The fourth quarter of 2017 developed as anticipated on all important parameters. I am proud to announce the second full year with a positive bottom line result and a slight increase in operating earnings compared to 2016, despite significantly lower milestone income during 2017.
We know the main driver of changes in volume and market share for Zubsolv® in the US is market access and to improve our market access position has been a key strategic focus for the company in 2017. We have worked closely with the managed care providers to prepare the implementation of the new agreements starting 2018 and to prepare the organization to fully leverage these opportunities in 2018. With the new improved market access position we have invested in additional field force in regions where market access provides growth opportunities in 2018.
In Q4, Zubsolv US net revenues grew 7.2 percent, in local currency, compared to the same quarter last year. I am pleased to report such an increase in the closing quarter of the year as we faced some negative developments related to United Health Group leaving the Health Exchanges early in the year, a large healthcare provider leaving WellCare and Maryland adding all products to their formulary list as from July 1.
We strive to expand our commercial platform in the US through business development or by developing our own proprietary products. To ensure we have the financial flexibility to capture opportunities when they emerge, we decided to issue a new corporate bond, even though we have a positive net cash position and expect to continue with a positive cash flow from operating activities on an annual basis in 2018 as well. With the financial position secured for the next four years, we will intensify our efforts in business development and further accelerate the development of our internal projects when feasible.
During the fourth quarter our internal pipeline progressed according to plan. The European Commission approved Zubsolv for treatment of opioid dependence in Europe, and our partner Mundipharma will commence launch of the product in Europe during the first half of 2018. For OX382, where we aim to be first-to-market, with a novel formulation of buprenorphine that enables oral administration, we initiated the clinical phase I trial, with trial results expected in Q2, 2018. We also continue the work to strengthen our pipeline with early stage projects that will fall into the addiction category and with the ambition to provide clear clinical differentiation versus currently available treatment alternatives. During the quarter, the OX-CLI program was discontinued by AstraZeneca, but the decision to discontinue the program has no financial impact on Orexo.
With the positive financial results, our improved market access and a final decision in the appeal process against Actavis upcoming, I am confident that we have paved the way for growth and an exciting 2018.
Uppsala, Sweden, January 25 2018
President and CEO