Specialty Care. I run our Specialty Care business unit, which is basically made up of immunology, oncology, neurology, and rare diseases. I think, as we've shared before, we're in a really interesting space these days where we have significant growth drivers of the organization sit within Specialty Care. Things, of course, like dupilumab, as we've said, that would have double-digit CAGR growth from 2023 through 2030, delivering around $22 billion by that 2030 timeframe. We have other assets that we've recently launched, like Altuviiio, recently fitusiran. We have Sarclisa that's growing and continuing to expand its indications from an oncology and multiple myeloma standpoint. It is really a growth story for us across each of those areas, including even neurology, where we're expecting our kind of re-entrant into the MS space with the upcoming launch of tolebrutinib.
For us, specialty care is all about across those therapeutic areas, delivering really meaningful and transformative therapies for this patient population and driving really meaningful growth for the company. A lot of work to do in those statements.
Yep, yep, lots to cover. Before getting there, I'm going to do the sort of the mandatory tariffs question. Again, I understand this isn't quite your sort of area, but in terms of from what you've seen so far in terms of the tariffs and from the internal discussions that you guys are having at Sanofi, what could the impact be for your business?
Yeah, I think overall what we've said as an organization is we just don't know yet what the tariffs will actually be. I think there's still more questions than there are answers to what that could actually mean. That said, we've scenario planned like every other organization. We've already made some preparations for what could be some mitigation strategies. Overall, the impact we believe will be manageable for us as an organization. Again, I still think that there are a lot more questions to be answered, first and foremost. Today we just remain focused on the more you can innovate, the more you can bring innovative therapies to the marketplace, you'll find ways to manage through whatever the tariff situation is.
Got it. Perfect. Mandatory question number two, most favored nation's pricing. Again, this is a potential impact for your business. How are you thinking about the implication? What do you know in terms of or what can you tell us in terms of the potential exposure here, whether it's the Medicare channel and on the differential between U.S. and express pricing across your key franchises?
Yeah, I think this one has less answers than the tariffs one does. This one is still a really developing topic. There is, I just read an article yesterday that was written up that kind of scenario planned what could be various different most favored nation types of approaches and what could be the impacts to the industry. I think like anything else, we're scenario planning as well. We just do not have a lot of answers to this particular point. I just remind everybody that at least for us today, as we sit here, we have by and large, the bulk of our business remains commercial in the U.S. We have a little less exposure to the government-based business in the U.S.
Of course, we've operated the same way everybody else has as to the way in which the current world works around launching drugs outside of the U.S. as well. I think you have varying degrees of differences from country to country outside of the U.S. as well. I think we'll see how this conversation develops, but we feel like we're in a good position as well as it relates to the most favored nation discussion also, but still more to come.
Got it. Perfect. Obviously we had the banker panel earlier today talking about M&A in the industry. Sanofi has been fairly acquisitive over the last couple of months. Could you talk through some of those recent acquisitions, what they add to your business, and why they're attractive, value-added for Sanofi?
Yeah, yeah. I think we've been very consistent, I think, in reference to our capital allocation. First and foremost, we always think about how do we invest internally and advancing innovation internally, but we're always going to be looking for external opportunities. We've been, I think, very consistent about how we will deploy capital for the types of opportunities. If you just look at, maybe I'll just speak to the last three that we've done recently. Dren Bio, obviously, so a B-cell, a depleting therapy, this could be something that could potentially have the promise of potentially resetting the immune system. You talk about durable effect or disease remission almost in some cases is the promise of something like that. In immunology, that's something very exciting.
The Vigil deal that we recently did, obviously with a TREM21, an opportunity there maybe from an Alzheimer's disease. I mean, this is an area of neurodegenerative diseases. I mean, you talk about 6 million patients potentially today, up to 13 million by 2050. I mean, this is a growing area that's going to require really innovative therapies. This makes sense for us from a neurology standpoint. Previous one made sense for us from certainly an immunology standpoint. The recent deal with Blueprint is still not a finalized deal yet, so we still have time to try and finalize that deal. If you look at that one, that was one where so much of that fit who we are as an organization, so much of the rare disease experience that we have, finding patients, getting them appropriately diagnosed.
Then the immunology side of things, the call points and a lot of these patients, it's a highly symptomatic disease. They tend to present themselves, these patients, the ISM patients tend to present themselves at allergists, dermatologists, and gastroenterologists. For us, it really helps us to accelerate our build for our next-gen immunology portfolio, things like amlitelimab, lung, zinc, amg, our TL1A with duvakitug, brevacamig, each of these assets that would come into the future. It just helps us accelerate our strategy. We'll continue to look at capital allocation in that way and be consistent as we can, obviously, with our strategy.
Excellent. Moving on to some of the growth drivers. Obviously, as you mentioned, Dupixent, the guidance implies sort of $22 billion peak sales before the patent expiry. We have recently had the COPD launch. Can you talk us through what are the key metrics you are tracking in COPD? There was a slide in one of the slide decks that showed that in asthma, GP was resonating well with pulmonologists as well. What are you tracking? How is it going versus expectations?
Yeah. Again, another good question. I think first point I always like to clarify is that because we've been on this journey before when we had given a waypoint of even Dupixent at $10 billion at one point, individuals said, "Oh, well, you're going to be $10 billion peak." I just want to clarify. The guidance that we'd given was we believe the drug will grow at a double-digit CAGR rate from kind of that 2023- 2030 timeframe. Your drug by 2030, not necessarily our peak sales, but by that particular timeframe. We'll continue to update that as we go. We're seven indications deep now. I want to come to your COPD question. We're seven indications deep now in the U.S. with the most recent approval in CSU. COPD was the indication before that. It's kind of funny.
We're very fortunate that that science has continued to read out and we've continued to be able to expand the patient population. COPD was the one that we launched in just before CSU. That one was one where we already were in the pulmonologist offices and the pulmonologists had already had a good experience with Dupixent in asthma. We were already set up nicely, I think, to go into that particular space. Now it's a very different patient population, 65+ , a sicker patient population, a lot of comorbidities with this patient population. That's why we had shared we felt like we would see a lot of that growth start to really take off in 2025. We've been very pleased. We've actually seen that happening this year. We've actually seen that it's delivering exactly as we anticipated.
The number one metrics we look at is patients on therapy. We've actually this has been our fastest indication as far as achieving coverage, both from a Medicare and from a private marketplace standpoint. It's been our second fastest indication as far as growth of patients on therapy. Again, it's still relatively early days, but we're very pleased with how COPD is progressing and also the impact that it's had positively on asthma as well.
Yep. Perfect. How are you thinking about how the biologic COPD market will play out? You mentioned that a number of the competitors are also present in the asthma spaces as well. Is your base case that this will be a cut and paste of the asthma market, or are there other sort of factors we need to consider in terms of the way the market shakes out?
I think there's some similarities and there's some big differences. I think there's some similarities in the thing. I think that as you go all the way back and you really think about asthma before there were biologics, as the biologics come into the marketplace, they're added on top of background therapies. You're looking for efficacy on top of what patients are already on. That's very similar in COPD. These COPD patients are the most severe, kind of like asthma, also similar, genotype patients. We're talking about the GOLD E patients, the really most severe patients. They're on the highest doses of double and triple therapies, and they're still exacerbating. Those are the similarities so far, I think, as far as patients go. There's exacerbation elements and there's also lung function elements. I think those are all pretty big similarities.
The big differences are, if you think about the patient population, asthma patient population skews a little younger. They tend to be a little healthier population in spite of obviously their asthma. COPD skews older and they tend to be a bit sicker with more comorbidities. I think the other big difference is when you see exacerbations really take off in COPD, there's a higher probability that they're going to re-exacerbate and potentially be readmitted into the hospital. The urgency to get these patients treated is probably a little more urgent, even though the patients are a little and probably for good reason. Patients are a bit sicker, so that makes a lot of sense. I think there's similarities and there's differences. I think the marketplace, though, will be a really meaningful marketplace. It's going to require different mechanisms of action in the future.
The bar to raise as far as improving efficacy over time, there's still a long way to go. Dupixent's very effective, but you're reducing exacerbations annually by about 30%-34%, depending on two different trials that we had. In asthma, you're much higher than that today. I think the future is going to require new mechanisms. We're advancing, as you know, lunsekimig as well, which is an IL-13 TSLP into that space also. I think there's lots of room for innovation in COPD.
Perfect. You mentioned CSU as well.
Yep.
Approved in April, I think, this year. What are your expectations for that market? Clearly, Xolair is approved there. There is a lot of competition coming down the road in terms of remibrutinib and a number of other assets that are also in development for CSU. What are your expectations?
It's the next indication for us, so we're excited about it. I mean, we had articulated the epidemiology of that in the U.S. alone. It's relatively similar to COPD as far as patient population goes, as far as size of the patient population, very different disease state because it presents, the patients present in multiple different physician types, allergists as well as dermatologists. If you think about it, Xolair has really been the only therapy in that particular space for quite some time. Now having another safe and effective therapy in the space, I think, is going to be meaningful for both the dermatology community as well as the allergist community. We're excited about it. Again, it's our seventh indication now, so it's a big base of business and it helps us grow on top of that. I think it'll be a meaningful one.
Already the feedback we've heard from physicians is it's meaningful to have another option now that they really have had very few options for a very long time.
Got it. In the initial indication, atopic dermatitis, obviously still growing. Competition is helping to build out the market as well. When you look at how competition is launching, you have Nemluvio, you have lebrikizumab, and a number of others in the oral space as well. How concerned are you that the competition is coming? How are you thinking about how that market is going to evolve?
Yeah, I think we've publicly said many times before in a disease state like atopic dermatitis, competition coming in is quite good because awareness of new treatment options. I mean, when you have a biopenetration rate that's still today around 14% in atopic dermatitis, and we're nearly eight years in with Dupixent, that shows you that there's a lot of opportunity for growth of the marketplace of more patients being treated with these advanced therapies. Not worried about that. I think it's actually good for the marketplace. It's good to have other options. I think having new mechanisms of action in a disease state like that, as heterogeneous as atopic dermatitis is, is going to be really meaningful. As we've said before, I think Dupixent will continue to grow kind of till its last day.
Atopic dermatitis is an area that's going to continue to help with that growth. Of course, we've got other assets, things like amlitelimab, which we're really excited about, that new mechanism of action that could be meaningful as well in a disease state like atopic dermatitis. I think new MOAs and new competitors coming into the marketplace is actually good.
Got it. Perfect. I think I'll move on from GP to the hemophilia portfolio as well. I think Altuviiio has been a very, very strong launch as we were discussing this morning. When you think about the market in hemophilia, you have the factor market and you have the bispecific market, sort of broadly how it's shaking out. Within that factor market, how much share do you think you can gain?
We have not really talked about it as far as how much share we think we can actually take. I mean, what we have seen so far is that a big part of that market was really factor-driven. I think you and I, it was funny, you and I were talking about this at one point earlier today. The marketplace was largely kind of used to the factor marketplace. We saw that you bring in a differentiated asset like Hemlibra came into the marketplace and really disrupted that marketplace a bit with a convenience story. They did an incredible job of that. I think what we did, what we have seen with Altuviiio is it was really about staying focused on what the patient needs were.
What was crystal clear was patients were looking for a higher degree of protection, a higher level of efficacy, if you will. When we were able to deliver that, even though it was a factor therapy in a once-weekly type of dosing, what you have seen is that we have actually taken very meaningful share of the marketplace. About two-thirds of our business is actually coming from competitors, as we have said, about a third of it is coming from our own. We had Eloctate that was in the space. About 10% of that is actually coming from Hemlibra. What we have seen is the switches are coming from both factors as well as Hemlibra. I think we obviously are going to continue to grow. We have actually said that this year we believe the drug will be a blockbuster, a blockbuster plus this year.
In the future, I think primarily we'll continue to take share from the factor marketplace, which is still relatively big, and a bit from Hemlibra.
Perfect. Another recent approval of the two's around Qfilia. Now, Paul has previously said this is one of the most underappreciated assets you have in the portfolio with blockbuster potential. We are only half of that in our model. How are the launch preparations going? Where could Qfitlia fit in the treatment paradigm and why am I wrong?
Why are you wrong? No, this one is also exciting because I think if you look at the space, to have, if you look at first and foremost what our label got, we really have probably the broadest label approval in the space, Hem-A, Hem-B, with or without inhibitors. Actually, to look at, you could have as few as six doses per year to bring you to or to have efficacy for these patient populations. The lowest treatment burden really in the space. I think we have, there's a lot of features to this particular product that I think are going to be really meaningful to both physicians, or we've already heard this actually from the community, both from a physician and a patient standpoint. There are patients out there and there are physicians out there that really see this as a nice fit.
I think first and foremost, we're going to see inroads in the Hem-B space because this is a space that really lacks that type of option at all. Of course, we've already heard positive signs as well in the Hem-A space as well because it's of the treatment burden side of things. The other thing that I think is really interesting about this one that probably is underappreciated is that it comes with a diagnostic. As you think about those antithrombin levels, it allows you to really customize the dosing and the treatment for the patient based upon the outcome that they're having in their antithrombin levels. It is a little bit more of a precision medicine type of approach per patient. We're seeing that the physician community so far has really latched on to that. They like that side of things.
Again, it's early days. We said that this would be probably a little bit of a slower ramp because you have the diagnostic piece of it and physicians will have to get used to that side of things. We definitely think it's going to be a meaningful therapy in both the Hem- A and Hem- B space.
Got it. And then moving to the neuroscience portfolio, Tom Brouttier, you mentioned, is currently with the FDA. Some questions we get on this are along the lines of the black box warning or the likely black box warning that could come for hepatotoxicity. Now, when you think about the launch and you think about Aubagio, which also had a black box warning, and also Lemtrada that you've launched, which again had a REMS program, how concerned are you about that being on the label? Is it a worry at all or is it, you've been here before with other assets?
I think the space, I mean, just as you mentioned, at first, you always think about the community, I think, more than anything else, both patients as well as the physician community and say, are they used to this? I think you ratted off a couple, but there are many more drugs in that space that actually have some sort of monitoring required. The physician community is used to this. The patient community is used to this. That is kind of point number one. I think point number two is given the differentiation of something like tolebrutinib, the potential, and we still are under the review process, but the potential to be the first in therapy to treat this kind of secondary progressive patient population, the physicians and the patient community are both excited about that.
I think you've just got to make sure that the outcomes are what you expect. I think for me, from a monitoring standpoint, that's not necessarily a bad thing at all. I think it just is one of the things that you learn in your clinical trial programs that this is something that you're going to need to do to make sure that the patients get the outcome that you're expecting. I think our experience with previous programs allows us to design one that not only delivers against making sure the patient has a great outcome, but also one that actually creates the least amount of resistance for physicians to try a new therapy like tolebrutinib.
Perfect. How are you thinking about the initial launch? Obviously, there is an element of SPMS being difficult to diagnose. In terms of increasing that diagnosis and getting awareness out there, that may suggest a steadier launch. On the other hand, there are a number of patients out there who already have been diagnosed with SPMS and are reliant on other therapies which have not necessarily shown a benefit. Is there a steady ramp or is it somewhere in between?
I think that's hard to know at this particular point. I think the way that I've talked about this is that all of the data and where we are even in the review process just further confirms our longer-term ambition for this asset of we've kind of created this class of drugs that will be in that kind of $2 billion-$5 billion range. And that's as we see tolebrutinib, it's squarely in that range, if you will. Now, how quickly we get there, I think is going to be the question is all the questions that you're asking is how quickly I think can we change the conversation from event-driven, like we've talked about before in the past, to more of a disability side of things?
Because this is where you've really seen that when you really think about the patient population, that is one of their number one, if it is their number one concern, is the progression of their disability. For us, this is going to be a really meaningful change in how we believe the HCPs and patients even talk about their disease. I think with that, that tends to take a little bit more time. The ambition that we have for the drug overall is stronger than ever.
Got it. How has KOL feedback evolved on tolebrutinib? If I go back about a year or so talking to physicians at medical conferences, the BTK assets as a class did not really, there was not a lot of enthusiasm. I think largely, obviously, the data in RMS has maybe impacted that. When you speak to doctors now, when you speak to the prescribing physicians, what are they saying in terms of the profile given that they have seen part of the data?
Yeah, maybe I'll break it into two things. What we saw back then when we were having the conversations and a lot of our learnings were led by our engagement with the external community. I mean, a lot of the physicians were saying they were the ones where we got a lot of the insights, quite frankly, about the patients where they said patients were coming in and they would have clean scans, but they were complaining about, "Hey, I feel a little less stable than what I once did," or, "I'm more tired than what I once was." There's a few of these things that they would say and the physicians really couldn't put their finger on, "Yeah, but your scans are clear." What they believe is this kind of there's a smoldering inflammation or smoldering MS, if you will.
What was really funny is that conversation was really led by them and started to take off. They were hopeful that you could have a mechanism or mechanisms in the future that could really help around this patient population that they were really struggling with. They were controlled, if you will, on current therapies, but they were still having this progression of disability, if you will. It kind of started with that, I would say, more than it did, "Here's a drug that we think it does this." As the data read out, I think for tolebrutinib, of course, first and foremost being brain penetrant, being differentiated in that way, and then, of course, delivering the results because we had the most comprehensive MS program of any of the BTK inhibitors.
I think it was the confidence started to then increase of, "Hey, we might have an asset here that actually could deliver against the problem that we were talking to about." We still have a lot of work to do. I think that's the job that we have to do as we get out there and launch it. I'd say the sentiment is very different than it was two years ago. There's much greater excitement.
Perfect. Thinking into the PPMS side of things. Firstly, obviously what we've seen across the BTK inhibitor trials is, as you say, disability progression benefits, whereas relapse rates haven't outperformed Aubagio. To what extent is that a positive read to the PPMS trial, number one? Number two, Roche-Strefner-Bouttier is going head-to-head versus Ocrevus in their PPMS trial. Does that matter from a commercial point of view? If, for example, we get a year down the line, two years down the line, both assets on the market, one has better than Ocrevus and one doesn't, does that matter?
I think it's a couple of things. I think the first thing for us that gave us confidence, and I think to answer your second question, that will matter the most is having the indication in secondary and then primary as well. I think having both of those and starting in secondary and then moving into primary progressive, if in fact it's positive in primary progressive, I think being successful in secondary gave us a bit more confidence that it might work in primary progressive. So that was a little bit more of the confidence builder.
I think that also links to what will matter, I think, a bit more in the community and even with payers will be, "Okay, do you have a secondary and a primary progressive indication?" Because it is obviously broader and obviously you continue to prove points that you have both a safe and effective drug. I think those are things that really matter. I think it is great that you see other therapies out there, BTKs, going out there and generating these other proof points because I think that will be positive for the class actually as well.
Got it. Perfect. We've got about 10 minutes left. I'll move on to the pipeline. It's itepekimab data readout recently. Is there any update yet in terms of what's going on in terms of the two different trials or two trials designed in a similar way? One showed a clear benefit, as you'd expect with the phase II results, but the other one didn't. So any updates there and what's the timeline from here in terms of learning more on RFI2?
Yeah, I think the second one's a little harder to answer because I think there's still work to do before we can really speak to kind of what the timelines will actually be. I think in the first part, Houman, our Head of R&D, has been out there. Regeneron, I think, has also spoken about this as well, was first immediately looking at the data and then starting to understand, "Okay, well, the second trial looks a bit interesting even after the 24 weeks," because it looked completely normal to 24 weeks and then something strange happened at 24 weeks. I think that requires us, we have a responsibility, I think, across the alliance, both companies to dig deeper into that and see if we can better understand, is there any hypothesis as to the why? Because it is, we have to admit, it's a bit strange.
Both companies having a lot of experience in doing clinical trials, both companies really saying that it's kind of the first time we've seen something that's that specifically different. There's already some building hypothesis as to why that may have been. Before we go any further, I think with any type of public disclosures of that, we want to make sure that we have stronger data to support it. I think the next step from that is once you have that, is to start to have conversations with the regulatory bodies and say, "Okay, well, based upon what we believe might have happened, what could be a path? Is there a path and what would that require?" I think following those two steps, then we would communicate with the external community about what we plan to do.
Hard to put a timeline on that, to be fair, but just trust and know that both companies will be doing it as quick as humanly possible.
Understood. Amlitelimab is the next one. A few questions on this one. I think in investors' minds, this has to work in order for the sort of the Sanofi R&D rebuild story to have credibility. What's the view internally in terms of is amlitelimab a must-have or is it the sort of portfolio in immunology approach is what offsets that?
Yeah, that's a tough question because if I say we've got a broad portfolio, I might get said, people might say, "Oh, well, you don't care about amlitelimab as much or he said he didn't care about amlitelimab as much." Or if I say, "No, no, no, it really matters," people say, "Oh, well, he's really just focused on." Look, I think that we're in a very strong position today where we have so many, I mean, look at already what we've talked about and we have a lot more to talk about. We're in such a strong position because we have in our hands incredible assets that are growing. We're a growth story. Many of them recently launched, several of them soon to launch. And then we've got so many readouts that are actually coming.
I'd say in the grand scheme of things, this is, yes, it's absolutely, it's an important readout, but it's part of a broader story. It is not the story. It's part of a broader story. Is it an important readout? Absolutely, it's an important readout for us. If you look at the way in which we've designed it, I mean, I think if you look at this mechanism first and foremost, we believe the mechanism is a really meaningful mechanism. We believe the ligand approach is the most strategic approach to the OX40 class because you had the best balance of efficacy and safety. If you look at the robust development program that we've designed around it, we've given ourselves a whole host of areas to really differentiate this asset in the atopic dermatitis space.
I think we've shown with the steps that we've taken that it's an important asset. I'd say our story is even broader. It's definitely not a one-asset story.
Got it. With COAST 1 , recruitment seems to have gone pretty quickly. Should we expect data for atopic derm by the end of the year? Number one. Number two, what are you hoping for in terms of a target product profile? Is Dupixent-like efficacy, but three months in the administration, is that the bar or does it have to be better in terms of efficacy from where you're looking to position it in the market?
Yeah. A couple of things. We've said H2 for the updates. Of course, it's recruited well. We'll, of course, update the community as soon as we have the data. H2 is what we've communicated. I always take a step back as it relates to when I get this question because I get this question a lot. I always take a step back and basically say you first have to think about the therapeutic area. If you think about atopic dermatitis, it's an incredibly heterogeneous disease state. Today, it still really lacks very differentiated mechanisms of action. Of course, Dupixent's been extremely successful and we've said this before, it'll continue to grow until its last day and it'll continue to grow in atopic dermatitis. Every time a new entrant comes into atopic dermatitis, the market grows, much like what we saw in psoriasis.
I think this is going to be no different. As this new mechanism of action comes into the marketplace, you're going to see the market grow. What do I have to see? I think number one, I'm expecting to see a new mechanism of action that has a scientific rationale for why it could be important in atopic dermatitis. Because we believe OX40 ligand is a broader target than even the current targets on the market, if you will, from a biologic standpoint, it's broader than the IL-13s alone, it's broader than Dupixent, and it's broader than the IL-31. Not as broad as a JAK, of course, but it's broader than the current biologics. It has a strong scientific rationale on why it might work across a broader patient population or a broad patient population.
New mechanism of action, strong scientific rationale as to why it might work. You need to look for areas of differentiation. It has got to be safe, got to be effective. From an efficacy standpoint, there are areas there that you can really dial that up a little bit. Meaningful, durable efficacy up to three months, that would be really meaningful in this space. Combination efficacy in combination with topical therapies, even working in patients that are inadequate responders to previous advanced therapies, so JAKs or previous biologics. We have got all of these in our trials. We have developed a way in which it should deliver a profile that could be very meaningful into the atopic dermatitis space.
Got it. Perfect. I just wanted to also touch on duvakitug, the TL1A. You've seen some encouraging data in both UC and Crohn's, but you're a little bit behind the other companies looking to develop this asset. How are you thinking about the sort of commercial opportunity here? Is there any sort of analogs, any other areas where you've seen this sort of situation before where you have a sort of third-to-market asset, but has potentially better efficacy? What would you sort of point to as an analog there?
It's a little harder with the analog. I have to think about that. Maybe I'll tell you the way in which we've thought about this because we looked at this class for a little while. We thought that this class was going to be really an interesting class, the TL1A target, if you will. What we've seen is you've seen, obviously, in our data in really early stages of it, is you could be really looking at certainly best-in-class, cross-trial comparison now, but best-in-class type of efficacy, but maybe even best disease type of efficacy. I mean, this is early data, but first and foremost across Crohn's and UC, these are two meaningful places we wanted to land at first because we thought that was really important.
Now, as it relates to the opportunity there, I mean, if you think about the disease state of UC quite specifically, this is an area where you see extreme amounts of switching because these patients actually reach a durable effect and then the effect starts to wane. We are also looking at, actually, could you have, it looks like you could have a bit more of a durable effect actually with the TL1A class. First and foremost, I think those anchor indications before we moved on to what might be next, we wanted to make sure we landed a differentiated profile there. We are working with our partners, Teva, to make sure that we do that now. The thinking is we are working across the alliance there with Teva to think about where else could you take this asset.
Stay tuned for where we're committing to there. I'm not so concerned about being a little later as long as you can deliver a differentiated profile, which we think we can.
Perfect. We've got about a minute left. The key debate really for Sanofi is potentially $22 billion that you need to offset from the pipeline in order to sort of promote growth into the longer term. Only really $12 billion of that in terms of, or half of that is the profitability you need to replace. In a minute, what is your sort of viewpoint at the moment in terms of the building blocks to replace that? Is the goal $12 billion or $22 billion in terms of sales you want to replace?
Only a minute for that question.
Yeah, it's a bit of a half-time, sorry.
No, I mean, we've been thinking about this for a long time. I think the answer to your question, the short answer to the question is it's going to have to be, we've been thinking about replacing the whole, even though you only have to replace half. We've been thinking about how do you replace the whole. It's going to have to be a multifactorial approach. It's not a one drug or a two drug or a one indication or two indication type of approach. It is doing exactly what we're doing, right? You stack up really innovative assets across the entire immunology portfolio. Some of them are going to be in similar indications. Some of them are going to be in completely new indications. Some of them are going to be alliance products like itepekimab. Some of them are going to be non-alliance products.
Some of them might be in Hem- A and Hem- B, as we've just talked about actually as well, and certainly in neurology. Some of the recent deals that we've even done with Vigil or Dren Bio, these are the types of things that we're thinking about that actually could help us in the future really offset the pending LOA of Dupixent, which is not until after the end of the decade, as we know. It is a holistic approach to it, and we've been thinking about it for quite some time.
Perfect. Brian, thank you for your time and thank you for traveling down to Miami to speak with us.
Thank you so much.
Appreciate it.