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