Good morning, everybody. I'm, Christopher Schott at JP Morgan, and it's my pleasure to be hosting a fireside chat with Christopher Viehbacher, who joined Biogen, I guess, a little bit less than two months ago-
That's right.
As CEO. Chris, happy New Year, thanks for joining us today.
Thanks, Chris. Happy New Year to you, too.
Thank you. Maybe just to kick off, it seems like you're joining a company that's kind of at a crossroads. We've got, obviously a very exciting new launch on the Alzheimer's side. We've got a large pipeline, but one I think is viewed as kind of high risk, high reward. We've got a base business that's got some LOE pressures. Can you talk about the key challenges that you see facing Biogen right now and how you're kind of planning to prioritize these as you think about your tenure as CEO?
Yeah. I mean, Biogen was founded over 40 years ago. I'm guessing, they were at the very first of this, JP Morgan conferences.
Yes.
41x ago, right? 'Cause I think it's probably more than 41 years ago.
Yeah.
It's been a very narrowly focused company on multiple sclerosis and very successful. Of course, that is now something we're calling basically a melting iceberg.
Mm-hmm.
It's not a patent cliff, but it's not got growth perspectives and my job as I see it is to restore the company to sustainable growth. There are a number of levers for that. First, we look inside the company, and the two biggest opportunities, quite honestly, having two blockbuster products to launch almost simultaneously, I never had that privilege at Sanofi.
That's a good way to start.
Genzyme for that matter.
Yeah.
It is a huge opportunity. Now, they're not simple launches, and we can go into that. You know, lecanemab clearly is a breakthrough. So is actually zuranolone. I mean, most people don't realize this is probably the first new mode of action in mental health in 20 years, certainly for depression. After that, we have our existing business. The MS franchise actually is quite interesting 'cause there's still a lot of people love TYSABRI and love even AVONEX. You know, I think we have to look at are we really spending the right amount of money on that? You know, we'll have to look at our cost base. SPINRAZA, I think actually has opportunity as well, particularly in the adult population.
Obviously in small children, babies, they're being screened now for SMA. There's an awful lot of undiagnosed or misdiagnosed cases in the adult population. Third opportunity is really the cost base. We still, you know, we have $5 billion less of profit than we did in 2019. I have to say that hasn't completely percolated through the company so far.
Mm-hmm.
The fourth is, you know, we're in a very healthy financial position, and we'll start to look at some external growth.
Yeah. Yeah. I guess maybe one of the things I think about is you've had obviously some prior experiences at very large companies. How has that prepared you for kind of taking a company like Biogen and taking kind of a fresh look at a business like that?
I'd say I've got two different experiences. I've got You know, growing up in the in the large company model where, you know, certainly there's always an element to leading complex organizations being global. I actually really enjoyed the last seven years in an entrepreneurial environment.
Mm-hmm.
You know, one of the things I learned was One of the reasons I think the biotech sector has become so strong is because of weak decision-making in large pharma and large biopharma. You know, this need to have validation at every milestone before you can raise money, I think is a healthy thing. I'd like to bring some of that actually into the company, particularly on earlier stage projects. You know, obviously Sanofi needed turning around as well and rebuilding. You know, there's an opportunity to bring some of the, I think, potential to look at value creating either acquisitions or business development. I'd say those things do, have helped.
Okay.
Of course, we're a much smaller organization. I actually like the nimbleness of Biogen, you know. I think we had 110,000 people at Sanofi, and we got 8,500. Now 8,500 is a whole lot more than I've dealt with the last seven years, I have to say.
Bring those two together. I guess, are you envisioning any strategic shifts for Biogen? You touched on this a little bit moving forward, I guess, as you think about whether it's the kinda mix of internal versus external. Like just how are you thinking about that?
No radical left turns. I would say some redefinition of what we're about.
Okay.
I think, Biogen has typically presented itself as a neuroscience company.
Mm-hmm.
I would argue we're already broader than that. You know, multiple sclerosis is really an autoimmune disease.
Mm-hmm.
I think that gives us some legitimacy to go towards immunology. With zuranolone, we're getting into psychiatry.
Mm-hmm.
With SPINRAZA, yes, it's a neurodegenerative disease, but it's also a rare disease. I think we could legitimately expand into the rare disease space. I don't see us getting into oncology tomorrow. There's enough other people in that space, or into cardiology. But I do think we'll widen our aperture a little bit. You know, one of the terrific things about Biogen is it has had the courage and the persistence to go after some areas of real unmet need. The issue in neurology is that these conditions evolve so slowly...
Mm-hmm.
That the trials have to be long, and they're expensive, and so you get this high-risk, high-reward type situation. I think we need to balance that out a little bit.
Okay. When I think about your ability to do that, is that something you can do internally? As you mentioned, you've got some strengths in markets that are maybe outside of traditional neurology or is that gonna be maybe more of a push on the external side of things?
I think there's on the near-term side, I think it's gonna come externally. You know, we're in psychiatry with our partner Sage, but, you know, we really don't have another product in that area, and I think it would be nice to flesh that out. I see actually Alzheimer's is becoming a franchise for us, so with our partners, Eisai, this isn't just about the launch of lecanemab, important as that is. We have two other assets in development. There's an awful lot of studies that can be done as well to build out that franchise. Yeah, it'll be a little bit of growth, but one of the other areas is research and I split the role of R&D into development and research.
You know, development is really there for the next three to five years of growth. Research is there for the five to 15-year timeframe. I wanted research to be a little disconnected almost or unencumbered by, you know, here's where our business is today, be able to pursue science in a little broader way. Not again dramatically differently, but through research, I think over time, we can actually build out a pipeline that's a little broader than just pure neurology.
Does that broadening of the pipeline, you know, inherently assume that there's some culling back of the more traditional neurology, you know, kind of opportunities, or can this be just additive to what you're already doing?
At this stage, I think it's gonna be more additive. You know, I think there is an interesting pipeline in there. I think, one of the assets I'm particularly interested in is the Ionis partnered asset for anti-tau. You know, obviously major breakthrough data. You know, Alois Alzheimer discovered these plaques and tau tangles in patients that autopsied 100 years ago, and it's taken us a century to actually have the first definitive data that says if you remove plaque, you can have a cognitive function. I think we'd all agree that there's still more to be done. Tau is promising. We also have two compounds in for lupus, SLE and CLE, and I think that's actually a promising area.
Got a project in stroke. That's another one of these high-risk, high rewards, and you'll find out at the last chapter whether it works or not.
Yeah. Exactly. I'm thinking about just Biogen traditionally, I think, has done business development through a series of maybe smaller partnerships. Is that Would you envision that you're gonna stay the course there, or could we see the company look at, you know, larger, I'll say, like multi-billion dollar acquisitions as you look to broaden out the focus of the organization?
Well, I'm gonna focus on getting the really the things right within the company sort of the first half of this year.
Okay.
I do think we'll have to turn our attention to some external growth in the second half. Then it's just. You know, you can have a strategy, but after 35 years, I've discovered you gotta be still pretty opportunistic, you know?
Right.
You can go fishing, but you don't know whether you're gonna eat bass tonight or anything for that matter. I think the... You know, I wouldn't shy away from an acquisition, but obviously, you know, that gets you into a different risk profile. I would say within Biogen, there's a lot that's already good, so I don't feel a pressure that we have to go do something quickly. Equally, we've got the financial wherewithal and it is an opportunity to shape the company. I really like these collaborations. You know, when I was at Sanofi, we had a very prolific one with Regeneron.
Mm-hmm.
I think Biogen is a really good partner. We're partnered with Ionis. We're partnered with UCB. We're partnered with Denali. We're partnered with Eisai. That's a cultural, I think strength of the company that they can do that. That is capital sparing in a lot of ways.
Mm-hmm. Okay. When I think about that, it seems like that, you know, kind of evolves over time. You've got the firepower to do it.
Yeah.
You know, partnerships needs to be looked at.
You don't, you don't wanna do an acquisition unless you've really got your own house in order.
Okay.
I don't think we're quite there yet.
Okay. Okay, that's helpful. Biogen's made some significant cost cuts, I guess, over the last year or so. I think it's about $1 billion of expenses been pulled from the budget. Would you envision there's additional cuts to come as we think about that cost base, or at this point, are you in a pretty good place?
No, we definitely can look at the cost base.
Okay.
I mean, if you strip out the collaboration revenue and the royalties and start doing ratio analysis, I think everybody here knows that we probably have ratios that are not competitive.
Okay.
with our sector. We're certainly looking short term at things like G&A.
Mm-hmm.
You know, I think we can look at return on investment in multiple sclerosis. Remember, this has been the bread and butter of the company, and so, you know, getting that company to reduce the investment on that is, you know. You really wanna make sure that you know what you're doing with that.
Okay.
There are some costs that are inherent in what we're doing. I mean, we built a factory to produce lecanemab that is not currently occupied, we have a number of idle costs. We are continuing to spend money on Aduhelm. To be honest, that's a question that we'll have to figure out. You know, we have to do a confirmatory study by the terms of the NDA. If we don't do it, we lose the NDA, if you lose the NDA, maybe this is an asset that has value to others, we have to evaluate that. I think, you know, we can bring a lot more of a return on investment type culture. It's a very gung-ho culture at Biogen, I don't wanna lose that. It's entrepreneurial.
It really goes after things, but somewhere along the line, we also have to have some capital discipline.
The timelines around this, is this, you know, you mentioned kind of getting the house in order. Is that, is this like kind of a first half 23?
Yeah.
Okay. We'll kind of get some clarity as the year goes along.
Yeah
how that goes.
Yeah.
Okay, perfect. Maybe kind of pivoting into some individual products. Alzheimer's obviously very exciting opportunity here. I guess, what are you seeing as the biggest challenges on the lecanemab launch, as we maybe just kinda couple that with what lessons you learned from Aduhelm?
Lecanemab is actually a really interesting product. You know, you'd think after 35 years in this business, you've seen it all, and yet you have something like this come along that's completely new. It has all the hallmarks of a specialty pharma drug. You know, we're into specialist, biologic, a lot of medical services wrapped around this, but we have the volume of a primary care product.
Mm-hmm.
So that actually creates its own unique challenges. you know, to get diagnosed, you're gonna need either a PET scan or a lumbar puncture. There's gonna be three MRIs over the first six months. It's a biweekly, every two-week infusion. You're talking about huge numbers. Specialty pharma, you're thinking about tens of thousands, maybe hundreds of thousands of patients here. One day you could be thinking about millions. Of course. There's a whole element of how the healthcare infrastructure has to evolve for this. Of course, then we're also dealing with Medicare in a lot of cases. There's gonna be budget issues that we have to all be cognizant of. We have to, you know, we'll have to work carefully with the system.
You know, I think as you've heard from Eisai, we're thinking about maybe 100,000 patients after the first three years. This launch is not really a reach and frequency model.
Okay.
This isn't about just sending out reps. It's really around working with the system to make sure that we can expand it and make this new treatment available. We're also doing other studies around this. You know, it seems like the earlier you treat, the more benefit you can have. We have a study called AHEAD that is ongoing in pre-symptomatic patients.
Mm-hmm.
As I say, we also have two other assets in this, in this space that we wanna develop.
Yeah.
The portfolio kind of builds out over time.
Reimbursement, obviously, kind of big controversy around this. How do you see reimbursement evolving over the next year or so?
You know, CMS has obviously confirmed that if we get full approval.
Mm-hmm
We will reimburse on the basis that there's a registry. You know exactly what the timing is. We first have to see how long is it gonna take to get full approval. The full approval was just submitted on Friday evening late in the evening. Is this gonna be a six-month, nine-month, 12-month review? We don't know yet. In general, I think, though, I believe that CMS... My personal view is that CMS will approve and reimburse this. Unlike Aduhelm, we've got very clear data with the Clarity study. I mean, statistical significance everywhere, not only on the CDR Sum of Boxes, but also ADAS-Cog and also the activities of daily life.
I think the safety issues are understood and you have to obviously be careful on that front. I don't really see why this wouldn't be made available. I think what we have as a job to do is really to explain the real benefit of this to patients. People say, "Oh, well, you know, you had a 27% increase or whatever." That doesn't really tell the story. Maybe what I look at from more of a commercial point of view is the activities of daily life.
Mm-hmm.
We had a 37% improvement in that, and that's not... You know, I think people have this view sometimes not in this type of audience, but in the more general public, that Alzheimer's is a little bit of memory loss. People don't, I think, fully understand that this is a fatal disease. This is a progressive disease that puts a massive burden on the caregivers. People have to quit their jobs to go and take care of loved ones. You progressively lose your ability to look after yourself. So this activities of daily care is not only memory loss, but it's orientation, it's personal care, it's ability to continue with hobbies, to be active in the social environment. That is, I think, quite significant.
There's something like 16 million people who today are actively involved with you know, taking care of someone with Alzheimer's, many of those family members. There's a massive societal burden that is only going to grow. I think we have to really do a good job of explaining that, because that sort of comes up in just about every conversation, what's the clinical benefit?
Yeah.
You know, this Sum of Boxes is not actually used by physicians when they see patients. I think what, you know, as we get this in the hands of physicians, we'll see who actually is really responding. We're gonna do an awful lot more data analysis to try to predict who's a responder.
Mm-hmm.
you know, can we start to predict who might have more moderate to severe ARIA? but I do think, you know, this is really an opportunity to provide hope for so many people.
Great. just going back to the reimbursement, just comment whether it's yourselves or Eisai, has there been much engagement with CMS at this point in terms of their willingness to, you know, kind of consider a different outcome in terms of the reimbursement?
I only know that from what, this is in the hands of Eisai.
Yeah.
You know, we've been working for eight years together, and Biogen had the lead on a number of things for Aduhelm, and Eisai has the lead for Leqembi. They're the ones who are actually engaging with CMS, and I haven't been privy to the actual detailed conversations.
Okay. speaking of just how the commercialization will work, can you just talk about individual responsibilities of the companies and how that's going to split up?
I'd say it's not really a reach and frequency model.
Yep.
To start. You know, usually you launch, it's a real education campaign and just getting out there and educating physicians. Here, there is an awful lot to think about in terms of this whole healthcare infrastructure build. At least in the U.S., Eisai will take on the lead with getting a first initial wave of field force out there, and we're working then with them collaboratively on marketing, on thinking about additional clinical studies that we may wanna do, and how do we build up an Alzheimer's business together over the longer term.
As we think about kind of geographies outside the U.S., how do you envision that working?
We're gonna do that country by country.
Okay.
I think, you know, we have a very strong presence in Europe, for example, so we'll be looking at that. There's some parts of the world like Latin America where we have a greater presence. They have a much greater presence in Asia. Remember, this is a 50/50 deal, so we have an inherent interest in making this efficient as well. You know, the reality is that co-promotion and co-marketing, you know, on the one hand, you leverage the abilities of two companies, but on the other hand, you can create some duplication.
Yeah.
What we wanna do is make this as both effective and also as cost efficient as possible.
In your time in the CEO role, have you had much you know, kind of engagement with your counterpart at Eisai in terms of how is that relating? How's that generally been?
Haruo Naito and I have known each other for many years. My first trip as CEO of Biogen was to Japan. We spent most of a Sunday together, thinking about how we wanted to work together. I talked to him at least three times this week.
Okay.
Yeah, we have an awful lot of interaction. You know, I would say because we've known each other, there is actually a tremendous amount of mutual respect. Most importantly, this is what you really need in a partnership, we have shared values and a shared vision of what we wanna build.
Yeah. Great. I think there's been a lot of, I think you mentioned before, focus on subQ. Can you just talk about what you believe you and Eisai have to do to get a subQ formulation to market?
That's in progress. There's a multi-pronged approach on that.
Mm-hmm.
We haven't talked about timing, but, that is well in hand.
Okay. What does that do, I think, as you think about kind of what this could mean for the market as a whole of getting this away from an infusion into something that's a little easier to manage?
The interesting thing is in market research, you know, the biweekly infusion is not necessarily the burden you might think it is.
Okay.
Because actually... Well, to be honest, what we've seen is sometimes this is a way of getting out of the house and getting some outside contact for patients. Obviously a subQ would be better. One of the most interesting things is, you know, we don't really understand how when the plaque builds up that leads directly to neuronal death, but it does in some sort of cascade, which is why, you know, the studies that have worked have been in earlier stage patients. We have a study ongoing called AHEAD, or A 3-45, that is looking at pre-symptomatic patients. If you go earlier, are you gonna get an even bigger benefit?
I think if you did get success there, then I think actually, subQ would be particularly important.
Mm-hmm.
We're also looking at different dosing regimens. Clearly, we have to make sure that we can make this as convenient for the patient as possible.
Okay. Okay. Then just one last one on, I guess, the Alzheimer's side is how do you just think about the competitive landscape? Do you kind of think of this as a split market or more of a winner-take-all kind of approach as I guess we're thinking about donanemab kind of readouts as we go through this year?
You know, this is a brand-new market.
Mm-hmm.
It never really existed before. That doesn't happen that much. You know, I had a lot of experience at the start of my career in HIV. Actually more entrants really actually helped develop the market.
Mm-hmm.
I actually, I'm not too concerned. I think actually if Lilly is successful, that they'll come in. They're completely different products, and I think, I think actually we're pretty confident that we could take a bigger share, largely because we don't know how long patients are really gonna be on the product. I mean, we studied this for 18 months.
Mm-hmm.
We'll have extended data. What happens if you're treating longer? You know, we haven't seen any data from Lilly, so it's hard to comment on it. I actually think having several entrants could actually be beneficial to everybody.
Just given all the infrastructure and education and everything else that goes into that. Excellent. Turning to the base business, you mentioned earlier Biogen's been a clear leader in the MS space. You've had clear some impact to the franchise with generics. How do you think about the kinda goals for that MS franchise at this point?
Well, first is to make sure the iceberg melts slowly.
Okay.
If I can put it that way. You know, it's interesting. I mean, TYSABRI is actually... I actually was visiting a neurologist in New York, and, you know, if you actually said, "What do you think is the best drug out there?" For them it's TYSABRI. Now, OCREVUS has clearly come in and had a lot of success, largely on the convenience. You know, people are saying, "Well, B-cell depletion , how long do you really wanna do that? And if you have COVID..." Actually, you know, what would've been good is to probably do a lot more outreach to patients to give them the balanced view of that. You know, at this stage of the life cycle, I'm not sure that that makes sense.
Mm-hmm.
We are still busy doing research, and.
Okay.
We have not given up and would like to also bring more new products to patients in this space.
Is the goal here to kind of more manage the profitability of this franchise? Is that fair to say or?
Yeah.
Okay. Versus trying to grow it, I guess.
Again, you know, you're gonna find with marketers, they love their products.
Mm-hmm.
You know, typically you get to, For instance, if you get to, in the old small molecule business, you know, you generally stop doing promotions somewhere 18 to 12 months before.
Mm-hmm.
-patent expiry. You have no idea how hard that is. You know, I remember one time with Plavix, we had to give an order that, you know.
Time stop.
You'd be fired if you started to promote that.
Yeah.
It's hard for people to give up. This has been the history of the company for 40 years. You know, we do have to do a better job, I think, of really understanding the promotions. There is a lot of competition out there.
Mm-hmm.
A lot of people are tied to these products, but I think we can do a better job on the profitability.
Okay. Great. Moving to SPINRAZA, how do you see that franchise evolving over time?
you know, you've got obviously an oral.
Mm-hmm.
The oral really only goes to 25 kg in weight.
Mm-hmm.
That's really for children at this point in time. There seems to be some sort of evidence that the gene therapy may not be as durable.
Okay.
As one might think, which is interesting. We actually have a study going on looking at what happens with gene therapy, because if that is the case, then that is an opportunity for Spinraza to come. You know, again, there's a quite a large adult population, and I think the low-hanging fruit in that market, if I can, or the easy to diagnose patients, if I can put it in, in a better way, have been done. The adult population is not quite so easy to diagnose.
Okay.
has been misdiagnosed. The whole secret to rare diseases is really hunting for new patients.
Okay.
You know, I remember when we acquired Genzyme years ago, and the head of marketing saying, "Marketing strategy is looking for needles in haystacks." That is amazing what can be done. I mean, you follow family trees and go out there and hunt for patients. I actually think there's a reservoir of growth there.
Okay. Is that growth dependent on, I guess, some of these ongoing studies you're running, or is there some element of this is just kind of a different commercial approach?
I think a lot of this is blocking and tackling.
Okay.
We're gonna have a company-wide day in the first quarter really just to share best practices and think about where we go. 'Cause I'm not so sure that we've really gone the full mile on really understanding how to go build rare diseases within the company.
Okay. Okay, great. Continuing along, as we think about other launches here, how big of an opportunity are you seeing with zuranolone?
I think zuranolone is the biggest undervalued potential of Biogen.
Okay.
You know, there's an awful lot of people say, "Well, it's every two weeks, and, you know, how is this gonna work?" I've done years of market research, and one of the things that you learn over the years is that as long as you are taking a medicine, you are sick.
Mm-hmm.
If you're not taking medicine, you are well. That is how patients think about things. It's why people. You know, you have to have television ads saying, "Take your antibiotics until the end of the therapy." Here you got an opportunity. You know, I had in my previous life, we had a company that operated clinics at Microsoft and Facebook. The demand for mental health treatment is enormous. You know, SSRIs have been helpful, but they're not really solving all of the problems. You've got, on one hand, an unmet need, and the second is I like this idea of, okay, two weeks of therapy, and then you don't have to take anything. You know, there's always a stigma associated with mental health.
You know, do you really go and talk to your friends about, "Oh, I'm taking this for my depression. What about you?" I mean, that doesn't happen at barbecues.
Mm-hmm.
You know, here you have an opportunity to say, "I'm treated and I'm well.
Yeah.
I don't have to take anything. Now, you may have to have another treatment later in the year, and we have a trial called SHORELINE that is looking at exactly when that is. I think this will be a little bit trickier for payers, because you now have to price kind of a year's therapy.
Sure.
In blocks of two weeks.
Yeah.
That's not gonna be simple. It is a change in the way physicians look at this, 'cause they're used to just putting someone on an antidepressant. I do think that from a patient perspective, I can see an awful lot that they would like in this. As I say, there's something like over 20 million people who have had a depressive episode. I think also the ability for potentially fast acting is important. I mean.
Mm-hmm.
I know a number of friends who are concerned their children are off in college and, you know, one friend just a couple weeks ago had to fly down, you know, because they're really worried for the safety of their child.
Mm-hmm.
If you say, "We have a therapy for that. You just have to wait six weeks," that doesn't necessarily correspond to the sense of urgency-
Absolutely.
-that you have in that circumstance. I do think that there are a number of things that I certainly learn. I mean, I was at GlaxoSmithKline when we had PAXIL and WELLBUTRIN. I know this market. I know those products. I think this is a product that really does add an awful lot of value that isn't there in the marketplace today. I think the... When I look at forecast for the product, I think it's tremendously undervalued.
When I think about the market-
Personal view.
Yeah. Yeah. There is a lot of generics here. I guess the question, From a payer perspective, do you think the payers get the differentiation of something like this?
You know, that's where we'll have a lot of work to do. It, you know, we're also looking at these value-based agreements. I will say The demand for mental health is pretty well established and I think the payers are interested in making sure that treatments are available. Doesn't mean it's gonna be a walk in the park but I actually think we will get there with the payers.
As this ramps, I guess, I think you made a comment earlier on this, is there a broader push at Biogen to move more into psychiatry as a vertical?
Well, once you build the field force and build the capability... Remember, you know, Biogen, if I said, where's the risk in this? Is to me it's more risk of execution.
Okay.
Biogen has never gone and visited primary care physicians.
Mm-hmm.
That's a different skill set. It's a much bigger target audience than what we have visited before. We may be into television advertising. We've not done that before. Even just back office things like sales ops are gonna be different because, you know, we have relatively small field forces. If you're starting to go visit primary care, that is a different thing. Then we also have to think about the postpartum depression, and that probably takes a slightly different team 'cause they're visiting a different type of physician. There are some things that we have to do internally, but I do think that this is something that really is I think offers a huge benefit for patients and could be quite a big opportunity.
I think with building out a portfolio there, would that be kind of get this up and running and then add over time? Is that the approach?
Yeah. Well, 'cause now you only have one product in the bank, right? It would make sense to start looking at other things in this space, but I think we wanna get this thing well launched and on a good trajectory before we do that.
Okay. Okay. That makes sense. Moving over to immunology, I know you've got a number of late stage studies in lupus across two different programs. Is immunology an area that is a, you know, kind of the area of focus for Biogen going forward?
Yeah, I do think that. You know, Elias Zerhouni that I brought in as head of R&D, years ago, always liked to say, "You know, we describe so many diseases by their symptoms or where the disease manifests itself, and increasingly we should be thinking about what are the causes of disease.
Mm-hmm.
There's so many diseases that are caused by the immune system.
Yeah.
I think we actually do understand some of that and have that capability. I think it's a legitimate space. Are we gonna get into RA? I'm not so sure.
Sure.
I think, certainly neuroimmunology is fair game for us.
Okay. Maybe just the last question here. Just as you think about the pipeline, what are the major opportunities for growth that we should be paying attention to as you've kind of evaluated what the company has internally?
Well, lupus is certainly one. I mean, there's a huge potential market as... You know, I was at GSK when we developed BENLYSTA, we, you know, looked at it already back then. You know, we all know that BENLYSTA is limited efficacy and... In the meantime, it has also been a graveyard-
Yeah.
of a lot of difficulty.
Mm-hmm.
Now AstraZeneca has been successful. I think if we can be successful with this, these could be massive growth drivers, both products. I think the [Sikenos lupus] is actually a particularly interesting product, and I, and, you know, I think we've seen some good early stage results on that. I think lupus is a huge opportunity, and as I say, I think Alzheimer's will grow.
Mm-hmm.
If we can be successful. We've had some very good, early stage data with the Ionis-partnered compound on the anti-tau, for example. They say there's a stroke compound, but very difficult to tell what that one will do.
Mm-hmm.
You know, it does come back to this, if it works, we're good, right?
Yeah.
The question I think that a lot of investors pose is, will it work?
Yes.
Can we do a little bit more to de-risk our gross growth profile?
Yeah.
That's gonna be a slight shift in what we're putting into development and also what we're looking at in terms of external growth.
Great. Just something else. As I think about the path you're going down here, it sounds like kinda first half of the year is some evaluation of the cost structure. You've got obviously these big launches you've got under your belt. How long does it take to kind of pivot the organization to get to that profile you're envisioning, where we're gonna end up with a more balanced pipeline and, you know, cost structure in the right place? Is this a kind of a multi-year process, or is this something you can...
Yeah, I mean, I always used to say, in this business, three years is tomorrow. I actually just ran into Dan O'Day this morning, and, you know, congratulating him on how he's doing with Gilead and... You know, he's been CEO for four years, and it's, you know, the first couple of years, you know, you had to believe as well. I think actually with Biogen it could be a little faster because we have these two launches. We're not relying on business development and acquisitions to deliver on some of the growth stories. From that point of view, it could go a little faster. You know, the regulatory timeframes, you know well, Chris, and it just, it does take some time. And cultural change is not that easy.
I do believe that there's an awful lot of strong fundamentals in the company. This is a company with great people. This is a company that has spawned so much talent in so many of the companies that are now at this conference around the table. I actually have a lot of confidence in the development organization. We have an opportunity with a new head of research to perhaps move ourselves in some different directions. You know, lecanemab and zuranolone, if we get those right, that's gonna count for an awful lot of the new Biogen.
Great. Well, I think we're just about out of time here. Really appreciate the comments, and yeah, look forward to seeing the progress of the company over the year.
Thank you.
Thank you.