Q1 2025 Sanofi SA Earnings Call
, Jessica M. Fernandez, that may cause active results to deepen materially. [inaudible]
We encourage you to read the disclaimer in our slide presentation. In addition, we refer to our new phone 20F on file with the USHCC and our friends registration document for description of these risk factors.
As last quarter, financials reported that under the new V-Porting Scope that excludes your failure of consumer health business.
As usual, we will be making comments on our paper for comments using constant exchange rates and other non-IFI or smish issues.
Numbers used on millions of euros and for Q1225, on this stated otherwise. Now, please go into slide number 4.
First, we have a presentation, then we'll take your questions. We have kept the presentation as shown as in the past, and other companies report today, and we aim at giving the call to maximum one hour.
With your need, we have Brian , Olivier, Thomas, Jacoba, our Global Businesses, as well as Roy, our Dillon Council and Brandon, Head of Manufacturing and Supply [inaudible]
To the Q&A, you have two options in Zoom, raise your hand, also meet your question using the Q&A function work. With this, I'll hand you over to Paul.
Speaker Change: Well, thank you Thomas, nice to be done, and hello everyone on the call. We're a strong start to 2025 with an I-put-7 defense sales growth in the first quarter. Our strategic focus on innovation continues to deliver to them by formal launches, due picks and bay fortes in our vaccines portfolio.
Speaker Change: Let me highlight our performance of new launches on slight sex in Q1, while launch is generated 1.1 billion euros in sales, contributing 11% of the total.
Speaker Change: David's performance was driven by an element of Bay Ford's phasing and expansion in Europe and rest of the world . . . .
Speaker Change: Altuvio benefited from continued patient switches and has the potential to become our next blockbuster this year.
Speaker Change: Of note, on March 28th, we obtained FDA approval for Q50a in Hemophilia, one of three potential launches this year, with initial prescriptions already recorded in early Q2.
Speaker Change: Moving to slide seven, DuPixand, DuPixand delivered strong growth of 20% in Q1, driven by broad-based demand, and reached 3.5 billion euros of sales. In the US, sales were 2.5 billion euros in the quarter of 18%. DuPixand now also leads total prescription share across all approved indications. Thank you.
Speaker Change: As usual, in the first quarter, US sales reflected the impact from the annual reset of insurance deductibles driving higher utilization of co-pay assistance.
Speaker Change: outside the US, depicts themselves exceeded one billion euros for the first time, supported by the contribution from Japan, China and Germany. Looking at the remainder of the year, we will continue to drive depictions growth across our markets and in all approved indications. Thank you very much.
Speaker Change: As a reminder, biopenetration still remains quite low. We are excited about the U.S. approval for CSU
Speaker Change: These additional indications continue to expand our leadership across type 2 inflammatory disease.
Speaker Change: On Sunday, let me brief remind you of the higher met need among people with uncontrolled CUPD, many of whom resign themselves to their condition.
DuPixson is the first biologic medicine approved in this disease.
Speaker Change: We have already launched CFBD in a country that is including the US, Germany, China and Japan. Depictions of value has been recognized by payers and key countries ensuring access for all patients.
Speaker Change: To improve an option, we focus on two main objectives. First, we continue to educate pulmonologists about duplex and benefits, the role of type 2 inflammation and the urgency to treat patients.
Speaker Change: II, to drive patient awareness, in April , we just launched our DTC campaign in the US.
Speaker Change: We have been to slide nine. Our vaccine business delivered double-digit growth in Q1. This performance was driven by favorable Bayfordas phasing and new country launches. In the US we are focused on improving the immunization rate to ensure our infants born in late season are also immunised and protected.
Speaker Change: Serving to flu, our manufacturing is progressing as planned, following the WHO and FDA's spring selection. As the world leader in flu vaccines we continue to focus on improving the vaccination rate by increasing awareness of the benefits of our differentiated flu vaccines.
Speaker Change: On our vaccine's pipeline, we continue to push the boundaries of innovation and in the development of a vaccine candidate for the prevention of chlamydia. We march the US FDA granted fast-track designation recognition of our commitment to improving public health and addressing high unmet medical needs.
Speaker Change: On site 10, I'd like to introduce you to our updated Sustainability Strategy, focus on aligning health outcomes with environmental and social responsibility.
Speaker Change: Environmental Challenges, and Human Health, an estimated 3.6 billion people are living in climate sensitive areas with 6 million deaths supported annually from air pollution.
Speaker Change: That makes it clear, people's health and environment are deeply linked. Our new air strategy focuses our efforts on three strategic imperatives, access to healthcare, environmental impact and the resilience of healthcare.
systems.
Speaker Change: with 70% of our portfolio and more than 75% of our pipeline involved in climate-related diseases, Sanofi has a key role to play. And through air we are furthering Sanofi's commitment to global health, by working to rate the cycle of the environmental decline and declining public health.
Speaker Change: Thank you on our hand over to Francois or CFO for more details on the financials.
Francois: Thank you, Paul, and hello to everyone. As highlighted by Paul earlier on, let's have a read by 9.7% of the cost of the chain rights to 9.9 billion euros. The gross was primarily driven by our new product launches and by favorable phasing in vaccines.
Francois: Ross Margin improved significantly to 78% up to 2.3% at each point, from the previous year, driven primarily by an improved product mix and by efficient scenes.
Francois: Q1 effective tax rate was 22.3% linked to a one-off item this quarter. We maintain a full-your indication of a broadly stable effective tax rate versus 2024, which means around 20% for this year. Thank you very much.
Francois: Business EPS was 1.79 euro, a 15.7% reflecting of success performance or improve growth margin and our operating level. The Q1 growth confirms or expected from the P.S. rebound in 2025.
Francois: Moving to Opela, we expect to close the transaction in the coming days.
Francois: Sanofi will receive about 10 billion euros while retaining a significant stake in Opelat to support the company in its journey to independence and to participate in its future value creation.
Francois: The expected proceeds from this cell will be reallocated in accordance with our capital allocation policy presented on the right hand side of this matter.
Francois: First, our primary focus is to invest in our business, to drive organic growth, which means investing in R&D, settled on marketing, industry on assets, AI and talents, just to name a few.
Francois: Second, we continue to explore external growth opportunities for bolt-on acquisitions. In March, for example, we agree to acquire DR0201 from the rent bio, this promising molecules transcends our early pipeline in immunology.
Francois: Third, we maintain our progressive dividend policy, and 2025, we'll mark our surfer's consecutive year of dividend increase.
Francois: Force, regarding value and nothing shared with purchases, we are executing our five billion euro share by the program in 2025 with 76% already completed as of yesterday.
Francois: We have repurchased 37.7 million shares at 10 average price of 1.5 euro, all for the purpose of consideration.
Francois: These underscores are commitment to delivering long-term shoulder value and partially mitigating the dilution from the opiate transaction.
Francois: Looking ahead to the balance of 2025, I would like to remind you of some anticipated key business dynamics which may be helpful for modeling purposes.
Francois: For Q2, please note that Lotus USA started to increase materially in Q2 2024 due to the unavailability of a competitor's product representing a higher base of comparison for the next few quarters.
Francois: Despite this higher-based line, we expect stable sales volunteers in 2025, as we continue to capitalize on favorable market dynamics and competitive opportunities.
Francois: In R&D, we remind you that we received in Q2 2024, a one-off payment from SOBI of about 200 million euros for the development of active vote at the time of approval in Europe .
Francois: For the full year 2025, for an exchange impact is moving against us, and it is now estimated to be around minus 1.5% on sales and around minus 2% on EPS.
Francois: All other business dynamics remain unchanged compared to what we communicated at the beginning of the year. I now hand over to Houman to provide an update on the progress of our innovative pipeline.
Houman: Thank you, François. During the first quarter, we obtained six approvals, including Confitliya, the first anti-thrombin lover, ring-prosyl axis therapy for patients with hemophilia A or B, regardless of inhibitors.
Houman: and additional approvals for depicting him in COPD in Japan, CSU in the US, and Sarkleder, Crossgrip, with different lines in several countries.
Houman: Moreover, as Paul is already alluded to, the pixel was granted prior to your review in Bullock, with a pedophadade of June 20th.
Speaker Change: Business followed by regulatory acceptance of Tollip Brutonet, which is now separate for two for dates of September 28, complemented by two recent New England Journal paper publications.
Speaker Change: As Francois said, last month we announced the acquisition of DR-0201 from Graham Bios, a potential first in class CD-20 directed by specific anti-body, targeting and engaging myeloid self
Speaker Change: with a potentially favorable and superior safety profile compared to T-cell engages, which may carry a risk your side can't release syndrome, and other immunological risks.
Speaker Change: DR201 has the potential to induce deep B-cell depletion via a phragocytosis, enabling sustained, treatment-free rhythmic remission in autoimmune diseases such as lupus and where significant unmet medical
Speaker Change: Next slide please. Last week we shared advances from our mid- and late-stage respiratory pipeline for Amulet Telamab, Lund Second Big, Anita Peckamab, of course, several indications.
Speaker Change: The clinical evidence supporting the OX-40 ligand inhibition across three major diseases, namely Asquire HS&AD, is compelling.
Speaker Change: Furthermore, the efficacy of our medicine is targeting this pathway with different medialities supported by the following data.
Speaker Change: Preliminary efficacy results shows that the treatment with AMLA telemaub led to clinically meaningful and durable efficacy on exacerbations lung function and symptoms and patients with moderate-diff severe asthma, including in but not limited to those with heterogeneous inflammation.
Speaker Change: This limited phase two forum dose findings study did not reach statistical significance. The primary endpoint of reductions in the distribution of highest space level.
Speaker Change: in the ITT population. As a result, all the endpoints are highly biological, but exploratory.
Speaker Change: In certain groups, including the subgroup of patients, Elizabeth Field, and Elevated Neutrophil, Amuletilamab showed a robust reduction of more than 70% in the annualized rate of severe incursion of us.
Speaker Change: Amletelamab was generally well tolerated with no new safety concerns. We and members of some of the national community feel that they are very excited by this result.
Speaker Change: With a relevant statistical caveat that I've already mentioned, Amla Tillembao appears to have a differentiated advocacy profile in selected asthma patients, potentially representing a breakthrough for this underserved population, it's this result is confirmed in future phase 3 studies, for which we are in the midst of designing.
Speaker Change: As our early R&D pipeline continues to develop increasingly, I'd like to take this opportunity to shine a light on our versatile nanobotin platform.
Speaker Change: Not only has this produced the potentially besting class in asthma, drug, lune, second meag, but now it's continued to deliver with brevacameg, anti-TNF, anti-ox 4-2 bi-specific in HS.
Speaker Change: Brevackemig achieved its primary objective with finically meaningful improvements of both high school 50, the primary endpoint, and other endpoints in patients with moderate to severe HS, that are naive to biologist.
Speaker Change: I'm delighted to observe that the treatment benefit as a competitive efficacy profile when conferred to currently approved an emerging medicine HS, with a safety profile in line with expectations, and no new safety concerns either.
Speaker Change: These results show the potential to increase efficacy by targeting ops 40 ligand on top of the conventional anti-tenant treatment in H.S. Through this deal targeting mechanism is effective.
Speaker Change: We have therefore decided to prioritize pervacumates for further development in HS. [inaudible]
Speaker Change: Finally, Amletilum App Recruitment is progressing ahead of the planned and atopic dermatitis from the SA's three studies. The Oceana Program is anticipated to read out in its entirety in 2026 and will provide the foundation for future regulatory submissions. As a result of the accelerated recruitment, the initial results from Coast one and sure studies might emerge earlier than anticipated. The Oceana Program will provide the foundation for future regulatory submissions and will provide the foundation for future regulatory submissions.
Speaker Change: Tell it, turning to ballet to the fin, preliminary results, preliminary shapes the results show that the treatment was generally well tolerated across multiple doses with no new safety concern being identified.
More significantly, the study confirmed that differentiated safety profile. [inaudible]
Speaker Change: While the primary endpoint of Pazie 75 compared to placebo amongst the highest treatment notice evaluated in patients with naïve to biologics, moderate to severe parapsurises did not meet the statistical significance due to the nature of this limited phase
Speaker Change: Loadoses across naive and experienced patients should clinically relevant as these 75 responses, which are comparable to other medicines previously assessed in the psoriasis.
Speaker Change: Our additional phase two in RAs anticipated to read out later in the latter part of this year, if successful we will combine our oral TNFR1, Siegling Innovator and Innovative
Speaker Change: Standards of care therapy with a view to increasing the efficacy ceiling.
Speaker Change: Like we've always considered one potential application of this molecule in combination, including six straight combination.
We are assessing combination options with internal assets. [inaudible]
Speaker Change: In addition, we're a various station discussion with major farmer and biotech partners to generate novel combination for multiple immune mediated disease.
Speaker Change: For example, with Eli Lilly in company, we're exploring the potential to combine and increase in with Sanofi Immunology Pipeline that's such a valid tune of it.
Speaker Change: The updates on the progress of our pipeline today support our ongoing commitment to bringing innovative methods to all patients. It was acknowledged that the study design
Speaker Change: and previous strategy were not optimised in all cases. However, the incorporation of knowledge enhanced productivity is from the way.
Speaker Change: Furthermore, the Progressive New Studies Exploring and Second Make that's potentially broader use in high risk asthma, COPD and atopic dermatitis and at the Peckermab in CRS with and without nasal polyps continue to enforce our pipeline.
Speaker Change: The FDA's recent approval of confettlers to prophylaxis for patients with hemophilia, AMB, irrespective of inhibitors underpins a significant milestone for this community of patients with a unique mechanism of action. [inaudible]
Speaker Change: Defectly, there's a small interfering ribonucleic acid therapy that targets antithrombin, requiring only six small volume subcutaneous injections per year.
Speaker Change: Disapproval is expected to contribute to a redefinition of the standard of care with a reduced treatment burden resulting from optimising, complementing by AT levels, monitored by Zeeman's companion diagnostic, available at no cost with Sanofi lab course support program.
Speaker Change: A regulatory decision in China is anticipated by the end of the year with submissions in the EU and Japan expected next year once pediatric data are available.
Speaker Change: I'd like to conclude with my usual news flow slides for 2025 and for next year. On plan 11, phase 3, we
Speaker Change: and 14 regulatory decisions and multiple jurisdictions increasingly capturing the improving value of our pipeline.
Speaker Change: I would mostly highlight two upcoming phase three results for this year, but will be significant, Colin Brutanabe, MPPMS, and it's a Peckermab in COPD, with a sum with the aim of launching next year depending on the date. [inaudible]
Speaker Change: Next year, I'm looking forward to seeing the results of the face-through data for improved by subject MSC1, mass pathway inhibitor, our objective is to improve the journey of CIDP patients, with really improved about as a potential treatment option for those who are inadequately responding
Speaker Change: We're very much looking forward to updating you on this progress. As I frequently emphasize, we adopt a humble stance in with ACCC, acknowledging that not all of our efforts will be successful.
Speaker Change: It is nevertheless anticipated the synergy of skilled science focused teams and conjunction with our augmented exposure to cutting-edge digital technology will facilitate the advancement of this unique pipeline within our core therapeutic areas with the objective of benefiting potential. [inaudible]
Speaker Change: I would like to thank all of my brilliant R&D team members and colleagues across the company for the positive progress made this year. We're chasing the Americans of science to improve people's lives. With this, I hum back to Paul for Q&A.
Paul: Okay, thank you. We'll now open the culture questions. As a reminder, we would ask you to limit your questions to one or two each. You'll be notified when your line is open to ask questions. Thank you.
Paul: A time please make sure you unmute your microphone or option two, submit your question right click in the Q&A icon at the bottom of the screen. The question will be read by our panelists. Now we'll take the first question. Please go ahead.
Good.
Emily Field: This is going to be a quick afternoon. It certainly is. I'll be very quick as well. I think I'll do that to work, hopefully. So a couple of questions please.
Emily Field: Firstly, maybe one just on the, I'm going to tell them I have asthma data. Obviously efficacy in these type two, type two low patients.
Emily Field: Just thinking more deeply, how you think that efficacy compares to Dupin and really how you think that will read to the efficacy in AD relative to depiction from what you can see.
And then a second question, just on this.
Emily Field: Novel Combination, which I think I heard was with in Cretin's annual anti-TNF. [inaudible]
Just thinking through that combination a week. [inaudible]
Emily Field: Should we be thinking about that in HS, obviously there's a disease overlap with obesity there, struggling to think beyond that in terms of the the the the combinability so just just thoughts on what how we should think about that that combination.
that you're thinking that. Thanks very much.
Speaker Change: Thanks, thanks Richard. Three little sneaky questions dropped in there and I'll address all three very quickly.
Speaker Change: Firstly, on Emily and Asma, let me start by saying that as we said at the top of this call, we remain hugely committed to depictions.
Speaker Change: with our partner in general, and we will continue to arriving that in pulmonology, both in asthma, in Ceres for MP, etc, and of course in soup.
Speaker Change: So, you know, I absolutely would not take a comparison between Emily and Chipilimab. Let me answer your question, though promptly.
Speaker Change: We're very excited by the results we've seen with Emily and Asma. We've been very clear and cautious that it missed its primary endpoint, but I have to say from where I'm sitting, when you see the data, I feel that in multiple subgroups we have...
Speaker Change: Really very compelling data, which has driven our commitment to going straight to Phase 3 in...
Speaker Change: Subgroups with Substantial Unmet Medical Need. You talked about the Pfizer-Methyl Group and indeed the Hectorotumis inflammation group and in those populations and the telemath has a distinct play.
Speaker Change: for the treatment of patients, both because of the efficacy in those groups, but also its Q12 dose. [inaudible]
Speaker Change: So I hope that answers your first question. The second question was related to Valentinifib and combination therapy as I said very clearly.
Speaker Change: Actually, we said this early on, there would be a small number of indications in which we would go with monotherapy, but we always plan to combine this in combination. Indeed, even in rheumatoid arthritis today, Antitiana has to combine with mass trexet, which is a synthetic demarc.
Speaker Change: So our strategy is indeed to go into combination therapies, including fixed-based combinations. We are in discussions with multiple.
um
Big Pharma, and Biotech Company.
Speaker Change: for the appropriate rational conversations and of course with our entire pipeline and your direct question about ingredients actually there is a substantial body of literature across multiple inflammatory disorders and we could list them but I won't do that here. We are metabolic.
Contributions to disease are extremely substantial. [inaudible]
Speaker Change: Earl, you'll appreciate that for the sake of disclosures we won't go into these disorders now, but you'll also appreciate we're exploring multiple opportunities.
Speaker Change: Thank you, thank you, Raymond, thank you, Richard. Okay, next question please. Yes, next question is from Luisa Hector, from Berendant, Luisa.
Louisa Hector: Thank you. Sorry, that's my unmute button. Thanks for the call. My question's still on.
Louisa Hector: Amletele Marvin, Asma, but maybe to go a little bit more broadly because you have other assets.
Louisa Hector: in development for asthma, so how do you see it up more broadly, a respiratory franchise?
and developing within your pipeline.
Louisa Hector: and then Seconding, etc. And then perhaps I could just check on on DuPixson again, respiratory, so a little bit more color on that COPD launch reimbursement status of COPD and how you wish to think about that phasing through 2025. Thank you.
Speaker Change: Thank you very much. I'll take the first part just to start up and then I'll take the second part with you know we've said all along that we want multiple different mechanisms addressing different parts of the patient journey. [inaudible]
Speaker Change: It's clear that biology penetration, even after all these years, is still in the high teams.
in Asthma, and of course we got to say a few days. [inaudible]
Speaker Change: and so we need to have different offerings. So you can mention the second, I think we showed data back in 23 at ATS.
on the Pino Drop.
which was radically different, and you can see us.
Speaker Change: starting to shape up how the market could look with high efficacy approaches so those are needed more, longer interval for those that want less needle burden. [inaudible]
and then, of course, safety and other elements of Africa, so you think we're? [inaudible]
Speaker Change: Very well positioned, given the low penetration and the very different offerings for each patient. It's been quite a novel approach that we've taken and done this multiple diseases. I think it's going to play out quite successfully for us.
It's just very clearly, I am.
Speaker Change: Remember, in the second week, we have multiple respiratory populations, including Hirons Gassma, and patients for Tiver Asma, and we really, really, Louis, as you know, with the combination of credential targets, yes, up in our 13th shooting for
Speaker Change: Breaking the efficacy ceiling, pretty straightforward, the TPP for that is really very straightforward. I won't repeat the other things that Paul said because I think our commitment from the very beginning was to take franchise areas, to take whole areas and to provide patients in those areas.
Speaker Change: with the very best treatment we could do, and to really begin to tease out substrasser, and that's what we've done. Brian .
Speaker Change: Thank you so much for the question. I love that we keep getting asked the questions on CFD. There's a really important disease state that's very heterogeneous like asthma, as a matter of fact, we're just articulating and we've got a couple of shots on goal. I think you're from a CFD standpoint, but let me first start off with DuPixant. [inaudible]
Speaker Change: You know, we anticipated always that it would continue to game momentum, we launched it at the end of last year, we saw really good progress in the last year, but it's game momentum even as we started into this year when we still see the inflection point will be in 2025.
Speaker Change: Actually, we've seen early data suggested we have a record.
Speaker Change: Settling Pace, so far as it relates to Medicare and Medicaid coverage, or Medicare and commercial coverage, about 90% Medicare coverage.
Speaker Change: and at this point, 88% commercialized recovered, so that's really a record setting for the indications that we've had. Additionally, as you look at initiations, we're seeing it's our most rapid, respiratory initiation launch so far, again, but these are initiations, they need to turn into in-birx, they need to turn into grx. [inaudible]
Louisa Hector: And that's what we're out there doing now. So, we feel that this is continuing to strengthen our position in the pulmonologist offices having it's having a nice play as well with asthma. But again, as we said before the week, we expect 2025 to be the inflection year pursuit.
Louisa Hector: Anthony, and for it to continue to be a part of many indications now, our seventh indication recently approved in CSU, but a part of the overall growth that we anticipate will drive double digit cacker growth from 23 to 30, generating roughly 20 to 22 billion or so by 2030 time frame.
Speaker Change: Okay, thank you. There's a question. Yes, let's try again, Emily Field, please.
Emily Field: Hi, thanks, and sorry for the mix up before. Anyways, okay, so, um, I was just wondering if you could help us kind of understand the or quantify the seizing impact, you know, is there any incentivizing for talking out of a potential competitor launch and then
Emily Field: You know, in the slides, you also mentioned that you're focusing on increasing the next season immunization rate. You know, particularly in U.S. What was the penetration? Thank you very much.
Emily Field: of B Fortress over last season, and how far do you see yourselves being able to take that up this year?
Emily Field: And then a question on Brayback Amid, I was just wondering if you'd give us a little more color on the synergistic component of the MLA given that, you know, we know the TNFs alone look inferior to the IL-17s and then the OX-40 ligand, your own model therapy didn't succeed. So I was just sort of curious why you think that...
Emily Field: The combination there will look better than each other. Thank you.
Thomas: Okay, Thomas. Yes, thank you very many, happy to probably be of color there. Thank you very much.
Emily Field: So just to get started, I want to reassure you or anybody but no, there is no incentive, there was no incentive [inaudible]
during this event to a stock-up...
Speaker Change: The colour is more specifically, indeed, as you were pointed out, on the US market.
Speaker Change: I'll give you a couple of numbers I think that can help. If you look at the overall RSV prevention vaccination coverage rate
Speaker Change: during the 2024-2025 season, so that's the month of October to February , March. Roughly in the US there's a vaccination coverage rate which is around 65 to 60% all product included. This is a vaccination coverage rate which is around 65 to 60% all product included. This is a vaccination coverage rate which is around 65 to 60% all product included.
Of course.
Speaker Change: The lion's share of that was before Tuesday, which is great. And therefore it means that we have more to go because of both 60% you know that we expect. Thank you.
Speaker Change: Big VCR to be close to the traditional vaccination coverage rate for infants, so that's room to go and that's why we're saying that we have job to do. We need to work on increasing the musician rate in 25 and 26 to go and needs to be because all babies need to be protected against against RZ. And to give you a bit of color exactly on what we're going to do. [inaudible]
Speaker Change: I think the qualitative part is important. When we look at the emissation of the past winter, what we saw is that the S community gathered and did a great job. [inaudible]
Speaker Change: at the dueing preventive measures early on, so let's see in the month of October and November , where the right interventions were in place.
Speaker Change: So it's got a little bit fading out when you look at the month of January , February and March. And I think that shows that people have netted fully understood that it's a full season protection, that babies are at risk when they're born in January , March and February and March. And that's the job we're going to do this season and the next season. So that's why we're focusing on this room to grow there. As far as this for the full year, we've told you last year that our intention is to grow 2025 sales of this for two seasons. Thank you very much.
Speaker Change: We are still on that trajectory and we are focusing on protecting as many babies as possible moving forward.
Speaker Change: Okay, thank you. Who would you want to make a comment on the recommending?
Thank you.
Speaker Change: Charmele, thank you for the question on Blacknick. I'll stretch to the answer briefly in three parts. One is, you know, this is a...
Demonstration of our Continuing Commitment to Internal Research at Simon Fee [inaudible]
Speaker Change: I'm reflective of the comments that people have historically made about research and development of Sanofi, and it's a sort of particular pride for me to bring in innovation from the outside, but especially do work internally, and these by specifics are beginning to demonstrate the muscle we have in research as well as development. Thank you very much, John .
Speaker Change: Point two is, you asked a question, why would there be a combination value in those two targets? Remember, of course, Alex Fautier-Igan, there's a member of the TNF super family, as is TNF, we specifically designed the exploratory
Speaker Change: Studies, to be able to see whether Oxfordy-Liegan alone or in combination with TNF would make a difference.
Speaker Change: posing the question that you asked in exactly the same way, and I'm really delighted to be able to provide, you know, albeit early with all the caveats to go with early studies and patients, particularly biologic nine patients.
Speaker Change: So that combination works. The reason it probably works is that TNF itself induces Oxfordy ligand on cells, Oxfordy ligand licenses multiple. [inaudible]
Speaker Change: Cell, particularly T-cells by Dendronic Cell. So, I really do feel that we, the double punch has a precedented biology for synergy.
The fact that it really... [inaudible]
Speaker Change: is competitive with besting class molecules out there for HS, gives me a great aspiration that we move forward with these studies.
Speaker Change: And maybe I could add, I mean, I think Houman touched on it in terms of... [inaudible]
Speaker Change: This cool work we're doing with bi-specific and things, let's not forget, I mentioned H.S. earlier from 23th
Speaker Change: IL-13 and TSOP, Fino Drop, was in excess of the individual model components. I also remember, I think the brand you print me from IL-13 didn't work in ASAP on its own. So it's a red herring to think that because you get good or mixed data on one, you don't get a synergistic effect.
Speaker Change: There is very definitely something in targeting two pathways that 1 plus 1 equals 3. It's the next sort of exploratory battleground for us. I think we're excited about what we've seen. [inaudible]
Simus Fernandez: Next question, please. Yes, next question is from Jimis Fernandez from Guggenheim,
Okay, so, ah, yes, Chimous. [inaudible]
Simus Fernandez: Hi, this is Colleen on Sir Seamus. Thanks for taking your question. If there anything you can share to help us, tell us get a sense of your level of care exposure, to transfer pricing, and I'll do picks in at any strategy and steps you're considering that it may limit this exposure. Thank you.
Simus Fernandez: Okay, thank you very much. Francois, over the year. Yes, at this stage, we have no specifics to share regarding U.S. turrets.
Simus Fernandez: That said, we have run through all scenarios and we will communicate any development if need be when the time is right
Simus Fernandez: I would really like to help you, but it's difficult to comment on the occurrence of possible future events that are still unknown or speculative at this stage.
Simus Fernandez: So there is no certainty beyond what has been announced, and have been announced so far, has been fully implemented in our confirmed guidance for the Fuea 2025, but not to go beyond that.
Simus Fernandez: would be a little bit complicated because we don't know which country would apply to, which products would be impacted, which rate would be applied, when would it start? That's right.
Simus Fernandez: So it's extremely difficult for us to comment on a certain number of scenarios but just be aware of the fact that we are ready and we have fully if anything has happened and we have fully factored whatever has been officially confirmed and announced so far.
Speaker Change: Thank you very much, next question please. Yes, next question is from Ben Jackson from Jeffries, Ben.
Ben Jackson: Hi, here. Thank you. Just two quick ones for me today. First just a little bit more on the Ops 40-HL, TNF approach.
Ben Jackson: with the results that you've seen in HHS, does this? [inaudible]
Speaker Change: bridge any kind of confidence that there are additional indications that this combination could be useful for and does that change the relative position that you're thinking about? Yeah, yeah, yeah, yeah.
Speaker Change: with regards to the Lord of Portfolio, obviously we've just mentioned thee. Thank you very much.
Speaker Change: The OX-40L standalone there and essentially seeing a synergistic effect but just has us change how you view any other assets in your portfolio. And then secondly just on the TFR one as well with regards to psoriasis read out.
Speaker Change: He's the data that you see and change any expectations of the Regal Sword arthritis read out coming up. And then with regards to the combo trustee, I appreciate that you...
Speaker Change: Well, it said that the monetary fee was only a small part of the actual opportunity because you were seeing in the first place, but perhaps could you provide a little bit more color around that? What you see the biggest potential bear is for thank you.
Okay, thanks, Ben, Houman.
Speaker Change: Let me start with Vivek Emig, your entirely right that the combination of Oxford-like anti-NF is super interesting. What I won't talk about today is the...
Speaker Change: The molecular data we got out of those studies, that of the molecular data from those studies give us a number of increased leads in what we do. I think it's an unspoken part of being...
and Emerging.
Immunology Powerhouse,
that we have enough. [inaudible]
Speaker Change: Internal Network Strength that we observe from human experiments that we do and it guides us to where we can drive these molecules. [inaudible]
Speaker Change: through Lifecycle Management. Short answer to your question, yes, asymmetric.
Contrarian in flight to Emerge from our own data.
Allow us to develop further research.
Speaker Change: , Immunology, Powerhouse, and then to your two direct questions on TNF small molecule, TNF one small molecule,
Speaker Change: The answer to your question is, we always knew this arises. [inaudible]
Speaker Change: It was a past one under indication. What I mean by that is allowed us to identify the differentiated safety profile tech that allowed us to establish dosing very straightforwardly and it allowed us to really understand where we would go with in combination therapy.
There are a number of disorders you'll appreciate disorders like.
Speaker Change: R.A. and Collision Spondylitis, that are very TNF responsive and we may well end up there in monotherapy, and then there are a variety of conditions that naturally lend themselves to combination therapy. I won't disclose those now, but the biology of those well precedent. [inaudible]
Speaker Change: Thanks, Simon. I mean, it's exciting actually in terms of the opportunities, why it's face floods, it really was HS. So I think we're very interested to see what the one plus five equals three is. [inaudible]
Speaker Change: On it personally, I haven't been involved with China for most of my career, the safety piece in the psoriasis study was the piece that you were looking out for first, followed by Africa, Stephen Scala, that was never our target.
Speaker Change: But the combinations with TNF as backbone, you know, it's interesting the number of conversations were having externally. There's a great level of interest in raising the efficacy of other adjacent oils to make sure that we can break new efficacy standards for different diseases as much.
Speaker Change: That was sort of always the goal and that's now playing out a little bit like that. So of course lots of work to do to get there, but I think we'll do a pretty positive. Okay, next question please. Yes, next one is from Peter Verdult from BNP Exxon.
Are you there?
Hello.
Hello. Hi Pete, hello.
Pete: Friday, how are you doing? Speak here from the MPXA. Just two questions, I'm surprised it's one of the minars here already Paul. The letter you invest in in the FT does make valid and fair points, but we know governments have big commitments to defend spending increases and not unlimited budget. Thank you.
Pete: This is a simple question for me, have you had any recent interactions with European politicians that give you hope or should we remain cynical about their appetite to better reward innovation in Europe ?
Speaker Change: and then Houman, sorry, to sort of lay with the point. I know you can't talk about the data, but H.S. is a big focus for everyone, you know why. So when you are when you're expressing excitement for the private company, where can we finally see that face?
Speaker Change: Two dates that we're all going to do, cross trial comparisons too.
Speaker Change: The IELTS 17, so if you want to be clear, are you saying that you feel the data is competitive to the data sets we've seen from the IELTS 17A's and AMF's? Thank you.
Speaker Change: Well, you go first and then I'll mention B. Leather's the F.T. Yes. Thank you.
So you may know I was...
Speaker Change: At a cameo role, maybe a bit more of it than the cameo role in the early days of him select when I was at UCB.
Speaker Change: and have an intimate knowledge of that molecule in multiple indications. Suffice it to say that
Or Beard Early with all the caveats that... [inaudible]
Speaker Change: You make about some more early exploratory studies, it's certainly competitive in relation to Memes Ali, and I'm excited to see how it goes forward and face to be on three end due course. [inaudible]
Speaker Change: Okay, thank you. And as for the latter, you know, we've been...
I think very poised. [inaudible]
Speaker Change: You know, given China, US, Europe , and the state of things in terms of...
Speaker Change: I think for a long time, even before the conversations over the last weeks, there was a change in administration, the US has been...
Speaker Change: A long time campaign to really help Europe understand the value of medicines and investing in them and the quality of jobs and the impact. Very few people.
Speaker Change: I really appreciate that the number one exporter from the EU is in fact pharmaceuticals, 300 billion plus. We've been public about that, that's been well documented. And I think we have had conversations with the presidency of the EU over the last. Thank you.
Speaker Change: over the last weeks, just to try and remind everybody of the role that Europe can play in the global pharmaceutical industry and that. [inaudible]
This is a good moment.
to express some commitment to him. [inaudible]
Of course these things. [inaudible]
have to be said, they don't always materialize us in changes. [inaudible]
Speaker Change: Instances, but I think it has to be no regrets from us to try and make sure people understand what we bring to patients, what we do it, what it means for countries and for Europe in particular, and be very composed with where Europe sits between the US and China. It's delicate, as you would imagine. Okay, nice question. Next question from Jo Walton from UBS. Bye.
Joe Walton: Thank you. I've got one I guess slightly philosophical question about R&D and then one about situation in the US.
Joe Walton: So the philosophical one is we've seen a couple of what looked like failed results or at least not particularly good results which have been blamed on very small sizes of studies so we can't
Joe Walton: Get to increase our probabilities of success until perhaps the studies are bigger. Are there any other of your phase two studies that are coming out that? [inaudible]
Joe Walton: We may also find it just perhaps a little bit too small to give us the answer that we want. And I'm thinking, the Oxford you like and the data wasn't statistically significant, but you're very, you're very convinced it's going to be competitive with Bimzilex, for example, in HS, but we can't see that data yet. [inaudible]
and the oral TNF.
Joe Walton: That also seems to be too small the study to be really very clear about it. Could you perhaps tell us whether you think there is still a decent chance of an oral only indication for something like R.A. Or whether this is really going to always now be perceived as a combination product.
My second question.
Speaker Change: is just in the US and Paul, I'm asking you this is your role in farmer more than from a Sanofi perspective, but if you do get the opportunity to renegotiate the IRA and go from 9 to 13 years for everything which everybody thinks is. [inaudible]
Speaker Change: appears to be what Trump is encouraging Congress to do. Do you think there will be a significant pay away that you will have to give in exchange for that? Because clearly the CBO would say, well that's going to cost us much more money. So should we see that still as a net benefit for the industry? Many thanks.
Houman: Okay, thanks, Joe. One of the fastest to connect. Thank you, Houman. Yeah, so, Joe, thank you for the philosophical question. Let me be...
Very direct.
Speaker Change: I've been very reflective about the comments we've received after the disclosure of our results.
Speaker Change: in an effort to demonstrate an abundance of caution and an effort to be extremely statistically rigorous. I think we may have not conveyed the clarity of the message about the value and success of these trials. I'm just going to say these very directly. [inaudible]
Speaker Change: And you will see the data, but with the Emily Asthmada, we've been very flared, we missed the primary endpoint, but I've been abundantly flared.
Blair, there is no equivocation in my mouth.
So this is a drug, we'll go through phase three. Thank you very much.
Speaker Change: and with a reasonable wind behind us, as with all face trees, I have significant confidence that it will be successful. So, this isn't a function of a small trial. There are always new exploratory data finding studies, a bit of statistical wobble, but my confidence in Emily Asthma is unequivocal. [inaudible]
Secondly, in Brevakimig,
The study did not miss its primary endpoint.
Speaker Change: We went to some pains the craft of language about not missing its primary end point just to be super clear for studies.
Speaker Change: Statistical Approach, was a Bayesian approach which we didn't invent actually.
Speaker Change: Sabajan approach that is very similar to the first in human for Bimzelics published by SOT
Speaker Change: Viglatt as the first author, and my old friend Steve Shaw as the final author, I would say when that study was delivered, so very straightforward and I won't explain it here, Daisy in study, the credibility intervals on that molecule did not pass and dull point. [inaudible]
Speaker Change: I won't talk about the exact numbers, but the level of confidence by which we know this is better than placebo, or be it in a super early study. It's not just compelling. It's not highly compelling. It's exquisitely highly compelling. [inaudible]
Speaker Change: Right, so we didn't miss the primary endpoint, but we've been really very diligent about not making claims that we might be criticized for later. [inaudible]
Speaker Change: And then the final question was on the small molecule TNFR1 signaling in the cell.
Speaker Change: We have to humble in the face of disease. We tried this molecule in a disease that isn't exquisitely anti-canine responsive. We did it because you can judge.
Speaker Change: Pleasant, he's on the skin very quickly. We needed to make sure the molecule was safe. We needed to make sure Paul is set to have a differentiated safety profile. We also needed to make sure that we could judge the dose appropriately. And skins are very good way to assess those response. [inaudible]
Speaker Change: I think that disorder like rheumatoid arthritis that is more exquisitely TNF responsive may show a greater relative efficacy profile, but we said from the very beginning that as well as treatment in rheumatoid arthritis and other TNF responses. [inaudible]
Williams, we would go into combination therapy and I feel that. [inaudible]
Speaker Change: The conversations with multiple large pharma partners who have significant prominence in this space is unequivocal in my mind validation of the value of this as a combination therapy for those who are not sorted. So philosophically, I think we're in good shape. Yeah, thanks. You know, it's. Thank you.
Speaker Change: It's a good question because you mentioned, you know, could we've had bigger populations? I don't want to repeat myself so we could be said too much but...
Speaker Change: He was about safely at least entering some efficacy in psoriasis.
and before we go and put R.A.
Speaker Change: I think I would, you know, back to the monetary question. [inaudible]
Speaker Change: It would be great to deliver a primary input in R.A. in later in the year. But the bubble will wait and see, because the safety meant they were combinable and that was always the subtext, I don't know if we can quite express it, but we'll see. There was efficacy, you know, we've been, I've been in trance for a long time, the efficacy bar has already been flat.
Speaker Change: There was really no way to have achieved that but our alternative was to do really start with the R.A. study and that would have taken too long. [inaudible]
Speaker Change: So I think perhaps we took some risk in terms of not delivering, you know, the primary endpoint in psoriasis, but I think we sort of understood that.
Speaker Change: To be clear, we're pretty much at the end of the phase two is now in immunology. So in essence, it's just a part of the question that we really, what else might we see if you're either in this one? I don't really do that. So a question at this point. As for the farmer piece
Speaker Change: You know, and I think Francois answered it very differently, you know, there's really scant detail in terms of the numbers to be able to make any type of predictions. However, the Executive Order from last week was, would he use somebody explicit in this? [inaudible]
Speaker Change: Intensity. Step back a little bit from most favour nation.
Speaker Change: Step forward a little bit into what it means for patients and what it could mean for out of pocket and importantly brought in.
340 BMPBMs into that narrative, so...
Speaker Change: I would imagine there would be a pay for, because clearly if you meet from 9 to 13 there would be, and we'd be delighted as an industry, because I think some small molecule innovation was lost.
in that mistake first time round. [inaudible]
Speaker Change: I think it looks to me at least from the Executive Order and subsequent conversations.
that it may be a shared responsibility. [inaudible]
Speaker Change: and how we get there to do that. I would hope that's the case. Again, with the administration, we take nothing but granted, we've read the executive order, we reflect on it, and we'll see what it means in practical application. Next question? Yes, next question from Grabsary from Wolfson.
Hey, can you hear me?
Graeme Thierry: Yeah, great, so just wanted to go back to the question on Tariff's [inaudible]
Speaker Change: and just sort of push Francis Avery a little bit on that. So, you know, based on the administration comments, they, they have talked about 25% far maternity disability legislation 232.
Speaker Change: and there's a lot of discussion around whether that goes on to transfer prices into the US. So perhaps you just help us by if that's the most likely scenario, what sort of impact could that have on Sanofi? A 25% tariff on transfer prices?
into the U.S.
Speaker Change: How easily could you mitigate that either with prices at one end or with just lowering transfer prices and with that is the material impact on Sanofi tax rate? And also perhaps on depicts and just help us understand where the US supplies coming from is it all Regeneron, Ireland, US plants or is there a Sanofi impact from Sanofi's European plants as well? It's all right.
Speaker Change: And then just following upon the revetomy question around being competitive, when you say competitive with existing assets, do you mean it's sort of same ballpark, or are you looking to something here that is better than what's there already. Thank you.
Speaker Change: Okay, thank you. I mean, François, show you are able to? No, no, I wish I could help you Ram, but once again, I mean, I don't want to start discussing about various scenarios because it's very speculative, by nature. Once again, we have, we are aware of some of the terrorists that are impacting, for example, tried between the US and...
Speaker Change: China, for example, which we have factored in fully, you know, some guidance for the year 2025. After that, I don't want to enter into this scenario, you are talking about 25% because we could run scenarios at 5% or whatever it is, on which product does it survive, to which country, from which country? Please.
Speaker Change: Very, very difficult to comment on what is once again relatively speculative as of now. Let me just help you a bit, though, on our industrial footprint. Thank you very much.
Speaker Change: The US, so regarding our present, some production footprint in the US, Sanofi has been even.
Speaker Change: Prior to the discussion about tariffs, actively increasing its share of manufacturing in the US and specifically biologics drug substance.
We continue to assess our future capacity requirements. Thank you very much.
Speaker Change: and we are considering additional measures potentially including investment in the US.
Speaker Change: The lining of industrial footprint to the knees of our pipeline and to our expected future goals.
Speaker Change: So just as we did of, for example, our modules investment in Europe and in Asia, as we do as well the modernization of our Frankfurt in Suleen site, we are always exploring opportunities to expand our industrial footprint, including in the US to meet both our production needs and the needs of our patients. [inaudible]
Thank you, Houman.
Speaker Change: Thanks for the question, Graham. Let's just very briefly start with the caveat, which is, as I said at the joke, we accidentally found this precaution, we don't overinterpret our small studies, we convey the messages very clearly to the outside world, because I believe we've obtained a level of credibility that we need to envisely protect.
Speaker Change: But with that said, and the caveat that we used, press-idented statistical approach, in fact, Bermakism Abuse.
Speaker Change: I think that this molecule has a chance to fall somewhere between the two bookends that you provided. And we will find out when we run it in broader group of patients. I still think, by the way, the A it's competitive. Thank you.
Speaker Change: and the unmet medical need, as we found with Sariasis, with this extremely severe skin disorder, will continue to progress and emerge, and that's what we're hearing from all the conferences of a cow. Okay, thank you. Next question please. Next question is from Florent Cespedes from Bernstein, Laura. What?
Okay, we should perhaps move on. Laura?
Speaker Change: Okay, I would seem to have some time. Thank you. Oh, James, we got you. Yes, thanks. Thank you, my questions. I got two, please. So, first on, I'm going to tell you I have an asthma apology, but if I may have missed that, but you've had your confidence in moving to phase three, given the potential benefits demonstrated, but would you be able to share if you're planning to move into phase three with the broad population, or a selected population or multiple phase three across different populations, it would be good to get your thoughts there and how quickly do you expect to move here and what could be the next step since the starting of phase three.
James III, and secondly on the Gross Margin. .
Speaker Change: The impact was pretty strong this quarter with cults declining slightly year and year.
Speaker Change: versus the increase in revenue. So, could you give us a little bit more color over the drivers of the Ghost Margin? To what extent is this partly driven by some of the benefits from the new depiction manufacturing process? And how would you expect the Ghost Margin to progress through the rest of 25 and into 26? Thank you. Thank you very much.
James: James, the Houman family. So thanks for the question James, the first point is that we you know it's important to say we've just got this data.
We've recently received a data, Aaron. [inaudible]
James: Deep Consultations with Significant Cails in the Space, and by the way, thus far, seem excited by the data, we'll continue that work to define the phase three protocol fully.
James: We need to make sure the community is with us, but the short answer to your question is that we have an equivocal identified in our phase two population with high unmet medical need and we will ensure that that population is over represented in any phase three study we do. [inaudible]
Speaker Change: Well, maybe I'll add a little bit to that because I, of course, we have the benefit of seeing the data and we would never want to risk any publications or anything like that [inaudible]
Speaker Change: But the population and the humans allude into it is a significant percentage of the biologicals just to be clear.
Speaker Change: So that's very, very important for us. And I think people need to realize that, you know, when we originally went to take on the Oxfordie ligand it was targeted at AD, originally that was the original acquisition.
Speaker Change: Well, base case in AD, not that anybody's asked, is that we meet the primary input, that is where we would like to be.
And that's our base case.
Speaker Change: Of course, the science will tell us whether we are right or not. [inaudible]
Speaker Change: Asma, the day when Asma is actually very encouraging in terms of safety and efficacy. So we'll wait and see, you know, these things you turn these cards over. Thank you very much.
Speaker Change: I think we feel very positive. I grossed margin. Yes, gross margin, James, if we look at it five years ago, we were significantly behind our peers in terms of gross margin, almost five percentage points today, we are almost at power with our peers. Thank you.
Speaker Change: in terms of average gross margin, you saw a significant increase in Q1, two percentage points from last year, about a third of it is linked to inventory evaluation that happens traditionally up or down, but in that case it's up in Q1, but being that you have two third of it is linked to essentially product mix.
Speaker Change: and efficiencies. As you know, we have significantly worked in order to improve the efficiency of our industrial footprint over the last couple of years.
Speaker Change: and we are starting to get the benefits now. And the product mix is opening across the board. It's not only the picks, and you are mentioning...
Speaker Change: The new Dupixent process, it is one factor among others, by the way.
Speaker Change: This one has been spread over a few years, so it's not specific to Q1. [inaudible]
Speaker Change: and it started already two years ago and it's not completed yet, so it's over a relative long period. Going forward, do expect to see some further increasing growth
Speaker Change: Significant for the remainder of 2025 but over the next couple of years we will continue to see our growth margin. Thank you, next question. Okay, let's try again with Florent Cespedes from Bernstein.
Speaker Change: Good afternoon from Ben Chen, can you hear me? Yes, we got you.
Francis Perez: Good, thank you very much for that. So, two quick questions, please. First, I would like to come back on Emily Kelly-Mab. Could you maybe give a little bit more color on the percentage of the population we see here as mad at you? Thank you very much.
Speaker Change: Should the person the most to the product you highlighted the as-in-a-feel or not-ho-feel? The most to the product you highlighted the as-in-a-feel or not-ho-feel?
What's the percentage of severe asthma population?
Speaker Change: and these people represent. And my second question is on Medicator B redesign. It was supposed to impact most likely the more every leader, first quarter, and then the impact should is...
Speaker Change: During the course of the year, could you maybe elaborate a bit and give some color on the impact from this measure on your accounts? Thank you. Thank you, Florent. An interesting time, I'll just quickly answer the subpopulation question. We're not shared and we're not. Thank you.
Speaker Change: Trying to help calibrate that at the moment. We're into the phase three and we can get into more detail on that. Brian Potty.
Brian Poddy: Yeah, Medicare Part D. Remember, there's two pieces to this. First piece, actually, a couple of depicts in a little bit more specifically. Just to remind you, most of our business, more than 70% of our business is still on the commercial side, about 30% of it is on the government base side. A percentage of that is actually Medicare quite specifically. And then there's two pieces that relates to the Medicare Part D redesign.
Brian Poddy: One is obviously the covering the gap there, and that is we've seen a slight impact of that, obviously, as we anticipated, and that was part of our plans. Actually, we originally knew this for quite some time. But the other part that actually is interesting to us is the cap of 2,000 out-of-pocket. And while we haven't seen an inflection of that yet,
Brian Poddy: There are some early signs that actually there might be more patients for grabs now with the fact that they have no more than 2000 out of pocket expense. So we'll see how that progresses in 2025. But so far we think that there'll be some positives and some offset of that actually for the Medicare Part D redesign.
Speaker Change: Okay, thank you. Next question. Yes, next question is from Sarita Kapila from Morgan Stanley .
Sarita Kapila: Hello, can you hear me? Yeah, we got you. Hi, thank you for taking my questions. It's a quick one on your US flu vaccine dynamic. I think you called out softer demand and intense fine pricing pressure. So is this baked into your guidance for this year and consensus is factoring 3% sales growth of flu this year. Should we be thinking about 25 as another year of potentially low single digit decline? Yeah, I'm fine.
Speaker Change: And then taking a step back on A.D., you have multiple modalities, Oxford T. I.R.
Speaker Change: also Bi-Specifics, Madeline Sikamig, some of your peers, Pfizer and J&J are pursuing Tri-Specifics, so it would be interesting to get your thoughts here as there's something you also plan to do and any thoughts on Tri-Specifics and AD, so it would be interesting. Thank you. Thank you.
Okay, Thomas.
Toma: Yes, thank you, Sarisa, on US flu a bit too early to be definitive there because we're still in pre-booking periods right now for flu in the US.
Toma: But we wanted to highlight what we observe in this process. You remember that last year during the two seasons, we observed in the US a soft vaccination coverage rate, roughly minus 5% for the US competition last year.
Toma: and that turned out to generate some price competition as we observe it today in the US for the UNU pre-booking. A bit too early, usually I give more color at the future earnings after the pre-booking season, so stay tuned for the next part.
Speaker Change: Thank you. Houman tries specifics. Yeah, I'll be, we're at close to time, so I'll be super brief. Just to say, obviously we are well aware of try specifics, our antibody platform allows us to generate try or quadru specifics, etc. It's an error, we've looked at just the point of caution. It's very hard to calibrate the geometric interactions between each of the heads, and we don't expect repeated incremental additional value.
Speaker Change: Bondology, but the short answer to your question is, yes of course we thought about Tri-specific and I should say when you talk about a topic that I'm going to remind everybody that it's a massively biologically under penetrated marketplace and there is substantial realm.
Speaker Change: New molecules in that space. We were managed by the depictions. Yeah, I just before being to ask question, I think this is we said this at the end of I think it was a 23 or a day like. [inaudible]
Speaker Change: I think it's still not fully appreciated that multiple mechanisms in diseases drive up biology penetration. I think we're still at low double digit or high single digit, 14 in AD. So 86% of the patients that are biological eligible don't get a biologic in AD.
Speaker Change: So we know that R.A. is close to the 50% at this point. There's so much opportunity and it's new entrance, different approaches.
Speaker Change: I think this co-existing of different mechanisms is completely underrepresented in forecasts and still we see people thinking it's winners and losers. A good example would be...
The enthusiasm we have and the human set it up top.
Speaker Change: for Amitela Marbon, DuPixson, to both grow very well. [inaudible]
Speaker Change: all the way to the end of Patent by taking up new patients and co-exist with different approaches. And over time, you know, people's confidence in this approach will play out. But for us, having seen a little bit more data than the rest of you, we're very confident in how that. [inaudible]
Speaker Change: Okay, last question. Yes, last question from Simon Baker from Red Bird? Thank you very much.
Simon Baker: Thank you for taking me like my question at the end. Most of them are picked off, so I can be pretty quick. Firstly, just going back to Brevecimag.
Speaker Change: You gave us the P value, Houman, I just wanted to give this Bayesian study if you could give us the posterior probability in that study.
Simon Baker: and then moving back to the all TNF and thinking about the internal combination candidates, the Ira Q4 degrees is to mind other than the others that we should be thinking about that you may more combine the all TNF with. Thanks so much.
Simon Baker: Okay, well we'll finish on this, Houman over the end. Repeat your second question briefly for me.
The combinations, other oral combinations, internal annexation. So, I guess, out of the 40 punters.
Speaker Change: Yeah, thank you. Okay, so Simon, thank you for asking the excellent Bayesian question. I can't give you the best theory of probability nor did I give you the probability unless I was hallucinating.
Speaker Change: Oh, apparently the probability was my footnote, which is great. So no, no, no, I can't, I can't give you the probability. But actually, based on the data in the public domain, in H.S., you could work it out. That's a little test for you. And the answer for you.
But you'll appreciate
That, based on the data in the footnote, it's compelling.
Speaker Change: and then the answer to the conversation is there are multiple rational combinations, it would be unwise of me to disclose.
I'm prior off myself in this discussion.
But I think that the... [inaudible]
the natural combination with a TNF. [inaudible]
Speaker Change: are super clear to people in the art and we will pursue many of them.
Speaker Change: Yeah, maybe just to finish on that note, there's sort of obvious, I guess, based on whether you're trying to break new efficacy goals, could be an IBD, could be an RA, could be in different bodies to treat diseases, you know, I think the open question we asked ourselves some time ago was...
Speaker Change: whereas TNF approved and indicated where was it overtaken on injectables by other more selective approaches and then if you're going into orals. [inaudible]
What does that tell you about the combinations?
Speaker Change: that would be ideal because either are likely to not make it on efficacy on the road but together, they would and that's the magic. So we'll get into that over the coming months and hopefully have some things to share and we'll do that as we go. But otherwise, thank you all for the call appreciated and we look forward to catching in Q2. Thank you.