Good afternoon. Ladies and gentlemen, thank you for standing by. And welcome to the Sanofi Second Quarter 2019 Earnings Conference Call. I would now like to turn the conference over to George Grofik, Vice President, Head of Investor Relations at Sanofi. Please go ahead, sir.

Good morning, good afternoon to everyone on the call. Thank you for joining us to review Sanofi’s second quarter results. As usual, you can find the slides of this call on the Investors page of our website at sanofi.com. Moving to slide two. I would like to remind you that information presented in this call contains forward-looking statements that involve known and unknown risks, uncertainties and other factors that may cause actual results to differ materially. I refer you to our Form 20-F document on file with the SEC and also our Document de Reference for a description of these risk factors. With that, please advance to slide three, and let me introduce our speakers today. With me are Olivier Brandicourt, Chief Executive Officer; Jean-Baptiste de Chatillon, Executive Vice President and Chief Financial Officer; and John Reed, Executive Vice President, Global R&D. Olivier will discuss key highlights, after which Jean-Baptiste will review the financials. John will then provide an update on R&D, and we will close with the Q&A session. Joining us for Q&A will be Olivier Charmeil, Executive Vice President, General Medicines and Emerging Markets; Karen Linehan, Executive Vice President, Legal Affairs and General Counsel; David Loew, Executive Vice President, Sanofi Pasteur; Alan Main, Executive Vice President, Consumer Healthcare; Bill Sibold, Executive Vice President, Sanofi Genzyme; and Dieter Weinand, Executive Vice President, Primary Care. With that, I’d like to turn the call over to Olivier.

Thank you, George. Good morning, good afternoon to everyone. And welcome to our second quarter earnings conference call. On slide five. We delivered continued sales and EPS growth into second quarter. The results allow us to raise our guidance, and we now expect to grow approximately 5%, which is the high end of our previous full year guidance. Our second quarter sales were €8.6 billion, up 3.9% at CER and our business EPS increased by 4.8% to €1.31. If we adjust for constant structure, our sales grew an impressive 5.8% on an organic basis. Slide six breaks down our second quarter sales performance to show the drivers of our organic growth. You can see that as in the past three quarters, the underlying dynamics of our business are more than offsetting the impact of LoEs. On slide seven, you can see the sales picture across our GBUs on a constant structure basis. The highlight goes to sustained rapid growth in our Specialty Care business Sanofi Genzyme. However, we also benefited from very strong growth in our Vaccines business, Sanofi Pasteur, and from a good performance in China and Emerging Markets. On slide eight, as in previous quarters, our diversified business structure clearly benefited us as we managed the impact of LoE headwinds in mature markets. In particular, Specialty Care and Vaccines showed impressive double-digit growth in both mature and emerging markets. In addition, our strong presence in emerging markets continued to be an important driver with overall emerging markets sales up 10% in the quarter. Looking at our Specialty Care franchise on slide nine. Sales grew by 22% at constant structure. Each of our franchises contributed to growth in the quarter. Rare blood disorders grew by 2% assisted by the successful launch of Cablivi into U.S. The overall franchise performance…

Thank you, Olivier. Good morning and good afternoon to everyone. So, before discussing the details of the P&L, I would like to highlight the positive impact of ForEx on our reported second quarter figures. This mainly resulted from the stronger U.S. dollar. In total, the benefit to sales was 1.6% with an offset at business EPS level, mainly due to the Argentinean peso. Looking forward, based on July 2019 average exchange rates, we expect a positive impact on 2019 business EPS of between 1% and 2%. On slide 19, we delivered an increase in BOI, despite the high base comparison in other operating income of last year. Our expense discipline is very clear in the SG&A line, which declined by 3%, despite the cost of new launches on the continuing global rollout of Dupixent. R&D expense grew by around 5% due to investments in our late-stage pipeline on the incremental costs of Ablynx. Other operating income and expense includes our share of the profit and loss of the Regeneron monoclonal antibodies alliance, net of marketing expenses incurred by Regeneron. The combined outflow in the quarter increased €143 million versus €46 million in Q2 2018, as the antibodies collaboration is now breakeven this quarter and we expect to be profitable in the second half of the year. Taking these factors together, BOI grew by 3%. On an IFRS basis, EPS was slightly negative, reflecting €1.8 billion impairment charge, mainly related to Eloctate. Looking now in detail about cost line on slide 20. The gross margin increased on a reported basis by 70 basis points to 72%. At CER, the increase was 50 basis points. This uplift in the quarter resulted from favorable geographic and product mix. It is now our expectation that the 2019 gross margin will be between 70 and 71 at constant exchange rate. Turning to OpEx. R&D growth was compensated by good SG&A control. Our OpEx performance underscored the change of mindset we are implementing across the organization. Overall, we expect to keep OpEx growth for the full year to around 1% with a similar trend over the next couple of years. On my final slide, we have increased our full-year guidance for 2019 business EPS and we now expect to grow approximately 5% at constant exchange rate. The impact of ForEx is expected to be around 1% to 2% positive, as I mentioned earlier. Given we delivered business EPS growth of 7% in the first half, we are confident of meeting our revised full-year guidance. But for your modeling consideration, we expect growth to be lower in the second half. This reflects the impact of the China VBP program, a higher basis of comparison for Pentaxim on the outlook for Praluent in Germany and for Eloctate, and the lower pricing on Admelog in the U.S. With that, I would like to turn the call over to John.

Thank you, Jean-Baptiste. And good morning and good afternoon to everyone. Well, it’s my pleasure to update you on the continuing the evolution of Sanofi R&D, beginning with slide 23. As we explained in February, our high level vision for Sanofi R&D emphasizes continuing our efforts to reshape the portfolio. First and foremost, our aim is to substantially elevate our impact for patients by increasing the level of innovation in the Sanofi portfolio, through a commitment to greater investments in first-in-class and significantly differentiated best-in-class medicines. To achieve this vision, we announced a reallocation of our R&D resources to priority therapeutic areas that we believe offer the greatest opportunity to advance the standard-of-care for patients with a focus on diseases where the unmet medical need remains very high. We also said, we will support the new focus by leveraging our broad range of therapeutic modalities and by accelerating our most promising early stage programs. Looking forward, our aspiration is for the Sanofi pharma portfolio to evolve towards a state where roughly 80% or greater of our R&D investments are in first-in-class or best-in-class molecules, where we envision that approximately 70% of the portfolio is likely to be biologics, and where we aim to accelerate the progress that has been made improving internal drug discovery, such that around two thirds of the pipeline should come from our Sanofi labs. I firmly believe we can deliver on this goal, given the building blocks we’re putting in place. Those building blocks include leveraging the recent Bioverativ and Ablynx acquisitions to bolster and reshape the portfolio, while also helping to increase our internal productivity with their technology platforms and expert scientists; shifting our allocations of internal resources to prioritize investments and specially care indications where we believe Sanofi has the best opportunity to deliver…

Thank you very much, John. So let me summarize. We achieved a number of important R&D milestones in the quarter. We sustained our new growth phase with sales momentum over the past four quarters averaging close to 5% at CER. Growth benefited from an accelerated contribution from Dupixent, clearly as we executed on new indications -- and indications and geographic expansion. We achieved improved top line growth, while keeping OpEx growth around 1% in the first half of the year. And we have raised our EPS guidance to approximately 5% growth. So, before I hand over to George to start the Q&A session, many of you will be aware that this will be my last quarterly earnings call with Sanofi, as I will retire as CEO at the end of August. I would like to take this opportunity to thank you all for your interest in Sanofi. I would also like to thank my executive colleagues and Sanofi employees worldwide for their hard work in supporting the transformation of the Company over the past four and a half years. And with that, over to you, George, to start the Q&A.

We will now open up the call to your questions. And as a reminder, we’d like to ask you to limit your questions to two each.

The first question comes from the line of Graham Parry of Bank of America. Please ask your question.

Great. Thanks for taking my question. So, firstly, best wishes to Olivier in whatever your next venture is. And thanks very much for all the timely information over the time you’ve been at Sanofi. And then, first question is just on Dupixent. It was growing ahead of prescriptions in the U.S. quarter-on-quarter. So, I just wanted to clarify if there’s any so called rebate benefit in there, or are we just seeing lower deductibles in the second quarter as patients have been through that because just you’re not paying as much co-pay there? And then secondly, on BIVV001, you flagged the strong proof of concept data at ISTH. And you talked about second half Phase 3 start. When in Phase 3 do you think you’ll actually start being able to dose patients there? And if you could help us just understand a little bit more about trial design there. Do you think you’re going to stick at the weekly dosing at either the 50 or 65 days, or do you think you’ll move up the dose higher and shoot for something in the two weekly range? Thanks.

So, starting with Dupixent, Bill, low deductible and great inventory and everything.

Great. So, thanks for the question, Graham. And first of all, just to say from Q2 to Q1, you’re right. A part of the driver in there is some favorable gross to net. But, the majority is driven by demand, so about 55% of it’s driven by demand, about 36% gross to net, and just as you said, it’s people that have finished their co-pay support. So, that reflects positively in Q2. And then, less than 10% of it is inventory. Now, just to anticipate the question on year-over-year Q2 ‘18 versus Q2 ‘19, 77%, is driven by demand. There’s about 13% on gross to net. And just to remind everyone, our first price increase with Dupixent was in July of last year at 3%, and then, we took a 3% in January of this year. So, that led to some favorability in gross to net as well. And then, there was about 10% on inventory versus last year. And the inventory fluctuations are just within our 3 to 5-week that we talked about, nothing unexpected, just a day or two here there. So, that’s going to continue to fluctuate over time.

All right. Thank you very much, Bill. ISTH and BIVV001 and design of the Phase 3 study, John, please?

Yes. Graham, thanks for your question and for your interest in BIVV001. With respect to the dose 50 versus 65, we actually haven’t reached the final decision. Both of them are pretty effective at maintaining that factor level close to 10% after one week. 65, clearly more consistently does, but 50 is close, and so we’re having internal debates about what it’ll finally be. So, I can’t tell you exactly. And the date of the start is in the second half of this year. I don’t remember the exact date. We can get that for you offline.

And just follow-up on that. The 50 to 65 is weekly. But, is there any scope here to go through two-weekly by pushing the dose hiring in Phase 2 is more the question?

Not at this point.

Okay. Thank you, John. Thank you, Graham. Next question, please?

Thank you. Next question comes from the line of Peter Verdult from Citi. Please ask your question.

Yes. Good morning. Peter here from Citi. Apologies for any background noise. Two questions. Jean-Baptiste, Q1 and Q2 showing a very strong gross margin and OpEx control -- gross margin ahead and OpEx control in line with your guidance despite the increased R&D investment. I’m just trying to gauge the upside risks around your efficiency drive across the P&L. So, wondering if you could spend a little time detailing some of the more fruitful initiatives you’ve undertaken, as well as whether you could confirm whether you are in line, ahead or behind the internal targets you set last year? And then, secondly, sorry, Bill, just go back to get back Dupixent, that we’re looking to go hopefully that we all managed to miss by 20%. I know you detailed some of the reasons. But, are you now in a position to give us a little more detail on the breakdown between atopic dermatitis and asthma in the U.S., just to get a little more handle on the dynamics there? Thank you.

Thank you, Peter. Our initiative in cost management, Jean-Baptiste?

Yes. Thank you for that question. But maybe first of all just word on gross margin. The same drivers have been impacting us in Q1. As you mentioned, in Q1 and Q2 is -- and we were just saying with Dupixent, of course, which is related by gross margin level and also China, which remains pretty high with the VBP, which is now kicking in really second half. So, that’s why we raised our gross margin guidance for the year to 70% to 71v, which is, of course helpful. We have, on the cost side, room for improvement, both in COGS and on SG&A. And that should help also to maintain our gross margin. Of course, on the SG&A side, the OpEx side, you see that we have between our late stage pipeline on the rollout of Dupixent, we have many opportunities of reinvesting to fuel the growth of the Company. So, that’s why we keep our 1% guidance for this year on the next two years in terms of around 1% for the growth OpEx. So, no specific worries on that front. What I can tell you is that I can feel that there is a real beginning of change of mindset in the way we deal with cash in the Company. And that’s not -- at headquarters it’s really starting to be a very significant in terms of action plans in the countries and within the team.

Okay. Thank you. Thank you, Jean-Baptiste. Bill

So, Peter, thanks for the question. I mean, look, the way to characterize Dupixent growth is it’s just strong all around, 51% sequential growth globally, 168% year-over-year; and its contribution from AD, from asthma, new indications, geographies. So, it’s really about the momentum across the whole product. And, you asked specifically about the U.S. We, on slide 10, have broken out the U.S. quarter-on-quarter NBRx growth, which is 25% overall, and that was driven by 23% derm, 22% allergists and as you would expect a little bit higher growth rate 59% with pulmonologists, since the launch of asthma’s new. For competitive reasons, we’re not going to break out the mix in allergists at the moment because that’s the group that’s writing for both AB and asthma. So, a highly competitive market, and we want to keep some of our information, proprietary.

All right. Thank you. Thank you, Bill. Next question, please? Thank you, Peter.

Your next question comes from the line of Florent Cespedes from Société Générale. Please ask your question.

Good afternoon, gentlemen. Thank you very much for taking my questions. Two quick ones. First, on hemophilia. Please, could you share with us your view on this business, how the performance for the first half is not exactly where it was expected to be? My second question is for Alan on consumer. And could you please tell us, like to try to understand why the performance on the emerging was a bit softer in Q2 as you see some recovery or more dynamic performance for the rest of the year? And follow-up on the consumer. What could be done to reenergize the business in Europe or as you may be -- mentioned during the call, we would have to wait until the first half of next year?

Thank you very much, Florent. I’ll take the first one. So, yes, we took an impairment charge on Eloctate, and that was and it is primarily due to the greater-than-expected share loss to Hemlibra. So, I think, Hemlibra share gain as maybe not be totally surprising to everyone, but certainly the magnitude of it has surprised almost everyone. So, at the time of the Bioverativ acquisition, we really believed that in the non-inhibitor market, the U.S. sales trajectory would be slower, due to -- at the time there were multiple serious safety events, which were reporting on Hemlibra. And we knew, thanks to Bioverativ, that historically, this market was rather sticky and very, very oriented towards safety, so very safety conscious, if you want, and most specifically in the hemophilia A market. So, that’s the historical perspective. Now, looking ahead, we do not expect -- we do expect competitive pressure to continue, of course. However, we do see some points of differentiation, which are built within Eloctate. And more specifically, what we have talked about, but maybe not sufficiently, which is its big advantage in joint health and also in c, the immune tolerance induction, which we have presented data on recently. So that’s one thing. To continue on future performance outside the U.S. and over the next few years, we are planning potential launches in additional markets within Latin America but also Asia. And finally, while we have taken an impairment charge on Eloctate to reflect what I described before, we still believe, and that’s I think the key of your question, so Bioverativ acquisition will deliver substantial value for Sanofi. And on a strategic basis, it is going to be the foundation of our wider rare blood disorder franchise. And we think we are, with Bioverativ, ready to build an industry-leading franchise which goes beyond hemophilia, hence, your question around blood franchise, rather than specifically hemophilia. We do have sutimlimab for CAD but also ITP. We just talked about BIVV001, which at one point will be the follow-on compound to Eloctate with very much stronger profile as you have heard from John. So all of that in addition to the early gene therapy programs that were part of the portfolio of Bioverativ. And here, I’m talking about Sangamo focused research on beta-thalassemia and significant sickle cell disease, in addition to also the San Raffaele Hospital collaboration on lentiviral gene therapy for hemophilia. All of that constitutes a strong pipeline, which we are very confident in. So, this is a long answer, but I felt that I needed to give that to you. So, CHC, Alan?

First of all, in emerging markets, overall, the first half has been quite strong with the growth of 4%. It was a little bit more biased towards the first quarter. The second quarter was flat, mainly reflecting lower performance from the allergy, cough and cold, so more of a seasonal impact, as well as the pain category in Brazil been relatively flat. That was offset by some price increases in Argentina to offset inflation and a continuing strong growth in China, Eurasia and Southeast Asia. So, overall, I think it’s more a phasing issue. We’ll continue to see strong growth in the second half in the emerging markets. You talked about Europe, and of course, Europe’s been impacted probably the most by seasonality over the last two quarters and also by the portfolio divestments that we’ve made of non-strategic brands. So, as those divestments grandfather, of course, that will start to have a positive effect. We also mentioned the tightening regulatory environment that’s also impacting Europe to some extent. For example, with new ICH guidelines and a stronger position from ANSM in France in terms of some old INNs requiring us to reformulate or withdraw some of our older products in Europe. And that’s why we have given a guidance that will have an impact through the rest of this year into the early part of next year. But it’s impacting predominantly the older portfolio, it’s not our focus categories. So underlying growth, I think, is still going to be seen as quite positive.

The next question comes from the line of Luisa Hector from Exane. Please ask your question.

So, it’s a pipeline question on two of the cancer drugs you highlighted., so, the SERD and then the anti-CEACAM. So, they’re both in relatively dynamic spaces, where we’re seeing quite long-PFS times. So, I just wonder whether you can say any more on your thoughts from the trial design for the pivotal studies or the positioning of each of those assets, as you move forward towards Phase 3. So, the SERD, you’ve got that space of the CDK4/6. Are you thinking of this as a potentially even an adjutant therapy eventually and how will you start assuming the Phase 2 comes to you positively? So, how do you see a SERD fitting in? And then, on the CEACAM, again a lot of movement within the non-small cell lung. So, anything more you can say? Because I see both assets you have down with a kind of filing timeline towards 2023? So, just essentially trying to think about the positioning and the duration of both Phase 3 studies? Thank you.

Thank you, Luisa. John?

Yes. Thanks for the question. I’ll start with SERD. Right now, we’re focusing on the Phase 1b testing in SERD in combination with palbociclib in the anticipation that if that combination proves successful, from a technical standpoint, we could move that into the front line metastatic breast cancer setting. We’re also gearing up to do a randomized study of our SERD against standard-of-care antihormonal therapy as a test of moving into a monotherapy environment, which would set the stage for adjuvant today. Although, as you know, adjuvant may change in the future, if palbociclib becomes part of that -- part of the therapy there. So, things are moving along, and we’re really continuing to develop a deep understanding of the SERD and how best to position it. The CEACAM, we think is very attractive in this second line setting for non-small cell lung cancer. As you know, most patients these days are getting chemotherapy plus a PD-1. And when they fail that, they have very few options left. They typically go under a variety of different chemo regimens or CYRAMZA. The side effect profile of those therapies and their efficacies are -- leave much to be desired. Our first study is going to be a head-to-head against docetaxel in the second line setting. We are also planning to do a Phase 1b in combo with CYRAMZA to see if that is a combination that could be deployed as a way to get even better efficacy if the safety profile proves to be satisfactory. And in terms of the timelines, I would say on the CEACAM5, here is the possibility to bring that forward faster, depending on how some of the interactions go with the regulatory authorities. We’ll be meeting with the FDA next month, in fact. So, we’ll be having discussions around that. I think 2023 is probably a fairly conservative date for that. For the SERD, we’re still -- have much to learn yet. And so, I would just stick with the 2023 for now. But, if there are opportunities to bring that forward, we’ll obviously emphasize that in the future.

Thank you, Luisa. Next question, please?

Thank you. Your next question comes from Richard Vosser from JP Morgan. Please ask your question.

Hi. Thanks for taking my question. Just extra question on CEACAM5 first of all. Just could you give us some help on the durability of the response that you’ve seen so far in the 17 patients? We’ve obviously seen other ADCs promising early data and then some of that efficacy fall away. So, just to give us some idea what that durability is on that product. And then, secondly, just going on to Eloxatine. Just thinking about future potential pressure in China. Obviously, not at the moment, but it should we think of a Eloxatine having some pressure in the future? Thanks very much.

Thank you. Thank you, Richard. Durability of response, John, with the CEACAM5, do you know?

The valuation is still ongoing. I don’t know that we’ve reached a median duration response yet. So, we’re still collecting data on that. It’s -- I guess, I’d like to say it’s been encouraging. I would also note that we had a 62% disease control rate as well in addition to the 25% overall response rate. So, we’ll have more update for you in the future.

Okay. And Eloxatine in China, Olivier?

Yes. So there’s been no official communication and extension in terms of product of the scope of the VBP. So it’s too early to say on whether Eloxatine could be impacted in the future.

Okay. All right. Thank you, Richard.

Thanks so much.

Next question, please?

Your next question comes from the line of line of Thibault Boutherin from Morgan Stanley. Please ask your question.

Thank you very much for taking my questions. So, the first one is on Praluent. Could you give us an update on the situation of the U.S. litigation with Amgen in terms of time line of the next event, and your expectations for the U.S. and for Praluent? And beyond the risk of injunction, I would be interested in your view on potential compensatory damages that may arise, and how these damages would be shared between Sanofi and Renegeron. And the second question, pipeline question on the avalglucosidase alfa. So, could you tell us more on your next-generation Pompe program? Could you tell us more about your expectations for these assets, how you think about it in terms of acceleration of growth of the Pompe franchise versus potential cannibalization of your existing assets?

All right. Thank you very much, Thibault. We’re going first with Karen. We’re lucky to have Karen Linehan with us today. So, Karen, do you want to give the status of the U.S. litigation?

Sure. Thanks for the question. As you may know, in February of this year, a jury found that three of the claims of Amgen’s patents were valid, and two were not. So, in other words, the jury had a split decision. There was a hearing on a permanent injunction. The judge has not ruled on that. And business continues as usual in the U.S. You should know that we filed a post-trial motion, one seeking to overturn portions of the jury’s verdict that were unfavorable to Sanofi and Regeneron. And we raised a ruling on these motions. The court has requested an oral argument which will take place on the 8th of August. And it will be very short problem. [Ph] But please be aware if there’s any adverse ruling against Sanofi and Regeneron, both parties are prepared to go to the Court of Appeals for the Federal Circuit. We cannot speculate how long this will continue, and no matter what the length, we’re committed to defending this case to ensure Praluent continues to be available to the appropriate patients in the U.S. The issue of damages has not been addressed by either the judge or the jury. And I think it’s premature to comment on that. But if there were any, they would be shared.

Okay. Second question on, avalglucosidase. Bill, do you have anything on this?

Sure, great. So, thanks for the question. We’re really excited about this product. And just to orient you, it’s a second-generation ERT for patients with Pompe. And this was discovered in-house by our researchers. And it’s -- the design -- it’s specifically designed to enhance the receptor targeting enzyme uptake, your greater affinity for the M60 receptors on muscles with the aim of having greater glycogen clearance and therefore potentially more efficacy than Myozyme. And just to give you an idea, we saw 5x higher uptake than Myozyme in vivo. So, we are hopeful that this will be a product, which is better than Myozyme. And we will continue our efforts still with diagnosis and treatment in this area. So, we believe that this -- we’re the leaders now and this is an extension of our leadership. And we’ll be reading out more data in the future.

And the question was, would you planning -- are you planning for some level of cannibalization? I think, the answer is probably at some levels...

Sure. Assuming that it shows -- that it’s ready, in which case, we would expect that patients would want to be on this drug. Yes.

Next question comes from the line of Jo Walton from Credit Suisse. Please ask your question.

Thank you. Can I just clarify one thing first? I wondered if we could ask Jean-Baptiste to repeat the Regeneron contribution or rather Regeneron payment in other operating income. The line went a bit crackly. My two questions, one would be on U.S. reform. We’ve seen the Senate proposals, and one of which appears to remove the pennies rule for Medicaid. Now, given the size of product like Lantus and the ability to have taken prices well over CPI over many, many years, I wonder, if you could tell us what the impacts of removing the pennies rule and actually having to pay out, if the proposals stay as they are -- remains? And my second question would be on Dupixent ex-U.S. And I wonder if you could tell us a little bit more about the adoption and how it’s going in Europe. And in particular, what may happen to pricing in Europe, as you add incremental indications, which typically result in countries asking for price cuts? Many thanks.

Thank you very much, Jo. So Jean-Baptiste starts with the other income.

The operating income and expense -- so it includes our share of the profit and loss of the Regeneron monoclonal antibody alliance, net of marketing expenses incurred by Regeneron. So, the combined outflow in the quarter increased €143 million versus €46 million in Q2, last year. This is because we are now breakeven, positive breakeven, and we expect to be profitable in the second half -- from the second half of the year. Remember, up to now, we were mentioning early 2020. We are now with the accelerated growth of Dupixent already breakeven and looking forward to have some profit. So, on these lines, we will be recording on top of the selling expenses incurred by Regeneron, half of the profit and loss of the P&L of the alliance. So, that will be growing negative on this line linked to the success of the partnership.

All right. Thank you very much, Jean-Baptiste. Dupixent, Bill, ex-U.S.?

Thanks for the question, Jo. We’re seeing very similar uptake in every country that we’ve launched in and in the -- around the world that is getting similar to what we’ve seen in the U.S. And just as a comparator, we have been anywhere from 2 to 7 times the uptake of the Cosentyx launch, another strong dermatology launch or well-recognized dermatology launch. But that that’s been a consistent story everywhere. And still very early obviously, in asthma, we’re just getting going, but we would also expect to see strong demand there. Now, regarding the pricing, as we always thought of this as being priced as a multi-indication product. So that was taken into account when we had our first discussions and our first internal plans and ultimately discussions with payers. You’re right that there can be some downward pressure on pricing as a result of the next indications. That’s been taken into consideration and we’re trying to mitigate that to the best extent that we can.

All right. Thank you, Bill. Jo, on the U.S. reform, I know you specifically asked on the A&P cap. But I just want to start by saying, as a company and as an industry, as you know, we oppose the Senate Finance Committee legislation. And the reason is because it does very little to what we tried to do since the beginning, which is to improve the affordability for the large majority patients. So that’s number one, but also because it introduces price control in the Medicare Part D program. So that’s our position. As you know, it’s a moving target, nothing is finalized. But you are right, within the different proposal of that draft bill, there is one piece, it has to do with A&P cap for Medicaid. And there are several versions, which have been considered for removing that cap. And the latest we are aware of -- the latest proposal suggests the modification of the maximum rebate cap moving from 100%, which is today to the 125%. However, that would only kick in during the fourth quarter of 2022. And it will be launched to -- it will be packed to the launch year of price. So, that’s one thing. But the second is even more important, it would not apply retrospectively. And that has to do with your question on Lantus. So, we don’t feel that would be applied retrospectively. Therefore, Lantus should not be affected. However, prospectively, it will have to -- companies will have to be very careful with price increases and the potential CPI impact on Medicaid. So that’s what I would say at this point. So, thank you very much, Jo. Next question, please?

Thank you. The next question comes from the line of Simon Baker from Redburn. Please ask your question.

Thank you for taking my questions. Two please? Firstly on Praluent. You indicated that in the second quarter, your sales were down 37% impacted by significantly higher rebates. From this prescription data we’ve seen, it looks like volumes are up about 65%, which would suggest probably that there were some prior period adjustments within that quarter. So, I wonder if you could give us a little bit more color on that. And then, secondly, Jean-Baptiste talked about the OpEx growth this year of 1% being an indication of the growth in the coming years. I assume that statement was made prior to the Friday’s inquisitor termination. Could you give us an idea what sort of impact that would have -- the elimination of that promotion would have on OpEx over the coming years? Thanks so much.

All right, very good. Dieter, did you get the question around Praluent U.S.?

Yes. So, the volume has been growing very nicely in the U.S. since we launched new NDC, and we got the expanded label for all cross account to be the only product for -- with that label now. We have seen our NBRx share grow by 8 percentage points. And we have seen total Rxs -- TRxs grow by 2 points. So, we are encouraged by the momentum. That was offset obviously by continued pricing pressure n the U.S. That did not completely offset the volume growth that we have experienced in the U.S. So, that really explains, there was nothing unusual in prior quarters. So that is just how the market has evolved. Going forward, I would hope that prices would stabilize, and we would see that volume translate into revenue growth as well.

Okay. Thank you, Dieter. OpEx growth, coming back to third question, Jean-Baptiste?

Yes. You’re perfectly right. Of course, it’s a fact that we will not foresee for the Zynquista launch will be a positive for next year and even probably second half in OpEx. That’s why we with our -- around 1% growth, we have an extra opportunity for reinvestment case to fuel our growth in other areas of the business.

Okay. Thanks very much, Simon. I think we have time for the last question. Operator, please, next question?

Next question comes from the line of Jordan McConnell from Deutsche Bank. Please ask your question.

Hi. Thanks for taking my question. This is Jordan McConnell from Deutsche Bank. Just the first one, please. Can you elaborate on your expectations for Dupixent in COPD, and highlight any data if you have in house supporting that progression to Phase 3 trials? Just looking to understand your level of confidence in that program? And then, secondly, do you have any feedback from the Cablivi launch that you can share? And how is that tracking versus your expectations? Thank you.

Okay. Thank you, Jordan. John, do you want to take the COPD question on Dupixent?

Yes, I’ll be happy to take that. Thanks for the question. It’s a thought that at least a subset of COPD patients have a component type 2 inflammation, which is an area where we know Dupixent really excels in squashing that information. So, we’re doing the study, as you’re probably aware to test that. In the same study, we’re comparing Dupixent with the IL-33 molecule and then doing a combo as well. And from this, then, we’ll have much better insights into the relevance of those cytokines and that immunobiology relevant to COPD. The PTS right now, we would put, probably technically success, we put standard levels on it for Phase 2 studies. So, we’re just waiting for data and with the data, we can then make decisions about where we go from here.

All right. Thank you, John. Second question was feedback on Cablivi.

On Cablivi. Great. Thanks for the question. So, we’re really pleased with the initial demand and usage in our early markets. And just to remind you, we’re now launched in Germany, Denmark, Austria, and of course, the U.S., and we’ll have some other Nordic countries that are planned to launch later this year. And, with each one of these, it’s building the market from scratch. This is something -- it’s a completely new, innovative therapy. And so, that takes a little time. But overall, we’re tracking well in each of the markets. And the feedback has been really quite impressive from physicians and patients. We’re hearing stories of lives that have been saved, and this has been really transformational. So it’s early, but so far, very pleased.

All right. Thank you, Bill. Thank you, Jordan. So, with that, I think it’s the end of our call. Again, I wanted to thank you very much for your interest in Sanofi, and with that wish you well. Thanks, everybody.

Thank you. That does conclude our conference for today. Thank you for participating. You may now disconnect.