Sanofi — Call Transcript 2026

Welcome to the J.P. Morgan Healthcare Conference. I'm Richard Vosser, European Pharma Analyst with J.P. Morgan. It's my great pleasure to introduce Sanofi from the conference. We have three of the very senior management here to entertain us now: Paul Hudson, CEO, François-Xavier Roger, CFO, and Houman Ashrafian... You fully butchered every name. Every name, every year. Every year. It's consistent. That's what we like. So I better shut up then and hand to Paul for a few introductory remarks, and then we're going to chat together. Thank you, Mr. Vosser. We appreciate that. That was wrong, Paul. Great. We only have a handful of slides, but I'll just... I have one, Houman has a couple. Thank you for making the time. It's been an extremely busy year last year for us, and we had a couple of challenges in R&D, which I think are well communicated. We also made very important commercial progress. We were growing 8.7% through Q3. Script trends, if they stay consistent through the remainder of the year across the major drivers of that, we're going to be close to double-digit growth. That double-digit growth profile, we think we can maintain for the next half-decade plus. And that puts us in quite a rare group in terms of how well we're executing. We have a new blockbuster with Altuviiio. We've got close to $4 billion in launch revenue, so we're working fast to offset the potential Dupixent LOE in the future. And we have the ambition to grow EPS through the Dupixent LOE. So we're well underway on our plan, our transformation, our capital allocation. We've exited consumer. We hopefully have added Inhibrx. We've done some things to try and continually modernize and equip us best for the future. We executed on Provention. We're delighted with that. And so the journey really strongly continues for us. We're well aware that we have a lot to prove still in R&D. We have some huge readouts ahead of us early this year. And with that, maybe I'll hand a little bit to Houman. Thank you, Paul. Happy New Year. Last time I'll say that. Delighted to be here at J.P. Morgan. As you can see from this slide in immunology, we have an exciting year ahead of us. Amlitelimab will read out COAST 2 in the near future. It's important to also call out there's a number of other studies coming, including SHORE, which is the combination study with topical corticosteroids. Germane to how atopic dermatitis is practiced today. Look forward to those. But it's not all about our rockstar amlitelimab. We have Dupixent COPD data coming later in the year, anti-TL1A in partnership with Teva. And we have excellent and interesting opportunities to assess the value of combination therapies in bispecifics in asthma and beyond in Lunsekimig. It's not all about immunology and autoimmune disease. We are excited to be a rare disease company and our commitment to the patients remains. We have a number of rare disease and oncology readouts, and we continue to be active both in vaccines and in neurology. As you can see on the next slide, the data flow is substantial in the first half of the year and will be extended further throughout the year, both in terms of early and late trial readouts as well as regulatory approvals. It's a good year to look forward to, and we will supplement, being here in J.P. Morgan, apropos, we'll supplement a commendable internal pipeline with partners that already exist in partners of the future. Excellent. Thanks, Houman. Thanks, Paul. Maybe we could start. Maybe I'll just compliment the jacket this year. It's very, very nice. Thank you very much. Socks last year, jacket this year. But Paul, you were in the White House at the end of last year. Maybe you could just talk about your thinking on U.S. pricing going forward for the industry. You're going to be head of pharma this year as well. But the impact for Sanofi, what are we thinking? We've said over the short term, we'll have to work very hard to make the impact manageable, and that's our intent. It was, like for everybody, a tough negotiation with the government. I think they got, I think, what they needed, but we felt well represented. Some of the team that pulled that together are in the room today, and congratulations to them. I think most of the companies found themselves roughly in the same place. It was, I think, as François calls it, cost avoidance. The tariff piece was an unnecessary drag on the thinking for 2026. We've been able to remove that. We've made some concessions to do that, but I think we feel very comfortable in our outlook. We haven't shared 2026 guidance yet, but when we do, you'll hopefully understand how we put those two things together. The White House experience is really for an after-dinner environment to go into more detail on that, but the president did say something extremely important at the end of his speech. If you were watching very carefully, he said, "Now we turn our attention to the insurers," and I think as incoming chair of pharma, that's a very important statement that he's made. If he attacks it with the same level of energy as he did MFN, that may be an opportunity, and it also may be a challenge. I offered to bring pharma back to the table to make sure that he felt that we'd be good partners in making sure that we create even more visibility with the insurers for the benefit of patients in the United States. Lastly, the comment really about the complexity around GDP-adjusted pricing in basket countries outside of the U.S. and what that means for future launches. I've met many heads of state in Europe over the last few months. Obviously, they're concerned at the level of U.S. attention to pricing and what it might mean for new launches. They're right to be concerned. But frankly, as I said to three heads of state in Europe the last quarter of the year, 54% of medicines that are approved by the EMA are not available in Europe today, long before the president turned his attention to it. So they have some work to do to reward innovation, and we'll be looking at that too. And just one other comment in this area, the vaccine policy. We've seen some policy changes, CDC recommendations, etc. Just how should we think about that from your business point of view? I suppose we're particularly thinking about Beyfortus and some of the RSV changes. Look, there's 50,000+ newborns that were going into the ICU in the United States every year in very distressing circumstances, many with complications that lived long after the RSV had passed. We'd been able to drop that close to 80%-90% with the launch of Beyfortus. Very proud of the work. It's clear this administration has a particular sensitivity around vaccination and indeed pediatric vaccination, preferring to give the parents the choice. We know that is a very delicate line to walk because not everybody's well-informed. Of course, when you're trying to protect communities, that leaves too much open to variability. We can't do much. I'm asked all the time, "What are you going to do to fix this?" The truth is, we just need to stay extremely objective and keep presenting the evidence. There's really very little else we can do. Then we'll see where Kennedy gets to. We'll see how it gets through the midterms. And for most of our work, we plan longer than three years. So we will have to maintain a steely focus on the long-term future of vaccines and deal with any uncertainty around vaccine coverage rates in the short term based on misinformation, Facebook posts, and statements from the top. We're just going to have to deal with it, try and provide patients and parents the very best advice we can. In your opening slide, you highlighted the strong growth of the first nine months and highlighted strong growth potential out towards 2030. How should we think about that growth developing going forward 26 and beyond relative to the near double-digit or around double-digit 25? I'll let François comment on the profitable nature of the growth, but I raise it upfront because to have high single-digit, close to double-digit growth with a clear line of sight through 2030 and perhaps beyond with that puts us in a rather unique club. We're well aware of the journey this company's been on. We've simplified again. We've become more of an R&D-led pharma company and got away from consumer. And we've done everything to really make the company one of the sort of leading R&D-led organizations. We're still missing the proof points, I'm first to admit it. And we've taken a lot of shots that are first-in-class, best-in-class. With the readouts that are just up ahead of us, we hope to reclaim some of the sentiment in our direction because we're trying to navigate what we call the two very simple basics: top-line pipeline, top-line pipeline. Top-line, we're one of the most predictable in the big pharmas because of the lack of LOEs. Pipeline, we're still a previous self. But to talk about the profitable growth, François, maybe you want to comment. Maybe to complement what Paul said, what is important to understand as well is our growth profile. We'll be around high single-digit to double-digit till the end of the decade at least. But we are not Dupixent-dependent. Dupixent is going to contribute about a third of the growth. A third of the growth will come from already marketed products on which there is a near commercial risk and not an R&D risk. One third will come from products to be launched. I think that it's a well-diversified profile. Obviously, we're talking of profitable growth as well, which means that our ROI and our EPS will grow faster than our sales, which means that we will see discipline in our spend. Just to give you maybe a little bit more color, we do expect to continue seeing our gross margin increasing. Anyway, the product mix is probably providing a tailwind of about one percentage point a year. Just for information, we were five years ago about four to five percentage points behind our peers. Today, we are almost at par with our peers. We'll continue investing significantly in sales and marketing, given that we have a superior level of growth. We'll be disciplined and we'll make choices on R&D, but we will continue increasing our R&D spend, and we will be super disciplined on G&A, which means basically we expect to see G&A being around flat. That will give us the profitable growth. Just to add to that, I think people don't fully see how radical the transformation has been in the company. We're 30,000 people lighter than we were five years ago. An extraordinary, really, in terms of the evolution of the company. We've lost a third of our manufacturing sites. We've divested them because we're trying to position ourselves on this margin expansion and on this ROI run at profitable growth. And we're asked a lot even this morning, "Do you have enough R&D capacity? If you turn the cards over positively, can you get it done?" And we believe, because of some pruning and some prioritization, we have enough bandwidth to carry us forward to be able to launch enough to generate that third from products yet to be launched. So I think we feel very good about it. Again, we still have to show some positives out of R&D to, I think, provide the confidence that the multiple can move. And we'll come to the pipeline in a sec, but just business development in terms of supplementing the pipeline. And you talked about managing the R&D spend, being disciplined. As you look to supplement the pipeline, I suppose there's two questions. One is on that R&D, how you make room, but also what's the plan in terms of business development? More assets later, earlier? I think we thought there's two, François' comment. There's two categories for us. I think we're light in phase I. We may be eight to a dozen high-quality programs that we want to add internally, advance into phase I or to some of the conversations we have here. We'll help that. We think we're a little bit light and early. We think we have enough in mid to late stage, but I think we have to accept that to underwrite the mid-late stage pipeline, we should continue to add externally. Now, that's not an easy thing to do. It's a very competitive space with many companies with huge LOEs ahead of us are rushing to add those sort of mechanisms. We're looking for things that launch in the sort of 2028, 2029, 2030 horizon because it's just, it fits our profile better. Some are trying to go fishing much earlier than that. And we're open-minded. We have a great balance sheet. We have cash flow increasing. We have a great credit rating. We feel like we can really do some things. Last year, we took people a little bit by surprise with Provention. Now the premium on Provention looks like it was a genius piece of work. But we've got a blockbuster there and already on flight to being a blockbuster. So we're excited about that. You should see us do more things, not too toppy, but with the intent of de-risking mid-late stage and adding more aggressively in phase I. François. Yes. So in BD and M&A, we will remain very disciplined as well. And we did that in 2025. If you look at it at the beginning of 2025, we said we would like to retain our double-A rating, which gives us, in the context of the disposal of a majority of a controlling stake of Opella, but capacity for about EUR 20 billion, almost $25 billion last year. We did half of it because we didn't find the right targets. We are looking at essentially investing in our four therapeutic areas, plus potentially some white spaces. But we don't feel any pressure to do so. We would like anyway to complement what we have in our pipeline in order to drive the LOE of Dupixent, which will be coming at the beginning of the next decade. But we will remain very disciplined anyway. That's what we have done last year. We have a good track record, by the way, on BD and M&A. Just for your information, we spent, we invested, not spent, but we invested about EUR 45 billion, more than $50 billion over the last 10 years. We lost only, sorry for the only, but 10% of it, about EUR 4-5 billion, which is not a lot in our space, I would say. Even if we had not lost anything, I would have been worried that we would not have taken the right level of risk. I think that we have created a lot of value through BD and M&A. Doesn't mean, by the way, that if we did it in the past, we will do it in the future, but I think it's a good starting point. Makes sense. Maybe turning to the pipeline, and you mentioned amlitelimab, and the upcoming COAST 2 data, but maybe we could just touch on what we've seen so far from COAST 1. The data was a little bit lower efficacy than Dupixent, but that's like a simple comparison that someone like me would do. So maybe you could give us a little bit of more context on the elements of safety, efficacy, dosing profile that give us to understand the ultimate profile of the product. Thank you, Richard. First, I'm rarely complimented on all my sartorial elegance, so I appreciate the notice. I'll try and keep it. Very rarely. Very rarely. I'll try and keep it up next year. Same for me as well. To COAST 1 and amlitelimab, I think that, taking a step back, the unmet medical need in atopic dermatitis remains. We have, in partnership with Regeneron, an excellent molecule in Dupixent, but it's an area of huge biologics-eligible underpenetration, and the more molecules we can bring in and options for the patients, especially for other molecules from which there is substantial switching, I think leaves a lot of value for patients on the table. How does amlitelimab address that with a novel biology of the OX40 ligand pathway, which has a broader coverage of TH2 and innate immunity? I think we had always been hopeful that it would be an interesting contribution to patients. We had always been super clear that because of its impact on T cell biology, it would take a bit longer to get to the lofty heights of efficacy. But we always anticipated that it would continue to improve over time. So what did we find on COAST 1? We found that it was a molecule that hit its primary endpoint as expected. It continued to get better from 16-24 weeks. The posology was excellent. What I mean by that is both at Q4W and Q12W, we had a really good result. All of those speaking to the value for patients. And finally, when you asked about safety, we were clear that the safety profile was entirely consistent with the safety profile that had been anticipated at the inception of the acquisition of the molecule from Kymab and onwards. What do we have to look forward to? I think that we remain enthused and hopeful that COAST 2 will replicate many of those features of the molecule. My own preference is, of course, that we hit the primary endpoint as we did in COAST 1. That is obviously the most important thing. But actually, we retained the posology, etc. And then I want to recognize that COAST 2 is an entry ticket to filing and submission. But actually, as we build the momentum around amlitelimab, and specifically around SHORE, I think that what we'll be able to do is, and throughout the year with Estuary Aqua, Hydro, and others, we'll be able to begin to convey, A, to the community that we have a drug that continues to improve in efficacy over the year beyond 24 weeks. And secondly, and perhaps equally, and perhaps more importantly, commercially, the combination early with corticosteroids, topical corticosteroids, etc., is something that amlitelimab will exhibit. Any differences in terms of the COAST 2 patient population that could have something slightly different in terms of COAST 1? Obviously, we'd expect it to be successful. But any differences there in the trials it was recruited that could give us a different result? Yeah, broader point is that lessons learned by us and others in immunology over the last year have made it very clear that molecules that go into areas with established standard of care make those clinical trials more complicated, both in placebo response, etc. So we have to be measured and thoughtful about that. And we'll keep our eye on placebo response rates, etc., which is, I think, what you're alluding to. There are no meaningful differences in recruitment strategies that we anticipate will, in any adverse way, direct the outcome of the trial. Yeah, I think maybe it's also worth adding that if COAST 2 reads out exactly the same as COAST 1, we have a Q12 in AD, which is going to be a huge deal for patients who really, particularly naive patients who don't want to get into an every two-week injection environment. The thing about this is, as more drugs have launched, and you've seen this, Dupixent actually accelerates in its growth in volume as more medicines come in because biologic penetration is so low in AD that the more drugs come, everybody, all boats rise. There is a potential for a small group of patients to come off drug and be in disease remission. And that's another reason why it will be used widely in the naive setting because some patients will always ask, "Am I going to be on this for the rest of my life?" Well, for some, they'll be able to come off it. Not a lot, but enough to be meaningful to make that choice. If we deliver that and the increasing efficacy profile out through 48 weeks, then I think we're going to find ourselves with one of the most important medicines in AD. And so fingers crossed for COAST 2. Yeah, and Estuary you highlighted the idea of increasing efficacy with time. What gives you the confidence in that, that you might see that in Estuary? I'm going to try and walk it back and make sure everyone understands that we will have COAST 2 and SHORE coming. I said that in our late-stage pipeline review on the 16th of December. We will continue that process just to give you guys a red thread of where we're going. I think SHORE is extremely important, and I would index on SHORE as a combination topical corticosteroid therapy. And then the second point is, I think it's important that we don't over-crystal ball the likely outcomes beyond 24 weeks, up to 52 weeks. What gives us confidence, though, is the biology of amlitelimab. As you energize T cells that encounter their cognate antigen throughout the life cycle of dosing, I think you'll see that that efficacy gets better. We hope to not only give you insights through Aqua and Hydro this year to biologic inadequate responders, but I also hope that through Estuary, but also some of our open-label studies, you'll get a better sense of improving efficacy. Paul, you touched on the growth of the market with new mechanisms, multiple mechanisms. You've got amlitelimab, frexalimab with positive phase III. How do you think about developing the wider portfolio in AD? Because you could address in different mechanisms, lots of those. So do you add to that portfolio? Is that something that you'd be thinking about? We just, I think it was announced today about our STAT6 going into the clinic for the first time. I think we look at other master switches that we think could do things with different ways of administration that patients want the choice, and if we can provide that for them, we will. Not everybody is perfectly treated, and you know, in AD and in psoriasis and these other areas, people go from very difficult disease burdens to 90% clear skin, and then they start to get disappointed that it's only 90%, and then they start moving between mechanisms. It's always been like that. These are highly symptomatic, highly motivated patients. Why I love these areas, and so consequently, we're open-minded about adding new mechanisms. We have bispecifics that we can take into AD. We have multiple shots in GI. We have multiple shots in asthma and hopefully COPD because we understand that dynamic as more medicines arrive, the market expands significantly. This is not a saturated market. It's the absolute opposite. And so it is worth having new things because patients are ready for them. And that gives us huge opportunity. Yeah, just to build on that, Richard, this time last year, you asked me throughout the year about the relevance of our bispecific platform in atopic dermatitis. It was a question that you were very interested to discuss, and I think there was some perhaps minor skepticism about the role of Lunsikimig in atopic dermatitis, well, the ball is sort of caught up with us, in that last year, we thought we had an asymmetric insight into the role of TSLP in atopic dermatitis. I think there were people who questioned it based on the Tezi data. I'm very pleased to announce that wholly internally generated R&D insights encompassing the role of IL-13 and Tezi, sorry, TSLP in atopic dermatitis came from Sanofi. We created the molecule. We, as an R&D organization that was responsible, took a measured risk into atopic dermatitis. Just late last year, there was another molecule, a TSLP, long-acting TSLP molecule that went into atopic dermatitis that showed early efficacy in phase II. I think that begins to demonstrate that not only does Sanofi have asymmetric insights, we, through thoughtful portfolio allocation, take the appropriate measured risks to give us breakout value, and we will have the results of that in the near future. Interesting and maybe thoughtful portfolio allocation. Duvakitug is obviously a little bit behind others, but a very small capital outlay from you guys, but actually could have one of the better profiles as well, so maybe you could put into context for us what we're going to see on duvakitug, how you see the profile as it's developed thus far, and where we go with that. Yeah, so duvakitug is very interesting. And I've often said, we've talked about this. It's a sleeper in our portfolio. And the reason it's a sleeper is that we said at the very beginning we had the best, we thought we had a real chance of having the best molecule, both from a biophysical perspective, but also with its impact on the DR3 receptor. And I was quietly bullish about that early on. The ECCO data in 2025, both in UC and CD, confirmed that we may have not only the best-in-class molecule, but potentially, and we should be sort of completely thoughtful about how we convey this, potentially a best-in-disease molecule. Let's see whether the maintenance data plays out. That comes later in the year. But that would be pretty exciting. I think that has the potential not only to transform common or garden IBD, if such a thing exists, but also in populations in whom safety has become a relevant issue. I won't talk more about those. The only thing I will say is that you pointed correctly to the view that we increasingly will have to use our proven development muscles to ensure that we position Dupixent correctly against its competitors. Excellent. Maybe turning to MS and frexalimab, maybe thoughts on that because data on lesions was very strong. How do you see that translating both in terms of disability progression, but also ARR, which has been a more challenging endpoint across the space these days? Just a first comment that I think that as I reflect on our year last year, I think that we showed, in the face of some complexity, real commitment to the patients with MS going forward. We remain committed to those patients. For Sanofi, obviously, we are entirely thoughtful about our shareholders. But what we did with MS last year demonstrates our unequivocal commitment to patients. Point one, and I think first and foremost, it's the only thing that gets us up in the morning, or at least the first thing, so that's our thoughts with the MS patients. Number two is I think the data speaks for itself. Our secondary progressive data was striking, and we await some regulatory decisions later this quarter for tolebrutinib. More broadly, your comment about endpoints in MS, we've been entirely consistent, I think, that we've said that ARR was a very convenient measure over the last 30 years, but increasingly disability will be important. For all of our molecules, whether it's Tolly or frexalimab, and otherwise, we've ensured that we remain consistent with the views of the past with ARR. We look forward to the future with disability. Specifically for FRAX, the safety of the molecule versus efficacy, just thoughts there? Yeah, and there's multiple CD40 pathway modulators out there. The theoretical considerations with respect to risk, which are minor, have actually not played out, so touch wood, and with a recognition that we're midway through trials, we don't have any signals that we're concerned about. Okay. Maybe in the last few minutes, we could just pivot maybe to some of the new launches that were on your initial slide, Wayrills, the COVID vaccine. I'm not even going to attempt. I can't even remember the brand, anyway. Producer round. Indeed. You know where I'm going. So yeah, thoughts on those progression of the launches, how they're doing, what we should think about them contributing to the growth? You know, we've been extremely effective on our launches. You look at Beyfortus, you look at Altuviiio. We've really, I think, surprised a lot of people with just how effective that we've been. Dupixent, well, we're not going to share the data because it's still early, is ahead of our expectations. And that's kudos to the team and everything that's being done by Brian and his guys. Dupixent is, and it's just getting started given the number of indications that it's going to have. So we're very happy with that. Fitusiran in hemophilia is a much slower start, but completely as anticipated because this is like a very specific tailoring of the medicine to each individual. But it is a true every eight-week dose for people with hemophilia. This is a life-changing moment. Slow and steady as people get up to speed with how to administer, but we're very encouraged by that too. In general, I think our commercial engine and our late-stage development and the team and regulatory on the labels have done an extraordinary job because we're really able to go and get share and to really land with some substance commercially. The question remains, can we bring duvakitug, amlitelimab, lunsekimig, can we provide data this year that gives people the confidence that we have two, three, four, five billion-dollar medicines that are coming behind to put in this excellent launch machine? Makes sense. And Ayvakit going well as well? Yes. Yeah, really well. I mean, it was, as I mentioned upfront, but it's a year ago since we began those conversations with Provention. I look at how deals are being done now and premiums being paid. I think we paid around 30% premium. We paid exactly what we'd hoped to pay, and we inherited a medicine that is really positively surprising everybody that was early in its launch phase. That profile for us, which means it continued to grow through Dupixent LOE, and the fact that it has a follow-on, LCM, the name, and the fact that it has a wild-type shot also in immunology further back in the pipeline made the profile a perfect overlay for us. Very happy with the Ayvakit performance. And again, Brian and his team and how they've integrated it and how they've kept the momentum is great. Makes sense. And François and you talked about François talked about Dupi being a third of the growth. On that third, how's that going in terms of the new launches, CSU, COPD, a smaller part of AD? AD will, as we've discussed multiple times, will grow for a very long time. But what's the growth outlook there? The growth's incredible. Are we eight years in, and we're growing close to 30% on a drug that was over EUR four billion on the quarter. This is incredible work by the team and incredible work on choosing the follow-on indications. It'll slow a little this year from that heady height because, of course, we've anniversaried COPD, CSU. So we're realistic, but it'll still be the dominant player. It'll be growing till its very last day. It's one of those rare combinations of medicines with extraordinary efficacy and extraordinary safety that launch first in class. That's why new mechanisms, new lengths of treatment, possibly for remission. That's why those things are what physicians want now for naive patients. But Dupixent is going to run hard right till its last day. Very proud to be involved in it. The growth rate's really incredible. And your partner showed a little bit of color maybe on that last day in terms of next generation products or longer duration. Is there any color on that last day from a Sanofi point of view? You know, depending on our own assumptions are a minimum of 2031, 2032 for Dupixent. If we take IPD as a sort of consensus, we're more likely 2033, 2034. That far out, it's not always good to overshare what you plan to do because there are plenty of companies that are waiting for a hint so they can then operationalize what they want to do to disrupt what we plan to do. I'm well aware, though, given the setbacks we had last year, the scrutiny around the Dupixent LOE and how we manage it has perhaps been brought even further forward. I know Len and the team have started to share a little bit of our philosophy. And I think 2026 is the year where we're going to be much more open about our intentions on how to manage Dupixent effectively for patients. Also what might be the opportunities around it and after it that we can do with our great partners, Regeneron. Makes sense. Maybe two other growthy questions. Altuviiio's had a, and was mentioned on the slide, going to be near blockbuster or blockbuster. Yeah. I mean, there is more competition in the same area as Hemlibra, launching at the end of 2026. But how much more room to go is there with Altuviiio, I suppose, is the question. I think the market sort of split, right? For a long time, it was three infusions a week. Then you had the options with Hemlibra to be monthly. Sadly, many of those patients ended up weekly. Altuviiio came and gave people a normal annual bleeding rate at a weekly dose. That gave people the opportunity to live a normal life, particularly young adults. While it didn't sound sexy, certainly I remember reading one of your notes, while it didn't sound sexy at the time, the fact that it's going on to be a blockbuster is a sort of affirmation that living a normal life, even at a weekly dose, is a very credible aspiration for patients. We've seen that pulled up very clearly. There's going to be new entrants on monthly. Fitusiran is every eight weeks. We're going to see the patients sort of split between, do I want the most convenience or do I want to live the most normal life? I think even with the new monthlies that are coming, their ABRs are not zero. So we just have to recognize that those trades will be made. Lots of opportunity in the factor market and beyond for Altuviiio. Fantastic. Maybe last question, just returning to Beyfortus, we talked about some of the pressures in the US. You highlighted the very strong efficacy. Maybe you could talk about how that strength of efficacy brings new countries on board and patients ex-US and the growth potential there because while the US is big, the world is quite a lot bigger. So how do you think? That's real insight for me, by the way. I think what surprised everybody about Beyfortus was for healthcare systems, it was a current fiscal year payback. It's a premium-priced vaccine approach, even though it's a monoclonal antibody. And that meant that access was within reach for almost every baby that needed the protection. What surprised people next was the data accumulated so fast. We spent a lot of time perfecting the real-world evidence data so that payers could look and make a decision very quickly. If you invest in protecting babies with Beyfortus, you will avoid significant costs this year. Now, with health systems under pressure financially, current year paybacks are a gift to health systems. And that's before we even get to babies who are protected, babies who can avoid some very difficult days in the ICU. So I think people saw very quickly, if you look at our revenue and how quickly it became a blockbuster, it's the most successful pediatric vaccination launch in the history of vaccines. So people see it as incredibly effective. The real-world evidence that has been accumulated showed that it absolutely pays back within a current year and protects those babies. And that is just a gift to parents, but it's also a gift to healthcare systems. So we have work to do. There's competition. We think our half-life guarantees us to protect a baby for the entire RSV season. We think we may be wrong that the competition doesn't offer that. We'll find out. But we've accumulated so much real-world evidence data, it's quite difficult for others to demonstrate this data set we have at launch because we're in great shape on Beyfortus. Perfect. Thanks very much, Paul. Thanks, François. Thanks, Houman. Thanks, everybody.

Speaker 1: Welcome to the J.P. Morgan Healthcare Conference. I'm Richard Vosser, European Pharma Analyst with J.P. Morgan. It's my great pleasure to introduce Sanofi from the conference. We have three of the very senior management here to entertain us now: Paul Hudson, CEO, François-Xavier Roger, CFO, and Houman Ashrafian... Welcome to the J.P. welcome to the j.p Morgan Healthcare Conference. morgan healthcare conference I'm Richard Vosser, European Pharma Analyst with J.P. i'm richard vosser european pharma analyst with j.p Morgan. morgan It's my great pleasure to introduce Sanofi from the conference. it's my great pleasure to introduce sanofi from the conference We have three of the very senior management here to entertain us now: Paul Hudson, CEO, François-Xavier Roger, CFO, and Houman Ashrafian... we have three of the very senior management here to entertain us now paul hudson ceo françois-xavier roger cfo and houman ashrafian

Speaker 4: You fully butchered every name. You fully butchered every name. you fully butchered every name

Speaker 1: Every name, every year. Every name, every year. every name every year

Speaker 4: Every year. Every year. every year

Speaker 1: It's consistent. That's what we like. So I better shut up then and hand to Paul for a few introductory remarks, and then we're going to chat together. It's consistent. it's consistent That's what we like. that's what we like So I better shut up then and hand to Paul for a few introductory remarks, and then we're going to chat together. so i better shut up then and hand to paul for a few introductory remarks and then we're going to chat together

Speaker 4: Thank you, Mr. Vosser. We appreciate that. Thank you, Mr. Vosser. thank you mr vosser We appreciate that. we appreciate that

Speaker 1: That was wrong, Paul. That was wrong, Paul. that was wrong paul

Speaker 4: Great. We only have a handful of slides, but I'll just... I have one, Houman has a couple. Thank you for making the time. It's been an extremely busy year last year for us, and we had a couple of challenges in R&D, which I think are well communicated. We also made very important commercial progress. We were growing 8.7% through Q3. Script trends, if they stay consistent through the remainder of the year across the major drivers of that, we're going to be close to double-digit growth. That double-digit growth profile, we think we can maintain for the next half-decade plus. And that puts us in quite a rare group in terms of how well we're executing. We have a new blockbuster with Altuviiio. We've got close to $4 billion in launch revenue, so we're working fast to offset the potential Dupixent LOE in the future. Great. great We only have a handful of slides, but I'll just... we only have a handful of slides but i'll just i I have one, Houman has a couple. i have one houman has a couple Thank you for making the time. thank you for making the time It's been an extremely busy year last year for us, and we had a couple of challenges in R&D, which I think are well communicated. it's been an extremely busy year last year for us and we had a couple of challenges in r&d which i think are well communicated We also made very important commercial progress. we also made very important commercial progress We were growing 8.7% through Q3. we were growing 8.7% through q3 Script trends, if they stay consistent through the remainder of the year across the major drivers of that, we're going to be close to double-digit growth. script trends if they stay consistent through the remainder of the year across the major drivers of that we're going to be close to double-digit growth That double-digit growth profile, we think we can maintain for the next half-decade plus. that double-digit growth profile we think we can maintain for the next half-decade plus And that puts us in quite a rare group in terms of how well we're executing. and that puts us in quite a rare group in terms of how well we're executing We have a new blockbuster with Altuviiio. we have a new blockbuster with altuviiio We've got close to $4 billion in launch revenue, so we're working fast to offset the potential Dupixent LOE in the future. we've got close to $4 billion in launch revenue so we're working fast to offset the potential dupixent loe in the future And we have the ambition to grow EPS through the Dupixent LOE. So we're well underway on our plan, our transformation, our capital allocation. We've exited consumer. We hopefully have added Inhibrx. We've done some things to try and continually modernize and equip us best for the future. We executed on Provention. We're delighted with that. And so the journey really strongly continues for us. We're well aware that we have a lot to prove still in R&D. We have some huge readouts ahead of us early this year. And with that, maybe I'll hand a little bit to Houman. And we have the ambition to grow EPS through the Dupixent LOE. and we have the ambition to grow eps through the dupixent loe So we're well underway on our plan, our transformation, our capital allocation. so we're well underway on our plan our transformation our capital allocation We've exited consumer. we've exited consumer We hopefully have added Inhibrx. we hopefully have added inhibrx We've done some things to try and continually modernize and equip us best for the future. we've done some things to try and continually modernize and equip us best for the future We executed on Provention. we executed on provention We're delighted with that. we're delighted with that And so the journey really strongly continues for us. and so the journey really strongly continues for us We're well aware that we have a lot to prove still in R&D. we're well aware that we have a lot to prove still in r&d We have some huge readouts ahead of us early this year. we have some huge readouts ahead of us early this year And with that, maybe I'll hand a little bit to Houman. and with that maybe i'll hand a little bit to houman

Speaker 2: Thank you, Paul. Happy New Year. Last time I'll say that. Delighted to be here at J.P. Morgan. As you can see from this slide in immunology, we have an exciting year ahead of us. Amlitelimab will read out COAST 2 in the near future. It's important to also call out there's a number of other studies coming, including SHORE, which is the combination study with topical corticosteroids. Germane to how atopic dermatitis is practiced today. Look forward to those. But it's not all about our rockstar amlitelimab. We have Dupixent COPD data coming later in the year, anti-TL1A in partnership with Teva. And we have excellent and interesting opportunities to assess the value of combination therapies in bispecifics in asthma and beyond in Lunsekimig. It's not all about immunology and autoimmune disease. We are excited to be a rare disease company and our commitment to the patients remains. Thank you, Paul. thank you paul Happy New Year. happy new year Last time I'll say that. last time i'll say that Delighted to be here at J.P. delighted to be here at j.p Morgan. morgan As you can see from this slide in immunology, we have an exciting year ahead of us. as you can see from this slide in immunology we have an exciting year ahead of us Amlitelimab will read out COAST 2 in the near future. amlitelimab will read out coast 2 in the near future It's important to also call out there's a number of other studies coming, including SHORE, which is the combination study with topical corticosteroids. it's important to also call out there's a number of other studies coming including shore which is the combination study with topical corticosteroids Germane to how atopic dermatitis is practiced today. germane to how atopic dermatitis is practiced today Look forward to those. look forward to those But it's not all about our rockstar amlitelimab. but it's not all about our rockstar amlitelimab We have Dupixent COPD data coming later in the year, anti-TL1A in partnership with Teva. we have dupixent copd data coming later in the year anti-tl1a in partnership with teva And we have excellent and interesting opportunities to assess the value of combination therapies in bispecifics in asthma and beyond in Lunsekimig. and we have excellent and interesting opportunities to assess the value of combination therapies in bispecifics in asthma and beyond in lunsekimig It's not all about immunology and autoimmune disease. it's not all about immunology and autoimmune disease We are excited to be a rare disease company and our commitment to the patients remains. we are excited to be a rare disease company and our commitment to the patients remains We have a number of rare disease and oncology readouts, and we continue to be active both in vaccines and in neurology. As you can see on the next slide, the data flow is substantial in the first half of the year and will be extended further throughout the year, both in terms of early and late trial readouts as well as regulatory approvals. It's a good year to look forward to, and we will supplement, being here in J.P. Morgan, apropos, we'll supplement a commendable internal pipeline with partners that already exist in partners of the future. We have a number of rare disease and oncology readouts, and we continue to be active both in vaccines and in neurology. we have a number of rare disease and oncology readouts and we continue to be active both in vaccines and in neurology As you can see on the next slide, the data flow is substantial in the first half of the year and will be extended further throughout the year, both in terms of early and late trial readouts as well as regulatory approvals. as you can see on the next slide the data flow is substantial in the first half of the year and will be extended further throughout the year both in terms of early and late trial readouts as well as regulatory approvals It's a good year to look forward to, and we will supplement, being here in J.P. it's a good year to look forward to and we will supplement being here in j.p Morgan, apropos, we'll supplement a commendable internal pipeline with partners that already exist in partners of the future. morgan apropos we'll supplement a commendable internal pipeline with partners that already exist in partners of the future

Speaker 1: Excellent. Thanks, Houman. Thanks, Paul. Maybe we could start. Maybe I'll just compliment the jacket this year. It's very, very nice. Excellent. excellent Thanks, Houman. thanks houman Thanks, Paul. thanks paul Maybe we could start. maybe we could start Maybe I'll just compliment the jacket this year. maybe i'll just compliment the jacket this year It's very, very nice. it's very very nice

Speaker 2: Thank you very much. Thank you very much. thank you very much

Speaker 1: Socks last year, jacket this year. But Paul, you were in the White House at the end of last year. Maybe you could just talk about your thinking on U.S. pricing going forward for the industry. You're going to be head of pharma this year as well. But the impact for Sanofi, what are we thinking? Socks last year, jacket this year. socks last year jacket this year But Paul, you were in the White House at the end of last year. but paul you were in the white house at the end of last year Maybe you could just talk about your thinking on U.S. pricing going forward for the industry. maybe you could just talk about your thinking on u.s pricing going forward for the industry You're going to be head of pharma this year as well. you're going to be head of pharma this year as well But the impact for Sanofi, what are we thinking? but the impact for sanofi what are we thinking

Speaker 4: We've said over the short term, we'll have to work very hard to make the impact manageable, and that's our intent. It was, like for everybody, a tough negotiation with the government. I think they got, I think, what they needed, but we felt well represented. Some of the team that pulled that together are in the room today, and congratulations to them. I think most of the companies found themselves roughly in the same place. It was, I think, as François calls it, cost avoidance. The tariff piece was an unnecessary drag on the thinking for 2026. We've been able to remove that. We've made some concessions to do that, but I think we feel very comfortable in our outlook. We haven't shared 2026 guidance yet, but when we do, you'll hopefully understand how we put those two things together. We've said over the short term, we'll have to work very hard to make the impact manageable, and that's our intent. we've said over the short term we'll have to work very hard to make the impact manageable and that's our intent It was, like for everybody, a tough negotiation with the government. it was like for everybody a tough negotiation with the government I think they got, I think, what they needed, but we felt well represented. i think they got i think what they needed but we felt well represented Some of the team that pulled that together are in the room today, and congratulations to them. some of the team that pulled that together are in the room today and congratulations to them I think most of the companies found themselves roughly in the same place. i think most of the companies found themselves roughly in the same place It was, I think, as François calls it, cost avoidance. it was i think as françois calls it cost avoidance The tariff piece was an unnecessary drag on the thinking for 2026. the tariff piece was an unnecessary drag on the thinking for 2026 We've been able to remove that. we've been able to remove that We've made some concessions to do that, but I think we feel very comfortable in our outlook. we've made some concessions to do that but i think we feel very comfortable in our outlook We haven't shared 2026 guidance yet, but when we do, you'll hopefully understand how we put those two things together. we haven't shared 2026 guidance yet but when we do you'll hopefully understand how we put those two things together The White House experience is really for an after-dinner environment to go into more detail on that, but the president did say something extremely important at the end of his speech. If you were watching very carefully, he said, "Now we turn our attention to the insurers," and I think as incoming chair of pharma, that's a very important statement that he's made. If he attacks it with the same level of energy as he did MFN, that may be an opportunity, and it also may be a challenge. I offered to bring pharma back to the table to make sure that he felt that we'd be good partners in making sure that we create even more visibility with the insurers for the benefit of patients in the United States. The White House experience is really for an after-dinner environment to go into more detail on that, but the president did say something extremely important at the end of his speech. the white house experience is really for an after-dinner environment to go into more detail on that but the president did say something extremely important at the end of his speech If you were watching very carefully, he said, "Now we turn our attention to the insurers," and I think as incoming chair of pharma, that's a very important statement that he's made. if you were watching very carefully he said "now we turn our attention to the insurers," and i think as incoming chair of pharma that's a very important statement that he's made If he attacks it with the same level of energy as he did MFN, that may be an opportunity, and it also may be a challenge. if he attacks it with the same level of energy as he did mfn that may be an opportunity and it also may be a challenge I offered to bring pharma back to the table to make sure that he felt that we'd be good partners in making sure that we create even more visibility with the insurers for the benefit of patients in the United States. i offered to bring pharma back to the table to make sure that he felt that we'd be good partners in making sure that we create even more visibility with the insurers for the benefit of patients in the united states Lastly, the comment really about the complexity around GDP-adjusted pricing in basket countries outside of the U.S. and what that means for future launches. I've met many heads of state in Europe over the last few months. Obviously, they're concerned at the level of U.S. attention to pricing and what it might mean for new launches. They're right to be concerned. But frankly, as I said to three heads of state in Europe the last quarter of the year, 54% of medicines that are approved by the EMA are not available in Europe today, long before the president turned his attention to it. So they have some work to do to reward innovation, and we'll be looking at that too. Lastly, the comment really about the complexity around GDP-adjusted pricing in basket countries outside of the U.S. and what that means for future launches. lastly the comment really about the complexity around gdp-adjusted pricing in basket countries outside of the u.s and what that means for future launches I've met many heads of state in Europe over the last few months. i've met many heads of state in europe over the last few months Obviously, they're concerned at the level of U.S. attention to pricing and what it might mean for new launches. obviously they're concerned at the level of u.s attention to pricing and what it might mean for new launches They're right to be concerned. they're right to be concerned But frankly, as I said to three heads of state in Europe the last quarter of the year, 54% of medicines that are approved by the EMA are not available in Europe today, long before the president turned his attention to it. but frankly as i said to three heads of state in europe the last quarter of the year 54% of medicines that are approved by the ema are not available in europe today long before the president turned his attention to it So they have some work to do to reward innovation, and we'll be looking at that too. so they have some work to do to reward innovation and we'll be looking at that too

Speaker 1: And just one other comment in this area, the vaccine policy. We've seen some policy changes, CDC recommendations, etc. Just how should we think about that from your business point of view? I suppose we're particularly thinking about Beyfortus and some of the RSV changes. And just one other comment in this area, the vaccine policy. and just one other comment in this area the vaccine policy We've seen some policy changes, CDC recommendations, etc. Just how should we think about that from your business point of view? we've seen some policy changes cdc recommendations etc just how should we think about that from your business point of view I suppose we're particularly thinking about Beyfortus and some of the RSV changes. i suppose we're particularly thinking about beyfortus and some of the rsv changes

Speaker 4: Look, there's 50,000+ newborns that were going into the ICU in the United States every year in very distressing circumstances, many with complications that lived long after the RSV had passed. We'd been able to drop that close to 80%-90% with the launch of Beyfortus. Very proud of the work. It's clear this administration has a particular sensitivity around vaccination and indeed pediatric vaccination, preferring to give the parents the choice. We know that is a very delicate line to walk because not everybody's well-informed. Of course, when you're trying to protect communities, that leaves too much open to variability. We can't do much. I'm asked all the time, "What are you going to do to fix this?" The truth is, we just need to stay extremely objective and keep presenting the evidence. There's really very little else we can do. Look, there's 50,000+ newborns that were going into the ICU in the United States every year in very distressing circumstances, many with complications that lived long after the RSV had passed. look there's 50,000+ newborns that were going into the icu in the united states every year in very distressing circumstances many with complications that lived long after the rsv had passed We'd been able to drop that close to 80%-90% with the launch of Beyfortus. we'd been able to drop that close to 80%-90% with the launch of beyfortus Very proud of the work. very proud of the work It's clear this administration has a particular sensitivity around vaccination and indeed pediatric vaccination, preferring to give the parents the choice. it's clear this administration has a particular sensitivity around vaccination and indeed pediatric vaccination preferring to give the parents the choice We know that is a very delicate line to walk because not everybody's well-informed. we know that is a very delicate line to walk because not everybody's well-informed Of course, when you're trying to protect communities, that leaves too much open to variability. of course when you're trying to protect communities that leaves too much open to variability We can't do much. we can't do much I'm asked all the time, "What are you going to do to fix this?" The truth is, we just need to stay extremely objective and keep presenting the evidence. i'm asked all the time "what are you going to do to fix this?" the truth is we just need to stay extremely objective and keep presenting the evidence There's really very little else we can do. there's really very little else we can do Then we'll see where Kennedy gets to. We'll see how it gets through the midterms. And for most of our work, we plan longer than three years. So we will have to maintain a steely focus on the long-term future of vaccines and deal with any uncertainty around vaccine coverage rates in the short term based on misinformation, Facebook posts, and statements from the top. We're just going to have to deal with it, try and provide patients and parents the very best advice we can. Then we'll see where Kennedy gets to. then we'll see where kennedy gets to We'll see how it gets through the midterms. we'll see how it gets through the midterms And for most of our work, we plan longer than three years. and for most of our work we plan longer than three years So we will have to maintain a steely focus on the long-term future of vaccines and deal with any uncertainty around vaccine coverage rates in the short term based on misinformation, Facebook posts, and statements from the top. so we will have to maintain a steely focus on the long-term future of vaccines and deal with any uncertainty around vaccine coverage rates in the short term based on misinformation facebook posts and statements from the top We're just going to have to deal with it, try and provide patients and parents the very best advice we can. we're just going to have to deal with it try and provide patients and parents the very best advice we can

Speaker 1: In your opening slide, you highlighted the strong growth of the first nine months and highlighted strong growth potential out towards 2030. How should we think about that growth developing going forward 26 and beyond relative to the near double-digit or around double-digit 25? In your opening slide, you highlighted the strong growth of the first nine months and highlighted strong growth potential out towards 2030. in your opening slide you highlighted the strong growth of the first nine months and highlighted strong growth potential out towards 2030 How should we think about that growth developing going forward 26 and beyond relative to the near double-digit or around double-digit 25? how should we think about that growth developing going forward 26 and beyond relative to the near double-digit or around double-digit 25

Speaker 4: I'll let François comment on the profitable nature of the growth, but I raise it upfront because to have high single-digit, close to double-digit growth with a clear line of sight through 2030 and perhaps beyond with that puts us in a rather unique club. We're well aware of the journey this company's been on. We've simplified again. We've become more of an R&D-led pharma company and got away from consumer. And we've done everything to really make the company one of the sort of leading R&D-led organizations. We're still missing the proof points, I'm first to admit it. And we've taken a lot of shots that are first-in-class, best-in-class. With the readouts that are just up ahead of us, we hope to reclaim some of the sentiment in our direction because we're trying to navigate what we call the two very simple basics: top-line pipeline, top-line pipeline. I'll let François comment on the profitable nature of the growth, but I raise it upfront because to have high single-digit, close to double-digit growth with a clear line of sight through 2030 and perhaps beyond with that puts us in a rather unique club. i'll let françois comment on the profitable nature of the growth but i raise it upfront because to have high single-digit close to double-digit growth with a clear line of sight through 2030 and perhaps beyond with that puts us in a rather unique club We're well aware of the journey this company's been on. we're well aware of the journey this company's been on We've simplified again. we've simplified again We've become more of an R&D-led pharma company and got away from consumer. we've become more of an r&d-led pharma company and got away from consumer And we've done everything to really make the company one of the sort of leading R&D-led organizations. and we've done everything to really make the company one of the sort of leading r&d-led organizations We're still missing the proof points, I'm first to admit it. we're still missing the proof points i'm first to admit it And we've taken a lot of shots that are first-in-class, best-in-class. and we've taken a lot of shots that are first-in-class best-in-class With the readouts that are just up ahead of us, we hope to reclaim some of the sentiment in our direction because we're trying to navigate what we call the two very simple basics: top-line pipeline, top-line pipeline. with the readouts that are just up ahead of us we hope to reclaim some of the sentiment in our direction because we're trying to navigate what we call the two very simple basics top-line pipeline top-line pipeline Top-line, we're one of the most predictable in the big pharmas because of the lack of LOEs. Pipeline, we're still a previous self. But to talk about the profitable growth, François, maybe you want to comment. Top-line, we're one of the most predictable in the big pharmas because of the lack of LOEs. top-line we're one of the most predictable in the big pharmas because of the lack of loes Pipeline, we're still a previous self. pipeline we're still a previous self But to talk about the profitable growth, François, maybe you want to comment. but to talk about the profitable growth françois maybe you want to comment

Speaker 3: Maybe to complement what Paul said, what is important to understand as well is our growth profile. We'll be around high single-digit to double-digit till the end of the decade at least. But we are not Dupixent-dependent. Dupixent is going to contribute about a third of the growth. A third of the growth will come from already marketed products on which there is a near commercial risk and not an R&D risk. One third will come from products to be launched. I think that it's a well-diversified profile. Obviously, we're talking of profitable growth as well, which means that our ROI and our EPS will grow faster than our sales, which means that we will see discipline in our spend. Just to give you maybe a little bit more color, we do expect to continue seeing our gross margin increasing. Maybe to complement what Paul said, what is important to understand as well is our growth profile. maybe to complement what paul said what is important to understand as well is our growth profile We'll be around high single-digit to double-digit till the end of the decade at least. we'll be around high single-digit to double-digit till the end of the decade at least But we are not Dupixent-dependent. but we are not dupixent-dependent Dupixent is going to contribute about a third of the growth. dupixent is going to contribute about a third of the growth A third of the growth will come from already marketed products on which there is a near commercial risk and not an R&D risk. a third of the growth will come from already marketed products on which there is a near commercial risk and not an r&d risk One third will come from products to be launched. one third will come from products to be launched I think that it's a well-diversified profile. i think that it's a well-diversified profile Obviously, we're talking of profitable growth as well, which means that our ROI and our EPS will grow faster than our sales, which means that we will see discipline in our spend. obviously we're talking of profitable growth as well which means that our roi and our eps will grow faster than our sales which means that we will see discipline in our spend Just to give you maybe a little bit more color, we do expect to continue seeing our gross margin increasing. just to give you maybe a little bit more color we do expect to continue seeing our gross margin increasing Anyway, the product mix is probably providing a tailwind of about one percentage point a year. Just for information, we were five years ago about four to five percentage points behind our peers. Today, we are almost at par with our peers. We'll continue investing significantly in sales and marketing, given that we have a superior level of growth. We'll be disciplined and we'll make choices on R&D, but we will continue increasing our R&D spend, and we will be super disciplined on G&A, which means basically we expect to see G&A being around flat. That will give us the profitable growth. Anyway, the product mix is probably providing a tailwind of about one percentage point a year. anyway the product mix is probably providing a tailwind of about one percentage point a year Just for information, we were five years ago about four to five percentage points behind our peers. just for information we were five years ago about four to five percentage points behind our peers Today, we are almost at par with our peers. today we are almost at par with our peers We'll continue investing significantly in sales and marketing, given that we have a superior level of growth. we'll continue investing significantly in sales and marketing given that we have a superior level of growth We'll be disciplined and we'll make choices on R&D, but we will continue increasing our R&D spend, and we will be super disciplined on G&A, which means basically we expect to see G&A being around flat. we'll be disciplined and we'll make choices on r&d but we will continue increasing our r&d spend and we will be super disciplined on g&a which means basically we expect to see g&a being around flat That will give us the profitable growth. that will give us the profitable growth

Speaker 4: Just to add to that, I think people don't fully see how radical the transformation has been in the company. We're 30,000 people lighter than we were five years ago. An extraordinary, really, in terms of the evolution of the company. We've lost a third of our manufacturing sites. We've divested them because we're trying to position ourselves on this margin expansion and on this ROI run at profitable growth. And we're asked a lot even this morning, "Do you have enough R&D capacity? If you turn the cards over positively, can you get it done?" And we believe, because of some pruning and some prioritization, we have enough bandwidth to carry us forward to be able to launch enough to generate that third from products yet to be launched. So I think we feel very good about it. Just to add to that, I think people don't fully see how radical the transformation has been in the company. just to add to that i think people don't fully see how radical the transformation has been in the company We're 30,000 people lighter than we were five years ago. we're 30,000 people lighter than we were five years ago An extraordinary, really, in terms of the evolution of the company. an extraordinary really in terms of the evolution of the company We've lost a third of our manufacturing sites. we've lost a third of our manufacturing sites We've divested them because we're trying to position ourselves on this margin expansion and on this ROI run at profitable growth. we've divested them because we're trying to position ourselves on this margin expansion and on this roi run at profitable growth And we're asked a lot even this morning, "Do you have enough R&D capacity? and we're asked a lot even this morning "do you have enough r&d capacity If you turn the cards over positively, can you get it done?" And we believe, because of some pruning and some prioritization, we have enough bandwidth to carry us forward to be able to launch enough to generate that third from products yet to be launched. if you turn the cards over positively can you get it done?" and we believe because of some pruning and some prioritization we have enough bandwidth to carry us forward to be able to launch enough to generate that third from products yet to be launched So I think we feel very good about it. so i think we feel very good about it Again, we still have to show some positives out of R&D to, I think, provide the confidence that the multiple can move. Again, we still have to show some positives out of R&D to, I think, provide the confidence that the multiple can move. again we still have to show some positives out of r&d to i think provide the confidence that the multiple can move

Speaker 1: And we'll come to the pipeline in a sec, but just business development in terms of supplementing the pipeline. And you talked about managing the R&D spend, being disciplined. As you look to supplement the pipeline, I suppose there's two questions. One is on that R&D, how you make room, but also what's the plan in terms of business development? More assets later, earlier? And we'll come to the pipeline in a sec, but just business development in terms of supplementing the pipeline. and we'll come to the pipeline in a sec but just business development in terms of supplementing the pipeline And you talked about managing the R&D spend, being disciplined. and you talked about managing the r&d spend being disciplined As you look to supplement the pipeline, I suppose there's two questions. as you look to supplement the pipeline i suppose there's two questions One is on that R&D, how you make room, but also what's the plan in terms of business development? one is on that r&d how you make room but also what's the plan in terms of business development More assets later, earlier? more assets later earlier

Speaker 4: I think we thought there's two, François' comment. There's two categories for us. I think we're light in phase I. We may be eight to a dozen high-quality programs that we want to add internally, advance into phase I or to some of the conversations we have here. We'll help that. We think we're a little bit light and early. We think we have enough in mid to late stage, but I think we have to accept that to underwrite the mid-late stage pipeline, we should continue to add externally. Now, that's not an easy thing to do. It's a very competitive space with many companies with huge LOEs ahead of us are rushing to add those sort of mechanisms. We're looking for things that launch in the sort of 2028, 2029, 2030 horizon because it's just, it fits our profile better. I think we thought there's two, François' comment. i think we thought there's two françois' comment There's two categories for us. there's two categories for us I think we're light in phase I. i think we're light in phase i We may be eight to a dozen high-quality programs that we want to add internally, advance into phase I or to some of the conversations we have here. we may be eight to a dozen high-quality programs that we want to add internally advance into phase i or to some of the conversations we have here We'll help that. we'll help that We think we're a little bit light and early. we think we're a little bit light and early We think we have enough in mid to late stage, but I think we have to accept that to underwrite the mid-late stage pipeline, we should continue to add externally. we think we have enough in mid to late stage but i think we have to accept that to underwrite the mid-late stage pipeline we should continue to add externally Now, that's not an easy thing to do. now that's not an easy thing to do It's a very competitive space with many companies with huge LOEs ahead of us are rushing to add those sort of mechanisms. it's a very competitive space with many companies with huge loes ahead of us are rushing to add those sort of mechanisms We're looking for things that launch in the sort of 2028, 2029, 2030 horizon because it's just, it fits our profile better. we're looking for things that launch in the sort of 2028 2029 2030 horizon because it's just it fits our profile better Some are trying to go fishing much earlier than that. And we're open-minded. We have a great balance sheet. We have cash flow increasing. We have a great credit rating. We feel like we can really do some things. Last year, we took people a little bit by surprise with Provention. Now the premium on Provention looks like it was a genius piece of work. But we've got a blockbuster there and already on flight to being a blockbuster. So we're excited about that. You should see us do more things, not too toppy, but with the intent of de-risking mid-late stage and adding more aggressively in phase I. François. Some are trying to go fishing much earlier than that. some are trying to go fishing much earlier than that And we're open-minded. and we're open-minded We have a great balance sheet. we have a great balance sheet We have cash flow increasing. we have cash flow increasing We have a great credit rating. we have a great credit rating We feel like we can really do some things. we feel like we can really do some things Last year, we took people a little bit by surprise with Provention. last year we took people a little bit by surprise with provention Now the premium on Provention looks like it was a genius piece of work. now the premium on provention looks like it was a genius piece of work But we've got a blockbuster there and already on flight to being a blockbuster. but we've got a blockbuster there and already on flight to being a blockbuster So we're excited about that. so we're excited about that You should see us do more things, not too toppy, but with the intent of de-risking mid-late stage and adding more aggressively in phase I. you should see us do more things not too toppy but with the intent of de-risking mid-late stage and adding more aggressively in phase i François. françois

Speaker 3: Yes. So in BD and M&A, we will remain very disciplined as well. And we did that in 2025. If you look at it at the beginning of 2025, we said we would like to retain our double-A rating, which gives us, in the context of the disposal of a majority of a controlling stake of Opella, but capacity for about EUR 20 billion, almost $25 billion last year. We did half of it because we didn't find the right targets. We are looking at essentially investing in our four therapeutic areas, plus potentially some white spaces. But we don't feel any pressure to do so. We would like anyway to complement what we have in our pipeline in order to drive the LOE of Dupixent, which will be coming at the beginning of the next decade. But we will remain very disciplined anyway. Yes. yes So in BD and M&A, we will remain very disciplined as well. so in bd and m&a we will remain very disciplined as well And we did that in 2025. and we did that in 2025 If you look at it at the beginning of 2025, we said we would like to retain our double-A rating, which gives us, in the context of the disposal of a majority of a controlling stake of Opella, but capacity for about EUR 20 billion, almost $25 billion last year. if you look at it at the beginning of 2025 we said we would like to retain our double-a rating which gives us in the context of the disposal of a majority of a controlling stake of opella but capacity for about eur 20 billion almost $25 billion last year We did half of it because we didn't find the right targets. we did half of it because we didn't find the right targets We are looking at essentially investing in our four therapeutic areas, plus potentially some white spaces. we are looking at essentially investing in our four therapeutic areas plus potentially some white spaces But we don't feel any pressure to do so. but we don't feel any pressure to do so We would like anyway to complement what we have in our pipeline in order to drive the LOE of Dupixent, which will be coming at the beginning of the next decade. we would like anyway to complement what we have in our pipeline in order to drive the loe of dupixent which will be coming at the beginning of the next decade But we will remain very disciplined anyway. but we will remain very disciplined anyway That's what we have done last year. We have a good track record, by the way, on BD and M&A. Just for your information, we spent, we invested, not spent, but we invested about EUR 45 billion, more than $50 billion over the last 10 years. We lost only, sorry for the only, but 10% of it, about EUR 4-5 billion, which is not a lot in our space, I would say. Even if we had not lost anything, I would have been worried that we would not have taken the right level of risk. I think that we have created a lot of value through BD and M&A. Doesn't mean, by the way, that if we did it in the past, we will do it in the future, but I think it's a good starting point. That's what we have done last year. that's what we have done last year We have a good track record, by the way, on BD and M&A. we have a good track record by the way on bd and m&a Just for your information, we spent, we invested, not spent, but we invested about EUR 45 billion, more than $50 billion over the last 10 years. just for your information we spent we invested not spent but we invested about eur 45 billion more than $50 billion over the last 10 years We lost only, sorry for the only, but 10% of it, about EUR 4-5 billion, which is not a lot in our space, I would say. we lost only sorry for the only but 10% of it about eur 4-5 billion which is not a lot in our space i would say Even if we had not lost anything, I would have been worried that we would not have taken the right level of risk. even if we had not lost anything i would have been worried that we would not have taken the right level of risk I think that we have created a lot of value through BD and M&A. i think that we have created a lot of value through bd and m&a Doesn't mean, by the way, that if we did it in the past, we will do it in the future, but I think it's a good starting point. doesn't mean by the way that if we did it in the past we will do it in the future but i think it's a good starting point

Speaker 1: Makes sense. Maybe turning to the pipeline, and you mentioned amlitelimab, and the upcoming COAST 2 data, but maybe we could just touch on what we've seen so far from COAST 1. The data was a little bit lower efficacy than Dupixent, but that's like a simple comparison that someone like me would do. So maybe you could give us a little bit of more context on the elements of safety, efficacy, dosing profile that give us to understand the ultimate profile of the product. Makes sense. makes sense Maybe turning to the pipeline, and you mentioned amlitelima b, and the upcoming COAST 2 data, but maybe we could just touch on what we've seen so far from COAST 1. maybe turning to the pipeline and you mentioned amlitelima b and the upcoming coast 2 data but maybe we could just touch on what we've seen so far from coast 1 The data was a little bit lower efficacy than Dupixent, but that's like a simple comparison that someone like me would do. the data was a little bit lower efficacy than dupixent but that's like a simple comparison that someone like me would do So maybe you could give us a little bit of more context on the elements of safety, efficacy, dosing profile that give us to understand the ultimate profile of the product. so maybe you could give us a little bit of more context on the elements of safety efficacy dosing profile that give us to understand the ultimate profile of the product

Speaker 2: Thank you, Richard. First, I'm rarely complimented on all my sartorial elegance, so I appreciate the notice. I'll try and keep it. Thank you, Richard. thank you richard First, I'm rarely complimented on all my sartorial elegance, so I appreciate the notice. first i'm rarely complimented on all my sartorial elegance so i appreciate the notice I'll try and keep it. i'll try and keep it

Speaker 4: Very rarely. Very rarely. very rarely

Speaker 2: Very rarely. I'll try and keep it up next year. Very rarely. very rarely I'll try and keep it up next year. i'll try and keep it up next year

Speaker 1: Same for me as well. Same for me as well. same for me as well

Speaker 2: To COAST 1 and amlitelimab, I think that, taking a step back, the unmet medical need in atopic dermatitis remains. We have, in partnership with Regeneron, an excellent molecule in Dupixent, but it's an area of huge biologics-eligible underpenetration, and the more molecules we can bring in and options for the patients, especially for other molecules from which there is substantial switching, I think leaves a lot of value for patients on the table. How does amlitelimab address that with a novel biology of the OX40 ligand pathway, which has a broader coverage of TH2 and innate immunity? I think we had always been hopeful that it would be an interesting contribution to patients. We had always been super clear that because of its impact on T cell biology, it would take a bit longer to get to the lofty heights of efficacy. To COAST 1 and amlitelimab, I think that, taking a step back, the unmet medical need in atopic dermatitis remains. to coast 1 and amlitelimab i think that taking a step back the unmet medical need in atopic dermatitis remains We have, in partnership with Regeneron, an excellent molecule in Dupixent, but it's an area of huge biologics-eligible underpenetration, and the more molecules we can bring in and options for the patients, especially for other molecules from which there is substantial switching, I think leaves a lot of value for patients on the table. we have in partnership with regeneron an excellent molecule in dupixent but it's an area of huge biologics-eligible underpenetration and the more molecules we can bring in and options for the patients especially for other molecules from which there is substantial switching i think leaves a lot of value for patients on the table How does amlitelimab address that with a novel biology of the OX40 ligand pathway, which has a broader coverage of TH2 and innate immunity? how does amlitelimab address that with a novel biology of the ox40 ligand pathway which has a broader coverage of th2 and innate immunity I think we had always been hopeful that it would be an interesting contribution to patients. i think we had always been hopeful that it would be an interesting contribution to patients We had always been super clear that because of its impact on T cell biology, it would take a bit longer to get to the lofty heights of efficacy. we had always been super clear that because of its impact on t cell biology it would take a bit longer to get to the lofty heights of efficacy But we always anticipated that it would continue to improve over time. So what did we find on COAST 1? We found that it was a molecule that hit its primary endpoint as expected. It continued to get better from 16-24 weeks. The posology was excellent. What I mean by that is both at Q4W and Q12W, we had a really good result. All of those speaking to the value for patients. And finally, when you asked about safety, we were clear that the safety profile was entirely consistent with the safety profile that had been anticipated at the inception of the acquisition of the molecule from Kymab and onwards. What do we have to look forward to? I think that we remain enthused and hopeful that COAST 2 will replicate many of those features of the molecule. But we always anticipated that it would continue to improve over time. but we always anticipated that it would continue to improve over time So what did we find on COAST 1? so what did we find on coast 1 We found that it was a molecule that hit its primary endpoint as expected. we found that it was a molecule that hit its primary endpoint as expected It continued to get better from 16- 24 weeks. it continued to get better from 16- 24 weeks The posology was excellent. the posology was excellent What I mean by that is both at Q4W and Q12W, we had a really good result. what i mean by that is both at q4w and q12w we had a really good result All of those speaking to the value for patients. all of those speaking to the value for patients And finally, when you asked about safety, we were clear that the safety profile was entirely consistent with the safety profile that had been anticipated at the inception of the acquisition of the molecule from Kymab and onwards. and finally when you asked about safety we were clear that the safety profile was entirely consistent with the safety profile that had been anticipated at the inception of the acquisition of the molecule from kymab and onwards What do we have to look forward to? what do we have to look forward to I think that we remain enthused and hopeful that COAST 2 will replicate many of those features of the molecule. i think that we remain enthused and hopeful that coast 2 will replicate many of those features of the molecule My own preference is, of course, that we hit the primary endpoint as we did in COAST 1. That is obviously the most important thing. But actually, we retained the posology, etc. And then I want to recognize that COAST 2 is an entry ticket to filing and submission. But actually, as we build the momentum around amlitelimab, and specifically around SHORE, I think that what we'll be able to do is, and throughout the year with Estuary Aqua, Hydro, and others, we'll be able to begin to convey, A, to the community that we have a drug that continues to improve in efficacy over the year beyond 24 weeks. And secondly, and perhaps equally, and perhaps more importantly, commercially, the combination early with corticosteroids, topical corticosteroids, etc., is something that amlitelimab will exhibit. My own preference is, of course, that we hit the primary endpoint as we did in COAST 1. my own preference is of course that we hit the primary endpoint as we did in coast 1 That is obviously the most important thing. that is obviously the most important thing But actually, we retained the posology, etc. And then I want to recognize that COAST 2 is an entry ticket to filing and submission. but actually we retained the posology etc and then i want to recognize that coast 2 is an entry ticket to filing and submission But actually, as we build the momentum around amlitelima b, and specifically around SHORE, I think that what we'll be able to do is, and throughout the year with Estuary Aqua, Hydro, and others, we'll be able to begin to convey, A, to the community that we have a drug that continues to improve in efficacy over the year beyond 24 weeks. but actually as we build the momentum around amlitelima b and specifically around shore i think that what we'll be able to do is and throughout the year with estuary aqua hydro and others we'll be able to begin to convey a to the community that we have a drug that continues to improve in efficacy over the year beyond 24 weeks And secondly, and perhaps equally, and perhaps more importantly, commercially, the combination early with corticosteroids, topical corticosteroids, etc., is something that amlitelima b will exhibit. and secondly and perhaps equally and perhaps more importantly commercially the combination early with corticosteroids topical corticosteroids etc is something that amlitelima b will exhibit

Speaker 1: Any differences in terms of the COAST 2 patient population that could have something slightly different in terms of COAST 1? Obviously, we'd expect it to be successful. But any differences there in the trials it was recruited that could give us a different result? Any differences in terms of the COAST 2 patient population that could have something slightly different in terms of COAST 1? any differences in terms of the coast 2 patient population that could have something slightly different in terms of coast 1 Obviously, we'd expect it to be successful. obviously we'd expect it to be successful But any differences there in the trials it was recruited that could give us a different result? but any differences there in the trials it was recruited that could give us a different result

Speaker 2: Yeah, broader point is that lessons learned by us and others in immunology over the last year have made it very clear that molecules that go into areas with established standard of care make those clinical trials more complicated, both in placebo response, etc. So we have to be measured and thoughtful about that. And we'll keep our eye on placebo response rates, etc., which is, I think, what you're alluding to. There are no meaningful differences in recruitment strategies that we anticipate will, in any adverse way, direct the outcome of the trial. Yeah, broader point is that lessons learned by us and others in immunology over the last year have made it very clear that molecules that go into areas with established standard of care make those clinical trials more complicated, both in placebo response, etc. So we have to be measured and thoughtful about that. yeah broader point is that lessons learned by us and others in immunology over the last year have made it very clear that molecules that go into areas with established standard of care make those clinical trials more complicated both in placebo response etc so we have to be measured and thoughtful about that And we'll keep our eye on placebo response rates, etc., which is, I think, what you're alluding to. and we'll keep our eye on placebo response rates etc which is i think what you're alluding to There are no meaningful differences in recruitment strategies that we anticipate will, in any adverse way, direct the outcome of the trial. there are no meaningful differences in recruitment strategies that we anticipate will in any adverse way direct the outcome of the trial

Speaker 4: Yeah, I think maybe it's also worth adding that if COAST 2 reads out exactly the same as COAST 1, we have a Q12 in AD, which is going to be a huge deal for patients who really, particularly naive patients who don't want to get into an every two-week injection environment. The thing about this is, as more drugs have launched, and you've seen this, Dupixent actually accelerates in its growth in volume as more medicines come in because biologic penetration is so low in AD that the more drugs come, everybody, all boats rise. There is a potential for a small group of patients to come off drug and be in disease remission. Yeah, I think maybe it's also worth adding that if COAST 2 reads out exactly the same as COAST 1, we have a Q12 in AD, which is going to be a huge deal for patients who really, particularly naive patients who don't want to get into an every two-week injection environment. yeah i think maybe it's also worth adding that if coast 2 reads out exactly the same as coast 1 we have a q12 in ad which is going to be a huge deal for patients who really particularly naive patients who don't want to get into an every two-week injection environment The thing about this is, as more drugs have launched, and you've seen this, Dupixent actually accelerates in its growth in volume as more medicines come in because biologic penetration is so low in AD that the more drugs come, everybody, all boats rise. the thing about this is as more drugs have launched and you've seen this dupixent actually accelerates in its growth in volume as more medicines come in because biologic penetration is so low in ad that the more drugs come everybody all boats rise There is a potential for a small group of patients to come off drug and be in disease remission. there is a potential for a small group of patients to come off drug and be in disease remission And that's another reason why it will be used widely in the naive setting because some patients will always ask, "Am I going to be on this for the rest of my life?" Well, for some, they'll be able to come off it. Not a lot, but enough to be meaningful to make that choice. If we deliver that and the increasing efficacy profile out through 48 weeks, then I think we're going to find ourselves with one of the most important medicines in AD. And so fingers crossed for COAST 2. And that's another reason why it will be used widely in the naive setting because some patients will always ask, "Am I going to be on this for the rest of my life?" Well, for some, they'll be able to come off it. and that's another reason why it will be used widely in the naive setting because some patients will always ask "am i going to be on this for the rest of my life?" well for some they'll be able to come off it Not a lot, but enough to be meaningful to make that choice. not a lot but enough to be meaningful to make that choice If we deliver that and the increasing efficacy profile out through 48 weeks, then I think we're going to find ourselves with one of the most important medicines in AD. if we deliver that and the increasing efficacy profile out through 48 weeks then i think we're going to find ourselves with one of the most important medicines in ad And so fingers crossed for COAST 2. and so fingers crossed for coast 2

Speaker 1: Yeah, and Estuary you highlighted the idea of increasing efficacy with time. What gives you the confidence in that, that you might see that in Estuary? Yeah, and Estuary you highlighted the idea of increasing efficacy with time. yeah and estuary you highlighted the idea of increasing efficacy with time What gives you the confidence in that, that you might see that in Estuary? what gives you the confidence in that that you might see that in estuary

Speaker 2: I'm going to try and walk it back and make sure everyone understands that we will have COAST 2 and SHORE coming. I said that in our late-stage pipeline review on the 16th of December. We will continue that process just to give you guys a red thread of where we're going. I think SHORE is extremely important, and I would index on SHORE as a combination topical corticosteroid therapy. And then the second point is, I think it's important that we don't over-crystal ball the likely outcomes beyond 24 weeks, up to 52 weeks. What gives us confidence, though, is the biology of amlitelimab. As you energize T cells that encounter their cognate antigen throughout the life cycle of dosing, I think you'll see that that efficacy gets better. I'm going to try and walk it back and make sure everyone understands that we will have COAST 2 and SHORE coming. i'm going to try and walk it back and make sure everyone understands that we will have coast 2 and shore coming I said that in our late-stage pipeline review on the 16th of December. i said that in our late-stage pipeline review on the 16th of december We will continue that process just to give you guys a red thread of where we're going. we will continue that process just to give you guys a red thread of where we're going I think SHORE is extremely important, and I would index on SHORE as a combination topical corticosteroid therapy. i think shore is extremely important and i would index on shore as a combination topical corticosteroid therapy And then the second point is, I think it's important that we don't over-crystal ball the likely outcomes beyond 24 weeks, up to 52 weeks. and then the second point is i think it's important that we don't over-crystal ball the likely outcomes beyond 24 weeks up to 52 weeks What gives us confidence, though, is the biology of amlitelimab. what gives us confidence though is the biology of amlitelimab As you energize T cells that encounter their cognate antigen throughout the life cycle of dosing, I think you'll see that that efficacy gets better. as you energize t cells that encounter their cognate antigen throughout the life cycle of dosing i think you'll see that that efficacy gets better We hope to not only give you insights through Aqua and Hydro this year to biologic inadequate responders, but I also hope that through Estuary, but also some of our open-label studies, you'll get a better sense of improving efficacy. We hope to not only give you insights through Aqua and Hydro this year to biologic inadequate responders, but I also hope that through Estuary, but also some of our open-label studies, you'll get a better sense of improving efficacy. we hope to not only give you insights through aqua and hydro this year to biologic inadequate responders but i also hope that through estuary but also some of our open-label studies you'll get a better sense of improving efficacy

Speaker 1: Paul, you touched on the growth of the market with new mechanisms, multiple mechanisms. You've got amlitelimab, frexalimab with positive phase III. How do you think about developing the wider portfolio in AD? Because you could address in different mechanisms, lots of those. So do you add to that portfolio? Is that something that you'd be thinking about? Paul, you touched on the growth of the market with new mechanisms, multiple mechanisms. paul you touched on the growth of the market with new mechanisms multiple mechanisms You've got amlitelimab, frexalimab with positive phase III. you've got amlitelimab frexalimab with positive phase iii How do you think about developing the wider portfolio in AD? how do you think about developing the wider portfolio in ad Because you could address in different mechanisms, lots of those. because you could address in different mechanisms lots of those So do you add to that portfolio? so do you add to that portfolio Is that something that you'd be thinking about? is that something that you'd be thinking about

Speaker 4: We just, I think it was announced today about our STAT6 going into the clinic for the first time. I think we look at other master switches that we think could do things with different ways of administration that patients want the choice, and if we can provide that for them, we will. Not everybody is perfectly treated, and you know, in AD and in psoriasis and these other areas, people go from very difficult disease burdens to 90% clear skin, and then they start to get disappointed that it's only 90%, and then they start moving between mechanisms. It's always been like that. These are highly symptomatic, highly motivated patients. Why I love these areas, and so consequently, we're open-minded about adding new mechanisms. We have bispecifics that we can take into AD. We have multiple shots in GI. We just, I think it was announced today about our STAT6 going into the clinic for the first time. we just i think it was announced today about our stat6 going into the clinic for the first time I think we look at other master switches that we think could do things with different ways of administration that patients want the choice, and if we can provide that for them, we will. i think we look at other master switches that we think could do things with different ways of administration that patients want the choice and if we can provide that for them we will Not everybody is perfectly treated, and you know, in AD and in psoriasis and these other areas, people go from very difficult disease burdens to 90% clear skin, and then they start to get disappointed that it's only 90%, and then they start moving between mechanisms. not everybody is perfectly treated and you know in ad and in psoriasis and these other areas people go from very difficult disease burdens to 90% clear skin and then they start to get disappointed that it's only 90% and then they start moving between mechanisms It's always been like that. it's always been like that These are highly symptomatic, highly motivated patients. these are highly symptomatic highly motivated patients Why I love these areas, and so consequently, we're open-minded about adding new mechanisms. why i love these areas and so consequently we're open-minded about adding new mechanisms We have bispecifics that we can take into AD. we have bispecifics that we can take into ad We have multiple shots in GI. we have multiple shots in gi We have multiple shots in asthma and hopefully COPD because we understand that dynamic as more medicines arrive, the market expands significantly. This is not a saturated market. It's the absolute opposite. And so it is worth having new things because patients are ready for them. And that gives us huge opportunity. We have multiple shots in asthma and hopefully COPD because we understand that dynamic as more medicines arrive, the market expands significantly. we have multiple shots in asthma and hopefully copd because we understand that dynamic as more medicines arrive the market expands significantly This is not a saturated market. this is not a saturated market It's the absolute opposite. it's the absolute opposite And so it is worth having new things because patients are ready for them. and so it is worth having new things because patients are ready for them And that gives us huge opportunity. and that gives us huge opportunity

Speaker 2: Yeah, just to build on that, Richard, this time last year, you asked me throughout the year about the relevance of our bispecific platform in atopic dermatitis. It was a question that you were very interested to discuss, and I think there was some perhaps minor skepticism about the role of Lunsikimig in atopic dermatitis, well, the ball is sort of caught up with us, in that last year, we thought we had an asymmetric insight into the role of TSLP in atopic dermatitis. I think there were people who questioned it based on the Tezi data. I'm very pleased to announce that wholly internally generated R&D insights encompassing the role of IL-13 and Tezi, sorry, TSLP in atopic dermatitis came from Sanofi. We created the molecule. We, as an R&D organization that was responsible, took a measured risk into atopic dermatitis. Yeah, just to build on that, Richard, this time last year, you asked me throughout the year about the relevance of our bispecific platform in atopic dermatitis. yeah just to build on that richard this time last year you asked me throughout the year about the relevance of our bispecific platform in atopic dermatitis It was a question that you were very interested to discuss, and I think there was some perhaps minor skepticism about the role of Lunsikimig in atopic dermatitis, well, the ball is sort of caught up with us, in that last year, we thought we had an asymmetric insight into the role of TSLP in atopic dermatitis. it was a question that you were very interested to discuss and i think there was some perhaps minor skepticism about the role of lunsikimig in atopic dermatitis well the ball is sort of caught up with us in that last year we thought we had an asymmetric insight into the role of tslp in atopic dermatitis I think there were people who questioned it based on the Tezi data. i think there were people who questioned it based on the tezi data I'm very pleased to announce that wholly internally generated R&D insights encompassing the role of IL-13 and Tezi, sorry, TSLP in atopic dermatitis came from Sanofi. i'm very pleased to announce that wholly internally generated r&d insights encompassing the role of il-13 and tezi sorry tslp in atopic dermatitis came from sanofi We created the molecule. we created the molecule We, as an R&D organization that was responsible, took a measured risk into atopic dermatitis. we as an r&d organization that was responsible took a measured risk into atopic dermatitis Just late last year, there was another molecule, a TSLP, long-acting TSLP molecule that went into atopic dermatitis that showed early efficacy in phase II. I think that begins to demonstrate that not only does Sanofi have asymmetric insights, we, through thoughtful portfolio allocation, take the appropriate measured risks to give us breakout value, and we will have the results of that in the near future. Just late last year, there was another molecule, a TSLP, long-acting TSLP molecule that went into atopic dermatitis that showed early efficacy in phase II. just late last year there was another molecule a tslp long-acting tslp molecule that went into atopic dermatitis that showed early efficacy in phase ii I think that begins to demonstrate that not only does Sanofi have asymmetric insights, we, through thoughtful portfolio allocation, take the appropriate measured risks to give us breakout value, and we will have the results of that in the near future. i think that begins to demonstrate that not only does sanofi have asymmetric insights we through thoughtful portfolio allocation take the appropriate measured risks to give us breakout value and we will have the results of that in the near future

Speaker 1: Interesting and maybe thoughtful portfolio allocation. Duvakitug is obviously a little bit behind others, but a very small capital outlay from you guys, but actually could have one of the better profiles as well, so maybe you could put into context for us what we're going to see on duvakitug, how you see the profile as it's developed thus far, and where we go with that. Interesting and maybe thoughtful portfolio allocation. interesting and maybe thoughtful portfolio allocation Duvakitu g is obviously a little bit behind others, but a very small capital outlay from you guys, but actually could have one of the better profiles as well, so maybe you could put into context for us what we're going to see on duvakitu g, how you see the profile as it's developed thus far, and where we go with that. duvakitu g is obviously a little bit behind others but a very small capital outlay from you guys but actually could have one of the better profiles as well so maybe you could put into context for us what we're going to see on duvakitu g how you see the profile as it's developed thus far and where we go with that

Speaker 2: Yeah, so duvakitug is very interesting. And I've often said, we've talked about this. It's a sleeper in our portfolio. And the reason it's a sleeper is that we said at the very beginning we had the best, we thought we had a real chance of having the best molecule, both from a biophysical perspective, but also with its impact on the DR3 receptor. And I was quietly bullish about that early on. The ECCO data in 2025, both in UC and CD, confirmed that we may have not only the best-in-class molecule, but potentially, and we should be sort of completely thoughtful about how we convey this, potentially a best-in-disease molecule. Let's see whether the maintenance data plays out. That comes later in the year. But that would be pretty exciting. Yeah, so duvakitug is very interesting. yeah so duvakitug is very interesting And I've often said, we've talked about this. and i've often said we've talked about this It's a sleeper in our portfolio. it's a sleeper in our portfolio And the reason it's a sleeper is that we said at the very beginning we had the best, we thought we had a real chance of having the best molecule, both from a biophysical perspective, but also with its impact on the DR3 receptor. and the reason it's a sleeper is that we said at the very beginning we had the best we thought we had a real chance of having the best molecule both from a biophysical perspective but also with its impact on the dr3 receptor And I was quietly bullish about that early on. and i was quietly bullish about that early on The ECCO data in 2025, both in UC and CD, confirmed that we may have not only the best-in-class molecule, but potentially, and we should be sort of completely thoughtful about how we convey this, potentially a best-in-disease molecule. the ecco data in 2025 both in uc and cd confirmed that we may have not only the best-in-class molecule but potentially and we should be sort of completely thoughtful about how we convey this potentially a best-in-disease molecule Let's see whether the maintenance data plays out. let's see whether the maintenance data plays out That comes later in the year. that comes later in the year But that would be pretty exciting. but that would be pretty exciting I think that has the potential not only to transform common or garden IBD, if such a thing exists, but also in populations in whom safety has become a relevant issue. I won't talk more about those. The only thing I will say is that you pointed correctly to the view that we increasingly will have to use our proven development muscles to ensure that we position Dupixent correctly against its competitors. I think that has the potential not only to transform common or garden IBD, if such a thing exists, but also in populations in whom safety has become a relevant issue. i think that has the potential not only to transform common or garden ibd if such a thing exists but also in populations in whom safety has become a relevant issue I won't talk more about those. i won't talk more about those The only thing I will say is that you pointed correctly to the view that we increasingly will have to use our proven development muscles to ensure that we position Dupixent correctly against its competitors. the only thing i will say is that you pointed correctly to the view that we increasingly will have to use our proven development muscles to ensure that we position dupixent correctly against its competitors

Speaker 1: Excellent. Maybe turning to MS and frexalimab, maybe thoughts on that because data on lesions was very strong. How do you see that translating both in terms of disability progression, but also ARR, which has been a more challenging endpoint across the space these days? Excellent. excellent Maybe turning to MS and frexalima b, maybe thoughts on that because data on lesions was very strong. maybe turning to ms and frexalima b maybe thoughts on that because data on lesions was very strong How do you see that translating both in terms of disability progression, but also ARR, which has been a more challenging endpoint across the space these days? how do you see that translating both in terms of disability progression but also arr which has been a more challenging endpoint across the space these days

Speaker 2: Just a first comment that I think that as I reflect on our year last year, I think that we showed, in the face of some complexity, real commitment to the patients with MS going forward. We remain committed to those patients. For Sanofi, obviously, we are entirely thoughtful about our shareholders. But what we did with MS last year demonstrates our unequivocal commitment to patients. Point one, and I think first and foremost, it's the only thing that gets us up in the morning, or at least the first thing, so that's our thoughts with the MS patients. Number two is I think the data speaks for itself. Our secondary progressive data was striking, and we await some regulatory decisions later this quarter for tolebrutinib. Just a first comment that I think that as I reflect on our year last year, I think that we showed, in the face of some complexity, real commitment to the patients with MS going forward. just a first comment that i think that as i reflect on our year last year i think that we showed in the face of some complexity real commitment to the patients with ms going forward We remain committed to those patients. we remain committed to those patients For Sanofi, obviously, we are entirely thoughtful about our shareholders. for sanofi obviously we are entirely thoughtful about our shareholders But what we did with MS last year demonstrates our unequivocal commitment to patients. but what we did with ms last year demonstrates our unequivocal commitment to patients Point one, and I think first and foremost, it's the only thing that gets us up in the morning, or at least the first thing, so that's our thoughts with the MS patients. point one and i think first and foremost it's the only thing that gets us up in the morning or at least the first thing so that's our thoughts with the ms patients Number two is I think the data speaks for itself. number two is i think the data speaks for itself Our secondary progressive data was striking, and we await some regulatory decisions later this quarter for tolebrutinib. our secondary progressive data was striking and we await some regulatory decisions later this quarter for tolebrutinib More broadly, your comment about endpoints in MS, we've been entirely consistent, I think, that we've said that ARR was a very convenient measure over the last 30 years, but increasingly disability will be important. For all of our molecules, whether it's Tolly or frexalimab, and otherwise, we've ensured that we remain consistent with the views of the past with ARR. We look forward to the future with disability. More broadly, your comment about endpoints in MS, we've been entirely consistent, I think, that we've said that ARR was a very convenient measure over the last 30 years, but increasingly disability will be important. more broadly your comment about endpoints in ms we've been entirely consistent i think that we've said that arr was a very convenient measure over the last 30 years but increasingly disability will be important For all of our molecules, whether it's Tolly or frexalima b, and otherwise, we've ensured that we remain consistent with the views of the past with ARR. for all of our molecules whether it's tolly or frexalima b and otherwise we've ensured that we remain consistent with the views of the past with arr We look forward to the future with disability. we look forward to the future with disability

Speaker 1: Specifically for FRAX, the safety of the molecule versus efficacy, just thoughts there? Specifically for FRAX, the safety of the molecule versus efficacy, just thoughts there? specifically for frax the safety of the molecule versus efficacy just thoughts there

Speaker 2: Yeah, and there's multiple CD40 pathway modulators out there. The theoretical considerations with respect to risk, which are minor, have actually not played out, so touch wood, and with a recognition that we're midway through trials, we don't have any signals that we're concerned about. Yeah, and there's multiple CD40 pathway modulators out there. yeah and there's multiple cd40 pathway modulators out there The theoretical considerations with respect to risk, which are minor, have actually not played out, so touch wood, and with a recognition that we're midway through trials, we don't have any signals that we're concerned about. the theoretical considerations with respect to risk which are minor have actually not played out so touch wood and with a recognition that we're midway through trials we don't have any signals that we're concerned about

Speaker 1: Okay. Maybe in the last few minutes, we could just pivot maybe to some of the new launches that were on your initial slide, Wayrills, the COVID vaccine. I'm not even going to attempt. I can't even remember the brand, anyway. Okay. okay Maybe in the last few minutes, we could just pivot maybe to some of the new launches that were on your initial slide, Wayrills, the COVID vaccine. maybe in the last few minutes we could just pivot maybe to some of the new launches that were on your initial slide wayrills the covid vaccine I'm not even going to attempt. i'm not even going to attempt I can't even remember the brand, anyway. i can't even remember the brand anyway

Speaker 4: Producer round. Producer round. producer round

Speaker 1: Indeed. You know where I'm going. So yeah, thoughts on those progression of the launches, how they're doing, what we should think about them contributing to the growth? Indeed. indeed You know where I'm going. you know where i'm going So yeah, thoughts on those progression of the launches, how they're doing, what we should think about them contributing to the growth? so yeah thoughts on those progression of the launches how they're doing what we should think about them contributing to the growth

Speaker 4: You know, we've been extremely effective on our launches. You look at Beyfortus, you look at Altuviiio. We've really, I think, surprised a lot of people with just how effective that we've been. Dupixent, well, we're not going to share the data because it's still early, is ahead of our expectations. And that's kudos to the team and everything that's being done by Brian and his guys. Dupixent is, and it's just getting started given the number of indications that it's going to have. So we're very happy with that. Fitusiran in hemophilia is a much slower start, but completely as anticipated because this is like a very specific tailoring of the medicine to each individual. But it is a true every eight-week dose for people with hemophilia. This is a life-changing moment. You know, we've been extremely effective on our launches. you know we've been extremely effective on our launches You look at Beyfortus, you look at Altuviiio. you look at beyfortus you look at altuviiio We've really, I think, surprised a lot of people with just how effective that we've been. we've really i think surprised a lot of people with just how effective that we've been Dupixent, well, we're not going to share the data because it's still early, is ahead of our expectations. dupixent well we're not going to share the data because it's still early is ahead of our expectations And that's kudos to the team and everything that's being done by Brian and his guys. and that's kudos to the team and everything that's being done by brian and his guys Dupixent is, and it's just getting started given the number of indications that it's going to have. dupixent is and it's just getting started given the number of indications that it's going to have So we're very happy with that. so we're very happy with that Fitusiran in hemophilia is a much slower start, but completely as anticipated because this is like a very specific tailoring of the medicine to each individual. fitusiran in hemophilia is a much slower start but completely as anticipated because this is like a very specific tailoring of the medicine to each individual But it is a true every eight-week dose for people with hemophilia. but it is a true every eight-week dose for people with hemophilia This is a life-changing moment. this is a life-changing moment Slow and steady as people get up to speed with how to administer, but we're very encouraged by that too. In general, I think our commercial engine and our late-stage development and the team and regulatory on the labels have done an extraordinary job because we're really able to go and get share and to really land with some substance commercially. The question remains, can we bring duvakitug, amlitelimab, lunsekimig, can we provide data this year that gives people the confidence that we have two, three, four, five billion-dollar medicines that are coming behind to put in this excellent launch machine? Slow and steady as people get up to speed with how to administer, but we're very encouraged by that too. slow and steady as people get up to speed with how to administer but we're very encouraged by that too In general, I think our commercial engine and our late-stage development and the team and regulatory on the labels have done an extraordinary job because we're really able to go and get share and to really land with some substance commercially. in general i think our commercial engine and our late-stage development and the team and regulatory on the labels have done an extraordinary job because we're really able to go and get share and to really land with some substance commercially The question remains, can we bring duvakitug, amlitelimab, lunsekimig, can we provide data this year that gives people the confidence that we have two, three, four, five billion-dollar medicines that are coming behind to put in this excellent launch machine? the question remains can we bring duvakitug amlitelimab lunsekimig can we provide data this year that gives people the confidence that we have two three four five billion-dollar medicines that are coming behind to put in this excellent launch machine

Speaker 1: Makes sense. And Ayvakit going well as well? Makes sense. makes sense And Ayvakit going well as well? and ayvakit going well as well

Speaker 4: Yes. Yeah, really well. I mean, it was, as I mentioned upfront, but it's a year ago since we began those conversations with Provention. I look at how deals are being done now and premiums being paid. I think we paid around 30% premium. We paid exactly what we'd hoped to pay, and we inherited a medicine that is really positively surprising everybody that was early in its launch phase. That profile for us, which means it continued to grow through Dupixent LOE, and the fact that it has a follow-on, LCM, the name, and the fact that it has a wild-type shot also in immunology further back in the pipeline made the profile a perfect overlay for us. Very happy with the Ayvakit performance. And again, Brian and his team and how they've integrated it and how they've kept the momentum is great. Yes. yes Yeah, really well. yeah really well I mean, it was, as I mentioned upfront, but it's a year ago since we began those conversations with Provention. i mean it was as i mentioned upfront but it's a year ago since we began those conversations with provention I look at how deals are being done now and premiums being paid. i look at how deals are being done now and premiums being paid I think we paid around 30% premium. i think we paid around 30% premium We paid exactly what we'd hoped to pay, and we inherited a medicine that is really positively surprising everybody that was early in its launch phase. we paid exactly what we'd hoped to pay and we inherited a medicine that is really positively surprising everybody that was early in its launch phase That profile for us, which means it continued to grow through Dupixent LOE , and the fact that it has a follow-on, LCM, the name, and the fact that it has a wild-type shot also in immunology further back in the pipeline made the profile a perfect overlay for us. that profile for us which means it continued to grow through dupixent loe and the fact that it has a follow-on lcm the name and the fact that it has a wild-type shot also in immunology further back in the pipeline made the profile a perfect overlay for us Very happy with the Ayvakit performance. very happy with the ayvakit performance And again, Brian and his team and how they've integrated it and how they've kept the momentum is great. and again brian and his team and how they've integrated it and how they've kept the momentum is great

Speaker 1: Makes sense. And François and you talked about François talked about Dupi being a third of the growth. On that third, how's that going in terms of the new launches, CSU, COPD, a smaller part of AD? AD will, as we've discussed multiple times, will grow for a very long time. But what's the growth outlook there? Makes sense. makes sense And François and you talked about François talked about Dupi being a third of the growth. and françois and you talked about françois talked about dupi being a third of the growth On that third, how's that going in terms of the new launches, CSU, COPD, a smaller part of AD? on that third how's that going in terms of the new launches csu copd a smaller part of ad AD will, as we've discussed multiple times, will grow for a very long time. ad will as we've discussed multiple times will grow for a very long time But what's the growth outlook there? but what's the growth outlook there

Speaker 4: The growth's incredible. Are we eight years in, and we're growing close to 30% on a drug that was over EUR four billion on the quarter. This is incredible work by the team and incredible work on choosing the follow-on indications. It'll slow a little this year from that heady height because, of course, we've anniversaried COPD, CSU. So we're realistic, but it'll still be the dominant player. It'll be growing till its very last day. It's one of those rare combinations of medicines with extraordinary efficacy and extraordinary safety that launch first in class. That's why new mechanisms, new lengths of treatment, possibly for remission. That's why those things are what physicians want now for naive patients. But Dupixent is going to run hard right till its last day. Very proud to be involved in it. The growth rate's really incredible. The growth's incredible. the growth's incredible Are we eight years in, and we're growing close to 30% on a drug that was over EUR four billion on the quarter. are we eight years in and we're growing close to 30% on a drug that was over eur four billion on the quarter This is incredible work by the team and incredible work on choosing the follow-on indications. this is incredible work by the team and incredible work on choosing the follow-on indications It'll slow a little this year from that heady height because, of course, we've anniversaried COPD, CSU. it'll slow a little this year from that heady height because of course we've anniversaried copd csu So we're realistic, but it'll still be the dominant player. so we're realistic but it'll still be the dominant player It'll be growing till its very last day. it'll be growing till its very last day It's one of those rare combinations of medicines with extraordinary efficacy and extraordinary safety that launch first in class. it's one of those rare combinations of medicines with extraordinary efficacy and extraordinary safety that launch first in class That's why new mechanisms, new lengths of treatment, possibly for remission. that's why new mechanisms new lengths of treatment possibly for remission That's why those things are what physicians want now for naive patients. that's why those things are what physicians want now for naive patients But Dupixent is going to run hard right till its last day. but dupixent is going to run hard right till its last day Very proud to be involved in it. very proud to be involved in it The growth rate's really incredible. the growth rate's really incredible

Speaker 1: And your partner showed a little bit of color maybe on that last day in terms of next generation products or longer duration. Is there any color on that last day from a Sanofi point of view? And your partner showed a little bit of color maybe on that last day in terms of next generation products or longer duration. and your partner showed a little bit of color maybe on that last day in terms of next generation products or longer duration Is there any color on that last day from a Sanofi point of view? is there any color on that last day from a sanofi point of view

Speaker 4: You know, depending on our own assumptions are a minimum of 2031, 2032 for Dupixent. If we take IPD as a sort of consensus, we're more likely 2033, 2034. That far out, it's not always good to overshare what you plan to do because there are plenty of companies that are waiting for a hint so they can then operationalize what they want to do to disrupt what we plan to do. I'm well aware, though, given the setbacks we had last year, the scrutiny around the Dupixent LOE and how we manage it has perhaps been brought even further forward. I know Len and the team have started to share a little bit of our philosophy. And I think 2026 is the year where we're going to be much more open about our intentions on how to manage Dupixent effectively for patients. You know, depending on our own assumptions are a minimum of 2031, 2032 for Dupixent. you know depending on our own assumptions are a minimum of 2031 2032 for dupixent If we take IPD as a sort of consensus, we're more likely 2033, 2034. if we take ipd as a sort of consensus we're more likely 2033 2034 That far out, it's not always good to overshare what you plan to do because there are plenty of companies that are waiting for a hint so they can then operationalize what they want to do to disrupt what we plan to do. that far out it's not always good to overshare what you plan to do because there are plenty of companies that are waiting for a hint so they can then operationalize what they want to do to disrupt what we plan to do I'm well aware, though, given the setbacks we had last year, the scrutiny around the Dupixent LOE and how we manage it has perhaps been brought even further forward. i'm well aware though given the setbacks we had last year the scrutiny around the dupixent loe and how we manage it has perhaps been brought even further forward I know Len and the team have started to share a little bit of our philosophy. i know len and the team have started to share a little bit of our philosophy And I think 2026 is the year where we're going to be much more open about our intentions on how to manage Dupixent effectively for patients. and i think 2026 is the year where we're going to be much more open about our intentions on how to manage dupixent effectively for patients Also what might be the opportunities around it and after it that we can do with our great partners, Regeneron. Also what might be the opportunities around it and after it that we can do with our great partners, Regeneron. also what might be the opportunities around it and after it that we can do with our great partners regeneron

Speaker 1: Makes sense. Maybe two other growthy questions. Altuviiio's had a, and was mentioned on the slide, going to be near blockbuster or blockbuster. Yeah. I mean, there is more competition in the same area as Hemlibra, launching at the end of 2026. But how much more room to go is there with Altuviiio, I suppose, is the question. Makes sense. makes sense Maybe two other growthy questions. maybe two other growthy questions Altuviiio's had a, and was mentioned on the slide, going to be near blockbuster or blockbuster. altuviiio's had a and was mentioned on the slide going to be near blockbuster or blockbuster Yeah. yeah I mean, there is more competition in the same area as Hemlibra, launching at the end of 2026. i mean there is more competition in the same area as hemlibra launching at the end of 2026 But how much more room to go is there with Altuviiio, I suppose, is the question. but how much more room to go is there with altuviiio i suppose is the question

Speaker 4: I think the market sort of split, right? For a long time, it was three infusions a week. Then you had the options with Hemlibra to be monthly. Sadly, many of those patients ended up weekly. Altuviiio came and gave people a normal annual bleeding rate at a weekly dose. That gave people the opportunity to live a normal life, particularly young adults. While it didn't sound sexy, certainly I remember reading one of your notes, while it didn't sound sexy at the time, the fact that it's going on to be a blockbuster is a sort of affirmation that living a normal life, even at a weekly dose, is a very credible aspiration for patients. We've seen that pulled up very clearly. There's going to be new entrants on monthly. Fitusiran is every eight weeks. I think the market sort of split, right? i think the market sort of split right For a long time, it was three infusions a week. for a long time it was three infusions a week Then you had the options with Hemlibra to be monthly. then you had the options with hemlibra to be monthly Sadly, many of those patients ended up weekly. sadly many of those patients ended up weekly Altuviiio came and gave people a normal annual bleeding rate at a weekly dose. altuviiio came and gave people a normal annual bleeding rate at a weekly dose That gave people the opportunity to live a normal life, particularly young adults. that gave people the opportunity to live a normal life particularly young adults While it didn't sound sexy, certainly I remember reading one of your notes, while it didn't sound sexy at the time, the fact that it's going on to be a blockbuster is a sort of affirmation that living a normal life, even at a weekly dose, is a very credible aspiration for patients. while it didn't sound sexy certainly i remember reading one of your notes while it didn't sound sexy at the time the fact that it's going on to be a blockbuster is a sort of affirmation that living a normal life even at a weekly dose is a very credible aspiration for patients We've seen that pulled up very clearly. we've seen that pulled up very clearly There's going to be new entrants on monthly. there's going to be new entrants on monthly Fitusiran is every eight weeks. fitusiran is every eight weeks We're going to see the patients sort of split between, do I want the most convenience or do I want to live the most normal life? I think even with the new monthlies that are coming, their ABRs are not zero. So we just have to recognize that those trades will be made. Lots of opportunity in the factor market and beyond for Altuviiio. We're going to see the patients sort of split between, do I want the most convenience or do I want to live the most normal life? we're going to see the patients sort of split between do i want the most convenience or do i want to live the most normal life I think even with the new monthlies that are coming, their ABRs are not zero. i think even with the new monthlies that are coming their abrs are not zero So we just have to recognize that those trades will be made. so we just have to recognize that those trades will be made Lots of opportunity in the factor market and beyond for Altuviiio. lots of opportunity in the factor market and beyond for altuviiio

Speaker 1: Fantastic. Maybe last question, just returning to Beyfortus, we talked about some of the pressures in the US. You highlighted the very strong efficacy. Maybe you could talk about how that strength of efficacy brings new countries on board and patients ex-US and the growth potential there because while the US is big, the world is quite a lot bigger. So how do you think? That's real insight for me, by the way. Fantastic. fantastic Maybe last question, just returning to Beyfortus, we talked about some of the pressures in the US. maybe last question just returning to beyfortus we talked about some of the pressures in the us You highlighted the very strong efficacy. you highlighted the very strong efficacy Maybe you could talk about how that strength of efficacy brings new countries on board and patients ex-US and the growth potential there because while the US is big, the world is quite a lot bigger. maybe you could talk about how that strength of efficacy brings new countries on board and patients ex-us and the growth potential there because while the us is big the world is quite a lot bigger So how do you think? so how do you think That's real insight for me, by the way. that's real insight for me by the way

Speaker 4: I think what surprised everybody about Beyfortus was for healthcare systems, it was a current fiscal year payback. It's a premium-priced vaccine approach, even though it's a monoclonal antibody. And that meant that access was within reach for almost every baby that needed the protection. What surprised people next was the data accumulated so fast. We spent a lot of time perfecting the real-world evidence data so that payers could look and make a decision very quickly. If you invest in protecting babies with Beyfortus, you will avoid significant costs this year. Now, with health systems under pressure financially, current year paybacks are a gift to health systems. And that's before we even get to babies who are protected, babies who can avoid some very difficult days in the ICU. I think what surprised everybody about Beyfortus was for healthcare systems, it was a current fiscal year payback. i think what surprised everybody about beyfortus was for healthcare systems it was a current fiscal year payback It's a premium-priced vaccine approach, even though it's a monoclonal antibody. it's a premium-priced vaccine approach even though it's a monoclonal antibody And that meant that access was within reach for almost every baby that needed the protection. and that meant that access was within reach for almost every baby that needed the protection What surprised people next was the data accumulated so fast. what surprised people next was the data accumulated so fast We spent a lot of time perfecting the real-world evidence data so that payers could look and make a decision very quickly. we spent a lot of time perfecting the real-world evidence data so that payers could look and make a decision very quickly If you invest in protecting babies with Beyfortus, you will avoid significant costs this year. if you invest in protecting babies with beyfortus you will avoid significant costs this year Now, with health systems under pressure financially, current year paybacks are a gift to health systems. now with health systems under pressure financially current year paybacks are a gift to health systems And that's before we even get to babies who are protected, babies who can avoid some very difficult days in the ICU. and that's before we even get to babies who are protected babies who can avoid some very difficult days in the icu So I think people saw very quickly, if you look at our revenue and how quickly it became a blockbuster, it's the most successful pediatric vaccination launch in the history of vaccines. So people see it as incredibly effective. The real-world evidence that has been accumulated showed that it absolutely pays back within a current year and protects those babies. And that is just a gift to parents, but it's also a gift to healthcare systems. So we have work to do. There's competition. We think our half-life guarantees us to protect a baby for the entire RSV season. We think we may be wrong that the competition doesn't offer that. We'll find out. But we've accumulated so much real-world evidence data, it's quite difficult for others to demonstrate this data set we have at launch because we're in great shape on Beyfortus. So I think people saw very quickly, if you look at our revenue and how quickly it became a blockbuster, it's the most successful pediatric vaccination launch in the history of vaccines. so i think people saw very quickly if you look at our revenue and how quickly it became a blockbuster it's the most successful pediatric vaccination launch in the history of vaccines So people see it as incredibly effective. so people see it as incredibly effective The real-world evidence that has been accumulated showed that it absolutely pays back within a current year and protects those babies. the real-world evidence that has been accumulated showed that it absolutely pays back within a current year and protects those babies And that is just a gift to parents, but it's also a gift to healthcare systems. and that is just a gift to parents but it's also a gift to healthcare systems So we have work to do. so we have work to do There's competition. there's competition We think our half-life guarantees us to protect a baby for the entire RSV season. we think our half-life guarantees us to protect a baby for the entire rsv season We think we may be wrong that the competition doesn't offer that. we think we may be wrong that the competition doesn't offer that We'll find out. we'll find out But we've accumulated so much real-world evidence data, it's quite difficult for others to demonstrate this data set we have at launch because we're in great shape on Beyfortus. but we've accumulated so much real-world evidence data it's quite difficult for others to demonstrate this data set we have at launch because we're in great shape on beyfortus

Speaker 1: Perfect. Thanks very much, Paul. Thanks, François. Thanks, Houman. Thanks, everybody. Perfect. perfect Thanks very much, Paul. thanks very much paul Thanks, François. thanks françois Thanks, Houman. thanks houman Thanks, everybody. thanks everybody