease Control and Prevention (CDC) Pediatric Vaccine Stockpilealso contributed to sales growth in the fourth quarter of 2019. The replenishment will result in the recognition of approximately $120 million in sales and a reversal of the related liability.
In June 2020, the FDA approved an expanded indication for Gardasil 9 for the prevention of oropharyngeal and other head and neck cancers caused by HPV Types 16, 18, 31, 33, 45, 52, and 58. The oropharyngeal and head and neck
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cancer indication was approved under accelerated approval based on effectiveness in preventing HPV-related anogenital disease.
In July 2020, Silgard 9 aqueous suspension for intramuscular injection syringes (recombinant adsorbed 9-valent Human Papillomavirus virus-like particles vaccine) were approved for use in women and girls by the Ministry of Health, Labor and Welfare in Japan.both periods.
Global sales of ProQuad, a pediatric combination vaccine to help protect against measles, mumps, rubella and varicella, declined 6%grew 12% and 14%18% in the third quarter and first nine months of 2020,2021, respectively, primarily due to lower demandhigher sales in the United States resulting fromU.S. reflecting higher demand driven by the ongoing COVID-19 pandemic partially offset byrecovery, as well as higher pricing.
Worldwide sales of M‑M‑R II (Measles, Mumps and Rubella Virus Vaccine Live), a vaccine to help protect against measles, mumps and rubella, declined 35%grew 11% and 3% in the third quarter and first nine months of 20202021, respectively, primarily driven by lower demanddue to higher sales in the United States resulting from fewer measles outbreaks in 2020 compared with 2019, coupled withU.S. reflecting the unfavorable impact of theongoing COVID-19 pandemic recovery inclusive of higher public sector mix of business. Lower demand and lower government tenders in international markets partially offset by higher pricing. Additionally, theM‑M‑R II sales declinegrowth in the first nine months of 2020 reflects lower demand in Brazil.both periods.
Global sales of Varivax, a vaccine to help prevent chickenpox (varicella), declined 10%grew 19% and 22%23% in the third quarter and first nine months of 2020, respectively. The sales declines reflect lower demand2021, respectively, primarily reflecting the ongoing COVID-19 pandemic recovery and higher pricing in the United States resulting from the COVID-19 pandemic, partially offset by higher pricing. TheU.S. Higher government tenders in Brazil also contributed to Varivax sales decline ingrowth for the first nine months of 2020 was also attributable to lower government tenders in Brazil.2021.
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Worldwide sales of Pneumovax 23, a vaccine to help prevent pneumococcal disease, grew 58%declined 26% and 26%20% in the third quarter and first nine months of 2020,2021, respectively, primarily due to higher volumesdriven by lower demand in the United StatesU.S. reflecting prioritization of COVID-19 vaccination.
Global sales of RotaTeq (Rotavirus Vaccine, Live Oral, Pentavalent), a vaccine to help protect against rotavirus gastroenteritis in infants and in the EU attributable in part to heightened awareness of pneumococcal vaccination during the COVID-19 pandemic and ahead of flu season. Higher pricing in the United States also contributed to sales growthchildren, grew 8% in the third quarter andof 2021 largely attributable to higher public sector purchases in the U.S., partially offset by lower demand in certain international markets. Worldwide sales of RotaTeq declined 1% in the first nine months of 2020.2021 reflecting lower demand in certain international markets, partially offset by higher public sector purchases in the U.S.
In July 2021, the FDA approved Vaxneuvance (Pneumococcal 15-valent Conjugate Vaccine) for active immunization for the prevention of invasive disease caused by 15 Streptococcus pneumoniae serotypes in adults 18 years of age and older. The approval was based on data from seven clinical studies assessing safety, tolerability, and immunogenicity in adults. In October 2021, the U.S. Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) voted to provisionally recommend vaccination either with a sequential regimen of Vaxneuvance followed by Pneumovax 23, or with a single dose of 20-valent pneumococcal conjugate vaccine both for adults 65 years and older and for adults ages 19 to 64 with certain underlying medical conditions. These provisional recommendations will be reviewed by the director of the CDC and the U.S. Department of Health and Human Services, and final recommendations will become official when published in the CDC’s Morbidity and Mortality Weekly Report. In September 2021, Merck announced a settlement and license agreement with Pfizer Inc., (Pfizer) resolving all worldwide patent infringement litigation related to the use of Merck’s investigational and licensed pneumococcal conjugate vaccine (PCV) products, including Vaxneuvance. Under the terms of the agreement, Merck will make certain regulatory milestone payments to Pfizer, as well as royalty payments on the worldwide sales of its PCV products. The Company will pay royalties of 7.25% of net sales of all Merck PCV products through 2026; and 2.5% of net sales of all Merck PCV products from 2027 through 2035.
Vaxelis (Diphtheria and Tetanus Toxoids and Acellular Pertussis, Inactivated Poliovirus, Haemophilus b Conjugate and Hepatitis B Vaccine), developed as part of a U.S.-based partnership between Merck and Sanofi Pasteur, is now available in the U.S. for active immunization of children six weeks through four years of age to help prevent diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, and invasive disease due to Haemophilus influenzae type b. In February 2021, the CDC’s ACIP included Vaxelis as a combination vaccine option in the CDC’s Recommended Child and Adolescent Immunization Schedule. Sales of Vaxelis in the U.S. are made through the U.S.-based Merck/Sanofi Pasteur partnership, the results of which are reflected in equity income from affiliates included in Other (income) expense, net. Supply sales to the partnership are recorded within Sales. Vaxelis is also approved in the EU where it is marketed directly by Merck and Sanofi Pasteur.
Hospital Acute Care
Three Months Ended
September 30,
% Change
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Foreign
Exchange
Nine Months Ended
September 30,
% Change
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Exchange
Three Months Ended
September 30,
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Nine Months Ended
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($ in millions)($ in millions)20202019% Change20202019% Change($ in millions)20212020% Change20212020% Change
BridionBridion$320 $284 13 %13 %$843 $817 %%Bridion$369 $320 16 %15 %$1,096 $843 30 %27 %
PrevymisPrevymis96 77 23 %22 %270 200 35 %31 %
NoxafilNoxafil79 177 (55)%(55)%247 560 (56)%(55)%Noxafil64 79 (19)%(20)%197 247 (20)%(23)%
Prevymis77 45 72 %69 %200 115 74 %74 %
Cubicin39 52 (26)%(25)%116 207 (44)%(43)%
ZerbaxaZerbaxa(2)43 (105)%(105)%(11)112 (110)%(110)%
Worldwide sales of Bridion, for the reversal of two types of neuromuscular blocking agents used during surgery, grew 13%16% and 3%30% in the third quarter and first nine months of 2020,2021, respectively, primarily attributabledue to higher demand globally, particularly in the United States. Fewer elective surgeries as a result ofU.S. and Europe, attributable in part to the COVID-19 pandemic unfavorably affected demandrecovery. Bridion was also approved by the FDA in 2020.
Global sales of Noxafil,June 2021 for the prevention of invasive fungal infections, declined 55%pediatric patients aged 2 years and 56% in the third quarter and first nine months of 2020, respectively, primarily due to generic competition in the United States and in the EU. The patents that provided U.S. market exclusivity for certain forms of Noxafil representing the majority of U.S. Noxafil sales expired in July 2019. Additionally, the patent for Noxafil expired in a number of major European markets in December 2019. Accordingly, the Company is experiencing volume and pricing declines in Noxafil sales in these markets as a result of generic competition and expects the declines to continue.older undergoing surgery.
Worldwide sales of Prevymis, a medicine for prophylaxis (prevention) of cytomegalovirus (CMV) infection and disease in adult CMV-seropositive recipients of an allogenic hematopoietic stem cell transplant, grew 72%23% and 74%35% in the third quarter and first nine months of 2020,2021, respectively, due to continued uptake since launch in several international markets, particularly in Europe and the EUU.S. Prevymis was approved by the EC in January 2018 and by the FDA in the United States.November 2017.
Global sales of CubicinNoxafil (daptomycin for injection)(posaconazole), an I.V. antibioticantifungal agent for complicated skinthe prevention of certain invasive fungal infections, declined 19% and skin structure infections or bacteremia when caused by designated susceptible organisms, declined 26% and 44%20% in the third quarter and first nine months of 2020,2021, respectively, primarily due to ongoing generic competition in the EU andEurope, partially offset by higher demand in the United States.
In June 2020, the FDA approved a supplemental New Drug Application (NDA)China. The patent that provided market exclusivity for RecarbrioNoxafil (imipenem, cilastatin,in a number of major European markets expired in December 2019. As a result, the Company is experiencing lower demand for Noxafil in these markets as a result of generic competition and relebactam) forexpects the treatment of patients 18 years of age and older with hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP), caused by certain susceptible Gram-negative microorganisms.
Zerbaxa (ceftolozane and tazobactam) is indicated for the treatment of HABP/VABP caused by certain susceptible Gram-negative microorganisms, and for the treatment of certain complicated urinary tract and intra-abdominal infections. The COVID-19 pandemic is unfavorably affecting sales of Zerbaxa, particularly in the United States. An increased focus on more stringent cleaning protocols at hospitals, along with visitor restrictions, have reduced patients’ exposuredecline to developing HABP/continue.
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VABP, resulting in a smaller populationIn December 2020, the Company temporarily suspended sales of patients that need to be treated with Zerbaxa. These factors resulted in lower cash flow forecasts, a combination antibacterial and beta-lactamase inhibitor for the treatment of certain bacterial infections, and subsequently issued a product recall, following the identification of product sterility issues. The Company expects a phased resupply for Zerbaxa beginning with the U.S. market in the United States, which constituted a triggering event requiring the evaluationfourth quarter of the Zerbaxa intangible asset for impairment. Although the “step one” impairment test that was performed indicated that the intangible asset related to Zerbaxa remains recoverable, in the event that these trends depress sales of Zerbaxa to a greater extent than anticipated by the Company, or in the event other circumstances arise that further reduce global cash flow projections for Zerbaxa, the Company may record an intangible asset impairment charge in the future and such charge could be material. The carrying value of Zerbaxa was $2.2 billion at September 30, 2020.2021.
Immunology
Three Months Ended
September 30,
% Change
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Exchange
Nine Months Ended
September 30,
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Exchange
Three Months Ended
September 30,
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Nine Months Ended
September 30,
% Change
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($ in millions)($ in millions)20202019% Change20202019% Change($ in millions)20212020% Change20212020% Change
SimponiSimponi$209 $203 %— %$615 $625 (2)%(1)%Simponi$203 $209 (3)%(5)%$619 $615 %(5)%
Remicade82 101 (19)%(20)%242 322 (25)%(24)%
Sales of Simponi (golimumab), a once-monthly subcutaneous treatment for certain inflammatory diseases (marketed by the Company in Europe, Russia and Turkey), declined 2%3% in the third quarter of 2021 and increased 1% in the first nine month of 2020 primarily driven by lower demand in the EU due to the uptake of biosimilars for a competing product, partially offset by the timing of shipments in Russia.
Sales of Remicade (infliximab), a treatment for inflammatory diseases (marketed by the Company in Europe, Russia and Turkey), declined 19% and 25% in the third quarter and first nine months of 2020, respectively, driven by ongoing biosimilar competition2021. Excluding the effect of foreign exchange, sales performance in theboth periods was largely attributable to lower pricing in Company’s marketing territories in Europe.Europe, partially offset by higher volumes. Sales of Simponi are being unfavorably affected by biosimilar competition for competing products. The Company lost market exclusivity forexpects this competition will continue to unfavorably affect sales of RemicadeSimponi.
The Company’s marketing rights with respect to Simponi will revert to Janssen Pharmaceuticals, Inc. in major European markets in 2015 and no longer has market exclusivity in anythe second half of its marketing territories. The Company is experiencing pricing and volume declines in these markets as a result of biosimilar competition and expects the declines to continue.2024.
Virology
Three Months Ended
September 30,
% Change
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Foreign
Exchange
Nine Months Ended
September 30,
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Exchange
Three Months Ended
September 30,
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Nine Months Ended
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($ in millions)($ in millions)20202019% Change20202019% Change($ in millions)20212020% Change20212020% Change
Isentress/Isentress HDIsentress/Isentress HD$205 $250 (18)%(18)%$646 $752 (14)%(12)%Isentress/Isentress HD$189 $205 (8)%(7)%$590 $646 (9)%(9)%
Zepatier28 83 (67)%(67)%122 304 (60)%(59)%
Global combined sales of Isentress/Isentress HD (raltegravir), an HIV integrase inhibitor for use in combination with other antiretroviral agents for the treatment of HIV-1 infection, declined 18%8% and 14%9% in the third quarter and first nine months of 2020,2021, respectively, primarily driven bydue to competitive pressure particularly in Europe and the United States and in the EU, as well as the timing of shipments in Brazil.
Global sales ofU.S. The Company expects competitive pressure for ZepatierIsentress/Isentress HD, a treatment for adult patients with chronic hepatitis C virus genotype (GT) 1 or GT4 infection, declined 67% and 60% in the third quarter and first nine months of 2020, respectively, driven by lower demand globally due to competition and declining patient volumes, coupled with the impact of the COVID-19 pandemic.continue.
Cardiovascular
Three Months Ended
September 30,
% Change
Excluding
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Exchange
Nine Months Ended
September 30,
% Change
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($ in millions)20202019% Change20202019% Change
Zetia/Vytorin$150 $204 (27)%(26)%$523 $674 (22)%(21)%
Atozet111 97 14 %12 %348 283 23 %25 %
Rosuzet32 32 %— %94 97 (3)%(1)%
Alliance Revenue - Adempas (1)
83 50 67 %67 %216 144 50 %50 %
Adempas55 57 (5)%(7)%167 158 %%
Three Months Ended
September 30,
% Change
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Exchange
Nine Months Ended
September 30,
% Change
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($ in millions)20212020% Change20212020% Change
Alliance Revenue - Adempas/Verquvo (1)
$100 $83 20 %20 %$248 $216 15 %15 %
Adempas59 55 %%188 167 13 %%
(1) Alliance revenue represents Merck’s share of profits from sales in Bayer’s marketing territories, which are product sales net of cost of sales and commercialization costs (see Note 34 to the condensed consolidated financial statements).
Combined global sales of Zetia (marketed in most countries outside the United States as Ezetrol) and Vytorin (marketed outside the United States as Inegy), medicines for lowering LDL cholesterol, declined 27% in the third quarter of 2020, primarily due to lower sales of Ezetrol in Japan. The patent that provided market exclusivity for Ezetrol in Japan expired in September 2019 and generic competition began in June 2020. Accordingly, the Company is experiencing a rapid and
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substantial decline in Ezetrol sales in Japan and expects the decline to continue. Higher demand for Ezetrol in China partially offset the sales decline in the third quarter of 2020. Combined global sales of Zetia and Vytorin declined 22% in the first nine months of 2020 primarily due to generic competition for Ezetrol and Inegy in the EU and Ezetrol in Japan. The EU patents for Ezetrol and Inegy expired in April 2018 and April 2019, respectively. The sales decline in the first nine months of 2020 was also attributable to lower pricing following loss of exclusivity in Australia in 2018. Higher demand for Ezetrol in China partially offset the sales decline in the first nine months of 2020.
Sales of Atozet (ezetimibe and atorvastatin) (marketed outside of the United States), a medicine for lowering LDL cholesterol, grew 14% and 23% in the third quarter and first nine months of 2020, respectively, primarily due to higher demand in most markets, particularly in the EU, Japan and other countries in the Asia Pacific region.
Adempas (riociguat), a cardiovascular drug for the treatment of certain types of pulmonary arterial hypertension, is part of a worldwide clinical development collaboration with Bayer AG (Bayer) to market and develop soluble guanylate cyclase (sGC) modulators including Adempas (see Note 34 to the condensed consolidated financial statements). Revenue from Adempas includes Merck’s share of profitsAlliance revenue from the sale of Adempas in Bayer’s marketing territories, whichcollaboration grew 67%20% and 50%15% in the third quarter and first nine months of 2020, respectively, as well as2021, respectively. Revenue from the collaboration also includes sales of Adempas in Merck’s marketing territories, which declined 5%grew 7% and 13% in the third quarter and grew 6% in the first nine months of 2020.2021, respectively, primarily reflecting higher demand.
In January 2021, the FDA approved Verquvo (vericiguat), an sGC stimulator, to reduce the risk of cardiovascular death and heart failure hospitalization following a hospitalization for heart failure or need for outpatient intravenous diuretics in adults with symptomatic chronic heart failure and reduced ejection fraction. Verquvo was also approved in Japan in June 2021 and in the EU in July 2021. The approvals were based on the results of the VICTORIA trial. Verquvo is part of the same collaboration with Bayer referenced above that includes Adempas.

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Diabetes
Three Months Ended
September 30,
% Change
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Exchange
Nine Months Ended
September 30,
% Change
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Exchange
Three Months Ended
September 30,
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Exchange
Nine Months Ended
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($ in millions)($ in millions)20202019% Change20202019% Change($ in millions)20212020% Change20212020% Change
Januvia/JanumetJanuvia/Janumet$1,327 $1,311 %%$3,948 $4,106 (4)%(3)%Januvia/Janumet$1,339 $1,327 %— %$3,895 $3,948 (1)%(4)%
Worldwide combined sales of Januvia (sitagliptin) and Janumet(sitagliptin/metformin HCl), medicines that help lower blood sugar levels in adults with type 2 diabetes, grewdeclined 1% in the third quarter of 2020 driven primarily by higher demand in certain international markets, particularly in China, partially offset by continued pricing pressure in the United States. Global combined sales of Januvia and Janumet declined 4% in the first nine months of 2020. The decline was2021 primarily due to continued pricing pressure in the United States and lower demand in the EU, partiallyU.S., largely offset by higher demand in certain international markets, particularly in China.China and Latin America. The Company expects U.S. pricing pressure to continue. Januvia and Janumet will lose market exclusivity in the U.S. in January 2023. The patentssupplementary patent certificates that provide market exclusivity for Januvia and Janumet in the United StatesEU expire in July 2022 (although six-month pediatric exclusivity may extend this date). The patent that provides market exclusivity for Januvia in the EU expires in July 2022 (although pediatric exclusivity has recently been granted which may extend this date to September 2022 and the Company is applying in individual countries for the extensions). The supplementary patent certificate that provides market exclusivity for Janumet in the EU expires in April 2023.2023, respectively. The Company anticipates sales of Januvia and Janumet in these markets will decline substantially after these patent expiries.loss of market exclusivity.
Women’s
Animal Health Segment
Three Months Ended
September 30,
% Change
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Exchange
Nine Months Ended
September 30,
% Change
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Exchange
($ in millions)20202019% Change20202019% Change
Implanon/Nexplanon$189 $199 (5)%(4)%$515 $581 (11)%(10)%
NuvaRing58 241 (76)%(76)%184 700 (74)%(73)%
Three Months Ended
September 30,
% Change
Excluding
Foreign
Exchange
Nine Months Ended
September 30,
% Change
Excluding
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Exchange
($ in millions)20212020% Change20212020% Change
Livestock$864 $758 14 %12 %$2,503 $2,145 17 %14 %
Companion Animal553 462 20 %18 %1,804 1,390 30 %26 %
Global salesSales of Implanon/Nexplanon, a single-rod subdermal contraceptive implant, declined 5% in the third quarter of 2020 primarily driven by lower demand in Latin America. Worldwide sales of Implanon/Nexplanon declined 11% in the first nine months of 2020 primarily due to lower demand in the United Stateslivestock products grew 14% and in the EU resulting from the COVID-19 pandemic.
Worldwide sales of NuvaRing, a vaginal contraceptive product, declined 76% and 74%17% in the third quarter and first nine months of 2020,2021, respectively, primarily due to generic competition in the United States. The patent that provided U.S. market exclusivityhigher demand for NuvaRing expired in April 2018ruminant products, including animal health intelligence solutions for animal identification, monitoring and generic competition began in December 2019. Accordingly, the Company is experiencing a rapidtraceability, as well as higher demand for poultry and substantial decline in U.S. NuvaRing sales and expects the decline to continue.
Biosimilars 
Three Months Ended
September 30,
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Nine Months Ended
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($ in millions)20202019% Change20202019% Change
Biosimilars$99 $68 45 %44 %$227 $189 20 %21 %
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Biosimilar products are marketed by the Company pursuant to an agreement with Samsung Bioepis Co., Ltd. (Samsung) to develop and commercialize multiple pre-specified biosimilar candidates. Currently, the Company markets Renflexis (infliximab-abda), a biosimilar to Remicade (infliximab) for the treatment of certain inflammatory diseases; Ontruzant (trastuzumab-dttb), a biosimilar to Herceptin (trastuzumab) for the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer and HER2 overexpressing gastric cancer; and Brenzys (etanercept biosimilar), a biosimilar to Enbrel for the treatment of certain inflammatory diseases. Merck’s commercialization territories under the agreement vary by product.swine products. Sales of biosimilarscompanion animal products grew 45%20% and 20%30% in the third quarter and first nine months of 2020,2021, respectively, primarily due to the launch of Ontruzant in Brazil in August 2020 and continued post-launch uptake of Renflexis in the United States and Canada. Sales growth in the first nine months of 2020 was partially offset by lower sales of Brenzys in Brazil.
In August 2020, the EC granted marketing authorization for Aybintio (bevacizumab) for the treatment of metastatic carcinoma of the colon or rectum, metastatic breast cancer, NSCLC, advanced and/or metastatic RCC, epithelial ovarian, fallopian tube and primary peritoneal cancer and cervical cancer. An application seeking approval of Aybintio in the United States was filed in September 2019.
Animal Health Segment
Three Months Ended
September 30,
% Change
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Exchange
Nine Months Ended
September 30,
% Change
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Exchange
($ in millions)20202019% Change20202019% Change
Livestock$758 $726 %%$2,145 $2,007 %11 %
Companion Animal462 396 17 %18 %1,390 1,264 10 %12 %
Sales of livestock products grew 5% and 7% in the third quarter and first nine months of 2020, respectively, primarily driven by higher demand for ruminant, swine and poultry products. Sales growth in the first nine months of 2020 was also driven by the April 2019 acquisition of Antelliq Corporation (Antelliq) (see Note 2 to the condensed consolidated financial statements). Sales of companion animal products grew 17% in the third quarter of 2020 and 10% in the first nine months of 2020 primarily driven by higher demand forparasiticides, including the Bravecto (fluralaner) line of products, as well as higher demand for companion animal vaccines.
Costs, Expenses and Other
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)20202019% Change20202019% Change
Cost of sales$3,481 $3,990 (13)%$9,952 $10,443 (5)%
Selling, general and administrative2,450 2,589 (5)%7,383 7,726 (4)%
Research and development3,390 3,204 %7,721 7,324 %
Restructuring costs114 232 (51)%269 444 (39)%
Other (income) expense, net(312)35 *(630)362 *
$9,123 $10,050 (9)%24,695 26,299 (6)%
* Greater than 100%.
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)20212020% Change20212020% Change
Cost of sales$3,450 $3,013 15 %$9,752 $8,589 14 %
Selling, general and administrative2,336 2,060 13 %6,804 6,336 %
Research and development2,445 3,349 (27)%9,177 7,609 21 %
Restructuring costs107 113 (5)%487 265 84 %
Other (income) expense, net(450)(312)44 %(1,007)(637)58 %
$7,888 $8,223 (4)%25,213 22,162 14 %
Cost of Sales
Cost of sales declined 13%increased 15% and 5%14% in the third quarter and first nine months of 2020,2021, respectively. Cost of sales includes the amortization of intangible assets recorded in connection with business acquisitions, collaborations, and licensing arrangements, which totaled $270$346 million and $320$403 million in the third quarter of 20202021 and 2019,2020, respectively, and $843 million$1.2 billion and $1.1$1.4 billion for the first nine months of 2021 and 2020, respectively. Costs in the first nine months of 2020 and 2019, respectively. Cost of sales2021 also includes the amortization of amounts capitalized in connection with collaborations of $117 million and $81 million in the third quarter of 2020 and 2019, respectively, and $509 million and $307 million in the first nine months of 2020 and 2019, respectively. Additionally, costs include intangible asset impairment charges of $612$225 million and $693 million in the third quarter and first nine months of 2019, respectively, related to marketed products. The Company may recognize additional impairment charges in the future related to intangible assets that were measured at fair value and capitalized in connection with business acquisitions and such charges could be material.discontinuation of COVID-19 development programs. Also included in cost of sales are expenses associated with restructuring activities which amounted to $38$48 million and $62$38 million in the third quarter of 2021 and 2020, respectively, and 2019, respectively,$113 million and $131 million and $161 million infor the first nine months of 20202021 and 2019,2020, respectively, including accelerated depreciation and asset write-offs related to the planned sale or closure of manufacturing facilities. Separation costs associated with manufacturing-related headcount reductions have been incurred and are reflected in Restructuring costs as discussed below.
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Gross margin was 72.3%73.8% in the third quarter of 20202021 compared with 67.8%72.4% in the third quarter of 2019.2020. The gross margin improvementincrease reflects lower intangible asset impairment charges (noted above), the favorable effectamortization of product mix and lower restructuring costs, partially offset by the unfavorable effects of pricing pressure, inventory write-offs and foreign exchange. Gross margin was 71.9% in the first nine months of 2020 compared with 70.1% in the first nine months of 2019. The gross margin improvement was primarily driven by lower impairment charges and amortization related to intangible assets (noted above), as well as the favorable effect of product mix, and lower restructuring costs, partially offset by higher manufacturing costs, including asset write-offs. Gross margin was 72.3% in the first nine months of 2021 compared with 71.9% in the first nine months of 2020. The gross margin increase reflects lower amortization of intangible assets and the favorable effect of product mix, partially offset by higher costs associated with COVID-19 development programs, including charges related to the discontinuation of certain COVID-19 development programs, as well as the unfavorable effects of pricing pressure, royalties,higher manufacturing variances,costs and inventory write-offs.foreign exchange.
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Selling, General and Administrative
Selling, general and administrative (SG&A) expenses declined 5%increased 13% and 4%7% in the third quarter and first nine months of 2020,2021, respectively, primarily due to lowerhigher administrative and selling costs, including reduced travelcompensation and fewer meetings, duebenefits, higher promotional expenses in part tosupport of the COVID-19 pandemic, andCompany’s key growth pillars, as well as the favorableunfavorable effect of foreign exchange, partially offset by costs relatedexchange. The COVID-19 pandemic contributed to the planned spin-off of Organon. Transaction costs related to the acquisition of ArQule also partially offset the decline in SG&A expenseslower spending in the first nine months of 2020 (see Note 2 to the condensed consolidated financial statements).prior year periods.
Research and Development
Research and development (R&D) expenses grew 6% and 5%declined 27% in the third quarter and first nine months of 2020, respectively,2021 primarily driven by higherdue to lower upfront payments related to collaborations, partially offset by higher oncology and license agreements (see Note 2 to the condensed consolidated financial statements), increasedCOVID-19 clinical development spending, increased investment in discovery research and early drug development, spending, as well as higher restructuring costs, partially offset by a chargecompensation and benefit costs. R&D expenses increased 21% in 2019 for the acquisitionfirst nine months of Peloton Therapeutics, Inc. (Peloton) (see Note 22021 primarily due to the condensed consolidated financial statements), lower costs associated with thehigher upfront payments related to acquisitions and collaborations, as well as higher clinical development spending and increased investment in discovery research and early drug development. The COVID-19 pandemic (net ofcontributed to lower spending on COVID-19-related vaccine and antiviral research programs), andin the favorable effect of foreign exchange.prior year periods.
R&D expenses are comprised of the costs directly incurred by MRL,Merck Research Laboratories (MRL), the Company’s research and development division that focuses on human health-related activities, which were $1.8 billion and $1.6 billion in both the third quarter of 2021 and 2020, respectively, and 2019, and $4.7$5.3 billion and $4.4$4.6 billion in the first nine months of 20202021 and 2019,2020, respectively. Also included in R&D expenses are Animal Health research costs, licensing costs and costs incurred by other divisions in support of R&D activities, including depreciation, production and general and administrative, which in the aggregate were approximately $645$710 million and $655$625 million for the third quarter of 20202021 and 2019,2020, respectively, and were$2.1 billion and $1.9 billion in both the first nine months of 2020 and 2019. In addition, R&D expenses include expense or income related to changes in the estimated fair value measurement of liabilities for contingent consideration recorded in connection with business acquisitions. The Company recorded a net reduction in expenses of $48 million and $36 million in the first nine months of 2021 and 2020, and 2019, respectively, related to the changes in these estimates.respectively. Additionally, R&D expenses also reflect $19 million and $67 millionin the first nine months of accelerated depreciation costs in connection with restructuring activities2021 include a $1.7 billion charge for the acquisition of Pandion as noted above. R&D expenses in the third quarter and first nine months of 2020 respectively.include charges of $832 million related to transactions with Seagen Inc. (Seagen) (see Note 3 to the condensed consolidated financial statements).
Restructuring Costs
In early 2019, Merck approved a new global restructuring program (Restructuring Program) as part of a worldwide initiative focused on further optimizing the Company’s manufacturing and supply network, as well as reducing its global real estate footprint. This program is a continuation of the Company’s plant rationalization, builds on prior restructuring programs and does not include any actions associated with the planned spin-off of Organon. As the Company continues to evaluate its global footprint and overall operating model, it subsequently identified additional actions under the Restructuring Program, and could identify further actions over time. The actions currently contemplated under the Restructuring Program are expected to be substantially completed by the end of 2023, with the cumulative pretax costs to be incurred by the Company to implement the program estimated to be approximately $2.5$3.0 billion. The Company expects to record charges of approximately $800$700 million in 20202021 related to the Restructuring Program. The Company anticipates the actions under the Restructuring Program towill result in annual net cost savings of approximately $900 million by the end of 2023. Actions under previous global restructuring programs have been substantially completed.
Restructuring costs, primarily representing separation and other related costs associated with these restructuring activities, were $114$107 million and $232$113 million for the third quarter of 20202021 and 2019,2020, respectively, and $269were $487 million and $444$265 million infor the first nine months of 20202021 and 2019,2020, respectively. Separation costs incurred were associated with actual headcount reductions, as well as estimated expenses under existing severance programs for headcount reductions that were probable and could be reasonably estimated. Also included in restructuring costs are asset abandonment, facility shut-down and other related costs, as well as employee-related costs such as curtailment, settlement and termination charges associated with pension and other postretirement benefit plans and share-based compensation plan costs. For segment reporting, restructuring costs are unallocated expenses.
Additional costs associated with the Company’s restructuring activities are included in Cost of sales, Selling, general and administrative expenses and Research and development costs. The Company recorded aggregate pretax costs of
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$186 $168 million and $296$185 million in the third quarter of 20202021 and 2019,2020, respectively, and $504$630 million and $642$500 million, infor the first nine months of 20202021 and 2019,2020, respectively, related to restructuring program activities (see Note 45 to the condensed consolidated financial statements).
Other (Income) Expense, Net
Other (income) expense, net, was $450 million of income in the third quarter of 2021 compared with $312 million of income in the third quarter of 2020 primarily due to higher income from investments in equity securities, net, largely related to higher realized and unrealized gains on certain investments, partially offset by higher pension settlement costs. Other income (expense), net, was $1.0 billion of income in the first nine months of 2021 compared with $637 million of income in the first nine months of 2020 primarily due to higher income from investments in equity securities, net, largely related to higher realized and unrealized gains on certain investments including the disposition in 2021 of the Company’s ownership
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interest in Preventice Solutions Inc. (Preventice) as a result of the acquisition of Preventice by Boston Scientific. The favorability in the year-to-date period was partially offset by higher pension settlement costs.
For details on the components of Other (income) expense, net, see Note 1312 to the condensed consolidated financial statements.
Segment ProfitsSegment ProfitsSegment Profits
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions)($ in millions)2020201920202019($ in millions)2021202020212020
Pharmaceutical segment profitsPharmaceutical segment profits$7,974 $7,747 $22,010 $21,437 Pharmaceutical segment profits$8,606 $7,026 $22,450 $19,235 
Animal Health segment profitsAnimal Health segment profits451 423 1,336 1,243 Animal Health segment profits505 459 1,629 1,347 
Other non-reportable segment profitsOther non-reportable segment profits(1)(2)(2)Other non-reportable segment profits— (1)— 
OtherOther(4,996)(5,821)(12,563)(14,005)Other(3,845)(4,778)(14,109)(12,175)
Income before taxes$3,428 $2,347 $10,784 $8,673 
Income from continuing operations before taxesIncome from continuing operations before taxes$5,266 $2,706 $9,970 $8,408 
Pharmaceutical segment profits are comprised of segment sales less standard costs, as well as SG&A expenses directly incurred by the segment. Animal Health segment profits are comprised of segment sales, less all cost of sales, as well as SG&A expenses and research and development costsR&D expenses directly incurred by the segment. For internal management reporting presented to the chief operating decision maker, Merck does not allocate the remaining cost of sales not included in segment profits as described above, research and developmentR&D expenses incurred by MRL, or general and administrative expenses, nor the cost of financing these activities. Separate divisions maintain responsibility for monitoring and managing these costs, including depreciation related to fixed assets utilized by these divisions and, therefore, they are not included in segment profits. Also excluded from the determination of segment profits are costs related to restructuring activities and acquisition and divestiture-related costs, including the amortization of intangible assets and amortization purchase accounting adjustments, intangible asset impairment charges, and expense or income related to changes in the estimated fair value measurement of liabilities for contingent consideration. Additionally, segment profits do not reflect other expenses from corporate and manufacturing cost centers and other miscellaneous income or expense. These unallocated items are reflected in “Other” in the above table. Also included in “Other” are miscellaneous corporate profits (losses), as well as operating profits (losses) related to third-party manufacturing sales.
Pharmaceutical segment profits grew 3% in both the third quarterincreased 22% and first nine months of 2020 driven primarily by higher sales, as well as lower administrative and selling costs. Animal Health segment profits grew 6% and 7%17% in the third quarter and first nine months of 2020,2021, respectively, reflecting higher sales and lower promotional costs,the favorable effect of foreign exchange, partially offset by higher R&D costsadministrative and promotional costs. Animal Health segment profits grew 10% and 21% in the unfavorable effectthird quarter and first nine months of foreign exchange.2021, respectively, reflecting higher sales, partially offset by higher promotional, selling and administrative costs.
Taxes on Income
The effective income tax rates of 14.1%from continuing operations were 13.2% and 18.7%14.0% for the third quarter of 20202021 and 2019,2020, respectively, and 14.9%14.4% and 14.5%15.1% for the first nine months of 2021 and 2020, and 2019, respectively, reflect the impacts of acquisition and divestiture-related costs and restructuring costs, partially offset by the beneficial impact of foreign earnings.respectively. The effective income tax rates from continuing operations in the third quarter and first nine months of 2019 also2021 reflect the beneficial impact of the settlement of a foreign tax matter. The effective income tax rate from continuing operations for the first nine months of 2021 reflects the unfavorable impacteffect of a charge for the acquisition of PelotonPandion for which no tax benefit was recognized, and the favorable impact of product mix on the estimated 2019 full-year tax rate. In addition, the effective income tax rate for the first nine months of 2019 reflects the favorable impact ofas well as a $360 million net tax benefit of $207 million related to the settlement of certain federal income tax matters.matters as discussed below.
In the first quarter of 2019,2021, the Internal Revenue Service (IRS) concluded its examinations of Merck’s 2012-20142015-2016 U.S. federal income tax returns. As a result, the Company was required to make a payment of $107 million.$190 million (of which $172 million related to Merck continuing operations and $18 million related to Organon discontinued operations). The Company’s reserves for unrecognized tax benefits for the years under examination exceeded the adjustments relating to this examination period and therefore the Company recorded a $360$236 million net tax benefit in the first nine months of 2019.2021 (of which $207 million related to Merck continuing operations and $29 million related to Organon discontinued operations). This net benefit reflects reductions in reserves for unrecognized tax benefits and other related liabilities for tax positions relating to the years that were under examination, partially offset by additional reserves for tax positions not previously reserved for.
Net Loss Attributable to Noncontrolling Interests
Net loss attributable to noncontrolling interests of $73 million for the first nine months of 2019 includes the portion of goodwill impairment charges related to certain businesses in the Healthcare Services segment that are attributable to noncontrolling interests.

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Net Income and Earnings per Common Share
Net income attributable to Merck & Co., Inc. was $2.9 billion for the third quarter of 2020 compared with $1.9 billion for the third quarter of 2019 and was $9.2 billion for the first nine months of 2020 compared with $7.5 billion for the first nine months of 2019. Earnings per common share assuming dilution attributable to Merck & Co., Inc. common shareholders (EPS) for the third quarter of 2020 were $1.16 compared with $0.74 in the third quarter of 2019 and were $3.61 for the first nine months of 2020 compared with $2.89 for the first nine months of 2019.examination.
Non-GAAP Income and Non-GAAP EPS from Continuing Operations
Non-GAAP income and non-GAAP EPS are alternative views of the Company’s performance that Merck is providing because management believes this information enhances investors’ understanding of the Company’s results as it permits investors to understand how management assesses performance. Non-GAAP income and non-GAAP EPS exclude certain items because of the nature of these items and the impact that they have on the analysis of underlying business performance and trends. The excluded items (which should not be considered non-recurring) consist of acquisition and divestiture-related costs, restructuring costs, income and losses from investments in equity securities, and certain other items.
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These excluded items are significant components in understanding and assessing financial performance. Non-GAAP income and non-GAAP EPS are important internal measures for the Company. Senior management receives a monthly analysis of operating results that includes non-GAAP EPS. Management uses these measures internally for planning and forecasting purposes and to measure the performance of the Company along with other metrics. In addition, senior management’s annual compensation is derived in part using non-GAAP pretax income. Since non-GAAP income and non-GAAP EPS are not measures determined in accordance with GAAP, they have no standardized meaning prescribed by GAAP and, therefore, may not be comparable to the calculation of similar measures of other companies. The information on non-GAAP income and non-GAAP EPS should be considered in addition to, but not as a substitute for or superior to, net income and EPS prepared in accordance with generally accepted accounting principles in the United StatesU.S. (GAAP).
A reconciliation between GAAP financial measures and non-GAAP financial measures (from continuing operations) is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions except per share amounts)2020201920202019
Income before taxes as reported under GAAP$3,428 $2,347 $10,784 $8,673 
Increase (decrease) for excluded items:
Acquisition and divestiture-related costs508 975 1,551 2,183 
Restructuring costs186 296 504 642 
Other items:
Charges for collaborations and acquisitions (1)
1,082 982 1,082 982 
Other(1)— (17)48 
Non-GAAP income before taxes5,203 4,600 13,904 12,528 
Taxes on income as reported under GAAP483 440 1,611 1,259 
Estimated tax benefit on excluded items (2)
356 281 616 555 
Adjustment to tax benefits recorded in conjunction with the 2015 Cubist Pharmaceuticals, Inc. acquisition(67)— (67)— 
Net tax benefit from the settlement of certain federal income tax matters— — — 360 
Tax charge related to finalization of treasury regulations for the Tax Cuts and Job Act of 2017— — — (67)
Non-GAAP taxes on income772 721 2,160 2,107 
Non-GAAP net income4,431 3,879 11,744 10,421 
Less: Net income (loss) attributable to noncontrolling interests as reported under GAAP12 (73)
    Acquisition and divestiture-related costs attributable to noncontrolling interests— — — 89 
Non-GAAP net income attributable to noncontrolling interests12 16 
Non-GAAP net income attributable to Merck & Co., Inc.$4,427 $3,873 $11,732 $10,405 
EPS assuming dilution as reported under GAAP$1.16 $0.74 $3.61 $2.89 
EPS difference0.58 0.77 1.01 1.13 
Non-GAAP EPS assuming dilution$1.74 $1.51 $4.62 $4.02 
Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in millions except per share amounts)2021202020212020
Income from continuing operations before taxes as reported under GAAP$5,266 $2,706 $9,970 $8,408 
Increase (decrease) for excluded items:
Acquisition and divestiture-related costs445 447 1,445 1,600 
Restructuring costs168 185 630 500 
Income from investments in equity securities, net(684)(346)(1,503)(944)
Other items:
Charge for the acquisition of Pandion— — 1,704 — 
Charges for the discontinuation of COVID-19 development programs— — 225 — 
Charges for the formation of collaborations (1)
— 1,082 — 1,082 
Other(87)(1)(26)(17)
Non-GAAP income from continuing operations before taxes5,108 4,073 12,445 10,629 
Taxes on income from continuing operations as reported under GAAP695 380 1,436 1,271 
Estimated tax (expense) benefit on excluded items (2)
(30)272 86 411 
Net tax benefit from the settlement of certain federal income tax matters— — 207 — 
Adjustment to tax benefits recorded in conjunction with the 2015 Cubist Pharmaceuticals, Inc. acquisition— (67)— (67)
Non-GAAP taxes on income from continuing operations665 585 1,729 1,615 
Non-GAAP net income from continuing operations4,443 3,488 10,716 9,014 
Less: Net income attributable to noncontrolling interests as reported under GAAP
Non-GAAP net income from continuing operations attributable to Merck & Co., Inc.$4,439 $3,486 $10,707 $9,013 
EPS from continuing operations assuming dilution as reported under GAAP$1.80 $0.92 $3.36 $2.81 
EPS difference(0.05)0.45 0.86 0.74 
Non-GAAP EPS from continuing operations assuming dilution$1.75 $1.37 $4.22 $3.55 
(1) Amount in 2020 includesIncludes $832 million related to transactions with Seagen. Amount in 2019 represents a charge for the acquisition of Peloton. SeeSeagen (see Note 23 to the condensed consolidated financial statements.statements).
(2) The estimated tax impact on the excluded items is determined by applying the statutory rate of the originating territory of the non-GAAP adjustments.
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Acquisition and Divestiture-Related Costs
Non-GAAP income and non-GAAP EPS exclude the impact of certain amounts recorded in connection with business acquisitions and divestitures. These amounts include the amortization of intangible assets and amortization of purchase accounting adjustments to inventories, as well as intangible asset impairment charges, and expense or income related to changes in the estimated fair value measurement of liabilities for contingent consideration. Also excluded are integration, transaction, and certain other costs associated with business acquisitions and divestitures. Non-GAAP income and non-GAAP EPS also exclude amortization of intangible assets related to collaborations and licensing arrangements.
Restructuring Costs
Non-GAAP income and non-GAAP EPS exclude costs related to restructuring actions (see Note 45 to the condensed consolidated financial statements). These amounts include employee separation costs and accelerated depreciation associated with facilities to be closed or divested. Accelerated depreciation costs represent the difference between the depreciation expense to be recognized over the revised useful life of the asset, based upon the anticipated date the site will be closed or divested or the equipment disposed of, and depreciation expense as determined utilizing the useful life prior to the restructuring actions. Restructuring costs also include asset abandonment, facility shut-down and other related costs, as well as
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employee-related costs such as curtailment, settlement and termination charges associated with pension and other postretirement benefit plans and share-based compensation costs.
Income and Losses from Investments in Equity Securities
Non-GAAP income and non-GAAP EPS exclude realized and unrealized gains and losses from investments in equity securities either owned directly or through ownership interests in investment funds.
Certain Other Items
Non-GAAP income and non-GAAP EPS exclude certain other items. These items are adjusted for after evaluating them on an individual basis, considering their quantitative and qualitative aspects. Typically, these consist of items that are unusual in nature, significant to the results of a particular period or not indicative of future operating results. Excluded from non-GAAP income and non-GAAP EPS in 2021 is a charge for the acquisition of Pandion, charges related to the discontinuation of COVID-19 development programs (see Note 3 to the condensed consolidated financial statements) and a net tax benefit related to the settlement of certain federal income tax matters (see Note 13 to the condensed consolidated financial statements). Excluded from non-GAAP income and non-GAAP EPS in 2020 are upfront payments related to licensing arrangements and collaborations, including the transactions with Seagen (see Note 23 to the condensed consolidated financial statements), and an adjustment to tax benefits recorded in conjunction with the 2015 Cubist Pharmaceuticals, Inc. acquisition. Excluded from non-GAAP income and non-GAAP EPS in 2019 is a charge for the acquisition of Peloton (see Note 2 to the condensed consolidated financial statements), a net tax benefit related to the settlement of certain federal income tax matters (see Note 14 to the condensed consolidated financial statements) and a tax charge related to the finalization of U.S. treasury regulations related to the Tax Cuts and Jobs Act of 2017.
Research and Development Update
MK-4482 (EIDD-2801), molnupiravir, is an investigational oral antiviral medicine, for the treatment of mild-to-moderate COVID-19 in adults who are at risk for progressing to severe COVID-19 and/or hospitalization. In July 2020,October 2021, Merck submitted an EUA application to the FDA accepted for priority reviewmolnupiravir based on positive results from a planned interim analysis of the NDA for vericiguat, an orally administered sGC stimulator, to reducePhase 3 MOVe-OUT clinical trial in which molnupiravir significantly reduced the risk of cardiovascularhospitalization or death and heart failure hospitalization following a worsening heart failure event in at risk, non-hospitalized adult patients with symptomatic chronic heart failuremild-to-moderate COVID-19. The FDA subsequently announced a November 30, 2021 meeting of its Antimicrobial Drugs Advisory Committee to discuss the available data supporting the use of molnupiravir to treat mild-to-moderate COVID-19 in adults who have tested positive for COVID-19 and who are at high risk of progression to severe COVID-19, including hospitalization or death. In October 2021, the EMA initiated a rolling review for molnupiravir. Merck plans to work with reduced ejection fraction,the CHMP of the EMA to complete the rolling review process to facilitate initiating the formal review of the Marketing Authorization Application. Merck is developing molnupiravir in combinationcollaboration with Ridgeback Bio. The companies are actively working with other heart failure therapies.regulatory agencies worldwide to submit applications for emergency use or marketing authorization in the coming months. Molnupiravir is also being evaluated for post-exposure prophylaxis in the Phase 3 MOVe-AHEAD trial, which is evaluating the efficacy and safety of molnupiravir in preventing the spread of COVID-19 within households. As previously announced, data from the MOVe-IN clinical trial indicated that molnupiravir is unlikely to demonstrate a clinical benefit in hospitalized patients, who generally had a longer duration of symptoms prior to study entry; therefore, the decision was made not to proceed to Phase 3.
MK-7264, gefapixant, is an investigational, orally administered, selective P2X3 receptor antagonist, for the treatment of refractory chronic cough or unexplained chronic cough in adults under review by the FDA. The New Drug Application (NDA) for gefapixant is based on results from the COUGH-1 and COUGH-2 clinical trials. In July 2021, the FDA setinformed Merck of its decision to extend the goal date for the NDA to provide time for a full review of the submission. The extended Prescription Drug User Fee Act (PDUFA), date, or target action date, of January 20, 2021. Vericiguat is being jointly developed with Bayer (see Note 3 to the condensed consolidated financial statements). The application is based on results from the Phase 3 VICTORIA trial, which is the first contemporary outcomes study focused exclusively on a population with worsening chronic heart failure who are at high risk for cardiovascular mortality and repeated heart failure hospitalizations. Data from VICTORIA were presented at the virtual American College of Cardiology’s 69th Annual Scientific Session together with World Congress of Cardiology and published in The New England Journal of Medicine. VericiguatMarch 21, 2022. Gefapixant is also under review in the EU and in Japan. Merck and Bayer plan to share VICTORIA data with regulatory authorities worldwide.
KoselugoV114, Vaxneuvance (Pneumococcal 15-valent Conjugate Vaccine), is an investigational 15-valent pneumococcal conjugate vaccine under review inby the EUEMA for the treatmentprevention of pediatric patients twoinvasive disease and pneumonia in adults. In October 2021, the EMA’s CHMP recommended the approval of Vaxneuvance for active immunization for the prevention of invasive disease and pneumonia caused by Streptococcus pneumoniae in individuals 18 years of age and older with NF1 who have symptomatic, inoperable PNolder. The CHMP recommendation will now be reviewed by the EC for marketing authorization in the EU, and a final decision is expected by the end of 2021. The CHMP opinion was based on data from seven randomized, double-blind clinical studies evaluating Vaxneuvance in a variety of adult populations and clinical circumstances. The Company has several ongoing Phase 3 trials evaluating V114 in pediatric patients. In August 2021, Merck announced positive topline results from the NCI CTEP-sponsoredpivotal Phase 2 SPRINT Stratum 1 trial. Koselugo was approved by3 PNEU-PED study evaluating the immunogenicity, safety, and tolerability of Vaxneuvance in infants and has submitted a supplemental licensure application to the FDA for pediatric use. V114 previously received Breakthrough Therapy designation from the FDA for the prevention of invasive pneumococcal disease in April 2020. Koselugo is being jointly developed and commercialized with AstraZeneca globally (see Note 3pediatric patients 6 weeks to the condensed consolidated financial statements).18 years of age.
Keytruda is an anti-PD-1 therapy approved for the treatment of many cancers that is in clinical development for expanded indications. These approvals were the result of a broad clinical development program that currently consists of more than 1,3001,600 clinical trials, including more than 900nearly 1,200 trials that combine Keytruda with other cancer treatments. These studies encompass more than 30 cancer types including: biliary tract, estrogen receptor positive breast cancer, cervical, colorectal, cutaneous squamous cell, endometrial, esophageal, gastric, glioblastoma, head and neck, hepatocellular, Hodgkin lymphoma, non-Hodgkin lymphoma, non-small-cell lung, small-cell lung, melanoma, mesothelioma, nasopharyngeal, non-small-cell lung, ovarian, prostate, renal, small-cell lung, triple-negativetriple-
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negative breast, and urothelial, many of which are currently in Phase 3 clinical development. Further trials are being planned for other cancers.
In July 2020,Keytruda is under priority review by the FDA accepted and granted Priority Review for a supplemental Biologics License Application (BLA) seeking accelerated approval for Keytruda in combination with chemotherapy for the adjuvant treatment of adult and pediatric (12 years and older) patients with locally recurrent unresectableStage IIB or metastatic triple-negative breast cancer (TNBC) whose tumors express PD-L1 (CPS ≥10). The application wasIIC melanoma following complete resection. This submission is based on data from the KEYNOTE-355Phase 3 KEYNOTE-716 trial. In August 2021, Merck announced that the KEYNOTE-716 trial in which Keytruda plus chemotherapy demonstrated a statistically significantmet its primary endpoint of recurrence-free survival for the adjuvant treatment of patients with surgically resected high-risk stage IIB and clinically meaningful improvement in progression-free survival (PFS) compared with chemotherapy alone in patients whose tumors expressed PD-L1 at CPS ≥10. In patients whose tumors expressed PD-L1 with
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CPS ≥1, Keytruda plus chemotherapy improved PFS versus chemotherapy alone, however theseIIC melanoma. These results did not meet statistical significance. These data were presented at the virtual scientific program of the 2020 AmericanEuropean Society of ClinicalMedical Oncology (ASCO) Annual Meeting. As previously announced, the trial will continue without changes to evaluate the other dual primary endpoint of overall survival (OS).(ESMO) Congress in September 2021. The FDA set a PDUFA date of November 28, 2020. In October 2020, Merck announced the submission of KEYNOTE-355 to the Japan PMDA.
Also in July 2020, the FDA accepted for standard review a supplemental BLA forDecember 4, 2021. Keytruda is also under review in the EU for this indication.
Keytruda is also under priority review by the FDA for the adjuvant treatment of patients with RCC at intermediate-high or high risk of recurrence following nephrectomy (surgical removal of a kidney) or following nephrectomy and resection of metastatic lesions based on data from the Phase 3 KEYNOTE-564 trial. The FDA set a PDUFA date of December 10, 2021. Keytruda is also under review in the EU and Japan for this indication.
Additionally, Keytruda is under review by the FDA for the treatment of patients with advanced endometrial cancer that is MSI-H or dMMR, who have disease progression following prior systemic therapy in any setting and are not candidates for curative surgery or radiation. This submission is based on data from the KEYNOTE-158 trial. The FDA set a PDUFA date of March 28, 2022.
Keytruda in combination with chemotherapy is under review in the EU and Japan for the treatment of patients with high-risk, early-stage TNBC in combination with chemotherapy as neoadjuvant treatment, and then as a single agent as adjuvantadjuvent treatment after surgery. The application was based on data from the KEYNOTE-522 trial in which neoadjuvant Keytruda plus chemotherapy resulted in a statistically significant increase in pathologic complete response in patients with early-stage TNBC, regardless of PD-L1 expression. The Keytruda regimen also demonstrated a favorable trend for the other dual primary endpoint of event-free survival. An interim analysis for this study was conducted by the Independent Data Monitoring Committee (DMC). Based on the recommendation of the DMC, the study continues to evaluate event-free survival. Data from the KEYNOTE-522 trial were presented at the European Society for Medical Oncology 2019 Congress. As previously announced, Keytruda plus chemotherapy was granted Breakthrough Therapy designation by the FDA in September 2019 for the neoadjuvant treatment of patients with high-risk, early-stage TNBC. The PDUFA date for this application is March 29, 2021.
The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) announced the start of a procedure to extend the currently approved therapeutic indication for the treatment of relapsed or refractory cHL in adults to an earlier line of therapysurgery based on the pivotal Phase 3 KEYNOTE-204 trial, in which Keytruda demonstrated a significant improvement in PFS compared to brentuximab vedotin (BV), a current standard of care in this patient population. Data from KEYNOTE-204 were presented during the virtual scientific program of the 2020 ASCO Annual Meeting. Keytruda was approved for this indication by the FDA in October 2020. The procedure also seeks to extend the indication to include pediatric patients.KEYNOTE-522 trial.
Keytruda is also under review in the EU and in Japan for the first-line treatment of patients with MSI-H or mismatch repair deficient unresectable or metastatic colorectal cancer based on the results from the Phase 3 KEYNOTE-177 trial. Keytruda was approved for this indication by the FDA in June 2020.
In addition to the Breakthrough Therapy designation from the FDA for the combination of Keytruda with neoadjuvant chemotherapy for the treatment of high-risk, early-stage TNBC noted above, Keytruda also received Breakthrough Therapy designation from the FDA in February 2020 for the combination of Keytruda with PADCEV (enfortumab vedotin-ejfv), in the first-line setting for the treatment of patients with unresectable locally advanced or metastatic urothelial cancer who are not eligible for cisplatin-containing chemotherapy. The FDA’s Breakthrough Therapy designation is intended to expedite the development and review of a candidate that is planned for use, alone or in combination, to treat a serious or life-threatening disease or condition when preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints.
In August 2020, Merck announced first-time data from the pivotal Phase 3 KEYNOTE-590 trial evaluating Keytruda in combination with platinum-based chemotherapy for the first-line treatment of patients with locally advanced or metastatic esophageal and gastroesophageal junction cancer. In the study, Keytruda in combination with chemotherapy significantly improved OS and PFS versus chemotherapy in all randomized patients; it was demonstrated that the risk of death was reduced by 27% versus chemotherapy as first-line treatment for locally advanced or metastatic esophageal cancer. With these results, Keytruda is the first anti-PD-1 therapy in combination with chemotherapy to show superior OS, PFS and objective response rate (ORR) versus chemotherapy, the current standard of care, for these patients regardless of histology or PD-L1 expression status. These data were presented at the European Society for Medical Oncology (ESMO) Virtual Congress 2020. Merck will be sharing these data with regulatory authorities worldwide.
In June 2020, Merck announced that the Phase 3 KEYNOTE-361 trial evaluating Keytruda in combination with chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic carcinoma of the esophagus or HER2-negative gastroesophageal junction adenocarcinoma in adults whose tumors express PD-L1 based on the results from the KEYNOTE-590 trial.
Additionally, Keytruda is under review in Japan for treatment of adult patients with advanced or metastatic urothelial carcinoma (bladder cancer) did not meet its pre-specified dual primary endpoints of OS or PFS, comparedrecurrent TMB-H solid tumors that have progressed after chemotherapy (limited to use when difficult to treat with standard of care chemotherapy. Incare) based on the final analysis of the study, there was an improvement in OS and PFS for patients treated with KEYNOTE-158 trial.
Keytruda in combination with platinum-based chemotherapy compared to chemotherapy alone; however, these results did not meet statistical significance perwith or without bevacizumab is also under review in Japan for the pre-specified statistical plan. The monotherapy armfirst-line treatment of patients with persistent, recurrent or metastatic cervical cancer based on the study was not formally tested, since superiority was not reached for OS or PFS in the Keytruda combination arm. Keytruda has three FDA-approved bladder cancer indications across multiple stages of bladder cancer. Additionally, Merck has an extensive clinical development program in bladder cancer and is continuing to evaluate Keytruda as monotherapy and in combination with other anti-cancer therapies across several disease settings (i.e., metastatic, muscle invasive bladder cancer, and non-muscle invasive bladder cancer).KEYNOTE-826 trial.
In May 2020, Merck announcedOctober 2021, the CHMP of the EMA adopted a positive results from two studies fromopinion recommending approval of the Company’s lung cancer research program. Initial results from the Phase 2 KEYNOTE-799 trial evaluatingcombination of Keytruda plus concurrent chemoradiation therapy
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demonstrated an ORR of 67.0% in Cohort A (squamous and nonsquamous NSCLC patients who received paclitaxel plus carboplatin) and 56.6% in Cohort B (nonsquamous NSCLC patients who received cisplatin plus pemetrexed) in untreated patients with unresectable, locally advanced stage III NSCLC.
Additionally in May 2020, Merck and Eisai presented data from analyses of two trials evaluating Keytruda plus Lenvima at the 2020 ASCO Annual Meeting, in which the Keytruda plus Lenvima combination demonstrated clinically meaningful ORR: the KEYNOTE-524/Study 116 trial in patients with unresectable HCC with no prior systemic therapy and the KEYNOTE-146/Study 111 trial in patients with metastatic clear cell renal cell carcinoma (ccRCC) who progressed following immune checkpoint inhibitor therapy.
In July 2020, Merck and Eisai announced that the FDA issued a Complete Response Letter (CRL) regarding Merck’s and Eisai’s applications seeking accelerated approval of Keytruda plus Lenvima for the first-line treatment of adult patients with unresectable HCCadvanced RCC based on data from the Phase 1b KEYNOTE-524/3 KEYNOTE-581 trial/Study 116 trial, which showed clinically meaningful efficacy in the single-arm setting. These data supported307. The CHMP also adopted a Breakthrough Therapy designation granted by the FDA in July 2019. Aheadpositive opinion recommending approval of the PDUFA action dates of Merck’s and Eisai’s applications, another combination therapy was approved based on a randomized, controlled trial that demonstrated improvement in OS versus standard-of-care treatment. Consequently, the CRL stated that Merck’s and Eisai’s applications do not provide evidence that Keytruda in combination with Lenvima represents a meaningful advantage over available therapies for the treatment of unresectable or metastatic HCC with no prior systemic therapy for advanced disease. Since the applications for KEYNOTE-524/Study 116 no longer meet the criteria for accelerated approval, both companies plan to work with the FDA to take appropriate next steps, which include conducting a well-controlled clinical trial that demonstrates substantial evidence of effectiveness and the clinical benefit of the combination. As such, LEAP-002, the Phase 3 trial evaluating the Keytruda plus Lenvima combination as a first-line treatment for advanced HCC, is currently underway and fully enrolled. The CRL does not impact the current approved indications for Keytruda or for Lenvima.
In July 2020, the FDA granted Breakthrough Therapy designation to the hypoxia-inducible factor-2 alpha (HIF-2α) inhibitor MK-6482, a novel investigational candidate for the treatment ofadult patients with von Hippel-Lindau (VHL) disease-associated RCCadvanced or recurrent endometrial carcinoma who have disease progression following prior treatment with nonmetastatic RCC tumors less than three centimetersa platinum-containing therapy in size, unless immediateany setting and who are not candidates for curative surgery is required. The FDA also granted orphan drug designation to MK-6482 for VHL disease. These designations areor radiation, based on data from athe Phase 2 trial evaluating MK-64823 KEYNOTE-775 trial/Study 309. The CHMP’s recommendations will now be reviewed by the EC for marketing authorization in patients with VHL-associated ccRCC, which were presented at the 2020 ASCO Annual Meeting. Additionally, Phase 2 data showing anti-tumor responsesEU and decisions are expected in VHL disease patients with ccRCC and other tumors were presented at the fourth quarter of 2021. ESMO Virtual Congress 2020Keytruda. is also under review for both of these indications in Japan.
In September 2020, Merck and Seagen announced a collaboration to globally develop and commercialize Seagen’s ladiratuzumab vedotin (MK-6440), an investigational antibody-drug conjugate targeting LIV-1, which is currently inEisai have stopped LEAP-007, the Phase 2 clinical trials for breast cancer and other solid tumors. The collaboration will pursue a broad joint development program3 study evaluating ladiratuzumab vedotin as monotherapy andthe first-line treatment of Lenvima in combination with Keytruda in triple-negative breast cancer, hormone receptor-positive breast cancerparticipants with metastatic squamous or non-squamous NSCLC, whose tumors are PD-L1 positive with no EGFR or ALK genomic tumor aberrations. The trial has been discontinued following the recommendation of the external Data Monitoring Committee (eDMC) which met, as scheduled, to assess safety and other LIV-1-expressing solid tumors. Seagen also granted futility. The eDMC determined that the study had met the criteria for declaring futility and the benefit/risk profile of the combination did not support continuing the trial.
Merck an exclusive license and entered intoEisai have closed LEAP-011 for further enrollment. LEAP-011 is a co-development agreementPhase 3 study evaluating Lenvima in combination with Merck to accelerate the global reach of Tukysa (MK-7119), a small molecule tyrosine kinase inhibitor, Keytruda for the treatmentfirst-line treatments of HER2-positive cancers, in Asia,patients with platinum-ineligible urotherial carcinoma. Enrollment was closed following the Middle East and Latin America and other regions outsiderecommendation of the United States, CanadaeDMC, which met, as scheduled, to assess safety and Europe. See Note 2 to the condensed consolidated financial statements.
Lynparza is an oral PARP inhibitor currently approved for certain types of advanced ovarian, breast, pancreatic and prostate cancers being co-developed for multiple cancer types as part of a collaboration with AstraZeneca (see Note 3 to the condensed consolidated financial statements).
In May 2020, the resultsfutility. Data from the Phase 3 GY004 trial, led by NRG Oncology and sponsored by the U.S. NCI, werestudy will be presented at the 2020 ASCO Annual Meeting. This follows the March 2020, Merck and AstraZeneca announcement of the high-level results from the Phase 3 GY004 trial that examined primarily the efficacy and safety of investigational medicine cediranib in combination with Lynparza versus platinum-based chemotherapy in patients with platinum-sensitive relapsed ovarian cancer. The trial did not meet the primary endpoint in the intent-to-treat population of a statistically significant improvement in PFS with cediranib in combination with Lynparza vs. platinum-based chemotherapy.an upcoming medical meeting.
In September 2020, Merck announced the results from two ongoing pivotal Phase 3 trials (COUGH-1 and COUGH-2) evaluating the efficacy and safety of gefapixant (MK-7264), an investigational, orally administered, selective P2X3 receptor antagonist, for the treatment of refractory or unexplained chronic cough. In these studies, adult patients treated with gefapixant 45 mg twice daily demonstrated a statistically significant reduction in 24-hour cough frequency versus placebo at 12 weeks (COUGH-1) and 24 weeks (COUGH-2). The gefapixant 15 mg twice daily treatment arms did not meet the primary efficacy endpoint in either Phase 3 study. These results were presented at the Virtual European Respiratory Society International Congress 2020. Merck plans to share data from COUGH-1 and COUGH-2 with regulatory authorities worldwide.
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In October 2020,April 2021, Merck announced Week 96 datathe discontinuation of development of MK-7110 (formerly known as CD24Fc) which was being evaluated for the treatment of hospitalized patients with COVID-19. Merck acquired MK-7110 in December 2020 through its acquisition of OncoImmune, a privately held clinical-stage biopharmaceutical company. In 2021, Merck received feedback from the Phase 2b trial (NCT03272347) evaluatingFDA that additional data would be needed to support a potential EUA application and therefore the Company did not expect MK-7110 would become available until the first half of 2022. Given this timeline and the technical, clinical and regulatory uncertainties, the availability of a number of medicines for patients hospitalized with COVID-19, and the need to concentrate Merck’s resources on accelerating the development and manufacture of the most viable therapeutics and vaccines, Merck decided to discontinue development of MK-7110 for the treatment of COVID-19. Due to the discontinuation, the Company recorded charges of $207 million in the first nine months of 2021, which are reflected in Cost of sales and relate to fixed-asset and materials write-offs, as well as the recognition of liabilities for purchase commitments.
In September 2021, the FDA approved updated labeling for Steglatro, Steglujan and Segluromet, medicines for adults with type 2 diabetes, to include the primary efficacy and safety of islatravir, the company’s investigational oral nucleoside reverse transcriptase translocation inhibitor (NRTTI), in combination with doravirine (Pifeltro), in treatment-naïve adults with HIV-1 infection. Week 96 findings demonstrated that the combination of islatravir and doravirine maintained virologic suppression (as measured by the number of study participants achieving HIV-1 RNA levels <50 copies/mL, similar to Delstrigo (doravirine/lamivudine/tenofovir disoproxil fumarate)), and the findings were consistent with Week 48 results. Additional Week 96 data from the study show low rates of participants meeting the definition of protocol-defined virologic failure in both the islatravir plus doravirine and the Delstrigo treatment arms, and no participants in either arm met the criteria for resistance testing. These data were presented at the virtual 2020 International Congress on Drug Therapy in HIV Infection (HIV Glasglow).
In October 2020, Merck announced findings from two Phase 3 studies evaluating the safety, tolerability and immunogenicity of V114, the Company’s investigational 15-valent pneumococcal conjugate vaccine. In the PNEU-PATH (V114-016) study, healthy adults 50 years of age and older received V114 or PCV13 followed by Pneumovax 23 one year later. Immune responses following vaccination with Pneumovax 23 were comparable in both vaccination groups for the 15 serotypes in V114. Results also showed that at 30 days post vaccination with either V114 or PCV13, immune responses were comparable for both groups across the 13 serotypes shared by the conjugate vaccines and higher in the V114 group for serotypes 22F and 33F, the two serotypes not included in PCV13. In PNEU-DAY (V114-017), a Phase 3 study in immunocompetent adults 18 to 49 years of age with underlying medical conditions associated with increased risk for pneumococcal disease, V114 generated immune responses generally comparable to PCV13 for the 13 shared serotypes and higher immune responses for serotypes 22F and 33F at 30 days post-vaccination.
In September 2020, Merck announced that two Phase 3 studies evaluating the safety, tolerability and immunogenicity of V114 met their primary immunogenicity objectives. The pivotal PNEU-AGE (V114-019) study in healthy adults 50 years of age or older demonstrated that V114 is non-inferior to the currently available 13-valent pneumococcal conjugate vaccine (PCV13) for the 13 serotypes targeted by both vaccines and superior for serotypes 22F and 33F, the two serotypes targeted by V114 but not PCV13. The PNEU-AGE study also met the key secondary immunogenicity objective, demonstrating superiority of V114 compared to PCV13 for serotype 3, a leading cause of invasive pneumococcal disease globally. In another Phase 3 study, PNEU-TRUE (V114-020), in healthy adults 50 years of age or older, V114 met its primary immunogenicity objective demonstrating equivalent immune response across all 15 serotypes for three different lots of V114.
In June 2020, Merck announced results from two initial Phase 3 studies evaluating the safety, tolerability and immunogenicity of V114. Results from the PNEU-WAY (V114-018) study in adults 18 years of age or older living with HIV showed that V114 elicited an immune response to all 15 serotypes included in the vaccine, including serotypes 22F and 33F. Results from the PNEU-FLU (V114-021) study in healthy adults 50 years of age or older showed that V114 can be given concomitantly with the quadrivalent influenza vaccine. These data were announced and published in the International Symposium on Pneumococci and Pneumococcal Diseases digital library in lieu of an in-person meeting.
The V114 Phase 3 clinical development program is comprised of 16 trials investigating the safety, tolerability and immunogenicity of V114 in a variety of populations who are at increased risk for pneumococcal disease including both healthy older adult and healthy pediatric populations, as well as people who are immunocompromised or have certain chronic conditions. Findings from the V114 Phase 3 clinical program, including the studies above, will be presented at a future scientific congress and will form the basis for global regulatory licensure applications, beginning with the FDA before the end of the year.
In June 2020, Merck and Pfizer Inc. announced the presentation of results from the Phase 3 VERTIS CV trial, which assessed the effect of Steglatro compared with placebo on cardiovascular (CV) outcomes trial that evaluated Steglatro (ertugliflozin), an oral sodium-glucose cotransporter 2 (SGLT2) inhibitor, versus placebo, added to background standard of care treatment, in adult patients with type 2 diabetes and established atherosclerotic CVcardiovascular disease. The study metFDA issued a Complete Response Letter (CRL) concerning the primary endpointCompany’s application for a new indication, based on additional results from the VERTIS CV trial, to reduce the risk of non-inferiority on major adverse CV events (MACE), which is a composite of CV death, nonfatal myocardial infarction or nonfatal stroke, compared to placebo. The key secondary endpoints of superiority for Steglatro versus placebo for time to the first occurrence of the composite of CV death or hospitalization for heart failure, timefailure. The Company is reviewing the CRL to CV death alone and time to the first occurrence of the composite of renal death, dialysis/transplant or doubling of serum creatinine from baseline were not met. While not a pre-specified hypothesis for statistical testing, a reduction in hospitalization for heart failure was observed with Steglatro.
In July 2020, the FDA granted V181, the Company’s investigational dengue vaccine in Phase 1 development, Fast Track designation.assess next steps.
The chart below reflects the Company’s research pipeline as of November 2, 2020.October 27, 2021. Candidates shown in Phase 3 include specific products and the date such candidate entered into Phase 3 development. Candidates shown in Phase 2 include the most advanced compound with a specific mechanism or, if listed compounds have the same mechanism, they are each currently intended for commercialization in a given therapeutic area. Small molecules and biologics are given MK-number designations and vaccine candidates are given V-number designations. Except as otherwise noted, candidates in Phase 1,
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additional indications in the same therapeutic area (other than with respect to cancer) and additional claims, line extensions or formulations for in-line products are not shown.
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Phase 2Phase 3 (Phase 3 entry date)Under Review
Antiviral COVID-19Cancer
MK-4482 (molnupiravir)(1)MK-0482
Cancer     Non-Small Cell Lung
MK-1026
     Hematological Malignancies
MK-1308 (quavonlimab)(2)
Non-Small-Cell Lung
MK-1308A (quavonlimab+pembrolizumab)
Advanced Solid Tumors
Colorectal
Hepatocellular
Melanoma
Small-Cell Lung
MK-2140
Breast
Non-Small-Cell Lung
MK-1454(2)
Head and Neck
MK-3475 Keytruda
Advanced Solid Tumors
MK-4280 (favezelimab)(2)
     Hematological Malignancies
     Non-Small-Cell Lung
MK-4280A (favezelimab+pembrolizumab)
     Renal Cell
     Small-Cell Lung
MK-4830
     Non-Small-Cell Lung
     Small-Cell Lung
MK-5890(2)
     Non-Small-Cell Lung
     Small-Cell Lung
MK-6440 (ladiratuzumab vedotin)(1)(3)
Advanced SolidBreast
Esophageal
Gastric
Head and Neck
Melanoma
Non-Small-Cell Lung
Prostate
Small-Cell Lung
MK-6482 Welireg(3)
Biliary
Colorectal
Pancreatic
Rare cancers
Von Hippel-Lindau Disease-Associated Tumors
Breast (EU)
MK-7119 Tukysa(1)
Advanced Solid Tumors
Biliary Tract
Bladder
Cervical
Colorectal
Endometrial
Gastric
Non-Small-Cell Lung
MK-7339 Lynparza(1)(3)
Advanced Solid Tumors
MK-7684 (vibostolimab)(2)
     Melanoma
Non-Small-Cell LungMK-7684A (vibostolimab+pembrolizumab)
    Biliary
    Breast
    Cervical
    Endometrial
    Esophageal
    Hematological Malignancies
    Prostate
MK-7902 Lenvima(1)(2)
Advanced Solid Tumors
Biliary Tract
Colorectal         Glioblastoma
Gastric         Pancreatic
Glioblastoma         Prostate
         Small-Cell Lung
V937
Breast
Cutaneous Squamous Cell
Melanoma
Head and Neck
         Melanoma
         Solid Tumors
Cardiovascular
MK-2060
Chikungunya virusVirus Vaccine
V184
CytomegalovirusHIV-1 Infection
V160MK-8591B (islatravir+MK-8507)
HIV-1 PreventionMK-8591D (islatravir+lenacapavir)(1)
MK-8591 (islatravir)Nonalcoholic Steatohepatitis (NASH)
MK-3655
MK-6024
Overgrowth Syndrome
MK-7075 (miransertib)
Pneumococcal Vaccine Adult
V116
Pulmonary Arterial Hypertension
MK-5475
Respiratory Syncytial Virus
MK-1654
Schizophrenia
MK-8189
Treatment Resistant Depression
MK-1942

Cancer
MK-1308A (quavonlimab+pembrolizumab)
Renal Cell (April 2021)
MK-3475 Keytruda
Biliary Tract (September 2019)
Breast (October 2015) (EU)
Cervical (October 2018) (EU)
Cutaneous Squamous Cell (August 2019) (EU)
Endometrial (August 2019) (EU)
Esophageal (December 2015) (EU)
Gastric (May 2015) (EU)
Hepatocellular (May 2016) (EU)
Mesothelioma (May 2018)
Nasopharyngeal (April 2016)
Ovarian (December 2018)
Prostate (May 2019)
Small-Cell Lung (May 2017) (EU)
MK-3475 (pembrolizumab subcutaneous)
Non-Small-Cell Lung (August 2021)
MK-6482Welireg(3)
Renal Cell (February 2020)
MK-7119 Tukysa(1)
Breast (October 2019)
MK-7339 Lynparza(1)(2)(3)
Colorectal (August 2020)
Non-Small-Cell Lung (June 2019)
Small-Cell Lung (December 2020)
MK-7684A (vibostolimab+pembrolizumab)
Non-Small-Cell Lung (April 2021)
MK-7902 Lenvima(1)(2)
Bladder (May 2019)Colorectal (April 2021)
Endometrial (June 2018) (EU)Esophageal (July 2021)
Gastric (December 2020)
Head and Neck (February 2020)
Melanoma (March 2019)
Non-Small-Cell Lung (March 2019)
Cough
MK-7264 (gefapixant) (March 2018)
HIV-1 Infection
     MK-8591A (doravirine/(doravirine+islatravir) (February 2020)
Pneumoconjugate VaccineHIV-1 Prevention
V114 (June 2018)MK-8591 (islatravir) (February 2021)

New Molecular Entities/Vaccines
Heart FailureAntiviral COVID-19
MK-1242 (vericiguat)MK-4482 (molnupiravir) (U.S.)(1)(4) (EU)
Cough
MK-7264 (gefapixant) (U.S.) (EU) (JPN)
Pediatric Neurofibromatosis Type 1Pneumococcal Vaccine Adult
MK-5618 (selumetinib)(1)V114 (EU)

(JPN)

Certain Supplemental Filings
Cancer
MK-3475 Keytruda
Metastatic Triple-Negative BreastResected Stage IIB and IIC Melanoma
(KEYNOTE-716) (U.S.) (EU)
• Adjuvent Renal Cell Cancer
         (KEYNOTE-355)(KEYNOTE-564) (U.S.) (EU) (JPN)
MSI-H or dMMR Endometrial Cancer
(KEYNOTE-158) (U.S.)
• High-Risk Early-Stage Triple-Negative Breast Cancer
(KEYNOTE-522) (U.S.)(EU) (JPN)
Refractory Classical Hodgkin LymphomaAdvanced Unresectable Metastatic Esophageal Cancer
         (KEYNOTE-204) (EU)(KEYNOTE-590) (JPN)
Unresectable or Metastatic MSI-H or dMMR ColorectalTumor Mutational Burden-High (KEYNOTE-158) (JPN)
• Cervical Cancer (KEYNOTE-177) (EU)(KEYNOTE-826) (JPN)

MK-7902 Lenvima(1)(2)
• First-Line Metastatic Hepatocellular Carcinoma
         (KEYNOTE-524) (U.S.)(2)(4)(5)
ThymicAdvanced Unresectable Renal Cell Carcinoma (NCCH1508/REMORA)
         (KEYNOTE-581) (EU) (JPN)
• Advanced Endometrial Cancer
         (KEYNOTE-775) (EU) (JPN)


Footnotes:
(1) Being developed in a collaborationcollaboration.
(2) Being developed in combination with Keytruda.
(3) Being developed as monotherapy andand/or in combination with Keytruda.
(4) Under review for Emergency Use Authorization.
(5)In July 2020, the FDA issued a CRLComplete Response Letter for Merck’s and Eisai’s applications. Merck and Eisai are reviewing the letter and willintend to submit additional data when available to the FDA.
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Liquidity and Capital Resources
($ in millions)($ in millions)September 30, 2020December 31, 2019($ in millions)September 30, 2021December 31, 2020
Cash and investmentsCash and investments$8,728 $11,919 Cash and investments$10,451 $8,835 
Working capitalWorking capital6,172 5,263 Working capital7,330 437 
Total debt to total liabilities and equityTotal debt to total liabilities and equity32.0 %31.2 %Total debt to total liabilities and equity28.3 %34.7 %
Cash provided by operating activities from continuing operations was $6.2$8.0 billion in the first nine months of 2021 compared with $4.2 billion in the first nine months of 2020 reflecting stronger operating performance. Cash provided by operating activities from continuing operations in the first nine months of 2021 includes $400 million of payments related to collaborations compared with $8.6$2.1 billion in the first nine months of 2019.2020. Cash provided by operating activities in the first nine months of 2020 includes $2.1 billion of payments related to collaborations compared with $505 million in the first nine months of 2019. Cash provided by operating activitiesfrom continuing operations continues to be the Company’s primary source of funds to finance operating needs, capital expenditures, treasury stock purchases and dividends paid to shareholders.
Cash used in investing activities of continuing operations was $4.7$4.4 billion in the first nine months of 20202021 compared with $1.9$4.5 billion in the first nine months of 2019.2020. The increaselower use of cash in investing activities was driven primarily by lower cash used for acquisitions, largely offset by lower proceeds from sales of securities and other investments and higher capital expenditures, partially offset by lower purchases of securities and other investments and lower use of cash for acquisitions.
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expenditures.
Cash used in financing activities of continuing operations was $2.1 billion in the first nine months of 2021 compared with $4.2 billion in the first nine months of 2020 compared with $6.9 billion in the first nine months of 2019.2020. The lower use of cash in financing activities was primarily driven primarily by a net increasethe cash distribution received from Organon in short-term borrowings in 2020 comparedconnection with a net decrease in short-term borrowing in 2019, as well asthe spin-off (see Note 2 to the condensed consolidated financial statements), lower payments on debt (see below) and lower purchases of treasury stock, partially offset by higher payments on debt (see below), lower proceeds from the issuance of debt (see below), a higher net decrease in short-term borrowings and higher dividends paid to shareholders, and lower proceeds from the exercise of stock options.shareholders.
Capital expenditures totaled $3.2 billion and $2.3$3.0 billion for the first nine months of 2021 and 2020, and 2019, respectively. The increased capital expenditures reflect investment in new capital projects focused primarily on increasing manufacturing capacity for Merck’s key products, as well as the purchase of a manufacturing facility in Dunboyne, Ireland to support upcoming product launches (see Note 2 to the condensed consolidated financial statements).
The Company has accounts receivable factoring agreements with financial institutions in certain countries to sell accounts receivable. The Company factored $2.1$2.4 billion and $2.7$2.1 billion of accounts receivable in the third quarter ofat September 30, 2021 and December 31, 2020, and the fourth quarter of 2019, respectively, under these factoring arrangements, which reduced outstanding accounts receivable. The cash received from the financial institutions is reported within operating activities in the Condensed Consolidated Statement of Cash Flows. In certain of these factoring arrangements, for ease of administration, the Company will collect customer payments related to the factored receivables, which it then remits to the financial institutions. The net cash flows relating to these collections are reported as financing activities in the Condensed Consolidated Statement of Cash Flows.
Dividends paid to stockholders were $4.7$5.0 billion and $4.3$4.7 billion for the first nine months of 20202021 and 2019,2020, respectively. In May 2020,2021, the Board of Directors declared a quarterly dividend of $0.61$0.65 per share on the Company’s common stock for the third quarter that was paid in July 2020.2021. In July 2020,2021, the Board of Directors declared a quarterly dividend of $0.61$0.65 per share on the Company’s common stock for the fourth quarter that was paid in October 2020.2021.
In January 2021, the Company’s $1.15 billion, 3.875% notes matured in accordance with their terms and were repaid. In October 2021, the Company’s €1.0 billion, 1.125% notes matured in accordance with their terms and were repaid.
In February 2020, the Company’s $1.25 billion, 1.85% notes and $700 million floating-rate notes matured in accordance with their terms and were repaid.
In June 2020, the Company issued $4.5 billion principal amount of senior unsecured notes consisting of $1.0 billion of 0.75% notes due 2026, $1.25 billion of 1.45% notes due 2030, $1.0 billion of 2.35% notes due 2040 and $1.25 billion of 2.45% notes due 2050. Merck used the net proceeds from the offering for general corporate purposes, including without limitation the repayment of outstanding commercial paper borrowings and other indebtedness with upcoming maturities.
In March 2019, the Company issued $5.0 billion principal amount of senior unsecured notes consisting of $750 million of 2.90% notes due 2024, $1.75 billion of 3.40% notes due 2029, $1.0 billion of 3.90% notes due 2039, and $1.5 billion of 4.00% notes due 2049. The Company used the net proceeds from the offering of $5.0 billion for general corporate purposes, including the repayment of outstanding commercial paper borrowings.
In 2018, Merck’s Board of Directors authorized purchases of up to $10 billion of Merck’s common stock for its treasury. The treasury stock purchase authorization has no time limit and will be made over time in open-market transactions, block transactions on or off an exchange, or in privately negotiated transactions. During the first nine months of 2020,In May 2021, Merck restarted its share repurchase program, which the Company had temporarily suspended in March 2020. The Company purchased $1.3 billion (16$822 million (11 million shares) of its common stock for its treasury under this share repurchase program.during the first nine months of 2021. As of September 30, 2020,2021, the Company’s remaining share repurchase authorization was $5.9$5.1 billion. In March 2020, the Company temporarily suspended its share repurchase program.
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The Company has a $6.0 billion credit facility that matures in June 2024.2026. The facility provides backup liquidity for the Company’s commercial paper borrowing facility and is to be used for general corporate purposes. The Company has not drawn funding from this facility.
Critical Accounting PoliciesEstimates
The Company’s significant accounting policies, which include management’s best estimates and judgments, are included in Note 2 to the consolidated financial statements for the year ended December 31, 20192020 included in Merck’s Form 10‑K filed on February 26, 2020. Certain25, 2021. See Note 1 to the condensed consolidated financial statements for information on the adoption of thesenew accounting policies arestandards during 2021. A discussion of accounting estimates considered critical as disclosed in the Critical Accounting Policies section of Management’s Discussion and Analysis of Financial Condition and Results of Operations included in Merck’s Form 10-K because of the potential for a significant impact on the financial statements due to the inherent uncertainty in such estimates.estimates are disclosed in the Critical Accounting Estimates section of Management’s Discussion and Analysis of Financial Condition and Results of Operations included in Merck’s Form 10-K. There have been no significant changes in the Company’s critical accounting policiesestimates since December 31, 2019. See Note 1 to the condensed consolidated financial statements for information on the adoption of new accounting standards during 2020.

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Recently Issued Accounting Standards
For a discussion of recently issued accounting standards, see Note 1 to the condensed consolidated financial statements.
Item 3. Quantitative and Qualitative Disclosures about Market Risk
There have been no material changes in market risk exposures that affect the disclosures presented in “Item 7A. Quantitative and Qualitative Disclosures about Market Risk” in the Company’s 2020 Form 10-K filed on February 25, 2021.
Item 4. Controls and Procedures
Management of the Company, with the participation of its Chief Executive Officer and Chief Financial Officer, has evaluated the effectiveness of the Company’s disclosure controls and procedures over financial reporting. Based on their evaluation, the Company’s Chief Executive Officer and Chief Financial Officer have concluded that as of September 30, 2020,2021, the Company’s disclosure controls and procedures are effective. For the third quarter of 2020,2021, there were no changes in internal control over financial reporting that materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.
CAUTIONARY FACTORS THAT MAY AFFECT FUTURE RESULTS
This report and other written reports and oral statements made from time to time by the Company may contain so-called “forward-looking statements,” all of which are based on management’s current expectations and are subject to risks and uncertainties which may cause results to differ materially from those set forth in the statements. One can identify these forward-looking statements by their use of words such as “anticipates,” “expects,” “plans,” “will,” “estimates,” “forecasts,” “projects” and other words of similar meaning, or negative variations of any of the foregoing. One can also identify them by the fact that they do not relate strictly to historical or current facts. These statements are likely to address the Company’s growth strategy, financial results, product development, product approvals, product potential, development programs and development programs.include statements related to the expected impact of the COVID-19 pandemic. One must carefully consider any such statement and should understand that many factors could cause actual results to differ materially from the Company’s forward-looking statements. These factors include inaccurate assumptions and a broad variety of other risks and uncertainties, including the impact of the global outbreak of COVID-19 and other risks and uncertainties some that are known and some that are not. No forward-looking statement can be guaranteed and actual future results may vary materially.
The Company does not assume the obligation to update any forward-looking statement. One should carefully evaluate such statements in light of factors, including risk factors, described in the Company’s filings with the Securities and Exchange Commission, especially on Forms 10-K, 10-Q and 8-K. In Item 1A. “Risk Factors” of the Company’s Annual Report on Form 10‑K for the year ended December 31, 2019, as2020, filed on February 26, 2020,25, 2021, in the Company’s Form 10-Q for the quarterly period ended March 31, 2020, as2021, filed on May 6, 2020,5, 2021, in the Company’s Form 10-Q for the quarterly period ended June 30, 2020,2021, as filed on August 5, 2020,9, 2021, and in this Form 10-Q, the Company discusses in more detail various important risk factors that could cause actual results to differ from expected or historic results. The Company notes these factors for investors as permitted by the Private Securities Litigation Reform Act of 1995. One should understand that it is not possible to predict or identify all such factors. Consequently, the reader should not consider any such list to be a complete statement of all potential risks or uncertainties.
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PART II - Other Information
Item 1. Legal Proceedings
The information called for by this Item is incorporated herein by reference to Note 9 included in Part I, Item 1, Financial Statements (unaudited) — Notes to Condensed Consolidated Financial Statements.
Item 1A. Risk Factors
For a discussion of risks that affect the Company’s business, please refer to Part I, Item IA, “Risk Factors” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019.2020. There have been no material changes to the risk factors as previously disclosed in the Company’s Annual Report on Form 10-K, except as follows:
The global COVID-19 pandemic is having an adverse impact on the Company’s business, operations and financial performance. The Company is unable to predict the full extent to which the pandemic and related impacts will continue to adversely impact its business, operations, financial performance, results of operations, and financial condition.
The Company’s business and financial results have been negatively impacted by the outbreak of Coronavirus Disease 2019 (COVID-19). The duration, spread and severity of the COVID-19 pandemic is uncertain, rapidly changing and difficult to predict. The degree to which COVID-19 impacts the Company’s results will depend on future developments, beyond the Company’s knowledge or control, including, but not limited to, the duration and spread of the outbreak, its
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severity, the actions taken to contain the virus or treat its impact, and how quickly and to what extent normal economic and operating conditions can resume.
Merck assumescontinues to believe that global health systems and patients have largely adapted to the majorityimpacts of the negative impact from the COVID-19 pandemic, occurred in the second quarter of 2020. However, the Company expects some residualand that while negative impacts inwill persist, the fourth quarter, largely in Europe and certain emerging markets. In addition,trend will continue to improve. For the phasingfull year of the recovery2021, Merck assumes a net unfavorable impact to sales of Gardasil 9 demand is slowerless than originally anticipated, in particular in the United States3% due to lower back-to-school demand.the COVID-19 pandemic, all of which relates to the Pharmaceutical segment. To the extent these assumptions prove to be incorrect, the Company’s results may differ materially from the estimates set forth herein.
Thus far in 2020, the COVID-19 pandemic has impacted the Company’s business and the Company continues to expect that it will impact the business in numerous ways, including but not limited to those outlined below:
InFor the third quarter and first nine months of 2020,2021, the estimated negative impact of the COVID-19 pandemic to Merck’s Pharmaceutical sales was estimatedapproximately $350 million and $1.3 billion, respectively, all of which related to be approximately $475 million. The negative impact to Animal Health sales was immaterial. The negative impact to sales in the first nine months of 2020 was approximately $2.0 billion for the Pharmaceutical segment and $50 million for the Animal Health segment. For the full-year 2020, including the impact for the first nine months, Merck expects an unfavorable impact to sales of approximately $2.35 billion (excluding the impact of foreign exchange) due to the COVID-19 pandemic, comprised of approximately $2.3 billion for Pharmaceutical revenue and approximately $50 million for Animal Health revenue.
Roughly two-thirds75% of Merck’s Pharmaceutical segment revenue is comprised of physician-administered products, which, despite strong underlying demand, werehave been affected by social distancing measures and fewer well visits and delays in elective surgeries due to the COVID-19 pandemic. These impacts, as well as the prioritization of COVID-19 patients at health care providers, have resulted in reduced administration of many of the Company’s human health products, in particular for its vaccines, including Gardasil 9 (Human Papillomavirus 9-valent Vaccine, Recombinant), as well as for Keytruda (pembrolizumab) and Implanon/Nexplanon (etonogestrel implant). Access to healthcare providers remains reduced, although improved from the second quarter. Merck anticipates reduced demand for its physician-administered products while pandemic-related access measures remain in place. In addition, declines in elective surgeries negatively affected the demand for Bridion (sugammadex) Injection in the year-to-date period. Sales of Pneumovax 23 (pneumococcal vaccine polyvalent) increased due to heightened awareness of pneumococcal vaccination during the COVID-19 pandemic and ahead of flu season.visits.
Operating expenses were positively affectedreflect a minor positive effect in the third quarter and first nine months of 2020 by approximately $115 million and $540 million, respectively, primarily driven by lower promotional and selling costs,2021 as well as lower research and development expenses, net of investments in COVID-19-related antiviral and vaccine research programs. Forprograms largely offset the full-year 2020, Merck expects a net favorable impact to operating expenses of approximately $625 million reflecting continued lower spending in other areas due to the COVID-19 pandemic, partially offset by spending on COVID-19-related antiviral and vaccine research programs.pandemic.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Issuer purchases of equity securities for the three months ended September 30, 20202021 were as follows:
ISSUER PURCHASES OF EQUITY SECURITIES
($ in millions)($ in millions)
PeriodPeriod
Total Number
of Shares
Purchased (1)
Average Price
Paid Per
Share
Approximate Dollar Value of Shares
That May Yet Be Purchased
Under the Plans or Programs (1)
Period
Total Number
of Shares
Purchased (1)
Average Price
Paid Per
Share
Approximate Dollar Value of Shares
That May Yet Be Purchased
Under the Plans or Programs (1)
July 1 - July 31July 1 - July 31— $0.00$5,888July 1 - July 311,636,842 $77.33$5,522
August 1 - August 31August 1 - August 31— $0.00$5,888August 1 - August 312,029,851 $76.37$5,367
September 1 - September 30September 1 - September 30— $0.00$5,888September 1 - September 304,104,249 $73.35$5,066
TotalTotal— $0.00$5,888Total7,770,942 $74.97$5,066
(1) The Company did not purchase any sharesShares purchased during the three months ended September 30, 2020 under theperiod were made as part of a plan approved by the Board of Directors in October 2018 to purchase up to $10 billion of Merck’s common stock for its treasury.









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Item 6. Exhibits
Number  Description
3.1
3.2
31.1 
31.2 
32.1 
32.2 
101.INSXBRL Instance Document - The instance document does not appear in the interactive data file because its XBRL tags are embedded within the Inline XBRL document.
101.SCHXBRL Taxonomy Extension Schema Document.
101.CALXBRL Taxonomy Extension Calculation Linkbase Document.
101.DEFXBRL Taxonomy Extension Definition Linkbase Document.
101.LABXBRL Taxonomy Extension Label Linkbase Document.
101.PREXBRL Taxonomy Extension Presentation Linkbase Document.
104 Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101).
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Signatures
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
 MERCK & CO., INC.
Date: November 5, 20202021 /s/ Jennifer Zachary
 JENNIFER ZACHARY
 Executive Vice President, General Counsel and Corporate Secretary
Date: November 5, 20202021 /s/ Rita A. Karachun
 RITA A. KARACHUN
 Senior Vice President Finance - Global Controller
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