2024-01-09 17:35:28 ET
Sanofi (SNY)
J.P. Morgan 42nd Annual Healthcare Conference Call
January 9, 2024, 13:30 PM ET
Company Participants
Paul Hudson - Chief Executive Officer
Jean-Baptiste de Chatillon - Executive Vice President and Chief Financial Officer
Houman Ashrafian - Executive Vice President and Head of Research and Development
Conference Call Participants
Richard Vosser - J.P. Morgan
Presentation
Richard Vosser
Welcome there. Hi, welcome to the Sanofi Presentation at the 42nd J.P. Morgan Healthcare Conference. I'm Richard Vosser, European Pharma Analyst at J.P. Morgan. It's my great pleasure to introduce Paul Hudson, the CEO of Sanofi here.
Before I hand over to Paul, just remind you that if you put your hand up for questions when we get to the Q&A period.
Paul, welcome to the conference.
Paul Hudson
Okay. Thank you. Thank you, Richard. Good morning. Good afternoon. What a warm introduction, Richard. Great job. Really got me in the spirit of things. Fortunately, my content's good. You'll decide. No, it's fine. That's fine. So, it's a great pleasure for me to be here, to be sharing a little bit about what's going on at Sanofi. It's a real moment for the company, and we're very excited about what we're becoming and it's good to share it, because it's been a long time in the making and we really feel like we're demonstrating that we're the new Sanofi.
Maybe I'll start with this. One of my favorite slides. Take note, because we'll share some thinking about aspirations and where we may be and you know the rules. So, take a look at this.
So, when I joined the company in 2019, I really aspired to lead an organization that could be operating like this. We've had bumps in the road. It's not always been easy, not for any company, frankly. But we've really started to put together a real cadence, a real determination about what we can really do in this really special company.
We're going to be one of the world's leading immunology companies. And that may raise eyebrows, as it did back in 2019 when we said Dupixent would have sales greater than 10 billion. And where are we now? Already achieved check and sales of around 13 billion is my expectation this year alone.
We're going to share with you some of our key assets and what they mean and what they look like and why we believe in them and how we can stack them up, and indications to win in immunology.
We've recently -- as Q3 last year we shared that we're going to spend more money in research and development, in particular development. We're going to increase our spend by about 700 million. It doesn't put us above median as a percentage of sales. But it's deliberate. It's deliberate to make sure that we fully deliver on the assets that we have, no compromises. This company's got incredibly proud history, but it has some gravitational pull to the fact that it's not punching through on R&D, at least not perceived as. And we just feel we've reached that moment now we're where we need to be.
We have 12 big shots on goal. I'll share with those in a moment. We'll have 50% more Phase 3s over the -- increased Phase 3s by more than 50% over the next 24 months. We've got late stage assets that really have a shot at doing something important for patients. It's a different company.
We're using AI at scale, more than 11,000 people across the company using AI every day for better decision intelligence. We actually -- whilst we were running our development committee, led by Houman, I'll introduce him a little bit later, our new Head of R&D. We actually are a level now where we could ask the AI to tell us whether we should go and initiate a Phase 3 with an important medicine. And strangely, he came back and said, you should and you should move faster. And here's three things you should do, which is great for me, by the way, to be able to tell him that. The important thing is weaponizing our decision intelligence, having no regrets of going faster and deeper than others to make sure we make the best choices, is an important part of the transformation of the company.
2023, for most of us in the company, certainly for me, was the first year in the company's history where we had so much scientific news flow, so much progress internally and in collaboration, that we really got to see what the company will look like. We really got to see what steady state will be for us. We have great partnerships with J&J and vaccines on E. coli and Teva, a shout out for them on the TL1A and really, really important work. We're excited about the progress with PCV. We advanced Dupixent, of course, now and have submitted with a regulator for Dupixent in COPD.
We've advanced on oral TNF, we've advanced Amlitelimab OX40-Ligand. We've made massive progress just in one year alone. And I put it to people that if you really stack up on use flow from 2023, it's as good as many, if not better than most. And we're very proud of the work that's been going on for quite a number of years to get us in this great situation.
Internally, when I share this slide, I often refer to it as my favorite slide since I've been with Sanofi from back in September 2019. This is the slide that really sets us up for the most productive and value creating future possible.
I'm not even sure it can be constructed anymore, given the sensitivities of regulators. This is a very important moment for the company to have multiple shots on goal in massive diseases. We can help a lot of patients. We can raise efficacy bars. We can extend intervals. We can do so much. And this is, I think, without equal in terms of our commitment to immunology. I won't forget vaccines, too. We've made staggering progress. We've never had this many Phase 3s in the air at one time in vaccines in the company's proud history, goes all the way in immunology across a transplant to neurology. And it's really startling how much progress we made.
I could pick out, people always say, what is your favorite asset? I'll get to that in a moment or your favorite child. I think it's often described. There is such a richness and depth that we will deliver successful medicines for patients and for value creation in the key TAs.
To dimensionalize it, that's often what people seem to think is one of the most important things. We try to just loosely bucket it in the 2 billion to 5 billion range and the 5 billion-plus range. We have a lot of conviction. We work with Regeneron and Dupixent. I'll talk about that in a moment. But Regeneron did an incredible thing, creating Dupixent. They've been a tremendous partner, and we've challenged each other at every stage to get the very best out of that medicine because of what it means for patients. And we've all learned along that journey. We know how to develop drugs in immunology. We know how to do it. If you think how far we've come since 2019, to be at a point with all these indications and the excellence of which has been operated, we've learned a lot. We know how to do these things. Regeneron have been a great partner on that journey.
So for the excitement, for me, the OX40-Ligand, which could change the game, and is clearly the best profile in that space Frexalimab in MS and, of course, in type 1 diabetes and the oral TNF, which is a slightly higher risk project, but it's never been done. It took us quite a few attempts, but we now have the opportunity to put before biologics in almost all of the major TNF indications, an oral TNF, and imagine what that means for expanding patient pools and populations. We're in orals. We're in monoclonals. And as you know, the probability of success of a mab is in the 70% to 80% range. So, this is a deck stacked for success. We'll have some failures, don't get me wrong, but this is a deck stacked for success.
People often say to me, well, Paul, if you do well with this medicine, it cannibalizes this medicine. If you make progress here, how can you possibly stand up all these medicines next to each other? Well, the reality is quite simple and this chart or next two charts, but this chart in particular is the one that often industry observers just fail to completely understand, which is the biologic penetration of those eligible in the moderate to severe patient populations is low. While Dupixent will achieve EUR13 billion in revenues this year, the penetration of those that deserve it is 9%. So, 91% of the patients that should be on Dupixent are not receiving it. That penetration gap, that patient pool is why multiple assets are needed. It's why competition is needed because we need the noise, the education, the investment to raise the boats. And that's why when you look right across here, there's over a hundred million patients that are eligible, and so far just single digit millions are getting treated. This is a big deal. This is the fundamental building block of why we'll go on to be so successful.
We chose at our recent R&D Day to give an example of psoriasis. We're not really in psoriasis, but we wanted to help people understand, okay, so you have these underpenetrated markets, but how can you launch so many biologics against the same patient population? And we took some time, I had the privilege a thousand years ago to launch Remicade as part of my career. And Remicade still does very well. And the reality is patients are heterogeneous and the reality is that improving selectivity, interval safety, these things evolve markets, grow patient populations. We know just cleanly looking at this, that more than I think five, six or seven of these medicines in psoriasis, they're all blockbusters. Many of them are IL-17s.
When you think about how they can all coexist, it's because patients want to raise the efficacy bar and do different things. And they know that if they go back to their physician because they're 95% clear, but not perfect, they know that they will say to the physician what else do you have for me? I'm getting used to being near normal in terms of skin clearance and there's a switch opportunity. It's just how it is. So, we fully understand the under penetration, and we fully understand how to coexist important medicines for patients. And if you get those two things right, you can do something extraordinary.
We haven't had a long history of launches. It's been a few decades that the company has really not got the cadence going, but now we're in the rhythm. There is no rust on the launch machine at Sanofi. What we've done with Beyfortus is simply sensational. It's three times the best ever pediatric vaccine launch. And not only that, we could have played it easy by just looking after the most vulnerable infants, but we chose not to. Our team chose to protect all infants, and the data we're seeing from across Europe and the U.S. is staggering. It's flatlining admissions into the emergency room for babies. It is absolutely incredible and kudos to the team for doing that work.
We've launched ALTUVIIIO. We've launched TZIELD in type 1 diabetes. We've launched all of these medicines and done particularly well. But the reality in Q2, we said we'd have more than EUR400 million in there, second half of 2023 in revenues. We upgraded that to more than EUR500 million at Q3. And I'm excited to share full year results on February 1st, how much progress we actually made, because it is impressive.
Why is that important? Because if you are stacked in the diseases that count, if they're underpenetrated, if you know how to position and you know how to launch, then you have a very bright future.
I just thought I'd put this slide in because Dupixent clearly will grow until its end. It's one of those once-in-a-career medicines that has efficacy and incredible safety and brings such hope and relief to so many. I like this chart because while you may understand the numbers around Dupixent, and many of you have been involved with Cosentyx, myself, you see many of the medicines, these are -- this 31% on the left of Dupixent share of prescriptions is not in atopic dermatitis, it's of all diseases in dermatology, which tells you just how successful this medicine is and will be.
We were the fifth biologic to launch in pulmonology, the fifth advanced therapy. We're now the leader. So, it's not always been easy. People say you must have it easy. It's a great medicine. Far from it. We were fifth in and now lead on new patients. This shows you what we're like at executing. It's pretty staggering. Over three quarters of a million patients on Dupixent, nine approved indications. Again, breaking new ground on COPD, really not hesitating, a truly amazing execution machine. So, we're putting the pieces together of what we like to think of as the new Sanofi and it's coming together very well.
On December the 7th, we tried to help people understand what the future could look like for us. Because while we're proud of Dupixent success, we also know that in the next -- in the thirties, it'll lose its intellectual property and we know that we need to be ready for that. Like all companies, many companies in fact having challenges. So, we just put it out there for people to understand why we think we will grow certainly EPS through that moment whenever that moment may come, because of all the things that I've already shared. We'll have greater than EUR10 billion sales of new medicines by the end of the decade, long before the patent expires. We will double the size of the vaccines business by the end of the decade. And even though the pace of growth will be double-digit CAGR for Dupixent through 2030, imagine that on a medicine of this size. We want people to understand that while we know that it's an important medicine for us, we've been preparing for 2019 for life after or life alongside, depending on how we go in our defense of its IP. So, we are really setting ourselves up for something very special.
There's a lot talked about of ESG. There's a lot of encouragement in KPIs. I think we would all agree two things are very important, proud at Sanofi that we get them right. It's not been easy, but they're important for a couple of reasons. One, a 100% of our studies have the patient voice in their creation of the study. So, there is nothing where a lot of smart people are sat around, drinking cappuccinos in headquarters and designing studies without that patient sensitivity of what it actually means. 100% of studies, and 100% of studies now have a DNI objective. And why should we do that? Is that Paul just to check a box? Absolutely not. Our patients that inevitably and eventually will be treated with the medicines represent society. Of course, they do. So making sure that all walks of life appear in how we think about designing studies. It's important, because they'll be the ones receiving the medicines in the end.
At the end of October, we also try to remind people that our focus now is on becoming a pure-play biopharma company. Our consumer team have done incredible job. They have simplified their business. They have simplified the SKUs. They have skinnied it down to grow faster. They have made acquisitions. They have become leaders I think in some of their marketing and customer insights. We've taken a business, and we've really shown we can grow as fast as the market, if not faster, depending on the category and kudos to them.
But the long-term, we think it's important for people to know that we will not be diversified, that we don't need to do that. And in fact, it's perhaps not even what our consumer team would like us to do. They want to go and stand on their own two feet. In many ways, they are doing already. They're eager for that moment. We declared at the end of October that we will take a capital markets play. We hope to list in Paris. We're open-minded about what that looks like. It's what's best for consumer and, of course, what's best for Sanofi. But in the end, where will be is a pure-play biopharma company.
We were specific on the timeline. We said it'll most likely be at the earliest Q4 of this year, of the earliest because we're ready. We're quite far down the line. So, we're determined based on the fact that our scientific progress is strong, based on the fact we know how to launch and we certainly know how to execute, and we know how to be tech powered. That we are ready to be a pure-play biopharma company.
As for capital allocation, we declared this as our list back in 2019, JB and I in Boston at our first Capital Markets Day. And it still holds true. We've been very single-minded, given the history of the company, we had no real desire to blink. We had no real desire to make a trade off. So what are the reasons why we decided to double down on R&D? Because our success have been strong. This stays the same, open-minded about BD and M&A, a growing dividend, of course, and thank you for those that invest in us, but continue to make organic investments, continue to keep the drum beat going. And where needed, we'll do a buyback, but on avoidance of anti-dilutive decisions that we've made so that everybody remains whole.
So, maybe just the last couple of slides. We are becoming a development driven, tech powered biopharma company. That's what we're becoming. Some days it feels more tech bio than biotech. Given how much AI and data we're putting at the heart of the decision-making, how we're removing the unconscious bias in the decision-making, how we are trying to be much more demanding about the decisions and the hurdles that we expect people to jump.
We will continue to reallocate. We'll continue to build out our hubs in lower cost areas. We will continue to modernize everywhere we can because every dollar then will be reallocated, because it must go towards R&D. We will deliver on that greater than EUR10 billion, of course, in new sales by 2030. And why this chart maybe didn't count it, maybe didn't count it. There were 12 assets on the chart, my favorite chart. Not all of them will work or perhaps they will work, but not how we would like or to compete. We declared last year that we need three to five medicines to deliver 2 billion to 5 billion in revenue. Remember the POS of mabs, which is three quarters of that list, is greater than 75% for some of those mechanisms say, the IL-13 TSLP, [indiscernible], those pathways are already approved. So, the combination has never been done, but the pathways are approved. So, the POS is even higher. So our confidence that we can get this done is very high indeed.
As for guidance for 2024, 2025, we said we may see a low single digit decline in 2024 because we're resetting the company for the long-term value creation. And we were clear, although people would always like you to be even more clear, that we'll see a very strong rebound in 2025. You can count on us for that. Everything has been within our control and everything has been determined to try and make sure we can get this done.
So maybe just to close out, extremely proud of how far we've come. It feels like a lot longer than four years that we've been on this journey. But we are becoming a new organization. We have incredible people. We've got an incredible pipeline, particularly around immunology. We're doing some absolutely world-class work. I'm very happy about that. We're delivering the underlying performance, and think about how many companies are executing flawlessly, launching perfectly, and building out a world-class pipeline simultaneously. Right? It feels very good to be leading Sanofi at this exact moment.
Thank you very much.
Question-an d -Answer Session
Q - Richard Vosser
Thanks Paul. We're moving to the Q&A session. If you have a question, please put your hand up and then we'll try and get a mic to you. Maybe I'll start. Paul, you mentioned the business development or capital allocation priorities, at the R&D Day in December, the internal pipeline was highlighted. You highlighted it here today. Any changes in the priorities for that business development, external -- bringing in external innovation on that basis?
Paul Hudson
Well, I'll let JB comment. I just say upfront that we -- it has to be game changing science. It's not about buying something, for example, that just increases your interval to every six months. It has to be something that is really fundamentally going to change something for patients. We can take more risk in immunology, because we have such a stack of great medicines. We can really be deliberate about carving out individual patient populations, but we're open-minded. You've seen TL1A deal with Teva. Great deal. You've seen the E. coli deal with J&J. There's no hesitancy where we can use our capability and excellence to get it done.
JB?
Jean-Baptiste de Chatillon
I think the two deals you just mentioned are good illustration of what we want to achieve, and we are active as we speak, of course, as we always are on a -- it'll have to be as Paul is saying really where we can win.
Richard Vosser
If you mentioned the Beyfortus launch, which is obviously doing exceptionally well. I mean, how should we think about the ramp of that product? There's been some supply -- the demand is outstripping supply. How should we think about that as we go forward?
Paul Hudson
Well, we planned, and it's really fascinating. Firstly, you -- we launched a mab into a immunization and vaccine space, and there was some concerns that will, that be accepted. Now we hear from a lot of young parents. We want it because it's a mab, because we understand that the tolerability. I don't want my newborn having some challenges with its -- with an injection site reaction or fevers or chills or whatever. So, we are -- so we're thrilled that the -- we were ready for a big demand. We were like two, three X ready. But we were surprised positively that the volumes are just massive because people can see it. And you look at the data, there's some data just been published actually in Galicia that shows that this could end up being one of the -- one of the -- sadly one of the most challenging RSV seasons in recent history, but that in the zero to 12 months range, that there are no cases of RSV, because we have almost a 90% coverage say, in that autonomous community.
Whereas if you are over one and a toddler, the cases are massive. So, you're just getting this real-time seeing of what's going on. There's no issue with manufacturing. There's just -- it's one of those things where I'd have shouted at people if they'd over manufactured. We did a three X, then of course, it's even bigger than anybody ever dreamt. So, it'll catch up. Some point this year, we'll catch up and we'll be able to protect almost all infants across the world over the next sort of 12 to 24 months. That's pretty amazing. So, we're thrilled with how it is.
And again, don't forget, this is Sanofi. This is -- sometimes people think we're a little unfashionable or not, not like other companies. Interesting you said in -- when I was making comment, we could have just gone after preterm infants and really just focus where it was easy. But it's like all infants, all infants irrespective of demographic or socioeconomic standing or desire to get to all infants. And that's not an easy thing to do, particularly with the mab. And we we're doing it. I'm really proud of that. Any questions for Houman?
Richard Vosser
Well, I was going to ask one question. I was going to build on that, and then maybe a question for Houman. So, you mentioned there, of course the development of higher infection rates beyond that first year of life. So, do we get more second year usage of the mab, or do we need your vaccine in development for that patient population?
Paul Hudson
Yeah. Look, I think what we've learned very quickly, and there's obviously competition, particularly in older adults. We think that we can be the player in RSV, I mean, to be clear, and it may be in combination in older adults to give more protection across more diseases, but we've seen enough now to know exactly what needs to be done, and we're doing the programs in toddlers. And so, we will get there and we'll do it very well.
I wanted to just introduce Houman because he's our new Head of R&D. He comes out of venture, a physician scientist, and perhaps not the typical profile, but still great and affectionately known internally as first in Houman. But he bringing agility, urgency, challenge, fresh eyes, raising the bar, it's an important part of how we make sure that we are really distilling the very best. Do you have a question for him?
Richard Vosser
I do have a question actually, Paul, thanks for the prompt. I mean, maybe there, what -- from your first few months, quarter or so, what do you see in terms of the Sanofi R&D that -- I suppose, what changes are you going to bring? What do you see is good? How do you see the profile? We've obviously seen the R&D Day with substantial new products coming, but in the processes, where do you see things changing under you?
Houman Ashrafian
So, you for the question unprompted. Three areas. I think one of the things that we see -- when I came to Sanofi, I was very pleasantly surprised by our late stage pipeline. We have an excellent team and a fantastic late stage pipeline. I think I at the risk of repeating what you said, Paul, I think if you, in a really dispassionate way, look at our dominance in immunology, becoming an immunology powerhouse is truly remarkable.
And I just want to remind everyone not to consider it as an asset by asset basis, but if you look at the way we are building a platform along with Brian sitting in the audience here to ensure that patients walk through Sanofi products, both in combination and all the way through their treatment and immuno inflammation, both in terms of biologics and small molecule therapies, I think we are truly differentiated, and we are building the connectivity between research development and commercial in a way that I could not believe possible. So there's -- that's the milk and honey.
The second part of it is that in order to sustain that pipeline, we don't have an infinite money tree. And so, dynamic capital allocation is exactly what a venture catalyst brings to the table. And we are, uh, monitoring the portfolio very carefully. And then finally, it's the use of AI and you will have seen that Richard, to do dynamic portfolio reallocation. And this is something I really want to emphasize from the first day a molecule is incepted to the day it gets to the patient and beyond, it's all mapped out from day one. It's kind of a remarkable thing. And I -- we just need to call out Thomas Triomphe, part of the value, one of the things that amongst the dynamic capital allocation theme that I brought out, the intersection between vaccines and R&D is ever closer and tribute to you for what you've done to Beyfortus and your team.
Richard Vosser
And at the R&D Day, there was a large number of Phase 2 and Phase 3 programs. They're going to start in 2024. And Paul, you called out obviously the increase in R&D. But if those start to work, you talked about capital allocation, but if those work then how do we see R&D spend in 2026? I can understand 2025 the readouts, but if go forward, do you need to spend more?
Houman Ashrafian
So, two comments on that, and I've got the wonderful JB to my left. R&D spend will stay flat beyond 2025, just to be really clear. And we are very careful. What you'll see is, is the tolebrutinib and amlilatilumab Phase 3s finish. Other things will come to fill that space, point one. But all -- and that's a super clear message. It's not the magic money tree. And we will continue being careful about our dynamic capital reallocation. But I just want to also be clear, as Brian would say, if he was up here, that what we've taken is a very thoughtful approach to lifecycle management of those molecules. What we haven't done, if you look at R&D Day, is do a string of pearls, do an indication after an indication. We are really thoughtfully under Paul's leadership building out the franchise approach to these drugs.
And I've said that once already in the last three minutes. But if you look at anybody in the industry, the ability to build small molecule with biologic combos, biologic combos, walkthrough strategies, being able to look after patient heterogeneity, thinking about patient stratification, making sure the TPPs align, thinking about pushing the efficacy bar and durability. I would say that we are -- and I come to this new, and I don't come to it with roast tinted eyes. I think we are the industry leaders in immunology in that regard.
And I -- last comment, I don't want anyone -- I don't want anyone to forget immunology and I means vaccines and that's important, but we're not forgetting our provenance and heritage and rare disease either. That's important. And we continue to be committed to our patients with rare disease.
Paul Hudson
Yeah. I think, just to add a comment if you indulges Richard, is that I see it in the analyst reports. I see it everywhere. It tends to be an asset driven description of winners and losers. It tends to be this versus this. And it's good for the smart people that know how to do the side by side trial comparisons where appropriate. I'm -- what we're doing is something a bit bigger than that now, because we don't need a win with everything. We need to participate at scale with multiple assets to give patients more choice on efficacy, convenience, selectivity. And we don't -- if you just acquired an immunology asset for tens of billions of dollars, you must win. You have to win and all -- you have to go against standard-of-care. We've created an ecosystem now in immunology internally where we can deliver multiple shots and have very important medicines with really generous peak year sales that will help us get these things done.
And nobody's really looked properly at what we've put together and good, really, because we will pleasantly surprise everybody as we move along because it's a really nice position we put ourselves in. It's been hard work. Not for you, you just inherited it. But we've worked really hard and you don't mess it up, and it's a different thing. But we've worked really hard to make that right. And I think we are really proud of the people in Sanofi where we're at.
Houman Ashrafian
Richard, you're getting a sense of the way, I'm treated in the organization.
Richard Vosser
Yeah, I do. I mean, the foundation of that Paul, is Dupixent and the size of that. One of the things that you've been looking to sort of improve is the manufacturing on Dupixent. And maybe we could talk, or maybe JB can talk about how that's going and how we see that providing more room for investing in.
Paul Hudson
Yeah. Well, I will let JB -- I mean, we love this. It's one thing to have a very successful medicine, but it should not mean you're complacent. So JB.
Jean-Baptiste de Chatillon
Yeah. So, as you know, we are effectively in a process of fully deploying the improvement of COGS in the manufacturing process and the drug substance, which will make a difference. And we will also reach a point where the spend on R&D will diminish. So, the profitability of the product for the partnering will be stellar till the end of time because of its time. So, yeah, no worries on that.
The profile of growth of Sanofi for the years to come is really solid and pretty unique. No LOEs, will have still a bit of drag in 2024 with the last bit of [indiscernible]. But next LOE is really the big sales thing. So the decision we took, the decision we took to invest on double down in R&D is really to take us with this three to five assets of 2 billion to 5 billion big sales through this LOE, with the capacity to go on progressing EPS. Because as you know $2 of Dupixent can be replaced by $1 of amlilatilumab or frexalimab or any other products you have in this pipeline over time. While, of course, Dupixent will go on growing till at the end of its time. So, it's a very peculiar position we are in and we are effectively very proud to take the company …
Paul Hudson
Yeah. And we said it -- I've been in many partnerships in the industry over many years. Some good, some bad, some good and bad. Our relationship with Regeneron on delivering for patients going more boldly into diseases like COPD, I got to call them out because I think Sanofi took some convincing at the beginning on atopic dermatitis even. But once we're in our stride, we're really moving and they went with us on COPD, and I think that's just how it should be. Great partnerships pushing each other with great relationship in the U.S. And we didn't -- I didn't really call it out, but our IL-33 Dupilumab in COPD for former smokers is going to be a huge deal. And we look forward to extending our partnership to do something very meaningful in immunology. It's a great partnership.
Richard Vosser
And you talked about atopic dermatitis there, and then in the presentation, the penetration rates being really low. Maybe you could just expand Amlilatilumab comes, you've got Dupixent there. Just how big can the penetration of that atopic derm market, where can you get?
Paul Hudson
Well, I think if it's just us in the market, the 9% could become 15%, 18%. And this is the thing, this is the paradox. This is what I think sometimes observers just miss, not, but obviously you don't miss much. But…
Richard Vosser
Thanks very much.
Paul Hudson
…is the fact that you need more players. And when you look at the chart I showed, it's -- as you've got more players, the patient pool just kept expanding and expanding because you need more education, you need more shots on goal. You need different mechanisms. And we know, for example, there's an IL-13 launched in the U.S., there's an IL-13 launched in Germany. There's JAKs launched and all really targeting the same patient population. And as soon as they launch, our growth of Dupixent accelerated, more people talking about AD, more people helping bring benefit to patients, more people spending time educating via television or social media. The market is big enough for everybody. Even in highly symptomatic illness like psoriasis, you're still less than 50% penetrated, still half the patients decades later are not getting a biologic. So, you can see the work that's needed, which is why everything grows, why Dupi will grow all the way till its very end. Partly it's profile, partly it's weight in the market. Partly the fact that the extra noise makes people remember to, maybe I should give this patient a go on Dupixent a bit earlier. I'm feeling more comfortable about the breadth of this conversation and I like it.
These are the realities. I don't think this gets talked about much, but this is what built RA, this is what built psoriasis, AD, IBD, AS, PSA, we are moving with some determination to be part of those growth stories and it's not winners and losers in immunology. If you have a great medicine, it's who wins more. And I think people sort of miss that. And it's an insight whether you like it or not, but we understand it and we -- that's why we take advantage of it with multiple shots on goal.
Richard Vosser
And can COPD be -- well, it'll accelerate your growth next year, but can that be a faster uptake given the quality of the data?
Paul Hudson
Well, we know the data's incredible, right? I mean, given that one-third of patients that go to hospital with COPD never come out. So, we know that -- it's -- the need is massive. We also know the economic and social burden on patients and health systems is huge. So, perhaps even unlike some of the diseases, there's a moment where the pull from the payer even sees it as an opportunity to be more efficient. A bit like we are with RSV, with empty emergency rooms, there's a very visible and visceral current year benefit to making an intervention that creates real rapid uptake. We have the P&T committees, we have some work to do, we have some education to do. We need to be on the podium at congresses. So 2024 will work that through whether we get a priority review or not. But I think for 2025 we're pretty optimistic, because we know how good it is and it's the only advanced therapy for these patients who really are completely incapacitated depending on the severity of the disease. So, this is a big deal. And I think the real benefit will come 2025 and beyond, but I think it's going to be -- it could be extraordinary.
End of Q&A
Richard Vosser
Thanks very much, Paul. Thanks JB. Thanks Houman. We're out of time, unfortunately.
Paul Hudson
Thanks very much.
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Sanofi (SNY) Presents at J.P. Morgan 42nd Annual Healthcare Conference Call Transcript