All right. G ood morning, everyone. Thanks for joining us at the Morgan Stanley Global Healthcare Conference. I'm Mike Ulz, one of the biotech analyst here, and it's my pleasure to introduce Doug Ingram, CEO from Sarepta Therapeutics.
Before we get started, I just need to read a quick disclaimer. For important disclosures, please see the Morgan Stanley research disclosure website at www.morganstanley.com/researchdisclosures. If you have any questions, please reach out to your Morgan Stanley sales representative. And with that, Doug, thanks for joining us today, and maybe I'll just hand it over to you to kick things off with a couple opening comments.
Sure, and I'll be quick. First, Mike, thank you for having us today. With me today is our CFO, Ian Estepan. So, you know, briefly, let me say 2024 has been an extraordinarily important year. I mean, it is important for Sarepta. This was a long journey to get where we are today.
I mean, we had a big ambition, started really in 2017 , but it actually stands on the shoulders of the work of Louise Rodino-Klapac and Jerry Mendell, and that goes back 20 years to get to this place. And the culmination of all that work, of course, is in June of this year. We were able to obtain a very broad label for the use of ELEVIDYS to bring a better life to boys and young men with Duchenne muscular dystrophy and some girls and women as well.
It's extraordinarily important for the Duchenne community. This is the most, in my view, at least, the most impactful thing that has happened so far in Duchenne muscular dystrophy since the cause of Duchenne muscular dystrophy. T he lack of dystrophin, was discovered in, I think, 1986 by Dr. Kunkel. It is extraordinarily important, of course, for Sarepta and all those who have committed themselves to supporting Sarepta, but it's really important as well, in my view, for the future of cell and gene therapy.
This is a bellwether moment. With the success that we're going to have with ELEVIDYS, we're going to bring a better life to patients. We are also going to prove the thesis that gene therapy is here and that we are at the beginning of a revolution, and I truly believe that.
We will have shown that you can develop therapies that are life-enhancing. We'll have shown that you can, in fact, work with the FDA and get them approved, and then we're going to show that we can serve the community and make them commercially successful, and on that basis, we're going to have an extraordinary 2025 and beyond w ith this launch.
We're gonna continue to support our PMOs. We have three approved PMOs as well, as you know, which are, you know, doing very well and bringing a better life to patients as well. We're going to advance our pipeline, which is very significant as well. And as you know as well, we're in a different place than a lot of other biotechs, and than that we were for a long part of our history. We are now a profitable organization. We will be, you know, sustainably cash flow positive in the next couple of quarters, and so, you know, things are very exciting for us right now, and we've got a lot to do as well as a people.
Yeah. Great. Thanks for that introduction, and Doug, as you mentioned, it's been quite a successful year for you with the broader label for ELEVIDYS, so maybe just talk about since that label expansion, you know, what you're sort of seeing in trends.
Look, first of all, things are going very, very well. The launch is going brilliantly, as we would have expected. We had the opportunity, not an opportunity that we chose but an opportunity that we took advantage of, to essentially beta test the launch by launching a much narrower label in June of last year.
And I think for those who were watching, you will see that we made a brilliant go of that launch. In fact, we more than doubled all of the recent gene therapy revenue over that period of time and for the last few years combined, which was not entirely surprising to us, but it was really comforting to us.
It showed that all of the work, the obsessive focus and attention to detail that we've had really since kind of early to mid-2018 paid off. We did a lot of work with access and reimbursement, with talking to payers, with working our distribution channel up by getting sites ready to go, having them well educated.
We were in a great place for that launch to essentially beta test this larger launch that's going very, very well right now, and it should come as no surprise to folks that things are going well. This is, in essence, our fifth launch. We have been very successful in serving the Duchenne community.
I am quite confident that there is no one that can come close to us in the service of the Duchenne community with therapies. We're battle-hardened and very execution-focused. I would also argue that there are a few companies that are as sophisticated in their approach to the launch of rare diseases more generally than us.
As everyone will recall, back in late 2016 , EXONDYS was approved. That was, in many ways, really one of the first opportunities that payers had taken to challenge rare disease therapies, and this organization really grew up with that, got very sophisticated in dealing with access and reimbursement and working with payers, as a result of which that EXONDYS launch was very, very successful, as was VYONDYS, as was AMONDYS 45. So I think we're in great shape to serve the community, and that's why we're seeing all the signals we're seeing right now with the launch of ELEVIDYS are very positive.
In the past, you've mentioned there's a couple key factors that might influence the launch. You've touched on one or a few already just in terms of infusion centers. Maybe talk about the status of that, your thoughts about further expanding that or not.
Yeah. So we're in great shape right now. One of our ambitions, which we thought was very ambitious, was to be in a position to have as many as 50 sites up and running and trained at about launch, and then moving to about 75 sites eventually. We're actually a little bit over 75 sites today. That is great coverage across the United States, and we're confident with that.
So our goal right now is not to be proactively going out and greatly increasing the number of sites. They may go up over time, but that will be mostly reactive. If a site, for instance, really wants to be a treating site, we'll certainly, you know, consider that and train them and get them up. So it could drift up, but it's not part of our broader goal. We have sufficient sites trained and ready that we can serve the community over the long term. So we're doing very well right now with that.
Yep. And another factor you mentioned is just payer reimbursements, and maybe just walk us through what you're seeing there and the time frame to sort of getting payers on board.
Yeah, a couple thoughts. Just to talk a little bit about the sort of patient journey itself, which includes the access and reimbursement-related issues. So if you went back and you saw our launch in June of 2023, one of the things you should know is that we were basically all in crisis mode. We were in crisis mode. The physicians were in crisis mode.
Payers, which I'm very heartened by, saw themselves as crisis mode as well, as did the physicians. And by that, I mean, this is a very narrow label. The kids could easily age out very easily, and everyone prioritized when a start form came in, to prioritize to getting those kids dosed. And from an access and reimbursement perspective, I am proud to say our payers really worked with us to accelerate that process. As far as I know, not a single kid who put in a start form inside that range aged out during that period of time. That's wonderful.
As we move to a broader label, we're out of crisis mode, and we're more in sort of that traditional approach. And as we've said, that really puts us in kind of a three month to five month, maybe even six month at times right now, only because in these early days, payers not only have to give an individual patient access but they have to actually put policies in place.
The cadence of that is not immediate. Sometimes there are meetings that are scheduled, and we have to wait for those schedules. That can take a little bit of time. So it's gonna be, you know, steady state, i t's gonna be somewhere in the three months- to- five months range from the moment a start form comes in, to the moment a boy or a young man is dosed with an infusion.
Very pleased with what we're seeing right now from payers. We have a wealth of data that supports this therapy, so I suppose I shouldn't be surprised, but we're getting, w e're having great interactions with payers. We've had interactions with payers that represent hundreds of millions of lives in the United States, so we've really had detailed conversations.
And we're seeing some really good policies, a number of very big policies that are focused on, you know, granting access to all patients to label in the written policy, which is very positive. So, you know, I'd say, you know, relative to P MOs, things are going very well, and the PMOs went very well, you know, as well. So I think we're in good shape.
Just given the much broader patient population now, do you think that could change in the future and you might see more pushback, or is that unlikely?
I think, l ook, the great thing about the Sarepta team is that we're really good at working with payers and overcoming objections when they occur. Well, that's not surprising. Every kid is not going to immediately get on therapy without dialogue and debate, and discussion.
One of the things I'm very proud of is that we win. Even if, you know, even in those situations where they're really pushing back, kids tend to get on therapy. Either we work through the process and get them on therapy. Sometimes, with commercial plans, they might have to go to an external appeal. We go to external appeal. We win those appeals the vast majority of time.
And I think, as a result of that, today, the more sophisticated plans are sort of acknowledging that and giving broad approval to label, s o I think it's, you know, a gain, I think it's gonna go very well. A nd there's no: With the risk of sounding a bit arrogant but arrogant on behalf of others, the team, I just don't know if there's another organization as equipped to deal with those issues and work with payers, and work through those issues than the team that exists at Sarepta.
One of the things that I'm really excited about, an interesting little factoid, is that that group, that sort of core group of commercial medical affairs folks that were really kind of, you know, cut their teeth on and became expert in this area with the launch of EXONDYS and VYONDYS, 90% of them are still at Sarepta today. So that core group has really brought forward to this day that ability to execute and work with payers.
Yeah.
And that's what it is too, I should say. Like, for the most part, it's not fighting with payers, it's working with them. I mean, that's one of the things we figured out early. If you can get to them, show them the data, have a medical affairs- to- medical affairs discussion, things tend to go well.
Yep, makes sense. Another factor you've talked about is just the supply and manufacturing, s o maybe talk about the current status there and your plans for the future.
Yeah. So let's start with the current. We're in great shape from a supply perspective. This is again I feel like I'm spending a lot of time bragging about Sarepta today. I apologize for that, b ut, you know, i t's something I'm very proud of. I'm very proud of where we've gotten from a supply and manufacturing perspective.
We started with this ambition in early 2018 at a standing start. Like we didn't know much about gene therapy manufacturing. And from there, we're, to the best of my knowledge, making vastly more gene therapy material than anyone else on Earth. And I know, at some point, we were making more than everybody else combined.
We're in great shape from a supply perspective right now. Just to give you, you know, sort of a proof point on that, for those who may wonder about it: We have the ability to take additional suites at Catalent. We have options on additional suites. We just don't need them right now. We're in great shape. So in the near to midterm, we're in great shape.
One of our goals from a manufacturing perspective is to move to suspension, right? We are doing really well with that. Why do we want to move to suspension? There's two big reasons. One, it's very efficient if you can make it happen. We're gonna have multifold better yields. The cost of goods are gonna be, you know, fairly dramatically lower. The ability to scale and serve a broad ex US population is, you know, just at a different order if we can get to suspension.
The data that we're seeing so far on suspension is really good. The product qualities look great. We've scaled. W e've done 500 L runs that are looking very good from an engineering perspective. We're doing a 2,000 L run as well. We'll make some decisions around that.
We really want to get to the place where we're making GMP material, doing our PPQs, making GMP material, and starting a bridging study by next year, with the goal of being able to bring suspension on probably by early 2027, which is about when it would be really valuable to us to have suspension.
I wanted to follow up on one of your earlier comments just about the patient journey, somewhere between three to s ix months from start form to infusion. You know, over time, are there opportunities to sort of shorten that more to the three-month timeframe, as opposed to the six months?
Well, it won't be six months over the long run. So that really is s ome of that longer time that can occur right now is just an artifact of the initial launch and policies needing to get in place, and you can't get policies in place before you have a label. It's not like this is all work we could have done with payers in advance.
In the long run, I think it will get shorter, but it's not gonna get shorter than three months. It's going to be kind of a three-month, four-month timeframe, even at steady state at some point, because the journey's just a long administrative journey to ensure that kids are going from start form, doing all the right physician appointments, eventually getting an antibody test. They need to be antibody negative to get the dosing and the like, that.
A nd that, up to dosing, let's be clear, that's the first part of the journey. Then the second part of the journey is the monitoring and the like. So one thing we have to remember: People often think, "Well, how many kids can you dose?" That's not the question. The question is, on a site, how many kids can you thoughtfully dose and then do the appropriate monitoring and follow-up?
I think one of the things I'm very proud of is that ELEVIDYS has had a, you know, very good safety profile relative to other programs, and I want to ensure that continues through being very thoughtful. We learned, in talking to thought leaders over the last few years, that they wanted to ensure that when we prioritized things, we always prioritized outcomes before we prioritized revenue. I think we've done a very good job of that. I think we've got a great support system for sites to ensure that, the results that we saw clinically, we're seeing commercially, and I think that should persist into the future given what we're doing.
Yep. And just given the patient journey, talk about how that impacts sort of the trajectory of revenues going forward, and sort of your level of confidence in hitting your 2025 guidance.
I feel I'm very confident. I mean I will just say I'm very confident. Obviously, I would not have provided that update. As everyone may know, we gave sort of specific guidance, actually, which is, you know, in this year, Q3 would be up about 30% over Q2 f or ELEVIDYS. Y ou can see this ramp starting. Then we would actually double that in Q4, assuming that that was at the 30% range. I want to be clear: if we overperformed in Q3. J ust d on't start raising. Let's not go crazy, b ut that shows you that this is gonna be a very significant ramp.
Then we led into 2025 , and we've given a number that I think should be, you know, very impressive in both our ability to serve the community and our ability to show that we can launch these therapies well, which is w e're gonna do, you know, $3 billion in 2025 , about 2/3 of which are gonna come from ELEVIDYS, approximately. So, yeah, we have a lot of conviction in our numbers.
Yep. And then just given your label has both ambulatory and non-ambulatory patients, and I think the non-ambulatory was sort of a bit of a surprise for some people, h ow do you expect utilization, at least earlier in the launch? Are you seeing some of those patients on therapy?
Yeah, I will say, if you don't mind me saying, Mike, you know, there were those that were surprised that we were able to get this broad label. Obviously, we weren't surprised. As everyone may recall, in the fall of last year, I had suggested that that is what we would get. I know that people generally thought I was a loon at the time, but there was great reason to believe that. The mechanism of action justified, the data justified it, and I'm very pleased that FDA leadership, scientific leadership, saw that, and you can see that in their decisional memo.
It's early days to know what the mix is when. You know, that is something we'll kind of know over time. There's a lot. Internally, we speculate, you know, what, who are they gonna, who are physicians gonna choose to dose first. There's a lot of different interesting arguments that people can make about that. We're gonna sort of see that as we track into 2025.
The one thing I'm very pleased with is that we're, you know, we're seeing a significant number of start forms for the non-ambulatory population r ight now. I t's not an inconsequential percentage of the start forms that we're getting are non-ambulatory. So that's very it's very, you know, positive.
Can you also talk about the ages of the patients you're seeing come onto therapy? Is it a broad range?
Yeah, it's a very broad range. I mean, we have dosed kids. Obviously, commercially, we can't dose kids below four years right now. We wanna work and gather additional data and then go back to the agency and discuss the opportunity to bring that age down.
We've already dosed kids significantly younger in clinical, significantly younger than four years, and we've done so with great results and with good safety. So that's an opportunity for us in the future. It's not an enormous near-term opportunity because what we really need to empower that is newborn screening, to really make that a value to patients.
Mm-hmm.
We're making great p rogress there. We have, I think, four states, if I'm not mistaken, by now that have adopted newborn screening. So it's kind of a state-by-state process to work there, b ut we wanna be in a position where we, when we have broad newborn screening, we can dose and bring this treatment to even younger patients as well.
We've also dosed, you know. We've dosed adults. I mean we've dosed kids. I'm not sure how high we've gone in the commercial setting, but in the clinical setting, we've gone, you know, I think higher, I think, 26 years old. And we've seen some fairly, you know, advanced non-ambulatory kids in the commercial setting as well with start forms. I'm not sure if they've yet been dosed.
Yep, makes sense. And can you talk about just the ENVISION study in terms of the current status, you know, when that data will read out and
Yeah.
W hat's important?
That study will be continuing. It's going well, as everyone may know. Just to remind everybody, ENVISION is late ambulatory, non-ambulatory study. It is a post-marketing requirement for the approval of the non-ambulatory patients, and that was one of the goals we had. We had a number of goals for it, but that was one of the goals in connection with starting it.
One of the things we did in advance of the approval is we stopped recruiting in the United States and recruited outside the United States. The reason for that, of course, is we didn't wanna be in a position where we had so loaded up this study with U.S. patients that there was a risk the study wouldn't complete.
If you think about it, it's a placebo-controlled study, so if we got an approval, as we imagined we would, for non-ambulatory patients, there might be a motivation for patients who were early in the process and weren't sure if they had gotten active or placebo to drop out of the study and try to get commercial therapy.
So we're dosing outside the United States. We're in a number of countries right now. I'd say recruitment is going very well. That will be recruiting through next year, and I believe it's a 72-month endpoint and placebo-controlled.
Okay, great. And you're also doing some work to further expand the addressable patient population. Maybe you can talk about that a little bit.
Yeah. So, you know, on the face of it, we're doing fantastic right now, right? We are able, with this broad label, to serve 80% of Duchenne boys and men and women in the United States. There's an opportunity to expand that. There are two, t he 20%. Broadly, the 20% is made up of two categories.
About 15% of those that screen out is for screening out because you have positive neutralizing antibodies. You've had some environmental exposure with something that looks like an rh74 capsid, even though it probably likely isn't. I t looks like it, and therefore, your body would have a reaction. You can't be dosed.
And then there's another approximately 5% of kids that are in this range covering exons eight and nine, where there is a risk, at least a theoretical and probably also a real risk, of an innate immune response if you dose in that range. That latter part is going to be, you know, challenging to get to. We're doing work on that right now, trying to find ways that we could narrow that population of exclusion, b ut that's gonna be some real work because there's, you know, real safety issues you have to keep in mind there.
On the 15%, we have a number of approaches to knocking down or clearing neutralizing antibodies. The most advanced approaches are the use of imlifidase to cleave antibodies or the use of apheresis to clear antibodies. We're dosing with imlifidase now. We're gonna start our apheresis study this year, and I'd say, you know, again, in advance of having data, take what I say and my team says with a grain of salt, but we have a lot of conviction that we can solve this issue.
Mm-hmm.
Knocking down pre-existing antibodies is important, but it's not a monstrous task. If you have pre-existing antibodies, you're not having like one in 1 million or one in 2 million, the sort of antibodies you get post dosing.
They tend to be, you know, larger than what we need, greater than what we need, which is under one in 400, but I think there is a real opportunity in the not- very- distant future to knock down those antibodies and to bring that other 15% into play. And that means we would expand the addressable population in the United States, I think, in the next few years, to 95% or so of kids with Duchenne muscular dystrophy and adults with Duchenne muscular dystrophy.
You have a big opportunity in front of you in Duchenne, but there's obviously also some competitors looking at other gene therapies as well. Maybe just share your thoughts there and any potential impacts.
I'm gonna be careful not to sound competitive, and I'll be honest, we just don't get up thinking much about competitors right now. I don't think there's anyone near us from a gene therapy perspective. There are some, you know, interesting longer-term technologies, but I don't think there's anything that's, you know, a near-term issue.
I think the greatest hope that families with Duchenne muscular dystrophy have right now is ELEVIDYS, to live a better life and, you know, slower, arrest the decline that is inevitable with Duchenne muscular dystrophy. So I just don't believe there's anything, you know, any significant competitor right now.
Yeah. Got it. And if you could touch just quickly on Europe and the progress you're making there with your partner.
Yeah, I wanna leave, I'll obviously leave the bulk of it to Roche to talk about. For those who don't know, I'm sure you do, Roche is our partner bringing this therapy outside of the United States to patients. They announced, right at the same time-ish that we obtained our approval, that they had submitted for and the EMA had accepted their submission for an approval in Europe. So that's very exciting, and then we should get an opinion to that, you know, next year.
And they've gotten a number of approvals as well. They've already had. I'm not sure if they've listed the exact number, but they have a number of approvals outside of the United States already, in those countries that can, you know, rely upon, primarily, the U.S. approval as their basis. They're doing a very nice job of serving the communities in those countries as well. You know, we were very pleased with the ability to have a partner like Roche outside of the United States, and we remain very pleased with our partner.
Okay, great. Maybe we can shift to some of your work you're doing in the pipeline and maybe 5051, your PPMO. Maybe remind us, you know, next steps for that program.
Yeah. Again, just quickly to remind everybody, the PMOs are, in many ways, you know, brilliant therapies that are bringing a better life to kids. They're delaying loss of ambulation, delaying mortality, delaying, you know, time to ventilation and a number of other things, hospital stays and the like.
The opportunity, of course, is to enhance the penetration of a PMO so that you can get even more therapy in the right place that can create more exon skipping and therefore more dystrophin. And a number of organizations are attempting to do this.
We're in the lead from both a timing perspective and, you know, I think our data looks, you know, generally great right now, with what's called 5051, which is essentially the same backbone of EXONDYS but conjugated to a cell-penetrating peptide. T hat's unique to us. We've had very good results. It did just what it was supposed to do: increase exon skipping, increase dystrophin production. Now, we have a go, no go based on some interactions with the FDA that will occur later this year.
There really are two big issues that have to be yes to bring this therapy forward. One is that the accelerated approval pathway has to be available to us. There's great precedent for the fact that, with respect to our PMOs, and the FDA had kind of repeatedly confirmed this with us in the past, that the accelerated approval pathway is open for other PMOs.
So if we wanted to go to another, you know, exon with a PMO today, I feel an enormous amount of confidence that if we saw the dystrophin production and exon skipping that we see in our other programs, that we would able, we would be able to use accelerated approval. Whether we can use that accelerated approval with a peptide- conjugated PMO is a different discussion. It has a different safety profile and the like. We need to get a yes answer to that, and we'll know that later this year.
The second issue is that we need a development pathway that is fit for purpose from our perspective, and that means that we really don't believe that one can use a placebo-controlled trial right now with 5051 or these PPMOs.
One can see, you know, we've been working hard, both with our MISSION study and our ESSENCE study. And you can see with these placebo-controlled trials it is very difficult to recruit them, and they take a very, very long time. And, you know, we've spent hundreds of millions of dollars. We're doing very well with MISSION and ESSENCE, but you can see how long it takes.
We think at this point in time it's gonna be even more difficult, particularly with the existence of ELEVIDYS and the like and other competing therapies, to recruit and execute a placebo-controlled trial. On top of that, there's just th ere is a real you're on the boundaries of good ethics, I think, if you're going to put a degenerating child on a placebo arm, s o we need to align on that issue. A nd if we get a yes to both of those answers, then we have a viable approach, and if we don't, we have a no-go decision to make there, and we'll know that by the end of this year.
Yep. And you mentioned some competitors. Maybe just talk a little bit about, you know, how you feel your data stacks up and.
I'm gonna slightly beg off of that. There are a number of folks looking at, you know, alternative approaches. You know, we got PepGen and Dyne and Avidity, and they're all doing very interesting work. I think they've learned what we had learned a long time ago, which is it's challenges with doing this stuff, and some of them have had faced challenges they didn't expect. All of them pretty interesting, different approaches, but they, I think they've got, you know, a long road ahead of them to prove out their thesis.
Makes sense. And maybe now, since you've got the broader label, you've started to talk about, you know, business development. So maybe just share your, you know, initial thinking there.
Yeah. To sort of give you the shape of where we are as an organization. We're gonna have a really brilliant 2020s, o kay? A nd we have a really exciting pipeline as well. So we're gonna be treating the prevalent population across the entire 2020s , moving to incident population in the 2030 s with Duchenne muscular dystrophy and ELEVIDYS, which, by the way, is still more than a $1 billion opportunity.
We also have a very deep pipeline, limb-girdle, and a number of other programs that we haven't really discussed or disclosed externally, only because they're so early. It would seem unduly promotional to be chatting about things that haven't even gone into the clinic yet.
What that means is there is this really interesting opportunity in the late 2020s to find new areas, from an external perspective, both to bridge the gap between the success we're gonna have over the 2020s and what's gonna start really delivering in the late 2020s into the 2030s. And it just makes sense to do that.
We're a grown-up biotech now. We're a profitable organization. We should deploy it to bring a better life to more and more patients, and to take advantage of the expertise that we have both in rare disease, genetic medicine, gene therapy, RNA, and the like. So that's what we're going to look for in the next couple of years, which is essentially, you know, we have a very broad aperture in what we're looking for, but we're gonna look for opportunities that are later stage.
So we're not looking for, you know, early research programs but something that can really benefit us in that timeline, that are very significant unmet need. We're an organization built on mission and we're not gonna lose sight of that. And then very likely, it would be, you know, continue to be rare and genetic, which is what we are particularly good at.
Yeah.
You know, we're looking at a lot of things. That's a high bar to be able to do that.
Yeah.
O ne of the things that it's important for us to, you know, to not do, is get complacent. There's definitely a tendency for an organization that gets about where Sarepta is right now to say, "Man, we just had an amazing seven-year run. We've hit all of our goals," which we have.
"We created this ambition. Now let's just sit back and enjoy the fruits of our success and watch this growth over the next few years." And I think that if we did that, we would lose an opportunity to bring a better life to a lot of patients and, I think, reward investors, s o, you know, nothing.
Don't imagine anything's coming in the next month or so, but we are looking for opportunities that, you know, with our balance sheet and our cash flow, that are coming that we can sort of augment our pipeline with, you know, sort of mid-stage, late-stage opportunities.
You mentioned, obviously, your experience in gene therapy. Does that, you know, drive the decision-making? Like, do you have a preference for those types of assets or not necessarily?
We're kind of agnostic, in a sense, because there's an argument on both sides. Like, one argument, and by the way, I don't. You know, it's gonna, the arguments are gonna sit out there, and then the opportunity is gonna tell us which, what we wanna do, b ut both concepts are exciting.
One concept is we are, I think, by now, with very little, I think, debate, the leaders in gene therapy right now, at least I believe that we are, if not the leader, one of the big leaders in gene therapy. And we have a lot of expertise building constructs, running development, working the regulatory process, all of that, serving communities with gene therapy. And so there's a real opportunity to sort of, you know, have additional gene therapy opportunities and exploit that.
The other opportunity would be to have a diversifying concept of chronic therapies that would, you know, add to our gene therapy focus, and that's a really interesting opportunity as well. We have a lot of really exciting internal programs in gene therapy that will come in 2030, s o which of those concepts, or maybe both, win the day, will really depend on opportunistically what's available, what makes sense, what works for us. And that's the issue with transactions, y ou know. Y ou've gotta be in the right place at the right time with the right opportunity. And so, we're gonna continue to look.
Yep. Okay, great. Looks like, unfortunately, we're out of time, but Doug, thanks so much for spending time with us today. We really appreciate it.
Thank you, all. Thanks very much, everybody.