Alrighty, welcome everybody to the JPMorgan Healthcare Conference. My name's Anupam Rama. I'm one of the senior biotech analysts here at J.P. Morgan. I'm joined by my squad: Priyanka Grover, Malcolm Kuno, and Rathi Pinheiro . Our next presenting company is Sarepta, and presenting on behalf of the company, we have CEO Doug Ingram. Doug?
Thank you very much, Anupam, to those in the room and also online. Thank you for joining Sarepta Therapeutics this morning. I apologize to people on that far side. Every once in a while, I'll just take a break and walk down and you can get a look at whether I'm nervous or not. Alright, so I think Sarepta has a well-earned reputation for tenacity. But I think these videos here, better than any words I could use, explain the basis for that tenacity. We're going to talk a lot this morning about performance and numbers and finances. I would like us all to recall that behind those numbers are the lives of patients that we're dedicated to improving. I'm going to be making some forward-looking statements this morning.
Please refer to our various public filings for the risks and uncertainties that come whenever one tries to make predictions about the future. There's a lot going on at Sarepta, and we have a short period of time, so I'm going to just get on with it. We're going to talk about three big things today. One, we're going to talk broadly about our four approved therapies and current performance, then we're going to talk about some of our late-stage development work, in particular our limb-girdle work, before moving on to the exciting new platform we have, which is our siRNA platform. We are exiting 2024 and entering 2025 fueled by very, very strong financial performance. In the fourth quarter of last year, our total net product revenue stood at $638 million. That is a 75% increase quarter-over-quarter growth over the prior year.
That means our full-year total net product revenue was $1,788 million. That's a 56% growth year- over- year. That's also exceeding our guidance for the full year by well over $100 million. Elevidys, as we sit here today, is undoubtedly the most successful gene therapy launch in all of history. Our fourth quarter net product revenue for Elevidys stood at $384 million. That is 112% growth over the immediately preceding sequential quarter. That also beat our guidance for the fourth quarter for Elevidys by over $60 million. Full-year net product revenue for Elevidys stood at $821 million, and as impressive as all that performance is, at least I believe it's impressive, we have barely scratched the surface of the opportunity in front of us. Even after all of that performance, you should know we have not even treated 5% of the on-label addressable patient population for Elevidys.
I am excited also to note that our three approved PMOs continue to perform well and grew last year, even in the face of our Elevidys launch, with fourth quarter net product revenue coming in at $254 million and full-year net product revenue standing at $967 million. You know, over the last seven or eight years, we've performed very well. We have four approved therapies over that period of time. We have grown revenue at, I think, an impressive 42%, actually, compounded annual growth rate and I would put this statistic up against just about anyone. Over that period of time, interestingly, we have never. Oh, Jesus Lord. Okay, there's going to be an electric outage in a second, so we're going to go acoustic in a moment.
The tragedy is here that fell on your shoes, which looked really nice.
That's okay. They're not real leather, Anupam. Apologies. Over that entire period of time, as I was saying before I interrupted myself, we have never missed any quarterly or yearly guidance. In fact, more often than not, if we don't meet our guidance, we exceed our guidance. And speaking of guidance, you will recall, as we tracked out of 2024, we said we would do $2.9-$3.1 billion in net product revenue for 2025. Please understand that the way we have set that guidance is consistent with our very long track record of accurately predicting where we're moving and feeling comfortable. And as you can imagine, we feel very comfortable about that guidance today, given the strength with which we exited 2024 and our over-performance in 2024. But a couple of things to note about that guidance.
For total net product revenue, that is a 70% or so growth over the prior year. But for Elevidys in particular, year- over- year, that's greater than 160% growth year- over- year. We'll continue to monitor this, and if there's a compelling reason to increase it over the year, we'll look to do that. But as it stands right now, we feel very good about where we are and where we're heading. Alright, talking about where we're heading and how we're doing, this slide is an interesting one. This describes the success of Elevidys over 2024 and 2025. In the first 30 months of our launch of Elevidys, we will do more net product revenue in Elevidys than every other in vivo gene therapy over that same period of time, in fact, by quite a bit. Now, our performance means a lot to us.
It means that kids live better, longer lives, and that's why we exist. It also is an extraordinary opportunity for those interested in investing in companies focused on financial performance and execution. Consider a couple of things. As you all know, there are thousands of biotechs, both private and public, that exist today. We are one of only about 14 that have ever been profitable, and we are profitable and durably cash flow positive. In fact, from the closing of our Arrowhead transaction, which I'm going to talk about in a little bit, through 2030, we're going to do greater than $16 billion in operating income. At the same time, we're going to do better than $13 billion in free cash flow. And consider how de-risked those numbers are. They do not rely on big, risky new approvals for the most part.
They do not require big, risky binary development readouts. This primarily comes from our existing therapies and continuing execution by us. So we feel very good about where we're heading. Speaking just a moment about the opportunity for Elevidys, hopefully you all know that today the labeled indication for Elevidys would allow us to treat and bring a better life to boys that are about 80% of the Duchenne population. That comes from multiple studies across a continuum of Duchenne muscular dystrophy, proving out both the safety and efficacy of Elevidys. Consider a few things as we sit here today. More than 600 patients have been dosed with Elevidys today. As you may know, Elevidys, when it was approved, was approved not only for ambulatory patients, for non-ambulatory patients.
At the time of its approval, we had dosed more non-ambulatory patients with Elevidys than any other Duchenne therapy ever approved at the time of its approval, and as we sit here today, we've dosed going on 100 non-ambulatory patients. Consider some other things as well. We've dosed children as young as two years old with Elevidys. We've dosed men in their mid-20s with Elevidys. We've dosed children as light as 26 pounds with Elevidys. We've dosed men that are 290 plus pounds with Elevidys, and I did not misspeak, over 290 pounds, and across that entire continuum of ambulatory, non-ambulatory, young, older, lighter, heavier, the profile of Elevidys, both from safety and efficacy, remains consistent and the same. And while we understand that continuum for Elevidys, and we understand the safety and efficacy of Elevidys very well, we're not slowing down.
We're continuing to do work to understand this brilliant therapy even better, but also to unleash more opportunity with Elevidys, and let me talk about that. There are a number of opportunities here that I think have gone somewhat under-recognized. The first one is this. You know, those numbers that I've shown you earlier about our performance, they do not include royalties from ex-U.S. sales. When one starts including the royalties that we receive on ex-U.S. sales for Elevidys, our estimate is our peak year sales for that, our peak year royalties will be over $500 million, all of which, of course, drops to the bottom line. We're doing the work right now in an effort to be able to dose antibody-positive boys. That will increase the opportunity by 15%. It'll bring the addressable patient population for Elevidys to about 95%.
We're doing the work right now to move to suspension, and if we're successful with suspension, that'll reduce COGS. It'll increase our margins for over 90%, and it will ensure that we can get Elevidys across the globe, into all corners of the globe, and building on the antibody work that we're already doing, our long-term goal is to be able to redose boys with Elevidys, which, if we're successful in doing that, will be an entire paradigm shift for the concept of gene therapy. Let's talk now about our limb girdle programs. To remind you, we have six programs for six different diseases, all under this broad umbrella called limb girdle, and to also remind you, we divide these up three and three between what we call the Sarcs and the non-Sarcs.
When we look across all of the programs we currently have for limb-girdle, all six of them, there are two things that you should know about them. The first is that each of these diseases is a deadly disease and entirely unserved. There is a desperate need among these patients, so a real opportunity to do good by these patients. The second thing to understand as an investor is there's an enormous commercial opportunity in here. Together, these represent about 71% of the Elevidys opportunity. If we focus down on our Sarcs, more specifically, there are three of those. They represent still about 25% of the Elevidys opportunity. So if we're successful and you consider them together, these will be likely in the top three most successful gene therapy launches when they come. And as it relates to the Sarcs, there's two things to know about them.
They are both significantly de-risked, and they are relatively late stage. They're de-risked for a number of reasons. First, know this. They all rely upon the same AAVrh74 platform as Elevidys, so we have a very good understanding of what we may see, both from an expression perspective and a safety perspective for all of these Sarcs. The second thing you should know is that the gene therapy itself and the gene here for each of them codes for the unaltered native protein, the absence of which is the sole and exclusive cause of degeneration and ultimate death in these patients. And the third thing to know is that the development programs, all in alignment with the FDA, are very lean, fast approaches. They all involve small single-arm studies, and they all involve looking at expression and safety as the basis for approval.
They're also late stage in a number of regards. First, let's think about SRP 9003. With 9003, we've already dosed all of the patients in its registration trial. We will have a readout on that program this year. We'll be submitting a BLA for an approval this year. With respect to 9004, we're already dosing those patients as we speak. And with respect to 9005, we'll be starting its registration trial this quarter. So if we're successful with these programs, and we have an enormous amount of conviction that we are going to be successful with these programs, we're going to translate this development work to successful launches very rapidly. Now, with that, let's move on to our newest platform, which is our siRNA platform that we received from Arrowhead Pharmaceuticals.
To remind everybody, in the fourth quarter of last year, we entered into a broad partnership with the innovator Arrowhead Pharmaceuticals to gain access to a very broad platform of siRNA. We have four clinical stage programs. We have three preclinical programs heading to the clinic, and we have six research programs with Arrowhead across neuromuscular, CNS, cardiomyopathy, and pulmonary. Alright? This platform that we have is going to play a really strategically important part of the future of Sarepta for a host of reasons. First, this is a chronic therapy platform. It nicely diversifies us as we have a very strong one-time gene therapy platform as well. So there's nice balance and diversification with this. Second, the lead programs, in particular DM1 and FSHD, leverage our deep understanding in the neuromuscular space. At the same time, this really broadens and diversifies us.
It diversifies us into CNS, cardiomyopathy, and even pulmonary. And finally, there are a significant number of big blockbuster potential opportunities if we're successful from a scientific perspective here. As an example, if we're successful, we'll launch FSHD in 2028. And if we're successful, we'll launch DM1 in 2029, both our multi-billion-dollar opportunities. So why did we get so excited about siRNA? There's broadly probably two reasons. One, let's just talk about the technology itself in the broadest of terms. We're really excited because siRNA is a very, very powerful modality, the purpose of which is to silence gene expression and knock down proteins. Probably the most powerful approach to doing that right now that currently exists, at least in our opinion. We're also really excited about the approach that Arrowhead has taken here and the work that Arrowhead has done in particular.
The first thing to know is that Arrowhead, as experts in RNAi, has made a number of modifications to the backbone, which they believe will increase targeting and reduce off-target effects. The second thing that really excites us about Arrowhead is they've done a great job of getting out of the liver and getting into other tissue. The example I'll use that we're really excited about right here is their approach to muscle. So Arrowhead uses this approach where they take the RGD peptide ligand, and it targets this thing called the alpha-v beta-6 integrin receptor. And they believe that approach to targeting will increase muscle concentration and therefore enhance efficacy and enhance safety at the same time. We also have an enormous amount of conviction around this approach.
And that conviction comes not only from the diligence that we've done, it also comes from our own work as well. Know this. We have, as some may know, a next-generation capsid, something that we call AAVrh74. Interestingly enough, AAVrh74 uses the same RGD motif to target the same integrin receptor. And in our hands, we're seeing just exceptional tropism with that approach. So we're really excited about that. The final thing that we love about this Arrowhead approach is that Arrowhead's made a lot of progress, as evidenced by the fact that we're currently in clinical trials with four programs with this siRNA platform. And let's talk briefly about each. The lead program here is FSHD. FSHD is a devastating neuromuscular disease. There are no good treatments for it today. There are about 13,000 patients in the U.S. alone who have FSHD.
Understand, I'm going to use U.S. numbers, but we have global rights here. We're in a phase one, two for FSHD, and if we are successful, we'll be launching FSHD in 2028. The next program we have is DM1. DM1 also is a devastating neuromuscular disease. It also is a disease that is not well served today. There are some 30,000 patients in the U.S. alone with DM1, so this is about three times the size of DMD. We're in a phase one, two with DM1, and again, if we're successful with this program, we'll be launching it in 2029. That means with those first two programs alone, we'll have multi-billion dollar opportunities before the end of this decade if we're successful and the science breaks the right way. The next program we have is spinocerebellar ataxia type two, otherwise known as SCA2. SCA2 is actually a neurodegenerative disease.
There are about 2,000 patients in the U.S. that have SCA2, so by our estimates, if we're successful, the peak year sales on this program is about $700 million, but know this also, we have SCA1 and SCA3 also heading to the clinic, and if you take all of those programs together, our peak year sales estimate for these is about $2 billion for this and the other programs, and finally, we have a program using ARO-MMP7 to target idiopathic pulmonary fibrosis, or IPF. Now, IPF is a rare disease in Sarepta, no, rare disease, but it's pulmonary, and this is very new to us, so why are we doing this? We're doing this because the opportunity to do good by patients and do well by investors here, if we are successful, is enormous. There are some 60,000 patients in the U.S. suffering from IPF.
From the time of diagnosis, the life expectancy of one of these folks is about five years, and we're in phase 1, 2 with this program as well. Those are our clinical programs, but I will remind you yet again that behind that, we have three preclinical programs for siRNA heading to the clinic, and we have six programs from a research perspective with Arrowhead. When I think about the things I'm most proud of at Sarepta, probably the one thing that I'm overarching proud of is that we're not afraid to take big swings, that Sarepta is not afraid to set ambitious goals, and then through a combination of great science, execution, and an obsessive attention to detail, overcome obstacles and achieve those goals. I'll give you an example.
In 2017, we entered into a written strategic plan that was so ambitious that we called it at the time, Project Moonshot. As we sit here today, I'm proud to say we have achieved every single obstacle that was set out in Project Moonshot back in 2017. Over that seven or eight years, we've gained approval on four therapies. We've launched all of those therapies. Those launches have all gone exceptionally well. We've grown revenue, as you've seen, at 42% compounded annual growth rate, and we're accelerating in that regard. At the same time, our peak year sales this decade, if we're successful, will be greater than $5 billion. If you include our ex-U.S. royalty revenue, it'll actually be $16 billion in operating income because we're profitable today and we're consistently cash flow positive today, and we'll be that over the rest of this decade.
You'll remember back in 2017, before we'd ever dosed a patient, we had a lot of conviction over this thing we at the time called 9001, now called Elevidys. In our strategic plan, we said we were going to develop that therapy as fast as possible, and we were going to make it available to the vast majority of patients living with and ultimately dying from Duchenne muscular dystrophy. And as we sit here today, we have done exactly that. Another thing that we said back in 2017, all the way back then, was that if we were successful with Elevidys, we knew that we needed to take advantage of that success as rapidly as possible and to diversify and leverage that success with another big acquisition and another modality. And we did exactly that.
As you know, in the fourth quarter of this year, we got the siRNA platform. So as we sit here today, we have a pipeline, a really deep pipeline of gene therapy and also a chronic therapy pipeline of siRNA that's moving rapidly towards hopefully approvals before the end of this decade. And probably most durably for us as an organization over this period of time, we have built a team that, at least in my opinion, is one of the best in biotech. A team that is passionate and patient-focused, but frankly, is expert in what they do and knows how to get things done. And we are getting things done. As we look at 2025, we have a lot to do in 2025, and we have a lot of readouts and milestones in 2025.
In fact, we have, frankly, more milestones than I could probably discuss today, but let me touch on a few of them. We have a lot of work to do still with Elevidys and a lot of readouts from Elevidys. The one I'm really excited to see is the two-year data on EMBARK. EMBARK is our pivotal trial for Elevidys. So this will be a really exciting opportunity to see the effect of this therapy on the lives of patients over two years and in a larger set of patients. So we're excited about that. We have a ton to do with respect to our limb-girdle program. To remind you, we need to keep dosing 9004. We need to start 9005 this quarter. We need to get our readout for 9003, and we need to submit a BLA for an approval for 9003 this year.
We're also going to be filing some INDs this year. We're going to file an IND for our next gene therapy for Limb-Girdle type 2A. We're going to file an IND this year for our Huntington's disease program, and our Huntington's disease program is an siRNA program, and interestingly enough, the Arrowhead deal has not yet closed. I should be clear about that, but already this year, we're planning for a number of readouts in our siRNA platform once closed, including in the second half of this year, a readout for FSHD, and in the second half of this year, a readout for DM1. So look for all of that. Also, over the last seven or eight years, we've done a lot of research, and we've been fairly quiet about it, focusing more on our late-stage development work and our approvals.
So we're going to start to pull back the curtain on some of the brilliant research and development work that Louise and her team have done. So look for an R&D day later this year. Now, I said earlier, a few slides back, that in 2017, we had a strategic plan that we called Project Moonshot and that we've hit all those objectives. We have a new strategic plan at Sarepta. It's called Sarepta 2030, and there is a ton of detail inside that strategic plan. But the overarching goal is easy to describe, and that is simply, we want to be the next globally relevant big biotech that is durable and spends its time bringing a better life to a broad array of rare disease patients. Thank you.
Do you want to introduce who's on stage with you?
Yes. So I have Ian Estepan, our CFO.
I have Dallan Murray, who's our head of customers, commercial and medical affairs. I have Dr. Louise Rodino-Klapac, who is our head of research and development and, by the way, the co-inventor of this little drug we call Elevidys.
I just want to remind everybody that there are three ways to ask a question, right? There's the old way, raise your hand and I'll call on you. You can submit a question in the email portal, or you could just email me.
Maybe I'll start. You guys obviously beat consensus in 4Q for Elevidys, pretty handily, actually. I was just wondering now, with that beat, how you think about the push-pull levers for the Elevidys guidance.
Let me say this. In the broadest of strokes, we set the guidance for Elevidys the way we set all of our guidances.
I said jokingly recently, not to be snarky, this isn't our first rodeo. We've been doing this for a very long time. We've had an exceptional track record of being able to set guidance well and then to meet or exceed that guidance, and it's in that context that we set the guidance for Elevidys, and I would remind you of how significant that guidance is. First of all, let's be clear. No one is going to question the fact that Elevidys is the single most successful gene therapy that has ever been launched. Our overall guidance for the year is just about 70% growth over the prior year. I don't think anyone's going to suggest 70% year-on-year growth, after what is, by most people's standards, a relatively big base, is impressive.
But with respect to Elevidys in particular, which is really the driver for guidance, the growth year- over- year is 160%. There's an enormous demand for Elevidys, but we're feeling very good about the guidance that we have right now. We'll continue to monitor it. And if we think there's a right appropriate time to update guidance, we'll consider it. But we feel very good about where we are right now.
We have, yeah, a question in the audience. Raise your hand.
Question on the redosing technology
Yeah, the two- and three-year follow-up data, thank you. What's your expectation for the need for redosing? I should turn it over to.
Yeah, so first things first. We have never, and you can correct me, Louise, or add to it.
So first of all, over the long period of time that we've been evaluating this therapy, starting in the non-clinical space first, we've never seen a need yet for a redosing concept. As long as we've been able to look in the animal models, non-human primate and the mouse model, we've never seen a diminution in expression or function. And in the clinical setting, we have patients that are now out six years or more. We have data on five years on this patient that has already been published, and you see no diminution in effect. So this isn't about immediately anticipating an issue with the long-term durability for Elevidys. This is a broader concept of increasing the long-term utility of gene therapy more generally. If we could redose, it's not just about the concept of redosing, and it's not just about the idea of dealing with durability.
If we could redose, we would completely turn on its head the paradigm. Today, what you do with a one-time therapy is this. You pick the highest dose you can pick that's safe, right? And unless you're getting to a place where you're getting real diminishing returns, then you dose and you cross your fingers and you get what you get, right? If we lived in a world where you could do serial dosing, we would change that paradigm in different ways. It works brilliantly with Elevidys, the current approach we have, but in the future, there may be gene therapies where you would benefit from smaller doses over a longer period of time or topping up doses over time, so this isn't about anticipating some monstrous durability issue. We have not seen anything like it.
We won't probably know whether there's a need for that for the next 15 or more years before we even know whether there's the concept of even needing this. But if we could redose an AAV-mediated gene therapy, I think it would be a game changer for the entire field. At least did I get that wrong?
I'm sorry. The only thing I'll add is the technology that we're using to treat antibody-positive patients, the two different trials, imlifidase and plasmapheresis, are the exact technology that we would try for redosing. And so the work that we're doing now will really inform that. And so that's why we're really excited about it.
We have a question in the portal, which is related to the $30 billion in cumulative revenue by 2030. What contribution are you expecting from limb-girdle and other pipeline programs? Is this assuming success or risk-adjusted?
The $30 billion, I believe, will include limb-girdle launches. It's un-risk-adjusted, but you should know we feel an enormous amount of conviction around it. Just remember with the limb-girdles, and I don't mean to oversell, we still have development work to do. And remember the forward-looking statement concept. But at the same time, this is the same platform as Elevidys. So we have a pretty good understanding of what we're going to see from a safety perspective after having dosed 600 patients and an expression perspective. And with respect to these limb-girdles, also understand that this is the native protein, the absence of which is the sole and exclusive cause of disease, and we're replacing it with this gene therapy and what will be, I'm quite confident, very robust expression. And finally, understand our approvals are based on expression and safety.
So if you believe that we understand safety and expression fairly well, you'll have a significant conviction for the pathway for these programs as well. With that said, there will be modest contribution from the Limb-Girdle programs to that $30 billion. But I will still note this, that the predominant sales that we're talking about over this decade and the predominant operating income that we're talking about this decade and the predominant cash flow that we're talking about this decade come from currently approved therapies and just continuing to execute. So I guess the bet you need to make is whether we have proven ourselves capable of executing as an organization.
Questions from the audience? Maybe one from me. So what are you seeing in the field in terms of how physicians are prioritizing patients on a Elevidys therapy? Because you've got a pretty wide label, right?
Yeah, we have a wide label. I think I'll let Dallan sort of answer the prioritization question if there is an answer to that, and I'll talk a little bit about some of the other things that are happening in the marketplace.
Yeah, and thanks for the question, Anupam. Each center is different in how they're prioritizing the patients. Early on, I think there's more of a skew towards the ambulatory population and, in particular, those patients that are at risk of losing ambulation, so that's early on. As Doug said, we're not even at 5% of the penetration of the population, so early, these are the trends that we've seen, but as Doug also pointed out, we've seen a broad range of patients across all the disease stages getting dosed with Elevidys, but early on, if you were to generalize, it's in the younger ambulatory population.
I think as you go younger and younger, you just see a slightly higher penetration, but you see it across all stages.
It's hard to generalize. These are still, I mean, even, again, I don't mean to sound very arrogant, but these are, I think, very impressive numbers that we're showing. But we haven't even dosed 5% of patients yet. There's an enormous demand for this therapy. So it's very difficult to sort of talk about what the stable prioritization is going to be. A lot of things you should know about the complexity of gene therapy. One of the reasons others have struggled with this is that it really requires an obsessive attention to detail.
Do you know in a site, for a site to infuse a boy, it takes about 20 to 25 different people across a broad array of that organization, not just infusion, infusion and finance and the pharmacy and distribution to get each patient dosed. There are only, in the average site, about two clinic days a month dedicated to DMD. And if you're going to be talking about something as consequential as gene therapy, it takes an hour or two to talk through that issue with the patients. So there is just a very, it's a very interesting and complicated process. In the face of that, the fact that we're doing this brilliantly well and working hard to, over time, meet this enormous demand for gene therapy, I think is impressive. And kudos to Dallan and your team for the work that you've done.
Questions from the audience?
What are you seeing on sort of reimbursement timelines once a patient has been selected for therapy and getting through that process? You talked about the 25 people too.
The combination of all of it is about four months. Dallan, you correct me. I think we're in about the four-month range. I understand that's another thing. People say, "What's the opportunity to really collapse that?" Really no opportunity. It's a complicated process. I'll give you another example of the interesting complications associated with gene therapy, so every single case, almost every single case, requires a single case contract. That's literally an agreement in advance from the site and the payer, in addition to the pre-auth process, just to ensure that they have all agreed they're going to get reimbursed, there's no issues, and the like. That process, which is administrative, we're not involved in it.
That's a three-week, sometimes a four-week process as well, so you can just sort of expect a cadence of about four months for each of these. Now, sites will become more productive over time as well. I don't want to suggest that everything is static, but this idea that we can just sort of turn a switch and meet all demand overnight just isn't realistic in the way things work, so with that said, I think we feel really good about where we're headed,
and those sites are incredible in what they're doing. They're waiting to get paid by the payers, and they've got certain terms where they have to pay for the therapy, so they're really, as Doug said. There's a whole lot of people coming together in support of dosing one patient. It's a pretty incredible and cool business model.
Yeah, I will say, and also, so there's a cadence issue, but I do want to give kudos first to the sites that are doing a really great job of serving these patients and dealing with what is sometimes probably to them what feels like an avalanche of demand. I have to also say that I think payers are doing their part in all of this. It will come as a surprise to hear a biotech CEO talk kindly about payers, but I think the payer community has done a very nice job overall addressing this issue as we sit here today. By the way, we initially got it launched in June of 2023. We got a broader label in 2024. We have not had a single situation where a patient has been permanently denied therapy as a result of an access and reimbursement issue.
So, so far, things are going very, very well.
Maybe final question from me. Doug, I believe that your contract at Sarepta may be coming to an end shortly. You've been in the industry a long time. You've had a really good career. You trailblazed the Elevidys approval. So what's next for you?
Do I look tired, Anupam? Is that the problem?
Well, you did spill the water on your shoes.
That's true. All right, let me be very clear. My board, take a careful look at the management team and figure out if they're happy or sad to hear this. But my board very much wants me to stay. I very much want to stay at the organization. There's been a misunderstanding. The agreement timeline is a compensation-related issue.
I have a certain kind of compensation in that timeline on that particular compensation is up in June of this year. But I am super excited about being at Sarepta. There won't be anybody here that would ever remember this, but I remember my first earnings call when I joined Sarepta back in the summer of 2017, and I was asked by someone on the call, "Why did you decide to come to Sarepta?" And I said, "Look, there may be a better opportunity than Sarepta. I just haven't found it. In all of the diligence that I've engaged in, there's just this enormous amount of opportunity. I knew with certainty when I joined Sarepta that we had an opportunity together to do great things.
If I sit here today with all that we have going on, with this amazing performance we're going to execute over the course of this decade in our gene therapy programs and our big siRNA platform, I am quite confident that if I left Sarepta, I wouldn't find anything more interesting and I wouldn't find a group of people that I'm more excited to work around than the management team that we have here and the larger employees at Sarepta. So I'm super excited about staying at Sarepta.
All right. Thanks, everyone.