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Citi Annual Global Healthcare Conference 2025

Dec 2, 2025

Geff Meach
Senior Biopharma Analyst, Citi Research

Just my name is Geff M each. I'm the Senior Biopharma Analyst here. We're pleased to have Jazz Pharmaceuticals with us. We have Phil Johnson, EVP and CFO, so welcome, Phil. We have Jack Spinks from Jazz as well. Thank you, guys, for joining us. Phil, you want to kick it off with some kind of opening comments, and we can get right into some questions.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Happy to. Thank you very much for the invite. It's a pleasure to be here at the conference. In addition to having Jack with me from our IR team, I also want to give a shout-out to John Bluth, who just recently joined us last week as our new Head of Investor Relations. We're pleased to have John on board. A number of you may know him from different roles in the past, including most recently with BioCryst. Look forward to having a chance for you to get to know him further in his new role at Jazz. Maybe just to start out, a couple of disclaimers. Please do consult our most recent earnings call for more details on our business, as well as our SEC filings for a number of the risk factors that do affect our business.

If we're referring to guidance during the discussion today, that would be referring to the guidance provided on our November 6th 3Q earnings call. We will probably refer to some non-GAAP financials as well. You can find in the earnings materials more complete reconciliations to the GAAP equivalents. Had a very strong quarter in the third quarter. Record revenues for the company, revenues up about 7%, coming in at $1.13 billion. Really strong growth from our two largest brands, Epidiolex and Xywav. Strong growth underlying both of those from a demand perspective that gives us great momentum as we head into the back part of this year and then into 2026.

We did, on the back of that strong performance, because of updates to our guidance, we had narrowed the range for revenue, given that we've got very few months left in the year, and everything was tracking to our expectations. Took down the top and pulled up the bottom to give a tighter range there. We did go ahead and bring up our ANI and EPS guidance, given the strong momentum and disciplined execution on expenses that we've been seeing through the year. There had been some things also that generally had pulled up the overall level of results for the year. I want to highlight one in particular. That was a recognition in the third quarter of a $206 million deferred tax asset related to the Chimerix acquisition. One of the reasons I want to bring this up is just to explain quickly what that is.

Effectively, those are tax loss carryforwards and their tax attributes that Chimerix had that we'll be able to utilize to reduce our future tax liability by $206 million, providing another source of significant value from that acquisition, which is, I'm sure we'll talk later, Modeso, the main asset that we acquired with Chimerix, is off to a phenomenal start. We're really excited with that initial performance. We also finished the quarter with about $2 billion in cash and investments. For the first nine months of the year, had about $1 billion of cash flow. That puts us in a great position to continue to do business development like we did with Chimerix. As we think about things that have happened since we had finished the third quarter in October, we got approval for the first-line maintenance indication for Zepzelca.

Most recently, and most notably, had the data readout for the first-line GEA trial for zanidatamab with very strong results. This was, for those of you that have been following us or maybe not, the final PFS readout and the first of three overall survival readouts. We're extremely pleased that for the doublet, zanidatamab plus chemo, we show statistically significant, clinically meaningful, progression-free survival and a very strong trend towards overall survival benefit as well, although not at this first interim reaching statistical significance. For the triplet, in addition, adding on top to lizumab, had both clinically meaningful and stat-sig progression-free survival as well as overall survival.

We look forward to presenting the results in detail at an upcoming medical meeting in the first quarter of the year and feel like we did accomplish our objective in this study of showing that zanidatamab should become the HER2 treatment of choice in this first-line GEA setting, supplanting Herceptin. Maybe I'll leave that for the opening remarks and see where you'd like to go with the questions. Really, really pleased to be here talking about Jazz and the excitement we've got moving forward.

Geff Meach
Senior Biopharma Analyst, Citi Research

Sounds good. Thanks, Phil. Yeah, I guess let's go in reverse order maybe with respect to BD capital allocation, then we'll get obviously into the commercial portfolio. Talk a little about the Chimerix deal, kind of the rationale going into it. What were you guys looking for from a contribution perspective? Talk about how we have a strategic fit here.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. It really hit a number of the things that we look for when we're looking for business development opportunities that we think we can be really successful with. There was a huge unmet need. This is one of a few therapies in development for this particular mutation in this really rare form of glioma. Frankly, had a little bit of controversy with it. There had been some physicians who'd written a letter criticizing some of the development that may have scared some others away. That's not the kind of thing that Jazz will get scared away from. We dove in in detail, got into diligence, looked at the data. We're very pleased with what we saw at a patient level in terms of durable responses these patients were seeing. The asset has really good patent protection, so a long-lived asset as well.

Another one of our criteria, very focused call point, really built on a lot of the things that we have in terms of capabilities, knowledge, and experiences, and felt we could be really successful with the launch of the product. There were some other things we saw as potential sources of value that frankly we didn't put into the original model. One of them I mentioned, the tax attributes that came with it as well. We think this really lines up well for us to be able to contribute meaningfully to improving on patient care in an area where there's really been no new therapies available for about 60 years. Bringing something that's meaningful, we'd love to be able to build upon this new presence for us in brain cancer and glioma. We'll look for opportunities to do that over time.

Really been pleased with the colleagues at Chimerix that we've added to Jazz. A number of them who are staying in key positions for us moving forward and bringing great expertise in this area for us to continue to build on the success of Zepzelca.

Geff Meach
Senior Biopharma Analyst, Citi Research

Yep. I guess same question on the SAN2355 licensing agreement. Talk about maybe the rationale there.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Jazz had not been in epilepsy before the GW acquisition. We are a leader now because of that acquisition and the primary role that Epidiolex plays in the treatment of a number of these epilepsies. Also a very combinable drug that's sort of a backbone that other treatments can be added to. Not too long ago, we had greater clarity on exclusivity for Epidiolex out to the very late 2030s, given the resolution with all the different antifilers. Certainly want to make sure that we're building upon our presence there and have looked at a number of opportunities to do that and really liked the attributes in the Saniona molecule to potentially overcome some of the potential limitations for dosing, therefore efficacy of other Kv7.2/7.3 directed molecules, and look forward to quickly advancing this through clinical development.

We will over time look to build sort of more generally on the corporate development theme, the existing areas that we're present in. There are most opportunities probably in oncology and in epilepsy. There are fewer opportunities given the state of the science in sleep, but there are some there as well. We have said in the past, we do continue to look at other areas within rare and orphan diseases, even if we're not there currently, where we could apply our capabilities and knowledge to be successful.

Geff Meach
Senior Biopharma Analyst, Citi Research

Yeah. Talk a little bit about the kind of the BD climate today. You guys are mostly focused on later stage kind of assets, but are there new indications that are peripheral to the ones you're at or newer technologies that you feel like you could really add value, maybe that are in more mid-stage development versus later stage?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

There are definitely, from I'd say very early stage like we did with the Saniona deal, mid-stage to even later stage, even marketed opportunities that we see as really fitting well with Jazz. We are open to a range of transaction types. It doesn't have to be acquisition like we did with Chimerix, although we're certainly open to that. Phil, we did a really successful, well-structured deal that shared risk and value appropriately between Zymworks and Jazz for zanidatamab. Certainly open to additional licensing deals like we did with the Saniona transaction. It does not seem like there are as many sectors maybe where there's froth in valuations or outsized expectations. I think things are on a relatively even keel with sellers or licensors of assets at this point where it's more likely you can get to crossing on value.

Geff Meach
Senior Biopharma Analyst, Citi Research

Yep. Makes sense. Let's go to the commercial product performance. Xywav, your overall sleep franchise has been growing quite nicely. Talk a little bit about the composition of new patients, maybe the mix between IH and narcolepsy and how you think that kind of evolves over time.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. IH has been a real success story for Jazz. We're the only oxybate with Xywav that is approved for that indication. It has been driving the majority of our new patient ads. In the most recent quarter, about 325 ads in IH and about 125 in narcolepsy. It is a place where we see the greatest opportunity for continued growth in patients for Xywav. In narcolepsy, we've been really pleased with our performance, even in the face of authorized generic competition and additional branded competition. There had been a point in time where we were signaling to the street that we could envision having net patient losses in narcolepsy given that competition. We've actually not experienced that to date. That speaks volumes to the benefit that Xywav offers as the only low-sodium oxybate in a patient population in narcolepsy patients.

IH is very similar where those patients are at a two to three times increased incidence of cardiovascular events. Certainly, having low sodium, less incidence of hypertension, we think is a really important contributing factor to the overall health of these patients and a strong reason why Xywav has done so well, not only in idiopathic hypersomnia, but also in narcolepsy. Going forward, as I said, we do see the bulk of the opportunity to add new patients in idiopathic hypersomnia. This is just based on the numbers that are available, a market that would appear to be about half the size of narcolepsy when you look at patients that are currently being treated. We do hear reports from many physicians that they feel in their practice, they have as many IH patients as narcolepsy patients.

It may be as we're building this market, building awareness that there could be upside to those current number of patients being treated that could benefit from Xywav. I do want to mention, we talked about this on our quarterly call. We do hit this time point upcoming as we move into 2026 where there can be generic versions not of Xywav, our low-sodium oxybate, but of Xyrem, our high-sodium oxybate. We do currently expect one or more generics to come into the market in 2026. Any impact on Xywav would be dependent upon the number of generics that come in, the timing in the year, what their pricing positions are. We feel we're well protected as well as we can be. Having established Xywav is really important with physicians and patients based on being the only low-sodium oxybate.

We do recognize payers may take actions depending on the opportunities that they have with the other generics that could create some headwinds for Xywav over the course of 2026.

Geff Meach
Senior Biopharma Analyst, Citi Research

Just real quick on the IH indication, do you feel like there is appreciation in the physician community about the subtleties of the indication and awareness, or is there more sort of build to come from the commercial investment?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

There's probably more, I think, that we can do with some of the physicians to help them understand why you would use an oxybate for this particular patient population. I think when they understand the kind of benefits that you're seeing in sleep and what that leads to in terms of the daytime benefits, they do understand then the rationale for it. There are some who, at face value, might question, why would I use an oxybate with this particular patient population? To date, those efforts have been going really well and will continue to drive penetration into that IH market over time.

Geff Meach
Senior Biopharma Analyst, Citi Research

Awesome. Let's switch gears to Epidiolex. Talk a little bit about the drivers of growth here as you're about to hit blockbuster status for this. It's a pretty impactful drug for you. What are the big drivers and kind of what should the trench be going into next year?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. We're definitely on track to achieve blockbuster status. I believe it was maybe 11% growth year to date. We need 3% growth over last year effectively to hit blockbuster status. We're well on track to achieve that. We're seeing really good results from a number of initiatives that we have, some around ensuring that there is appropriate titration in the initial experiences that patients are having as they come on to Epidiolex. We have some nurse navigators that are assisting with that process, and we're seeing really good results with increased persistence in patients that are receiving that service. We've also increased some of the resources that we have that are providing more information on the benefits not only for seizure, but non-seizure benefits, making sure that some of the publications that we've been presenting at medical meetings are fully understood.

The combinability of Epidiolex, again, as physicians are looking at things that they can use to treat their patients best, really using this as a backbone therapy and making sure that they understand not only, again, the seizure benefits, but the non-seizure benefits that come. Jack, there's a couple of other things we may have talked about over time as well. I don't know if you want to add any.

Jack Spinks
Executive Director of Investor Relations, Jazz Pharmaceuticals

Yeah. I think a focus of ours has been on patient identification. Doing things like utilizing tools that healthcare providers can have to better diagnose patients, such as the REST LGS tool, has been really quite effective for us. We've also implemented commercial initiatives like the Nurse Navigator program, which really helps patients titrate through the initial course of therapy and really working to improve persistency across patients. There is a number of commercial initiatives that we've been working through.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

LGS patients in particular are ones that often diagnosis can take over a decade. That patient identification has been really key, and that REST LGS tool has been very helpful for physicians as they're trying to identify patients that could benefit from Epidiolex and then potentially other anti-seizure medications as well.

Geff Meach
Senior Biopharma Analyst, Citi Research

Let's talk a little bit about the persistent rate. Maybe how has that evolved over time and what is sort of typical for the category?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

We have not quantified the persistence. We have talked about pretty substantial increases in persistency in those patients that are using that Nurse Navigator program to titrate up and get to a therapeutically effective dose that gives them the kind of benefits that they are hoping for and expecting. Beyond that, we have not gotten into the specifics of the number of months of average persistence. Certainly, these are patients where there can be loss early on. Those patients that once they are on and are perceiving benefit, they do tend to stay on for multiple years.

Geff Meach
Senior Biopharma Analyst, Citi Research

Yep. And then the evolution to the more adult population. Talk a little bit about the growth opportunities there and maybe the timing of when you could see the impact of that.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

We are already seeing some impact to our efforts to ensure that there's appropriate understanding of the benefit that can be, particularly for LGS patients, for example, achieved in adult patients. We've had for the last couple of years focus on some of the long-term care centers and other centers where these patients are most prevalent, and those efforts do continue. I'd say it's not a bolus. It's sort of like we're seeing with the IH population with Xywav, sort of a continual build over time as we get more and more awareness of the product for those patients, more and more physician experience treating those patients and seeing the benefits that Epidiolex can bring to those adult patients.

Geff Meach
Senior Biopharma Analyst, Citi Research

Phil, you mentioned kind of the payer mix here as well. Talk a little bit about how that has evolved over the course of the past year or so on gross and NED and on formulary positioning. This is a unique skill for you guys to try to get better access, but it's been a bit of a challenging environment right this year with some more policy uncertainty.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. I'd say just from the pure payer perspective, apart from the policy side of things, compared to what I was used to prior to coming to Jazz, these are categories where the gross to net is nowhere near as high. It certainly exists, but it's not the same kind of both competitive intensity and then just mass market that leaves those very large gross net reductions that you see with some of the primary care products. Our payer mix has not changed dramatically in the last few years. It depends on which product, sort of our exposure to some of the government programs, getting to some of the policy questions.

To date, there is some potential exposure to some of the policy initiatives, most favored nations and things that have been discussed, but nothing's really been put concrete out there for us to really react to and to quantify. I would say Epidiolex is one of those products that does have a decent amount of some of the government pay, but I think compared to other maybe larger pharma, the exposure we have probably is proportionally not quite as large as they would have. On the policy side as well, obviously, and related to the pricing or gross to net, we've had discussions of tariffs for much of this year. As a company that has 90% of its revenue in the U.S. and much of its production outside, there are a lot of early interest in understanding steps that we could take to mitigate that exposure.

We've significantly built and continue to inventory here in the U.S. to buffer any impact from tariffs to date, and the most recent example being the U.K.-U.S. agreement. I think we're getting to things that seem much more reasonable and manageable, not some of the initial fears that had been put out with some of the very large tariff rates that were being represented by the administration. I think at this point, we have a very manageable potential impact as we look forward into 2026 from tariffs as well. Not zero, but not something that's particularly concerning to us at this point in time.

Geff Meach
Senior Biopharma Analyst, Citi Research

You're comfortable with where Jazz is today on an MFN and a manufacturing. Have you guys talked about the level of investment with respect to onshoring that you could make?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

There's been a lot of work done through bio primarily. I think making sure the administration understands that there are certain participants in the industry that are really well positioned to actually sink their own capital into the ground and build facilities. Some of the smaller and mid-sized players really aren't in that position and probably definitely open to, and we are moving production to the U.S., but using third parties to do that. It is bringing employment to the U.S., in some cases additional investment into the U.S., but not something being done directly by Jazz. It's possible for us in the future to potentially have our own U.S. site, but I think our first protocol would be to work with known, trusted, established contract manufacturing organizations that can do that work here in the U.S.

We're already set up to have a CMO that can do all of our oxybate needs and have that supply up and running and are working on some other moves of that drug product manufacturing here to the U.S. as well for a number of our products.

Geff Meach
Senior Biopharma Analyst, Citi Research

Okay. Let's switch gears to oncology. Zepzelca, I wanted to ask you maybe about the small cell lung market, how that's evolved, how you think this product. There's some new entrants. This has been historically, though, a tough indication, I think.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Definitely tough indication. I know one of the medical meetings this year, one of the people asking questions of the discussants after a couple of the presentations said they felt there had been more presented in that hour and a half or so block on advances in small cell lung cancer than they'd seen for probably 30 years before. A lot of really exciting things for patients. We're very pleased to be participating in that. The first-line maintenance data with Zepzelca and atezolizumab, we think should become standard of care in that setting. As we've noted and presented, PFS benefit, OS benefit, very meaningful, significant advance for patients there. Now, we're not the only one making advances in this area. Certainly, Imdelltra has had in the second-line setting a similar PFS and OS benefit, has been building its share. We'd expect that likely to continue.

In the first-line setting, about 70% of patients are extensive stage. That is where we had studied Zepzelca. About 30% are limited stage. There has been some really stellar first-line data in limited stage with Durvalumab that is giving great results for those patients, leading to fewer patients progressing into the second line. As we think about Zepzelca, very strong opportunity for us to benefit patients and build first-line maintenance share, but there in the second line likely will be fewer patients that are coming from limited stage because of the Durvalumab data and then greater share over time to Imdelltra with their second-line results. Really excited for patients for what is happening in that segment of the market in small cell lung cancer and with the data that we have got for first-line maintenance.

Geff Meach
Senior Biopharma Analyst, Citi Research

You have combination, you have maybe more runway in the maintenance. What are maybe the other opportunities that you would see for growth, maybe line extensions?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

For Zepzelca, I think just given the remaining patent life, it's unlikely that we would make substantial new investments in that product at this point in time. We do see, though, great growth in oncology for Jazz, but it'll be different molecules like Midaso, Ziihera, and others hopefully to come with our continued CorpDev efforts.

Geff Meach
Senior Biopharma Analyst, Citi Research

Yeah. Yeah, Midaso, let's focus on that. You've had a good initial launch. Talk about the initial physician feedback, kind of positioning. Is it kind of what you thought?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. We're really pleased. I'm going to let Jack take this one and get involved here in the chat.

Jack Spinks
Executive Director of Investor Relations, Jazz Pharmaceuticals

Yeah, thanks, Jeff. We are really pleased with the initial uptake we've seen. It's been very strong since our approval on August 6th. We did recognize $11 million in net sales in 3Q 2025, and that's after being on the market for only a couple of weeks. That's about 200 patients, which is really exciting to see. I mean, there's huge unmet need here with existing treatments around for the last 60 years. This represents the first advance for patients with H3K27M mutant diffuse glioma in a very long time. It has been fantastic to see. The majority of those 200 patients were de novo patients, about 60%, with the other 40% coming over from EAP. Given that massive, significant unmet need, we do have very strong relationships with patient advocacy and support organizations which have helped drive that uptake. I think we're excited about the initial launch.

We see this product as being around north of $500 million in peak sales. There have been a number of initiatives ongoing to make sure we continue to drive that awareness and uptake.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

I think it's a little too early at this point to change our peak sales expectations, but certainly the initial uptake has exceeded our expectations. Really pleased with the results today and the trajectory that we're on.

Geff Meach
Senior Biopharma Analyst, Citi Research

There hasn't been really much in the way of limitations on diagnostics, right? I mean, it's a fairly straightforward path.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

It is typically done in your academic centers. It's been part of the protocol for these patients for quite some time now. It's possible that not everyone was getting tested since there really was no product that was approved for this specific mutation. We're making sure that we're educating not only in the academic centers, but in community centers about testing for patients that may have this kind of mutation so that they can be identified as often as possible and then available to receive Midaso.

Geff Meach
Senior Biopharma Analyst, Citi Research

Yep. Talk a little bit about the impact that you would see over time with sort of an OS benefit moving, expanding the opportunity a little bit.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. Jack, you want to?

Jack Spinks
Executive Director of Investor Relations, Jazz Pharmaceuticals

Yeah. I think we have an ongoing confirmatory trial, the ACTION trial in front line, which would serve to confirm benefit in that second line post-approval. We've talked about having OS results for that trial late 2026, early 2027. We are very excited about having that option for patients. Again, this is an extremely aggressive brain tumor. While frequently tested for, these patients are certainly in need of additional options. We look forward to being able to bring additional options for patients in the front line with hopefully positive results from that ACTION trial.

Geff Meach
Senior Biopharma Analyst, Citi Research

From maybe a guideline context, would that be another driver of growth, or do you think it's mostly awareness and kind of patient testing as maybe the next, call it 12 months or so?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

The awareness of the drug itself, I think, is extremely high. Making sure that there is appropriate awareness of testing is certainly something we're focused on. This is one where there's strong enough awareness. Clearly, we promote to label, so we will promote to first line post getting the positive confirmatory study and then approval from the FDA. We do know of physicians who have really no other choices. There's probably some utilization that we'll have in this interim period in that first line setting given physician choice, not motivated by Jazz actions. That could be part of what's driving some of the additional early uptake that is a bit beyond the expectations that we had originally. I think it does speak to the strong unmet need and the confidence that physicians have in this product.

Also, relatively benign safety profile, so very easy for them to administer. Again, we're seeing a relatively 20-some % patient overall response rate, but within those, some very long and durable, meaningful responses that are delivering significant benefit to these patients.

Geff Meach
Senior Biopharma Analyst, Citi Research

The ACTION trial is going to take, I think, a little bit of time to mature, but are there any other studies that maybe you could continue to look to as they mature or maybe longer follow-up?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

We are looking at other opportunities for Midaso. Just real quick on the timeline for the ACTION study, we did make a determination that we wanted to have overall survival be the main endpoint for that study. We thought that was the most appropriate. We did go ahead and increase the number of patients from 410- 510. If you're comparing some of the prior statements that Chimerix had made on potential trial readout and comparing that to what we're talking about now, that's the driver for a bit of that shift out in time is for that additional patient accrual and then getting to the overall survival readout.

Geff Meach
Senior Biopharma Analyst, Citi Research

Gotcha. Okay. Let's switch gears to Rylaze. Walking down the oncology portfolio, talk a little bit about the growth drivers there when you look at the adolescent, young, adult setting.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. Definitely the adolescent, young adult setting is the area where there's more opportunity for growth. For quite some time, Rylaze has been widely adopted in almost all of the pediatric protocols. Within that AYA setting, those treating physicians are using a mix of asparaginase-based therapies or others. Our efforts there have really been focused on ensuring that they understand the benefits of an asparaginase-based regimen and then the role for Rylaze if they have any issues with their patients in that first line asparaginase setting, hypersensitivity reaction in particular. It's been relatively stable in terms of the product given some of the overall dynamics we've seen to date. Again, probably minimal opportunity for growth in that pediatric setting since we're highly penetrated there. We'll work to maintain that positioning and then increasingly look to drive penetration into the adolescent and young adult patient population.

Geff Meach
Senior Biopharma Analyst, Citi Research

The switching component, maybe talk about kind of what ending we're in with respect to that and how much that could be a driver.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

I think the product here is really well positioned as the go-to after you've had a hypersensitivity reaction in the first line with one of the other asparaginase therapies. At this point, I think that's already played out and we're sort of into a steady state for that and the positioning is well known and respected and understood by physicians.

Geff Meach
Senior Biopharma Analyst, Citi Research

Yeah, that makes sense. Phil, you mentioned we started off with a bit of a discussion on BD and oncology. Would you say if you had to rank them, would that be a therapeutic area that you probably would be most acutely focused on? Obviously, the kind of history of Jazz is more in the rare disease space. How do you kind of look at those from an ROI perspective?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

I'd say even before we get to ROI, just what's happening in terms of the science. There certainly is a lot going on in oncology, including in rare diseases. It's a fertile area for us to continue to build, just like we did with the acquisition of Chimerix and/or Davapron. Also quite a bit going on in epilepsies in terms of new mechanisms of action, improvement upon existing mechanisms of action. Quite a bit of scientific substrate there. Sleep, the other main area that we've been in, frankly, there's less. There's sort of at this point in time erections, and there's not a lot else. Now, there's some things that are percolating in preclinical that could come to the fore over the coming years. Just in terms of scientific substrate, that's how I would view our current areas of participation.

We have been looking, I know we haven't done a deal yet, but we have been looking in areas that are in rare and orphan diseases that aren't sleep, epilepsy, or oncology. There is quite a bit of substrate there as well. We're looking for opportunities for us, again, high unmet need, significant improvement upon standard of care, relatively limited call point, a lot of the things that characterize the product we've been successful with that we think we could translate into a new therapeutic area for us as well. There are certainly opportunities there. When you get to the actual return piece, there I think is probably more gated by at what point in time you're entering with your acquisition or your licensing. Clearly, as you get beyond proof of concept, things get a little more fully priced.

As you're accessing those, probably more of that value goes to the seller or the licensor. If you're pre-proof of concept, then obviously you're taking more of that clinical risk and retaining more of that potential future value. In general, I'd say we're comfortable taking that earlier clinical risk, including preclinical, in areas where we've got significant existing expertise, like we did with the Saniona molecule in epilepsy.

Geff Meach
Senior Biopharma Analyst, Citi Research

What are your thoughts on, I think in the bigger pharma category, we've seen CVRs dominate a lot of activities in BD. We've also seen assets coming from China that are more Biobuck sort of backend loaded. What are your thoughts about the creative structures that we've seen and maybe what could Jazz use going forward?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Definitely open to structuring. CVRs, I think, have been used for quite some time, a little more in vogue at this point in time, probably more to bridge final discrepancies on value. They're typically not a large percentage of the overall deal value, but certainly something that's been employed in the past by Jazz. We'd be very open to that kind of structuring. I definitely want to continue to build out the sources for innovation that we have access to. China, obviously, is exploding, and that's one of the areas that I think we do need to continue to build our relationships into that market and innovators, particularly for those drugs that are going to be applicable to rare and orphan disease so that we're a port of call for them to come to with those opportunities as well.

Geff Meach
Senior Biopharma Analyst, Citi Research

You mentioned upfront the strong cash position that you guys are in. Do you have, how do you balance that? Are investors more biased to investing internally and commercial, or is it be aggressive on the external kind of BD, M&A front?

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

I'd say if you ask 10 investors, you're going to get a variety of responses to that. In fact, Jack and I just recently had been on a CEO listening tour with Renee, our new CEO, both in person and then on video calls with investors. I would say the mass balance of those individuals expressed a strong interest in Jazz continuing to invest externally to bring in molecules that would be in their minds more innovative. And often Rylaze and Ziihera were cited as good examples of that kind of asset. Certainly, people across the board, I think, interested in understanding our plans to maximize the value of Zanidatamab given this most recent first line GEA readout.

I'd say don't drop the ball on the internal opportunities that you've already got, but definitely an expectation that we'll continue to build on the future growth prospects of the company through corporate development.

Geff Meach
Senior Biopharma Analyst, Citi Research

Awesome. Phil, Jack, thank you very much, guys.

Philip Johnson
EVP and CFO, Jazz Pharmaceuticals

Yeah. Thanks for having us. We appreciate it.

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