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| Maybe we’ll switch gears to Dupi and I was only modestly joking when I made my joke about Sanofi collaboration accounting, but the margin improvement has been pretty impressive and part of that is COGS, part of that is scale |
| So, in the end, I think it rounds out a very nice respiratory portfolio |
| So that’s something we recently surpassed and I think further solidifies the profile that is comparable to what we saw in the trials |
| I think our view is it’s going really well and it certainly compares favorably to the competitor launches that have occurred in the recent past |
| That was largely attributable to a new manufacturing process for Dupixent, which is a higher yielding manufacturing process, had a significant improvement on COGS |
| So that’s the next inflection for the ongoing launch here of HD and we’re very excited to see it advance |
| What we did see was a very compelling signal in former smokers, regardless of eosinophil count at baseline |
| Probably as exciting as the revenue but it has been the enthusiasm market around the profile of the product where retinal specialists and patients are seeing efficacy and safety in line with EYLEA, but with longer dosing intervals, which has always been the goal of this program and what we saw in the clinical studies |
| On allergy, that’s a huge opportunity |
| I’d add that recently we’ve passed the 100 vial threshold for orders and that is a significant milestone for some prescribers who want to see real-world safety in the marketplace |
| And as you think prospectively about the brand and the profitability, obviously, just as the sales increase, we also hope to get just sort of leverage of the operating expenses relative to the sales |
| I guess lastly, the J code, which will come in just a few weeks now, we think will reinforce the confidence to prescribe because reimbursement risk is seemingly eliminated once that goes into place |
| It’s obviously a large market opportunity and it will inform for us whether or not we’ve got something there and if, hopefully, it’s positive, we’ll figure out how to best roll it forward from there, what our commitment looks like to obesity |
| We haven’t found anything to-date that we’ve thought was interesting, but we have the flexibility with our balance sheet, and obviously, our cash flow to do things if it makes sense |
| We have the ability with our balance sheet, obviously, to do things that are larger |
| I started out -- I ran our financial planning and analysis function and then about seven years ago our former CFO tapped me on the shoulder and said, just from a career development perspective, thought it would be good for me to get some controllership experience |
| But we should get our answer pretty quickly and if you’re testing once you’re in the maintenance phase of this and you’re not seeing IgEs expressed, then you can be pretty confident that your IgE-mediated allergies have been reversed |
| There are a few things that get me as excited as Sanofi collaboration accounting |
| So when you swing big, you can make really important advances for patients |
| And thanks for the opportunity to be here and have us |
| If you look at what we book in terms of our Sanofi collaboration profits, that margin increased about 300 basis points in 2023 |
| I’m pleased to welcome Regeneron Pharmaceuticals to the stage |
| Of course, you’d love to control the cocktail, but is it better to be kind of a free agent so that you can be able to augment or improve the body composition of existing therapies out there across all of them |
| Great |
| Fingers crossed for success in Phase 3 |
| And obviously, looking at the portfolio as a whole, you mentioned sort of the allergy side of things, which George Yancopoulos particularly excited about and really a focus of our internal R&D efforts |
| So if you look at our guidance for 2024, it’s about a 12% increase year-over-year when you look at the midpoint |
| We have to run the business, and obviously, do what we can to make sure that that future revenue growth and opportunities for our shareholders are there and we’re obviously following things very closely |
| So we might see some incremental improvement in 2024, but I think it will be fairly modest |
| I think we have a number of opportunities pre-clinically now that will expand upon Dupixent, which blocks the IL-4 receptor alpha, as well as other, I’ll call it, adjacent targets in the cascade -- type 2 cascade, all of which are being expedited and we’re trying to bring them to the clinic as quickly as we can |
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| It does carry a risk |
| Carter Gould And after 4Q, there was a number of questions around just how the pricing headwinds the class as a whole is facing |
| You can see that reflected in the ASP data that CMS publishes every quarter and we’ve seen anywhere between 50 basis points to 150 basis points sequential declines in price over that period |
| While in advance, Zoller is hardly the solution to allergies |
| Any comments there, Ryan? Ryan Crowe I think the competitiveness of the market really ramped up a couple of years ago with the introduction of fianlimab, ranibizumab biosimilars, and with it came pressures on price |
| It was hardly a cure, which is what we’re seeking to do |
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