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2011 - IR - Strategy and Outlook
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2011 - IR - Strategy and Outlook


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Strategy and Outlook - IR thematic seminar 2011

Strategy and Outlook - IR thematic seminar 2011

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  • 1. Forward Looking StatementsThis presentation contains forward-looking statements as defined in the Private Securities Litigation Reform Act of1995, as amended. Forward-looking statements are statements that are not historical facts. These statementsinclude projections and estimates and their underlying assumptions, statements regarding plans, objectives,intentions and expectations with respect to future financial results, events, operations, services, productdevelopment and potential, and statements regarding future performance. Forward-looking statements aregenerally identified by the words “expects”, “anticipates”, “believes”, “intends”, “estimates”, “plans” and similarexpressions. Although Sanofi’s management believes that the expectations reflected in such forward-lookingstatements are reasonable, investors are cautioned that forward-looking information and statements are subjectto various risks and uncertainties, many of which are difficult to predict and generally beyond the control of Sanofi,that could cause actual results and developments to differ materially from those expressed in, or implied orprojected by, the forward-looking information and statements.These risks and uncertainties include among otherthings, the uncertainties inherent in research and development, future clinical data and analysis, including postmarketing, decisions by regulatory authorities, such as the FDA or the EMA, regarding whether and when toapprove any drug, device or biological application that may be filed for any such product candidates as well astheir decisions regarding labelling and other matters that could affect the availability or commercial potential ofsuch products candidates, the absence of guarantee that the products candidates if approved will becommercially successful, the future approval and commercial success of therapeutic alternatives, the Group’sability to benefit from external growth opportunities as well as those discussed or identified in the public filingswith the SEC and the AMF made by Sanofi, including those listed under “Risk Factors” and “CautionaryStatement Regarding Forward-Looking Statements” in Sanofi’s annual report on Form 20-F for the year endedDecember 31, 2010. Other than as required by applicable law, Sanofi does not undertake any obligation toupdate or revise any forward-looking information or statements. 2
  • 2. Agenda 2008-2011 Transformation ● Christopher A. Viehbacher, Chief Executive Officer 2008-2011 Financial Discipline ● Jérôme Contamine, Executive Vice President, Chief Financial Officer 2012-2015 Key Drivers of Growth Platforms ● Emerging Markets Hanspeter Spek President, Global Operations ● Diabetes Pierre Chancel Senior Vice President, Diabetes ● Vaccines Olivier Charmeil Senior Vice President, Vaccines Break 3
  • 3. Agenda (cont’d) 2012-2015 Key Drivers of Growth Platforms (cont’d) ● Genzyme David Meeker, MD Chief Operating Officer, Genzyme ● Merial Jose Barella Chief Executive Officer, Merial ● Consumer Health Care Hanspeter Spek President, Global Operations 2012-2015 Financial Indicators & Capital Allocation ● Jérôme Contamine, Executive Vice President, Chief Financial Officer 2012-2015 Growth Outlook ● Christopher A. Viehbacher, Chief Executive Officer Wrap up and Q&A 4
  • 4. 2008-2011 TRANSFORMATIONChristopher A. ViehbacherChief Executive Officer
  • 5. Objectives for Today 1 Highlights of key achievements to date 2 Evolution of our growth platforms 3 Capital allocation and commitment to shareholder return 4 Growth perspectives beyond the patent cliff 6
  • 6. Agenda Industry transformation Strategy we are executing The new Sanofi 7
  • 7. 2008-2011The Pharmaceutical Industry Has Demonstrated Resilience Pressures on Industry Industry Responses ● Significant patent cliff looming ● Geographic expansion ● Fewer new blockbusters ● Diversification outside large branded Rx drugs ● Cost containment (e.g. U.S. healthcare reforms ● Increased Business Development and EU price cuts) ● More focus on operating ● Increased regulatory hurdles efficiency ● Reimbursement challenges ● New approaches to R&D 8
  • 8. 2008-2011The Sector Offers Attractive FCF and Dividend Yields European Healthcare Sector(1) Yields (%)10 9.4%8 Free Cash Flow Yield6 Dividend Yield4 4.2%20 Jan-88 Jan-89 Jan-90 Jan-91 Jan-92 Jan-93 Jan-94 Jan-95 Jan-96 Jan-97 Jan-98 Jan-99 Jan-00 Jan-01 Jan-02 Jan-03 Jan-04 Jan-05 Jan-06 Jan-07 Jan-08 Jan-09 Jan-10 Jan-11 (1) Actelion, Elan Corp, William Demant Hol, Shire, Straumann Hldg, Fresenius SE, Fresenius Med Care, Coloplast, Synthes Inc, Biomerieux, Essilor Intl, Smith & Nephew, Novo Nordisk AS, Merck KGAA, Getinge AB, Nobel Biocare AG, H.Lundbeck A/S, UCB, Ipsen, Celesio AG, Novartis AG, Sanofi, Roche Hldgs AG, GlaxoSmithKline, AstraZeneca 9 Source: Broker data
  • 9. 2008-2011Pharma Sector Offered One of Highest TSR in Last 3 Years Total Shareholder Return Total Shareholder Return (including distributions reinvested in equity; three years to Aug 2011) (including distributions reinvested in equity; three years to Aug 2011) 10.3% 11.0% 5.0% -1.0% -10.7% -10.2% -11.8% -18.2% -20.0% -22.9% Consumer Capital Telco Banks(1) Utilities(1) Durables Energy(1) Pharma(2) Media(1) CAC 40 S&P 500 Goods(1) Services(1) & Apparel(1) Equity indices Confident in resilience of the pharma sector in a volatile economic environment Source: FactSet as of August 26, 2011 (1) MSCI indices (2) Includes AstraZeneca, Bristol-Myers Squibb, Sanofi, Merck & Co, GlaxoSmithKline, Bayer, Novartis, Pfizer, Johnson & Johnson, Abbott Laboratories, Roche Holding and Eli Lilly & Co. on an equal-weight basis 10
  • 10. Agenda Industry transformation Strategy we are executing The new Sanofi 11
  • 11. 2008-2011Repositioning Sanofi for Sustainable Growth 2005-2008 2009-2011 2012 onwards Focusing on Generating Rx Blockbusters Transforming Sustainable Growth • Blockbuster drugs • Investing in growth platforms • Growing recurring sales • Patents challenged • Increasing diversification • Improving risk profile • R&D setbacks • Managing patent cliff 12
  • 12. 2008-2011Three Point Strategy We Are Executing 1 Increase innovation in R&D Sustainable Pursue external growth earnings 2 opportunities growth beyond 2012 Adapt structure for future 3 challenges and opportunities 13
  • 13. 1 Improving R&D: A Clear Progress ● Stress-test R&D portfolio ● Keep tight control of total R&D spend ● Reduce infrastructure costs ● Rigorous decision making process ● Open innovation In progress 14
  • 14. 1 Increasing Innovation in R&D Restructuring the organization 12 fewer R&D pharma sites (from 26 to 14) and 22% headcount reduction in 2011e vs. 2008 New governance policy Focusing on high-value projects A new R&D 2 new products filed mid-2011 approach 4 new drug filings expected before end Q1 2012 19 potential new launches before end 2015 Opening up to external innovation Multiple networks of excellence New head of R&D: Dr. Elias Zerhouni 15
  • 15. 2 Pursuing External Growth Opportunities Since January 2009: ● Acquired 23 companies Added 20% including Genzyme to 2011e ● Completed 61 in-licensing consolidated sales agreements growing to ~30% ● Entered 2 joint ventures in 2015 ● Invested a total of ~€23bn in external growth Demonstrated integration capabilities 16
  • 16. 3 Adapting Sanofi around Growth Platforms(1) Emerging Diabetes Human Markets(2) Solutions Vaccines ~ x1.5 ~ x1.5 ~ x1.2 €2.9bn €6.5bn €3.1bn 2008 2011e 2008 2011e 2008 2011e Consumer Animal Innovative Health Care Health(3) Products ~ x2.4 ~ x2.3 €1.2bn €0.9bn 2008 2011e 2008 2011e 2008 2011e (1) Expected sales are based on 1€=1.40$ (2) Excluding Genzyme (3) 50% of Merial sales in 2008 17
  • 17. 3 Transforming our Organization with a Renewed Management Team with Significant Global Experience Christopher A. Viehbacher Jérôme Contamine Elias Zerhouni Chief Executive Officer Executive VP President Chief Financial Officer Global R&D David-Alexandre Gros Hanspeter Spek Olivier Charmeil Chief Strategy Officer President Senior VP Global Operations Vaccines Philippe Luscan Karen Linehan Roberto Pucci Senior VP Senior VP, Legal Affairs Senior VP Industrial Affairs & General Counsel Human Resources 18
  • 18. Agenda Industry transformation Strategy we are executing The new Sanofi 19
  • 19. 2008-2011The New Sanofi We Have Been Building Past Today Geographic balance U.S. / Western Europe Global Exposure to High Declining patent cliff R&D Dependence Above average Below average Functional Business oriented Organization silos divisions Top down and Collaborative Culture inward looking and open Risk profile High Balanced 20
  • 20. 2008-2011An Unprecedented Shift in Business Mix and Focus From …to Key Growth Platforms Top 15 Products… & Genzyme Sales Split in 2008 Sales Split in 2011e €27.6bn Base business Growth 29% Platforms & Other Top 15 Genzyme 25% 61% Vaccines ~ 66% 10% Key Genericized 9% Genzyme Key genericized products: Lovenox® U.S., Plavix® Western EU, Taxotere® Western EU & U.S., Eloxatin® U.S., Ambien CR® U.S., Allegra® U.S., Aprovel® Western EU, Xyzal® U.S., Xatral® U.S., Nasacort® U.S. - Generic makers of oxaliplatin (Teva, Fresenius Kabi (formerly Dabur), Sandoz, Mayne/Hospira, MN/Par, Actavis and Sun) required to cease selling in the U.S. since June 30, 2010 but litigation continues. 21
  • 21. 2008-2011Successfully Managing the Top Line Transition Getting the Patent Cliff … while Ramping up behind us… Key Growth Platforms & Genzyme Sales of key genericized products(1) Sales of growth platforms(2) & Genzyme + >€10bn - €4.6bn >€22bn €18.4bn €7.6bn €13.8bn €7.5bn €11.8bn €5.4bn ~€3.0bn 2008 2009 2010 2011e 2008 2009 2010 2011e% of % of 27% 25% 17% ~9% 43% 47% 57% ~66%Total Total (1) Lovenox® U.S., Plavix® Western EU, Taxotere® Western EU & U.S., Eloxatin® U.S., Ambien CR® U.S., Allegra® U.S., Aprovel® Western EU, Xyzal® U.S., Xatral® U.S., Nasacort® U.S. - Generic makers of oxaliplatin (Teva, Fresenius Kabi (formerly Dabur), Sandoz, Mayne/Hospira, MN/Par, Actavis and Sun) required to cease selling in the U.S. since June 30, 2010 but litigation continues. 22 (2) 2010 include sales of Merial. In 2008 and 2009, Merial Joint Venture sales were not consolidated by Sanofi
  • 22. 2008-2011Offsetting the Impact of the Patent Cliff on Sales Sales €30.4bn €29.3bn €27.6bn CAGR ~+6% at CER(1) 2008 2009 2010 2011e (1) 2008 exchange rates 23
  • 23. 2008-2011Mitigating the Impact of the Patent Cliff on EPS Business EPS -2% to -5% €7.06 at CER(1) €6.64 CAGR from €5.59 +3% to +4% at CER(2) 2008 2009 2010 2011e Positive impact from growth platforms, (1) 2010 exchange rates cost savings and acquisitions (2) 2008 exchange rates 24
  • 24. IN SUMMARYEntering into the Next Phase● Sanofi has undergone an impressive transformation over 2008-2011● Sanofi’s patent cliff will be over in 2012, leading to one of the lowest patent exposures, post cliff● R&D rigor has allowed us to create an emerging pipeline of higher quality assets Development has been rationalized and is now state-of-the-art● Focus shifts now to execution: ● Growth of platforms ● New approach to research ● Continued discipline on costs 25
  • 25. 2008-2011 FINANCIAL DISCIPLINEJérôme ContamineExecutive Vice President, Chief Financial Officer
  • 26. Agenda Progress on cost savings Realigning the organisation Disciplined M&A Profitability in growth platforms 27
  • 27. 2008-2011€2bn Cost Savings - Progressing Faster than Anticipated Cost Savings(1) €2bn €1.3bn ● Original plan was €2bn(1) by 2013 ● Will achieve target 2 years ahead of schedule €0.5bn Plan Actual Plan Actual Plan Revised 2009 2010 2011e (1) At CER, before inflation and tax on a constant structure basis compared to 2008 28
  • 28. 2008-2011Tight Cost Control while Investing in Growth Platforms CoGS Expenses Investing in Growth Platforms R&D SG&A Expenses Expenses 29
  • 29. 2008-2011CoGS Ratio Peaking at around 31% in 2011/2012 CoGS Ratio ● Degradation of reported CoGS CoGS ratio 33.8% excluding 33.5% 33.3% ~33% ratio as anticipated from key 2008 to 2011 genericized ● Loss of exclusivity of former products(1) blockbusters ● Higher cost of raw heparin: negative impact >1% in 2011e vs. 2008 28.8% ~31% Reported 26.6% 26.8% ● Productivity improvement CoGS ratio resulting in decrease of CoGS ratio excluding key genericized products(1) 2008 2009 2010 2011e (1) Lovenox® U.S., Plavix® Western EU, Taxotere® Western EU & U.S., Eloxatin® U.S., Ambien CR® U.S., Allegra® U.S., Aprovel® Western EU, Xyzal® U.S., Xatral® U.S., Nasacort® U.S. - Generic makers of oxaliplatin (Teva, Fresenius Kabi (formerly Dabur), Sandoz, Mayne/Hospira, MN/Par, Actavis and Sun) required to cease selling in the U.S. since June 30, 2010 but litigation continues. 30
  • 30. 2008-2011Reduced R&D Infrastructure Costs and HeadcountPharma R&D Infrastructure Costs(1) Pharma R&D Headcount(1) ~ -12% ~13,000 ~ -22% €939m ~€830m ~10,000 54% 2008 2011e 2008 2011e (1) Excluding Genzyme 31
  • 31. 2008-2011A Deep Dive on Structural Changes in R&D Pharma Spend Pharma R&D Spend(1) R&D costs R&D costs R&D costs Research Development evolution split between split between costs split costs split (projects, internal & Research & between between infrastructure, external Development internal & internal & support) (excluding (excluding external external infrastructure) infrastructure) (excluding (excluding infrastructure) infrastructure) -15% between 50/50 33/66 70/30 40/60 2008 and in 2011e in 2011e in 2011e in 2011e 2011e Our focus remains on improving the ratio of fixed vs. variable costs (1) Excluding Genzyme, Phase IV studies, local studies and medical support 32
  • 32. 2008-2011Refocusing Investment from Infrastructureto Licences/Acquisitions Pharma R&D Capital R&D Investments(1) in Expenditures Licences and Acquisitions €577m €392m €334m €300m Vaccines €165m Pharma 54% €72m 2008 2009 2010 2011e 2008 2009 2010 2011e (1) Including BiPar, Fovea, TargeGen, but excluding Genzyme 33
  • 33. 2008-2011Keeping SG&A Expenses under Tight Control SG&A/Sales Ratio ● 2008-2010: >1 ppt reduction in SG&A ratio 26.0% 25.0% 24.9% ● Significant restructuring of sales forces in the U.S. and Europe ● Resource reallocation towards growth platforms ● Acquisitions of businesses with higher relative sales and marketing expenses ● 2011: Slight increase in SG&A ratio due to integration of Genzyme 2008 2009 2010 2011e 34
  • 34. 2008-2011Successfully Navigating through the Patent Cliffdespite a Tougher Environment Pressure on Rx Pharma in Mature Markets ● U.S. healthcare reform ● EU price containment ● ~$220m reduction in sales measures in 2010 ● Cumulated impact of ● ~$90m impact from excise ~€470m on sales in 2011 fee in 2011 versus 2009 ● ~$100m impact from “donut hole” 35
  • 35. Agenda Progress on cost savings Realigning the organisation Disciplined M&A Profitability in growth platforms 36
  • 36. 2008-2011Adapting Industrial Site Network with LargerFootprint in Emerging Markets Number of Industrial Sites (including 2008-2011 acquisitions except Genzyme and Merial) Mature Markets Emerging Markets 42 43 40 41 38 38 36 Pharma 37 35 36 31 Pharma 35 6 6 7 Vaccines 6 Vaccines 3 4 2009 2011 Ongoing 2009 2011 Ongoing Plan Plan 37
  • 37. 2008-2011Reshaping of Commercial Operations in the U.S. and EU ● U.S. restructuring announced ● EU organisation redesigned in 2010 ● Sales force reduction by ~2,700 ● Sales force reduced by ~3,800 people over 2008/2011e people over 2008/2011e ● Implementation of 8 Multi-Country Organisations ● Investment in mature brands significantly decreased & ● Targeted resource allocation towards growth platforms 38
  • 38. 2008-2011Alignment of Resources to Match High Growth Opportunities Sales Force Evolution since 2008(1) U.S. Western Europe Emerging Markets +22% 20,246 ~20,800 17,080 8,313 ‐46% ‐34% 7,971 5,822 6,167 ~5,300 ~4,500 2008 2010 2011e 2008 2010 2011e 2008 2010 2011e (1) Excluding Merial and Genzyme 39
  • 39. Agenda Progress on cost savings Realigning the organisation Disciplined M&A Profitability in growth platforms 40
  • 40. 2008-2011Discipline in M&A ● Return on capital has to exceed WACC after tax Rigorous financial between Year 3 and Year 5 following the evaluation criteria acquisition Geographic complementarities Rationale for business synergies with existing Growth Platforms Portfolio complementarities Business opportunities with attractive sustainable growth profile 41
  • 41. 2008-2011Strong and Rapid Value Creation from Key Acquisitions ROCE expected to exceed WACC after tax Year 1-2 Year 3-4 Strong value creation in Brazil and beyond Successful launch of Allegra® OTC Large expertise in Branded Generics in Eastern Europe Strong position in Animal Health Unique expertise in Rare Diseases 42
  • 42. Agenda Progress on cost savings Realigning the organisation Disciplined M&A Profitability in growth platforms 43
  • 43. 2008-2011Solid Profitability of our Different Activities 2011e Business Operating Margin Pharmaceuticals excluding Plavix®/Avapro® in the U.S. ~29%  Diabetes(1) ~35%  Consumer Health Care(1) ~25%  Generics(1) ~18%  Genzyme(2) ~27% Vaccines ~29% Animal Health ~31% Total Group excluding Plavix®/Avapro® in the U.S. ~29% (1) Figures estimated assuming allocation of indirect costs proportional to sales (distribution, G&A, medical marketing) and R&D costs (R&D infrastructure) (2) Historical Genzyme perimeter 44
  • 44. 2008-2011Sustainable Profitability in Emerging Markets ● Sustain solid and stable operating margin excluding central, administrative and R&D costs: ● Around 40%(1) ● Unique ability to manufacture locally ● Lower selling costs ● Limited G&A expenses ● Regional pricing (1) Estimate for Business Operating Margin excluding central administrative and R&D costs in 2011 45
  • 45. IN SUMMARYAn Impressive Transformation is Underway Cost savings ahead of target Control over key financial ratios A disciplined approach to M&A Growth platforms all solidly profitable and growing 46
  • 46. EMERGING MARKETSHanspeter SpekPresident, Global Operations
  • 47. Agenda Emerging Markets opportunity Sanofi’s leadership Growth drivers in BRIC countries and beyond 48
  • 48. Macro Factors Point to Strong Growthin Emerging Markets Emerging Markets Population(1) 6bn Estimated GDP growth 2010-2015(2) 5-9% Healthcare expenditure as % of GDP(3) 5-6% Estimated Pharmaceutical Market growth CAGR 2010-2015(4) 13-16% Annual birth cohorts(5) 120m Large middle class by 2030(6) ~2bn (1) IMF; CIA The World Factbook (2) IMF; internal analysis (3) IMF; WHO 2008 (4) IMS Pharmerging Markets CAGR 2010-2015 (5) WHO, World Population Prospects: The 2010 revision; CIA The World Factbook 49 (6) Brookings Institution; Goldman Sachs
  • 49. Growth Contribution from Emerging Markets to be >70% Opportunities and Challenges World Pharmaceutical Market(1) Sales Split Contribution● Growing and aging populations to Growth €837bn● Shift from acute to chronic diseases €656bn● Need for greater access to medicines 26% 64%● Cost burden on governments 74% and healthcare reforms● Largely out-of-pocket markets 36% 74%● Increased investment from all 26% market players 2010 2015e Mature Markets Emerging Markets (1) IMS Market Prognosis, 2011-2015 50
  • 50. Agenda Emerging Markets opportunity Sanofi’s leadership Growth drivers in BRIC countries and beyond 51
  • 51. Emerging Markets Growth Historically at Double-digitRates from a Large Base Sanofi’s Performance in Emerging Markets(1) ● Leading position built on historical ~€10bn strengths +15% ● Around €10bn of sales in Emerging Markets expected in 2011e +9% ● ~30% of Group sales in€5.0bn Emerging Markets in 2011e vs. 24% in 2008 ● Most active company in M&A in last 3 years in Emerging Markets resulting in accelerated sales growth(2)2005 2006 2007 2008 2009 2010 2011e (1) The world less the U.S. and Canada, Western Europe, Japan, Australia and New Zealand (2) Internal estimates 52
  • 52. Sanofi is the #1 Healthcare Company in Emerging Markets Sanofi’s Scorecard in Emerging Markets(1)Number one A top position Largest One of the A wide A commercialcompany in in most of the proportion of biggest sales network of presence in a Emerging fast growing sales generated forces in industrial sites large number Markets by economies in Emerging Emerging across of Emergingmarket share Markets Markets Emerging Markets among peers Markets #1 #1 >30% ~21,000 42 ~100 with in BRIC of global sales industrial countries with 5.5% market and sales representatives sites commercial share non-BRIC presence (1) IMS MIDAS MAT Q1 2011 (with constant Brazil retail panel scope) 53
  • 53. Growing Exposure to Emerging Markets witha Broad and Diversified Offering Emerging Market Sales and % Represented by Emerging Markets per Segment(1) Diabetes Animal Health(2) Other Pharmaceuticals(3) €4,614m €528m €355m 20% 28% 24% 2008 2011e 2008 2011e 2008 2011e Vaccines Consumer Health Care Generics €814m €551m 48% 34% 65% €33m 2008 2011e 2008 2011e 2008 2011e (1) Without Genzyme (2) Merial sales not consolidated in 2008 (3) Pharmaceuticals excluding Diabetes, CHC and Generics 54
  • 54. Significant Contribution from Legacy Brandsin Emerging Markets despite Generic Competition Top Brands in Sales 2011e in % of Global Product Sales Growth Emerging Markets Emerging Markets Sales in 2011e H1 2011 (at CER) ~€730m 35% +8.3% ~€540m 26% +12.7% ~€370m 29% +11.4% ~€310m 33% -23.5% ~€250m 53% +7.2% ~€220m 59% +12.6% ~€200m 48% +0.1% ~€160m 15% +12.9% 55
  • 55. Building a Tailored Portfolio in Emerging Marketsthrough Multiple Acquisitions and Partnerships Adjusting our Offerings to Local Needs in Fast Growing Market Segments ● A total of 17 deals since 2008 ● Addressing income disparities Generics ● Tapping into out-of-pocket and markets Consumer Health Care ● Adding local brands ● Invested a total of around €3.7bn in acquisitions 56
  • 56. Agenda Emerging Markets opportunity Sanofi’s leadership Growth drivers in BRIC countries and beyond 57
  • 57. Consolidating Sanofi’s #1 Position in Brazil Opportunity Focus● Expected to be 6th largest market by 2015(1) ● Tailored approach with leading presence in each market segment ● Largely out-of-pocket ● Launch generics of high-demand ● Rising middle class with increased off-patent Rx drugs purchasing power ● Leverage broad CHC portfolio through ● Growth driven by generics and volume extended distribution channels● Sanofi ranks #1 in Brazil(2) ● Strengthen Diabetes leadership ● Sales of ~€1.2bn in 2011e in private and public market ● #1 in Generics(3) and #2 in CHC(4) ● Leverage strong presence at pharmacy ● Sales force covering >25,000 points of sales (>80% of total demand) ● Strong local manufacturing capabilities (> 90% of products manufactured locally) (1) IMS Market Prognosis, 2011-2015 market ranking in constant US$ (2) IMS PMB MAT June 2011 (restated base), 1€ = 2.30 (3) Estimated from IMS MIDAS MAT Q1 2011 (4) Nicholas Hall, DB6 2011 (2010 sales) 58
  • 58. Sanofi Covers Fastest Growing Market Segments in Russia Opportunity Focus● Expected to be 10th largest market by 2015(1) ● Maximize the advantage of local insulin manufacturing capacity ● Hybrid market with out-of-pocket and reimbursed funding ● Lead conversion to modern basal insulin analogs ● Strong historic market growth ● Low rates of diagnosis and ● OTC and Generics are large and fast insulinization provide opportunity growing segments(2) ● Regional market segmentation ● Increased government attention to ● Drive leadership in CHC through higher healthcare market (e.g. Pharma 2020) investment in marketing mix● Sanofi ranks #2 in Russia(3) ● Offer high quality generics at affordable ● Sales of ~€750m in 2011e prices ● #3 in OTC(4) market (Essentiale®, No-Spa®) ● Zentiva: one of the fastest growing players in Generics(5) (1) IMS Market Prognosis, 2011-2015 market ranking in constant US$ (2) Estimated from IMS MAT Q1 2011 : Market shares of Generics and OTC are 33%. Generics and OTC are growing 13% (3) IMS MIDAS MAT Q1 2011 (4) Nicholas Hall, OTC YearBook 2011, DB6 2011 (2010 sales) (5) IMS MIDAS MAT Q1 2011. Zentiva growth: +27% 59
  • 59. A Fast Expanding Industrial Hub in India Opportunity Focus● Expected to be 8th largest market by 2015(1) ● Expand ‘Prayas’ project to improve quality of healthcare in rural India ● Highly fragmented with >10,000 players ● Quality medicines at affordable prices ● Growing population and shifting disease profile ● Enter CHC with Universal deal ● Need for better accessibility and ● Provide high quality & affordable production delivery of healthcare in rural areas resources to support expansion strategy in Emerging Markets ● Private healthcare accounts for nearly 80% of total healthcare spend● Sanofi is present in India for >55 years ● 2nd fastest growing multinational company(2) ● 4 industrial sites (~7bn tablets annually) (1) IMS Market Prognosis, 2011-2015 market ranking in constant US$ (2) IMS MIDAS MAT Q1 2011 60
  • 60. Reaching out to the Next Billion Customers in China Opportunity Focus● Expected to be 3rd largest market by 2015(1) ● Diversify geographic concentration ● Healthcare reform to improve ● Fully leverage broad portfolio infrastructure and to address affordability issues ● Invest in the county hospital market ● Strategic Business Unit implemented ● Growing demand of ~900m people in China’s 2,000 counties(2) ● Sales force expansion by ~1,000 representatives● Sanofi ranks #3 company in China(3) ● Expand CHC business ● Sales of ~€1bn in 2011e for Greater China ● Shape market through public-private ● Fastest growing multinational company(3) partnerships ● Support of “China Alliance ● Sales force of 4,500 reps for Diabetes Excellence“ ● 6 industrial sites (1) IMS Market Prognosis, 2011-2015 market ranking in constant US$ (2) Includes county-level cities and counties (3) IMS MAT June 2011 61
  • 61. Beyond BRIC, Well Poised to Capture Growthin Other Fast Growing Economies ~€10bn Total Emerging Markets Sales in 2011e Sanofi Leadership Large Countries Position Population with Scale outside BRIC(1) BRIC Non-BRIC #1 in Africa and 10 35% Middle East ## countries with 65% #2 in CEE sales between ~3bn €100m and #2 in LatAm €500m #4 in Asia in 2010 BRIC: Brazil, Russia, India, China (1) IMS MIDAS MAT Q1 2011 62
  • 62. Key Success Factors to Sustain our UnmatchedLeadership Position in Emerging Markets Historical ● Leverage unique accumulated experience presence and diversified product portfolio Market reach ● Expand sales forces to address rural areas Manufacturing ● Grow network of industrial sites to serve increasing volume capacity Quality of ● Attract, train and retain local management talent management Tapping into ● Broaden R&D networks in Asia local innovation Bolt-on ● Continue to enlarge our portfolio by successfully acquisitions identifying and integrating M&A targets 63
  • 63. DIABETESPierre ChancelSenior Vice President, Diabetes
  • 64. AgendaMarket opportunitiesDelivering full value of current portfolioSustaining long term growth through R&D 65
  • 65. Diabetes Remains One of the Largest Opportunitiesin the Healthcare Space Adults with diabetes worldwide(1) 350m % of patients not achieving glycemic control target values in the U.S. and EU(2) >50% Patients remaining undiagnosed in BRIC countries(3) ~2/3 Expected CAGR growth of global diabetes market between 2011 and 2015(4) 4-7% Expected size of global diabetes market in 2015(4) $43-48bn (1) G. Danaei, Lancet 2011; 378: 31-40 (2) Adelphi Disease Specific Program (DSP) III and VII (sample of over 10,000 diabetic patient records) (3) Internal estimates based on multiple sources 66 (4) The Global Use of Medicines: Outlook through 2015, IMS Institute for Healthcare Informatics, May 2011
  • 66. The Diabetes Epidemic is Expandingin Emerging Markets Key Epidemiology Facts People with diabetes 2010 26m 24m 56m 9m Rate of diagnosis 75% 75% 36% 58% Expected diabetes +14% +9% +34% +14% population growth 2010-2015 Insulinized patients 2010 5.6m 5.1m 4.6m 1.3m Expected insulinized 6.9m 6.4m 8.9m 1.7m patients 2015 Source: IMS data and internal patient model 67
  • 67. AgendaMarket opportunitiesDelivering full value of current portfolioSustaining long term growth through R&D 68
  • 68. Lantus® #1 Insulin Brand Worldwide – A Growth Story Lantus® Global Sales €3.5bn €3.1bn €2.5bn €2.0bn €1.7bn €1.2bn 2005 2006 2007 2008 2009 2010 2011e 120m Lantus® SoloStar® pens sold in 2010 69
  • 69. Key Pillars to Fuel our Ambition ) (1 ts rke Ma ns t io in g solu g d er ase ® b Em s - in tu n Lan n sio nd to an ® a ® br a m E xp us d Insu • L ant dra ® an rom Api • F ith nw itio a mb New P-1s • e of GL ® to exp and us mia • Lyxu rbidities ressed card iovascular mo • T ackling unadd 9 mAb K with anti-PCS (1) The world less the U.S. and Canada, Western Europe, Japan, Australia and New Zealand 70
  • 70. Ability to Grow Insulin Market Share in U.S. and EU U.S. Insulin Market EU Insulin Market Value Share Value Share 37% 37% 34% 30% June 08 June 11 June 08 June 11 Volume Share Volume Share 33% 28% 28% 24% June 08 June 11 June 08 June 11 Eli Lilly Novo Nordisk Sanofi IMS data – Monthly basis – June 2008 to June 2011 71
  • 71. Sanofi - Fast Growing Insulin Player in BRIC-M BRIC-M Insulin Market(1)Growth yoy % Insulin Sales (constant €) 50% ● Historical focus on value market 40% ● Opportunity for volume expansion 30% Sanofi ● Strong leadership position in diabetes in Brazil and Mexico(2) 20% ● Renewed efforts to expand Novo basal treatment paradigm 10% in China ● New manufacturing site for 0% Lilly Lantus® SoloSTAR® in China ● Acquisition of Bioton Wostok- 10% insulin plant in Russia in 2010 0% 10% 20% 30% 40% 50% Market Share % (1) IMS Monthly data base – MAT June ’11 vs MAT June ’10 (Data for Russia only reflect IMS retail channel) (2) IMS sales MAT June ’11 72
  • 72. 2012-2015: Set to Remain #1 Diabetes Brand From Lantus® Brand to Lantus®-Based Solutions & Emerging Markets ● Now 40% of U.S. ● Encouraging launches in ● Further market access Lantus® new France & Germany initiatives ongoing prescriptions with ● Disease management SoloSTAR® ● Roll-out in key markets expected to be ● Treatment paradigm ● Majority of U.S. patients completed by end 2012 ● Tiered pricing expected to use ● Type-1 diabetes SoloSTAR® by 2015 ● Development ongoing to integrate advice for Lantus® dosing 73
  • 73. Testing Early Insulinization with Lantus® for Better Long Term Outcomes >12,500 Patients Trial Results Expected Mid-2012At high CV risk• and IFG, IGT• or newly detected diabetes• or established diabetes Lantus® label improvement Main Endpoints Endpoints if trial endpoints met• CV morbidity/mortality• All-cause mortality Potential benefits of early insulinization• Risk of diabetic Additional data on disease control microvascular outcomes on Lantus®• Rate of progression of IFG or safety profile IGT to Type 2 diabetes CV – Cardiovascular IFG – Impaired fasting glucose IGT – Impaired glucose tolerance 74
  • 74. Continuous Commitment to Safety Epidemiology Program Ongoing Retrospective cohort studies Case-control studyNordic databases U.S. databases International Study on Insulin and Cancer (France, UK and Canada)Communication to regulatory agencies Communication to regulatory agencies in Q4 2011 (Nordic) and Q1 2012 (U.S.) by Q1 2013 Scientific presentation in 2012 Scientific presentation in 2013 75
  • 75. Is the Gold Standard Basal Insulin Indirect comparison of event rates using same hypo definition as respectively shown in Degludec NN-3579 ● Indirect comparison of nocturnal event and two Sanofi glargine studies (3002, 4009) rates in the Lantus® arm from the Nocturnal confirmed hypoglycemia over time (weeks) Novo-3579 study vs. Sanofi studies shows a different pattern of cumulativeNocturnal hypoglycaemia Degludec NN-3579 study(1) T2–BOT (n=1030) Glargine curves (events/subject) End trial HbA1c: ~7.0% ● In representative* Sanofi glargine Degludec trials nocturnal hypo rates are consistent despite different glycemic control achieved at end of trials(2,3) ● Factors other than end of trial HbA1c or FPG may contribute to an increase Nocturnal confirmed hypoglycemia over time (weeks) occurrence of nocturnal hypoglycemia for the Lantus® arm in Novo-3579 trialNocturnal hypoglycaemia Glargine 3002 study(2),T2–BOT (n=570) End of trial HbA1c: 8.5% such as (events/subject) Glargine 4009 study(3),T2-BOT (n=624) ● Unusually aggressive titration target End of trial HbA1c: 7.2% (70-90 mgl/dL FPG) in Degludec trials Glargine (4009)(4) ● Lack of enforcement of same time of injection for the study drug and the gold standard comparator (e.g. dinner Glargine (3002)(4) time vs any time of the day(1)) * 3002 study representing a non treat-to-target trial design * 4009 study representing a treat-to-target trial design 1) As presented at Novo Nordisk Capital Markets Day on May 5th, 2011 2) Massi Benedetti et al, Horm Metab Res 2003; 23:189-196 3) Standl et al, Diabetes Care 2005; 28 (2): 419-420 4) Calculated from each study using confirmed hypoglycemia of PG <3.1 mmol/L; data on file.
  • 76. Delivering the Full Value of Other Portfolio Assets Established Insulins● New ambition with Apidra® ● New U.S. sales and marketing platform • Dedicated sales force since July 2011 ● Expansion in Asia • Accelerate penetration in Japan Optimized Devices • Partnered with IDF and Chinese Diabetes Society to help building the first Type 1 diabetes registry • Launch expected in 2012 in China● Untapped opportunities for Insuman® Innovative Blood ● Regulatory submission anticipated in 2011 Glucose Monitoring in South-East Asia ● Short-acting and pre-mixed forms currently in Phase III in China ● SoloStar® submission in Russia expected by end 2011 IDF: International Diabetes Federation 77
  • 77. AgendaMarket opportunitiesDelivering full value of current portfolioSustaining long term growth through R&D 78
  • 78. Six R&D Projects with a Goal of Submission in 2011-2015 Products in Development / Status Update Major LCM Activities Lyxumia® (lixisenatide) Planned submissions for EU in Q4 2011, GLP-1 agonist Type 2 diabetes Japan mid-2012, U.S. in Q4 2012 Lantus® Phase III Insulin glargine ORIGIN study results expected mid 2012 Reduction in CV morbidity & mortality Insuman® (Asia) Human insulin vials and cartridges Phase III ongoing in China Type 2 diabetes Submissions ongoing in SE-Asia SAR236553 Phase II Anti-PCSK-9 mAb Entered Phase II in Q1 2011 – Fully enrolled Hypercholesterolemia Lantus® + lixisenatide Insulin glargine + GLP-1 agonist Initiation of Phase III expected early 2013 Single pen device / Type 2 diabetes Phase I(1) New formulation Insulin glargine Phase I trials completed in Q3 2011 Type 1 + 2 diabetes (1) Also includes other Phase I projects which are not for submission before 2015 and therefore not mentioned here, i.e. SAR407899 and SAR101099 Partners: Lixisenatide (AVE0010): Zealand Pharma, SAR236553 (REGN727): Regeneron 79
  • 79. ® Broad Phase III Program Including as Add-on to Basal Insulin Phase III Program Drug naïve patients GetGoal‐Mono  GetGoal‐Mono Japan GetGoal‐F1 (metformin)  GetGoal‐S (sulfonylurea)   Placebo controlled in OAD failure GetGoal‐M (metformin)  GetGoal‐P (pioglitazone)  GetGoal‐M Asia (metformin)  Active‐controlled GetGoal‐X vs. exenatide  Placebo controlled on  GetGoal‐L Asia (basal insulin)  top of basal insulin GetGoal‐L (basal insulin)  CV Study ELIXA  ReportedLyxumia® is the intended trademark for lixisenatide. Lixisenatide is currently not approved or licensed anywhere in the world. 80
  • 80. ® : First Data Leading To Unique Profile ®● Main efficacy A1c(1) endpoint met in all studies● Pronounced effect on post-prandial glucose(2)● Decrease in body weight as monotherapy or in combination with OAD or basal insulin(2)● Promising safety profile vs. exenatide twice daily(3) ● 3-fold fewer symptomatic hypoglycemic events ● Better gastrointestinal tolerability● Simplicity for enhanced compliance ● 1 injection per day ● 1 step to maintenance dose(4) ● 1 single pen device per dose ~90% of patients stayed on maintenance dose Lyxumia® is the intended trademark for lixisenatide. Lixisenatide is currently not approved or licensed anywhere in the world. (1) A1c used for HbA1c – Glycated hemoglobin (2) GetGoal program (3) GetGoal-X (4) GetGoal-F1 81
  • 81. ® Ideal Partner to Basal Insulin● High willingness of physicians to use GetGoal-L Asia GLP-1s as add-on to basal insulin(1) Subgroup analysis of Lantus® users(4) A1c change from baseline (%)● More than 7m patients receiving Placebo Lyxumia® Lantus® worldwide(2) Patient, N 93 94 Baseline A1c 8.45 8.43● GetGoal-L & -L Asia to support +0.02 indication as add-on to basal insulin Mean Change (%)● [Lyxumia® + Lantus®] combination moving forward ● “Free combination” Phase III trial(3) expected to complete by end 2011 ● Injection device in development to allow Lantus® variable dose and Lyxumia® fixed dose -0.89 LS Mean Difference vs. Placebo p<0.0001 Lyxumia® is the intended trademark for lixisenatide. Lixisenatide is currently not approved or licensed anywhere in the world. (1) >30% of GLP-1 users receive insulin in the UK. Source: ABCD (Association of British Clinical Diabetologists) Audits, B. Ryder at the Diabetes UK Annual Professional Conference (April 2011), and (2) IMS Full year data 2010, Adelphi DSP VII, internal estimates (3) Trial EFC10781 / “Free combination” means Lyxumia® (vs. Placebo) after Lantus® titration in patients insufficiently controlled with MET +/- TZD 82 (4) >60% of patients previously on Lantus® in GetGoal-L Asia
  • 82. Anti-PCSK9 mAb - A Significant Opportunity to TackleUnaddressed Cardiovascular Morbidities LDL-C Mean % Change from Baseline(1) Subcutaneaous Injection of SAR236553 or Placebo ● New ESC/EAS guidelinesLS Means Calculated LDL-C recommend more stringent Percent Change (%) LDL-C target for very high 20 risk patients including 10 diabetic patients with target 0 organ damage(2) - 10 - 20 ● Only 41% of very high risk - 30 - 60% patients reach the newly - 40 defined goals with current - 50 lipid lowering therapies(3) - 60 - 70 ● Phase II results expected in 0 10 20 30 40 50 60 70 80 90 100 110 H1 2012 Study Days Placebo A B C D (1) Swergold G. J Am Coll Cardiol 2011;57:E2023 (2) ESC/EAS guidelines on dyslipidemia European Heart Journal (2011) 32, 1769–1818 (3) Virani American Heart Journal 2011; 161:1140-6 83
  • 83. Diabetes: Focusing on Sustainable Growth Expansion in Emerging Markets From Lantus® brand to Lantus®-based solutions New ambition with Apidra® and Insuman® Lyxumia® to expand use of GLP-1s Tackling unaddressed cardiovascular morbidities with anti-PCSK9 mAb (1) CAGR 84
  • 84. VACCINESOlivier CharmeilSenior Vice President, Vaccines
  • 85. AgendaThe vaccines marketSanofi Pasteur leadershipGrowth drivers 86
  • 86. Vaccines Market – All the Key Attributes for aGrowth Platform Major unmet needs remain ● Large birth cohorts in Emerging Markets ● Many diseases with low immunization rates or no vaccines ● Expansion opportunity in adult segment Vaccines Barriers to market entry are high Market ● Complex biological processes ● Rigorous manufacturing and regulatory standards ● Expertise required in many technologies ● Reliability and commitment to public health key to market access 87
  • 87. Top 5 Companies Have Combined ~80% Market Share 2010 Market Share(1) excluding A/H1N1 Global Market Sales(2): Others Sanofi 19% ~€17bn Novartis Pasteur 5% 21% Pfizer 16% GSK 20% Merck 18% Sanofi Pasteur: a leading global player (1) Market share based on Sanofi Pasteur internal estimates (2) Excluding pandemic influenza Sanofi Pasteur MSD sales allocated 50/50 to Merck and Sanofi (minus supply sales from JV partners to SP MSD) 88
  • 88. Global Vaccines Market Growth to Remain Healthy Projected Worldwide Vaccines Market Sales CAGR(1) +6 to 7% €23bn 2012e 2013e 2014e 2015e (1) 2012-2015 CAGR based on Sanofi Pasteur internal estimates 89
  • 89. AgendaThe vaccines marketSanofi Pasteur leadershipGrowth drivers 90
  • 90. Sanofi PasteurGreat Fundamentals to Capture Future Growth● Leading commercial presence Broad Product Offering ● €3.8bn consolidated sales in Sales Split 2011e 2010(1) ● >1bn doses produced per year Polio/  Flu Pertussis/  ● Present in 150 countries 27% Hib ● Leadership position in pediatrics, 31% flu, meningitis, travel & endemic● Promising R&D pipeline Other ● 13 projects in clinical 6% Meningitis/  development, including Dengue Travel &  Pneumo Endemics 13% ● Strong record of alliances Boosters 11% 12% (1) Including €452m of pandemic influenza revenues (A/H1N1) 91
  • 91. World Class Industrial Operations Sanofi Pasteur Industrial Sites Swiftwater (PA) Canton (MA) Toronto Marcy-l’Etoile Rockville (MD) Val de Reuil Neuville Shenzhen Ocoyoacac Hyderabad Chachoengsao(1) Pilar €1bn investment in production capacity in last 5 years to meet global demand (1) Joint Venture: GPO-MBP 92
  • 92. AgendaThe vaccines marketSanofi Pasteur leadershipGrowth drivers 93
  • 93. Two Strategic Imperatives for 2012-2015 1 2 Defend and Reinforce Position Aggressively Pursue Growth in Mature Markets(1) Opportunities in Emerging Markets(2) ● Value creating opportunities through ● Large population and birth cohorts product differentiation ● Low immunization rates ● Still room for expansion of coverage ● Economic growth driving demand ● Concentrated competition and public funding Market Market CAGR +4%(3) €14bn CAGR +11%(3) €9bn 2012e 2013e 2014e 2015e 2012e 2013e 2014e 2015e (1) U.S, Canada, Western Europe, Australia, New Zealand, and Japan (2) World less North America, Western Europe, Japan and Australia/New Zealand (3) Estimated CAGR 2012-2015 for the vaccines market based on Sanofi Pasteur internal estimates 94
  • 94. Key Growth Drivers Mature Markets – Flu vaccines U.S. – Enhanced performance of JV with Merck in EU – Expansion in Japan Emerging Markets – Pediatric combos – BRICM – Dengue Strong Pipeline 95
  • 95. 1 MATURE MARKETSFlu Vaccines Will Drive U.S. Sales Growth in 2012-2015 Sustained leadership and value creation Segmentation expected to be through differentiation completed by 2015 Value Marketed Fluzone® Quadrivalent:70m doses; 43% MS in 2010 • 4 strains for broader protection Fluzone® QIV ID • Intramuscular (QIV IM) Fluzone® QIV IM • Intradermal (QIV ID) Fluzone® ID Fluzone® High-Dose U.S. recommendations for universal Fluzone® Time coverage expected to contribute illustrative U.S. flu sales expected to grow at double-digit CAGR 2012-2015 QIV: Quadrivalent IM: Intramuscular ID: Intradermal 96
  • 96. 1 MATURE MARKETSOpportunities in Europe and Japan Europe Japan ● Strong presence with Sanofi ● Market opening more widely to Pasteur MSD joint-venture(1) non local players ● €918m sales in 2010, 30% MS ● Unprecedented government ● Strong leadership position in HPV, funding €2bn over 2010-2015 booster and flu vaccines to support immunization, ● New JV Head appointed including Hib ● Restructuring implemented to ● ActHIB®, first and only Hib adapt to end of HPV vaccination vaccine introduced in Japan catch-up period (Dec 2008) ● Opportunities with LCM initiatives ● Opportunity to launch new in existing segments (HPV, vaccines (IPV stand alone, boosters) and new launches pediatric combos, Adacel®) (1) 50/50 JV with Merck & Co in Europe: sales not consolidated by Sanofi Pasteur – JV accounted for using the equity method HPV: Human papilloma virus IPV: Inactivated polio vaccine Hib: Haemophilus influenzae type b 97
  • 97. 2 EMERGING MARKETSSanofi Pasteur Has a Well Established Presencein Emerging Markets Sanofi Pasteur 2010 Sales(1) and Market Share (MS)(2) in Emerging Markets €309m €312m €196m Emerging Markets €157m Sales(3): MS €1,025m 20% Eastern Africa & Latin Asia Europe Middle East America & Turkey • Present in over 100 countries • Investing in local manufacturing • Regional approaches for R&D (1) Global Sanofi Pasteur 2010 sales: €3,808m, including €452m A/H1N1 vaccine (2) Market Share: Sanofi Pasteur internal estimates (3) 2010 sales excluding pandemic influenza. Including pandemic influenza, sales in Emerging Markets were €1,386m. 98
  • 98. 2 EMERGING MARKETSA Pediatric Combo PortfolioTailored to Unmet Needs in Emerging Markets Immunization Rate % ● Full range of combo vaccines to address 100%(2) different market needs ● Inactivated Polio Virus / Acellular Pertussis combo vaccines: TetraximTM Pentaxim® Hexaxim® submitted to EMA for wcP OPV Scientific Opinion under Article 58 ● Whole cell Pertussis combo vaccine: Shan5® (by Shantha) ● Investment in capacity for key combo(1) acP antigens to meet global demand IPV ● Up to 300md IPV, 200md acP and 0% 180md Hib, etc. Pertussis Polio Hib (1) Pediatric combination includes Diphtheria, Tetanus, Pertussis, inactivated Polio, plus Haemophilus b and/or Hepatitis B depending on vaccine (2) Corresponding to birth cohorts of about 124m in Emerging Markets. Primary series in 3 doses for each antigen. wcP: whole cell Pertussis acP: acellular Pertussis OPV: oral polio vaccine IPV: inactivated polio vaccine Hib: Haemophilus influenzae type b 99
  • 99. 2 EMERGING MARKETS2012-2015: Unique Footprint in Emerging Markets toContribute to Expansion Brazil Mexico ● Expansion of flu immunization, ● Unique flu industrial base (Ocoyoacac) in partnership with Butantan Institute and partnership (Birmex) ● IPV introduction in public market ● AcXim range included in national immunization program ● Expansion of new vaccines (Menactra®, Adacel®) ● High potential for future products: Hexaxim®, Dengue ● Key country for Dengue vaccine China India ● Pentaxim®: first 5-in-1 launched in ● Leading OPV supplier for polio 2011 eradication ● Flu facility about to come on line ● Shantha: Strategic asset for further expansion in India and Emerging ● Rabies vaccines VRVg expected Markets launch in 2014 ● Shan5: Expected to bid for supply for 2nd part of 2013-2015 UNICEF tender 100
  • 100. 2 EMERGING MARKETSDengue – Increasing Geographic Spread and Burden Global Dengue Activity (CDC) Country level Province or local level Area of ongoing transmission ● 2.5-3.5bn people in tropical and subtropical regions ● Annual incidence of 230m cases, 2m severe, 25,000 deaths ● High economic burden ● Market estimated to be over €1bn Dengue Risk Transmission Areas and Dengue Reports (From U.S. CDC-HealthMap, Year 2010): CDC: Centers for Disease Control 101
  • 101. 2 EMERGING MARKETSDeveloping a Safe and EffectiveTetravalent Vaccine against Dengue Worldwide clinical First submissions Construction of development (n=43,000(1)) planned in 2013 manufacturing facility ● Satisfactory consistent ● Working with various ● 100m doses facility safety profile and stakeholders to support planned to be on line by balanced immune creation of appropriate 2014 (Neuville, France) response observed in immunization policies early trials and funding ● Large investment: €350m ● 1st efficacy Phase IIb ● Priority access to highly results expected end endemic countries in 2012 (n=4,000) SE-Asia and Latin America (2014 onwards) ● Expanded efficacy Phase III studies ongoing (1) Phase IIb and Phase III final enrollment 102
  • 102. 3 PIPELINEA Solid R&D Pipeline to Fuel our Growth beyond 2015 ● 1 Dengue vaccine (Ph III) global roll-out to continue beyond 2015 ● 2 Three projects targeting hospital-acquired infections (Ph I & II) ● Clostridium difficile (Ph II), Pseudomonas aeruginosa and Streptococcus pneumonia (Ph I) ● 3 Several pediatric vaccines tailored for specific markets ● Hexaxim® (Registration), DTP-HepB-Polio-Hib (Ph III) ● 4 New generation of existing vaccines ● Flu (Ph III), Rabies (Ph II), Meninge (Ph II) ● 5 Shantha R&D capabilities facilitate opportunities to meet health needs of the developing world ● Rotavirus (Ph I), HPV and Shan6 (Pre-clinical) Higher probability of success in vaccines vs. pharmaceuticals 103
  • 103. Vaccines: Well Positioned with a Long Growth Runway● Leverage industrial platform to meet demand and optimize market access● Solid R&D pipeline, including first Dengue vaccine, addressing unmet needs worldwide● Leading global market position with 2011e sales growth of 7-8%(1) ● Solid operating margin of around 29% in 2011e● Delivering single digit growth rate in 2012-2013 and double digit in 2014-2015 ● > 50% of growth in mature markets expected to be driven by flu vaccines ● Emerging Markets expected to represent 40-45% of sales in 2015 (1) At constant exchange rates, excluding 2010 pandemic influenza revenues (A/H1N1) 104
  • 104. GENZYMEDavid Meeker, MDChief Operating Officer, Genzyme
  • 105. AgendaOrphan diseases and GenzymeThe new GenzymePersonalized genetic health opportunityMultiple sclerosis opportunity 106
  • 106. Orphan Drug Market is Attractive and Offers GrowthPotential Due to Significant Unmet Needs ● Significant unmet needs create strong growth potential ● Under-served patient population ● Drugs available for only ~200 out of >6,000 orphan diseases(1) ● 85% orphan diseases are life threatening and 50% are pediatric(2) Orphan Drug ● Several attractive market characteristics Market ● Unique development challenges ● Regulatory exclusivity period ● >$10bn sales for orphan-only drugs growing at high single digit since 2000 ● Expected to reach $18bn in 2015(3) (1) BioWorld Today, 2011 (2) Food and Drug Administration, "Office of Orphan Products Development," Budget 2010 107 (3) EvaluatePharma; internal analysis
  • 107. A Pioneering Approach to Orphan Diseases Challenges Genzyme Expertise Limited disease awareness Physician education Small number of experts Identification/training/engagement Limited patient advocacy Enabling patient communities Patient registries establish natural history Limited outcomes data and long-term follow up 20 years of innovation, next generation Lasting commitment therapies 108
  • 108. A 30 Year History of Expansion● Global leader in rare genetic diseases Genzyme PGH Historical Sales(1) ● Transformative therapies treating patients in >100 countries $2,227m ● 77% of sales outside the U.S. in 2010 ROW● Established, long-term partnerships U.S. $1,571m ● Rare genetic disease KOLs ● Patient groups ● Governments/health authorities● Technical expertise across broad range $645m of technology platforms ● Protein-based, cell and gene therapies ● Therapeutic polymers and biomaterials ● Small molecules 2002 2003 2004 2005 2006 2007 2008 2009 2010 (1) Includes only Personalized Genetic Health historical sales of Genzyme 109
  • 109. AgendaOrphan diseases and GenzymeThe new GenzymePersonalized genetic health opportunityMultiple sclerosis opportunity 110
  • 110. Unleashing the Full Potential of Genzyme within Sanofi Broaden Leverage biologics global experience scope and manufacturing expertise Escalate Develop Create existing MS R&D hub R&D franchise in Boston programs 111
  • 111. The New Genzyme – A More Focused Scope Marketed Products Gaucher MPS I(1) disease Products in Development Fabry MPS II(1) disease PGH MS (2)Personalized Multiple Genetic Sclerosis Health Pompe Thyroid disease cancer (2) Products in Development Familial Gaucher Hyper- eliglustat KynamroTM disease cholestero- lemia (1) MPS: Mucopolysaccharidosis (2) LemtradaTM and AubagioTM are the registered names submitted to health authorities for investigational agents, respectively 112 alemtuzumab and teriflunomide.
  • 112. Integration of Other Genzyme Divisions into Sanofi Biosurgery / Renal Oncology Key Brands from Genzyme Key Brands from Genzyme Leverage Sanofi global footprint 113
  • 113. AgendaOrphan diseases and GenzymeThe new GenzymePersonalized genetic health opportunityMultiple sclerosis opportunity 114
  • 114. Cerezyme® is the Foundation of the Genzyme ModelTransformative Therapy Extensive Global Reach Ensure Market Access 1983 ● Increase awareness 2010 Sales Split ● Enable access to diagnostic testing ROW U.S. 27% ● Identify and train experts 32% 2001 ● Support patient advocacy ● Partner with healthcare systems 41% EU 115
  • 115. Untapped Cerezyme® Opportunity in Gaucher Disease Large population of undiagnosed ● Focus is on supplying patients 9% of patients(1) diagnosed ● Differentiated profile: patients not treated ● 20 years of proven safety and efficacy ● Demonstrated bone benefits(2) ~7,000 ● Significant additional opportunity ~6,400 ~4,800 exists with undiagnosed patients Diagnosed Total treated CZ treated (1) Symptomatic prevalence and diagnosed patient estimates from 2010 PGH Market Models / Epidemiology Database. (2) Sims K, Pastores G, Weinreb N, Barranger J, Rosenbloom B, Packman S, et al. Improvement of bone disease by imiglucerase (Cerezyme®) therapy 116 in patients with skeletal manifestations of type 1 Gaucher disease: results of a 48-month longitudinal cohort study. Clin Genet 2008; 73:430-40.
  • 116. Myozyme®/Lumizyme®: Only Approved Treatmentfor Pompe Large population of undiagnosed ● Long-term potential commercial patients(1) opportunity similar to Cerezyme® ● Documented clinical benefit across 19% of disease spectrum diagnosed patients not ● Focus is on: treated(2) ● Driving disease awareness ~2,000 ~1,500 ~1,500 ● Partnering with physicians to increase early diagnosis Diagnosed Total treated MZ/LZ treated 117 (1) Symptomatic Prevalence based on 2011 Pompe Epi Model in 92 countries (excluding China and India). (2) Identified and treated patient numbers from regional patient trackers and LSD WW Report as of December 2010 117
  • 117. Myozyme®: Our Most Successful Launch $m 450 Myozyme®/Lumizyme® 400 350 Fabrazyme® 300 250 Ceredase®/Cerezyme® 200 150 Aldurazyme® 100 50 0 (1) 0 1 year 2 year 3 year 4 year (1) Reflects the first full fiscal year after launch 118 118
  • 118. Fabrazyme® Potential Unleashed when Supply is Restored Large population of undiagnosed ● Efficacy demonstrated at 1mg/kg patients(1) ● Regain significant market share by: 30% of diagnosed ● Restoring supply patients not ● Driving importance of dose in treated clinical outcomes ● Growing patient awareness ~6,000 ~4,200 ● First Framingham product release ~1,600 anticipated in Q1 2012 Diagnosed Total treated FZ treated (1) Symptomatic prevalence and diagnosed patient estimates from 2010 PGH Market Models / Epidemiology Database. 119
  • 119. Fabrazyme® – Treating the Family Finding 1 new index patient leads, on average, to diagnosis of another 5 patients in that family 120
  • 120. Expanding Manufacturing Capacity is Key to Future Growth Sites Today 2012e 2015e Capacity 12,000L Allston, MA 20,000L Geel, Belgium 8,000L Framingham, MA new plant 121
  • 121. Leveraging Genzyme’s Innovative Capabilities ● Strong expertise ● Unique biologics in PGH and MS platform Creation of the Genzyme R&D Center ● Integrated innovation ● Commitment to open hub in the Boston area innovation 122
  • 122. Eliglustat – A Potential Game Changer in Gaucher Disease The Product Status ● Potent, novel substrate ● Global Phase III program inhibitor underway ● Oral therapy convenience ● Phase III data anticipated in with a capsule H1 2013 ● Eliminating challenges of infusing patients ● Clinical profile expected to be similar to Cerezyme® 123
  • 123. Eliglustat Clinical Data Comparable to Cerezyme® Eliglustat Phase 2 Trial Results: Treatment Changes to 2 Years % Change Change in g/dL 90 Platelets 81% 8.0 63% 60 40% 6.0 Hemoglobin 4.0 22% 30 2.0 0 0.0 0.9g/dL 1.6g/dL 1.8g/dL 2.1g/dL -2.0 -30 Spleen -22% -4.0 -60 -36% -47% -52% -6.0 -90 -8.0 Baseline 6 months 1 year 18 months 2 years Cerezyme® Range 124
  • 124. Eliglustat: Potential Transformative Therapy(1) December 2006 December 2009 pre-treatment (18 years) 3 years post treatment (21 years)(2) (1) Investigational drug (2) Patient from Phase II clinical trial 125
  • 125. Familial Hypercholesterolemia: Maximizing Kynamro™ Potential through Genzyme’s Orphan Disease Expertise Understanding Rarity ~40,000 patients(1) HoFH(2) Severe FH(3) On statins: 60 million patients HeFH(4): 1 million patients (1) Patients for HoFH and Severe FH in US and EU markets (2) Homozygous Familial Hypercholesterolemia (3) Severe Familial Hypercholesterolemia = treated LDL-C >200mg/dL with CAD, or >300mg/dL without CAD 126 (4) Heterozygous Familial Hypercholesterolemia126
  • 126. Long-term Effects of Kynamro™ in Extension StudyInterim Data Analysis Change from Baseline in Lipids(1)● Safety profile consistent with all four Phase III studies 0 Mean % Change (95% CI) -5● Liver fat stabilized or -10 decreased in some patients -15 with treatment beyond 12 -20 months -25● Sustained reduction in apo B -30 production decreased LDL -35 LDL-C ApoB Lp(a) and Lp(a) -40● Filed in EU for HoFH and 26 n=130 52 n=110 76 n=58 104 n=26 severe HeFH in July 2011 Study Week Filing expected in the U.S. for HoFH in Q4 2011 (1) Data on file 127
  • 127. Strong PGH Growth Potential Projected Genzyme PGH Sales Key Growth Drivers ● Drive Pompe disease awareness 2012e-2015e double digit ● Regain Cerezyme® and CAGR Fabrazyme® market share ● Restore manufacturing supply ● File eliglustat, a 2nd generation Gaucher product ● File Kynamro™ to treat familial hypercholesterolemia 2012e 2015e 128
  • 128. AgendaOrphan diseases and GenzymeThe new GenzymePersonalized genetic health opportunityMultiple sclerosis opportunity 129
  • 129. Global MS Market Expected to Continue to Grow MS Market Sales(1) Key FactsSclerosis Multiple about MS CAGR ● ~2.1m patients worldwide ~6% ~$15.3bn ● Prevalent in young women (~2:1 female/male ratio) ● Life expectancy 5-10 years lower $11.2bn than unaffected people 57% ● A major impact on family, social U.S. 53% and professional life ● Symptoms include fatigue, weakness, walking and balance 43% difficulties, vision problems ROW 47% 2010 2015e (1) Evaluate Pharma 130
  • 130. : A Promising Investigational Agent for MS● Strong efficacy(1) CARE-MS I CARE-MS II ● 55% reduction in relapse rate over Patients 581 840 2 years compared to Rebif® Study 2 years 2 years Duration ● Non statistically significant result on time to 6-month SAD(2) Patient Population Treatment naïve Treatment experienced (HR=0.70, p=0.22)● Unique convenience Treatment Alemtuzumab Alemtuzumab Arms vs. IFNβ 1a vs. IFNβ 1a ● Annual dosing Co- Relapse Rate Relapse Rate primary Disability Disability● Manageable safety Outcomes Progression Progression Data Jul 2011 Q4 2011 ● Safety profile consistent with Timing Phase II clinical trial experience Filing expected in the U.S. & EU in Q1 2012 (1) Results as reported from CARE MS I trial (2) SAD - Sustained Accumulation of Disability 131
  • 131. Aubagio®: An Exciting New Oral Treatment for MS TEMSO: Reduction in Adjusted(1) AAR● Solid safety profile Placebo ● No deaths, malignancies or serious infections T. 7 mg RRR: 31.2% p=0.0002 ● Drop out rate in Phase III RRR: 31.5% similar to placebo T. 14 mg p=0.0005● Convenient 0 0,1 0,2 0,3 0,4 0,5 0,6 ● Once daily oral dosing TEMSO: Reduction in Disability Progression (%) 30%● Efficacy Placebo T. 7 mg HRR: 23.7% p=0.0835 20% T. 14 mg ● 32% relapse rate reduction HRR: 29.8% ● 30% reduction in disability 10% p=0.0279 progression 0% 0 12 24 36 48 60 72 84 96 108 Week Filed in the U.S. in Q3 2011 and EU filing expected in Q1 2012 (1) Adjusted for Expanded Disability Status Scale score strata at baseline and takes duration of treatment into account. ARR - Annualized Relapse Rate, RRR - Relative risk reduction, HRR - Hazard ratio reduction 132
  • 132. Addressing the Full Spectrum of MSDrivers: Safety, Efficacy, and Support Services RRMS(2) and RMS(3) severe/ Early MS/CIS(1) early active MS highly active Unmet need 1 Unmet need 2 Unmet need 3 Convenience Convenience Efficacy with & safety & efficacy manageable safety Quality of patient/physician support services Aubagio™ Aubagio® Rebif® Lemtrada™ Lemtrada™ (1) CIS: Clinically Isolated Syndrome, study presently ongoing (2) RRMS: Relapse Remitting Multiple Sclerosis 133 (3) RMS: Relapsing Multiple Sclerosis 133
  • 133. 2012-2015: Key Growth Drivers● Maximize market opportunity for PGH business ● Increase manufacturing capabilities for Cerezyme® & Fabrazyme® ● Increase Pompe disease awareness/diagnosis ● Launch eliglustat and Kynamro™● Further expand PGH business through internal and external opportunities● Establish leading MS franchise ● Launch Aubagio™ and Lemtrada™ 134 134 134
  • 134. ANIMAL HEALTHJose BarellaChief Executive Officer, Merial
  • 135. Agenda Market opportunities in Animal Health Merial - A leader in Animal Health Strategic priorities for Merial 136
  • 136. Animal Health Offers Attractive Business Dynamics ● Pets increasingly treated as a family member ● Protein consumption increasing given demographic trends and living standards ● Long product life cycles and limited generic competitionAnimal Health ● Importance of brand equity Market ● Complex manufacturing (e.g. biologicals) ● Complex regulatory environment (e.g. food safety, multiple agencies) ● Higher probabilities of success and lower costs of development than human pharma ● Synergies with the human pharma business 137
  • 137. A Diversified Market by Region and Species2010 Market Split by Geographic Area 2010 Market Split by Segment 31% 41% 59% 69%69% Developed Markets 31% Emerging Markets 59% Production animals 41% Companion animals • United States • Latin America • Cattle, Sheep • Dogs, Cats • Western EU • Asia • Pigs • Horses • Japan, Canada, Australia, • Eastern Europe • Poultry • Other New Zealand • Middle East, Africa • Veterinary Public Health A €15bn market in 2010 Source: Vetnosis ($20bn 2010 market converted to Euro at 1.3$/Euro); Sanofi regional format. 138
  • 138. Strong Growth Drivers in Both Segments Companion Animals Production Animals ● Increasing human / pet emotional bond – ● Increased consumption of protein food in “Pet as a family member” Emerging Markets - “Feed the planet” ● Pets is the largest individual AH segment ● Increased medicalization of animal population to improve animal yields ● Aging populations in western countries ● Convenience for mass medicalization ● Growing GDP per capita in Emerging Markets ● Focus on prevention ● Unmet medical needs (e.g. cancer, diabetes) Market Market CAGR +5% CAGR +5% €9bn €6bn 2010 2015e 2010 2015e A €20bn market expected in 2015 Source: Vetnosis ($20bn 2010 market & $26bn 2015 market converted to Euro at 1.3$/Euro) 139
  • 139. Emerging Markets Expected to Grow Twice As Fast asDeveloped Markets Global Animal Health Sales €20bn CAGR €15bn ~8% 36% Emerging 31% Markets CAGR ~4% Developed 64% 69% Markets 2010 2015e Source: Vetnosis ($20bn 2010 market & $26bn 2015 market converted to Euro at 1.3$/Euro); Sanofi regional format. 140
  • 140. Agenda Market opportunities in Animal Health Merial - A leader in Animal Health Strategic priorities for Merial 141
  • 141. Merial Has Strong Positions in BothCompanion and Production Animals Segments The Leader in Companion Animals A Strong Foothold & Parasiticides in Production Animals (2010 Proforma Sales) (2010 Proforma Sales) €1.3bn €0.7bn Medicated Feed Additive Source: Vetnosis 142
  • 142. A Wide Range of Leading Premium Brands #1 Animal Health brand(1) Parasiticide controlling fleas and ticks for pets Top-tier Pets brand Parasiticide controlling heartworms for pets Internal and external parasiticide control for cows, sheep and pigs Recombinant DNA vaccines Merial is a leader in pets vaccines Leading innovative recombinant vaccine for poultry (1) Vetnosis 2010 product ranking 143
  • 143. A Broad, Diversified Geographic Footprint Merial: 2010 Sales Split by Region● Merial’s strength is led by the #1 position in the U.S., the largest Pets Other Countries market(1) 8%● 23% of sales in Emerging Markets, approaching Western Europe in size Emerging (vs. 19% in 2007) Markets 23% U.S. 42% ● ~50% of Emerging Market revenues are from Latin America ● Growth driven by Asia and Latin America ● Room for further expansion 27% Western Europe (1) Vetnosis 144
  • 144. Agenda Market opportunities in Animal Health Merial - A leader in Animal Health Strategic priorities for Merial 145
  • 145. Strategic Priorities for Merial Reinforce position in core markets Diversify portfolio: Pursue opportunistic opportunities in acquisitions Emerging and Markets alliances Ensure steady Leverage progression of a industrial assets balanced portfolio 146
  • 146. Core MarketsAnimal Health Products Have Long Life Cycles Frontline® EMEA(2) Sales● Absence of third party payers limits attractiveness for competitive entries Branded generic entry● Long product life cycles of pioneer brands(1) ● Average of 60% molecular share despite generic competition ● Average age of compounds exceeds 30 years● Merial brand awareness will be key in its defense against generics 6/2008 6/2009 6/2010 6/2011 Last 12 Month Sales Limited impact of Frontline® generics in major markets (1) Vetnosis study on the top 50 compounds of the AH industry based on 2008 sales. Average computed based on a universe of 35 compounds subject to generic competition. (2) EMEA: Western Europe, Eastern Europe, Middle East, Africa 147
  • 147. Core MarketsReinforcing our Leadership in Pet Parasiticides● Frontline®: largest product in the Merial: Estimated Pet Flea & Tick Sales Animal Health market ● 2010 sales of €762m● Strong IP rights(1) ● U.S. compound patent expired in 2010 ● Key patents: formulation, fipronil manufacturing process, and combination● New products ● Certifect®: U.S. launched in Q3 2011; ROW launch planned in 2012 2011 2012 2013 2014 2015 ● Next generation Pet Parasiticides New pet parasiticide products Frontline® (1) The U.S. District Court for the Middle District of Georgia ruled that Velcera and Cipla are in contempt for sales of Pet ArmorPlusTM products (fipronil + methoprene) and enjoined (prohibited) such sales 148
  • 148. Emerging MarketsMaximizing the Emerging Markets Opportunity Animal Health in Emerging Markets Merial Strategy ● Market needs still fairly basic ● Focus on Production Animals ● Cost sensitive, generic markets by leveraging strongholds: ● Growth from Production Animals ● Grow Avian leadership linked to demand for protein ● Invest in Swine franchise ● Pet market only in early stages ● Expand Ruminant position of development ● Secure #1 VPH(1) position (Foot and Mouth disease, etc.) ● High barriers to entry ● India: local production ● Enhance position as Pets leader(2) ● China: government control ● Leverage Sanofi footprint over specific disease treatments (1) Merial internal estimates, VPH: Veterinary Public Health (2) Vetnosis 149
  • 149. R&D PortfolioRobust Development Pipeline● 6 launches in 2011 Projected New Drug Launches(1) ● Certifect® for flea, tick control ● Zactran® for Bovine Respiratory Disease ● Equine West Nile Virus vaccine 2011 6 ● Supleneo®, a nutraceutical for joint health ● Feline Rabies vaccines for EU 2012 7 ● Blue Tongue Virus 1-8 vaccine● 27 potential launches from 2011 to 2015 2013 3 ● 13 for companion animals ● 14 for production animals ● 17 biological and 10 pharmaceutical 2014 8 products● Consistent R&D investment of ~7% 2015 3 of sales Higher probabilities of success and lower development costs than human pharma (1) Projects evaluated with greater than 50% probability of success 150
  • 150. Direct Benefits of Sanofi’s Scale and Expertise Cost Savings Research Emerging Markets ● Shared services: ● Common technology ● Sanofi’s strength and IS, Finance, Legal, platforms: expression established presence Communications, etc. systems, formulations, enable Merial to move delivery devices quickly ● Procurement: Travel, raw materials, ● Molecule discovery for ● Initiative to leverage Sanofi services, logistics (freight Pets: pain management, footprint in India and & distribution), real oncology, diabetes, etc. Russia in the near term estate, etc. Operating margin projected to further increase 151
  • 151. Animal Health: A Sustainable Growth Platform ● Strong industry fundamentals ● Reinforce positions in Mature Markets, extend the pet parasiticide franchise, strengthen position in production animals ● Capture Emerging Markets growth supported by Avian, VPH and Sanofi’s footprint ● Deliver on key pipeline projects: new launches expected to account for >20% of 2015 sales ● Improve operating margin through manufacturing efficiencies and integration into the Sanofi organization ● Selected opportunistic business development transactions 152
  • 152. CONSUMER HEALTH CAREHanspeter SpekPresident, Global Operations
  • 153. AgendaMarket characteristicsSanofi’s expansion in CHCGrowth drivers 154
  • 154. OTC Market Offers Sustainable Growthwithout Volatility Caused by Patent Expiries Market Drivers A €77bn Market in 2010(1) CAGR ● Large and highly fragmented market ~3.4% €77bn ● Growing propensity to self-medicate €68bn €71bn €74bn ● Importance of brands to convey quality and trust ● M&A still a major focus for growth ● Only a few worldwide brands ● Unregulated pricing 2007 2008 2009 2010 OTC market expected to grow to €100bn by 2015(1) (1) Nicholas Hall, OTC YearBook 2011, DB6 2011 (2010 sales) 155
  • 155. AgendaMarket characteristicsSanofi’s expansion in CHCGrowth drivers 156
  • 156. Sanofi Has Become a Global Player inConsumer Health Care Key Actions Results(1)1● Expanded market position beyond European focus of Sanofi’s legacy CHC business #3 #3 in Russia ● Enlarged revenue base Among2 in Central & through 11 acquisitions top 10 Eastern Scaling up in U.S.(2) ● Improved presence in the Europe in China3 U.S. and China and Asia ● Obtained access to new retail4 and distribution channels in Asia ● Experienced management #15 recruited to drive CHC business in Latin #1 in Australia in regions America ● Continued expansion in all6 key CHC markets through regional hubs Target of high single digit growth over 2012-2015 (1) Nicholas Hall, OTC YearBook 2011, DB6 2011 (2010 sales) (2) Including Allegra® OTC sales in 2011, internal estimates 157
  • 157. New Strategic Focus in Late 2008 Driving Performance Strategic Priorities Doubling Global Revenue Base 2008-2011 Expected in Only 2 Years ~2x Boost sales of existing brands Rx-to-OTC switch strategy e.g. Allegra® Bolt-on acquisitions €1.4bn in key OTC markets 2008 2009 2010 2011e 158
  • 158. Leveraging the Strong Platform of Legacy Brands OTC "Local Champions" Ranking(1) Doliprane® #1 in France ● Significant contribution from "local champions" Dorflex® #1 ● Total sales of top 5 legacy brands in Brazil expected to be >€750m in 2011e ● Iconic brands NoSpa® #9 ● Strong brand recognition in local in Russia markets ● Solid presence in key categories Enterogermina® #2 ● Fever & Pain, Digestive Health in Italy ● Continue to drive brand strategy #2 through improved marketing mixes Essentiale® in Russia in the countries locally TOTAL 2011e sales growth: ~+18% 1) IMS MIDAS MAT Q2 2011 159
  • 159. Building a Strong CHC Base through Bolt-on Acquisitionsand Organic Growth CHC Sales Split in 2011eSignificant transactions Others in established andemerging CHC markets in 2008-2011 Top existing brands Allegra® Doliprane® Essentiale® Enterogermina® Maalox® Added No-Spa® important brand Magne B6® equity to existing Dorflex® Lactacyd® CHC business CHC revenue base increased through acquisitions by >€800m 160
  • 160. AgendaMarket characteristicsSanofi’s expansion in CHCGrowth drivers 161
  • 161. Key Growth Drivers 1 Expanding in the U.S. 2 Reinforcing brand equity in Europe 3 Investing in the dynamic CHC market in China 4 Strengthening #1 position in Australia(1) 5 Rx to OTC switches (1) Nicholas Hall, OTC YearBook 2011, DB6 2011 (2010 sales) 162
  • 162. 1 E X P A N D I N G I N T H E U.S. Strengthening U.S. Position OTC Acquisition Value Creation ® ● Filled geographic hole in ● Switch Allegra from Rx global presence to OTC in U.S. ● Immediate “leadership” position in U.S. ● Development of Chattem portfolio in the U.S. and ● Large portfolio of OTC beyond products ● Operating margin ● Allergy, skincare, estimated among topical pain, toiletries best-in-class OTC players 163
  • 163. 1 E X P A N D I N G I N T H E U.S. U.S. Sales Up Almost 100% CHC U.S. Sales $442m ® $225m (1) $188m H1 2010 H2 2010 H1 2011 1) Chattem was acquired by Sanofi on February 9, 2010 164
  • 164. 1 E X P A N D I N G I N T H E U.S. Allegra® – A Very Successful Rx to OTC Switch Nielsen Unit Share (%)(1)● Launched in March 2011 18● Exceptional trade success 16 and speed to market 14 12● Premium merchandising and 10 promotional support 8 6● Successfully building brand 4 awareness 2 0 11 10 12 /10 10 1● Allegra® #2 brand 4/ 1 6/ 1 11 5/ 1 1 11 3/ 1 10 0 0 2/ 0 /1 /1 /1 /1 /1 /1 /1 0/ /1 1 5/ 7 9/ 6/ 11 19 14 16 22 9/ 19 10 /3 /2 8 /2 7/ 8/ 7/ 4/ in the category(1) 1/ 2/ 4 weeks ending Allegra® Claritin® Zyrtec® (1) A.C. Nielsen Food, Drug and Mass excluding Walmart (represents 64% of all outlets) 4-week data through week ending 8/6/2011 165
  • 165. 2 GROWING IN EUROPE Harmonizing Marketing Mixes of Pan European Brands for Profitable Growth Pan European Brands Category Available in DIGESTIVE Maalox® 12 ● Existing pan European brand HEALTH countries equity and recognition ● Broader presence across HEALTH Magne B6® 8 key categories helped by CAPITAL countries acquisitions ● Improve advertising and 7 promotional efficiency by BEAUTY Oenobiol® countries harmonizing marketing mixes ● Seamless execution of Allegra® / 8 multi-country launches ALLERGY Telfast® countries 166
  • 166. 2 GROWING IN EUROPE Opportunity to Build Pan European Umbrella Brand Developing an Umbrella Brand in the Allergy Category ● Allergy category – Attractive 8 countries growth area for CHC in Europe Different package designs and promotional campaigns ● >€300m category(1) ● Highly fragmented 6 different local brands ● Opportunity to consolidate Sanofi’s localized anti-allergy portfolio Harmonization of brand marketing mix ● Diverse portfolio of multiple brands mainly in smaller countries Cost of goods sold Advertising and promotional investment ● Objective to develop a pan European umbrella brand to provide complete solution for Allergy needs 1 European Umbrella Brand (1) IMS-OTCIMS (MAT Q1 2011) 167
  • 167. 3 INVESTING IN CHINA Accelerating CHC in China Three-pronged Strategy in Consumer Health Care in China 1 M&A and 2 3 Organic Growth Enlarge Portfolio Joint Venture and OTC Switches • Vitamins, Minerals, • Lactacyd® launched in May Supplements(1) • Essentiale® • Cough & Cold(2) Scaling up to create Acquired leadership Leverage platform by top position in China in the two biggest access to expanding and Asia categories in China(3) distribution channels CHC expected to generate >10% of total China sales by 2015 (1) 21 Super Vita: #2 VMS brand by volume in China (IMS Pharmatrend June 2011) (2) Good Baby: #3 Cold brand by value in China (IMS Pharmatrend June 2011) (3) Nicholas Hall, OTC YearBook 2011, DB6 2011 (2010 sales) 168
  • 168. 4 GROWTH IN AUSTRALIA Built #1 Position in Australia Symbion Deal Symbion deal in 2008 laid foundation for Sanofi’s leadership in OTC market(1) Vitamins & Mineral Supplements Enhanced #1 position in VMS category through acquisition of leading Vitamin D brand(2) Strong Brands CHC contributing to redesign of Australian affiliate profile 1) Nicholas Hall, OTC YearBook 2011, DB6 2011 (2010 sales) 2) Aztec information systems, National Market data, July 2011 169
  • 169. Strategic Priorities for Future Growth inConsumer Health Care ● Opportunity for global coordination of product development ● Further expansion of geographical reach in Emerging Markets ● Harmonizing marketing mixes to boost investments behind brands ● New launches of existing brands from other regions ● Cenovis®, Lactacyd®, Essentiale® ● Rx to OTC switch opportunities actively pursued ● Targeted M&A opportunities locally and globally 170 170
  • 170. 2012-2015FINANCIAL INDICATORS& CAPITAL ALLOCATIONJérôme ContamineExecutive Vice President, Chief Financial Officer
  • 171. Agenda Impact of U.S. Plavix® and Avapro® Cost savings Margin trends Capital allocation 172
  • 172. 2012-2015One Last Significant Headwind Remaining Patent Expiry of Plavix® and Avapro® in the U.S.(1) Evolution of Group Evolution of Group "Other Revenues" "Associates" Impact on Business Net Income €1,651m Evolution €1,036m - 54% - 61% 2012e ~ €1.4bn 2013e ~ €700m 2010 2011e 2012e 2010 2011e 2012e (1) Avapro® on March 30, 2012 and Plavix® on May 17, 2012 173
  • 173. Agenda Impact of U.S. Plavix® and Avapro® Cost savings Margin trends Capital allocation 174
  • 174. Significant Cost Synergies Expected from theAcquisition of Genzyme… $700m ● Level of cost synergies expected to reach $700m by 2013 Synergies Split ● Around 30% of 2010 OpEx baseline Support Functions, IS ● Main drivers of cost synergies: and Other ● Integration of Oncology in Sanofi Operations ● R&D sharing platform and leveraging Boston as a hub for Sanofi in the U.S. R&D ● Focus on purchasing and CapEx efficiency in Industrial Affairs Industrial ● Shared organisation for support Affairs functions per country/region 0% 10% 20% 30% 40% 50% 60% 175
  • 175. New Initiatives Combined with Genzyme Expected toGenerate Total Cost Savings of €2bn by 2015 ● CoGS ● Industrial network balancing ● Increased headcount producitivity: +7% pack p.a. /FTE ● Increase global capacity utilization by 10% (2010-2015) ● R&D(1) ● Flat to slightly declining expenses Cost savings ● Commercial operations of ● Reinforce new operating model in mature markets ● Purchasing €2bn(2) ● Continue to improve purchasing cost ● Support functions ● Leverage shared services and North American model ● Merial synergies ● Genzyme synergies (1) 2011 R&D expenses on a proforma basis should reach around €5bn (2) At CER, before inflation and tax on a constant structure basis 176
  • 176. Agenda Impact of U.S. Plavix® and Avapro® Cost savings Margin trends Capital allocation 177
  • 177. 2012-2015Business Operating Margin Set to Rebound from 2012 Business Operating Margin Evolution ILLUSTRATIVE Impact of Plavix® 2015 and Avapro® in the U.S. (1) New cost savings programs Synergies from 2012 Genzyme and Merial ~31% Leveraging growth platforms Sustained profitability improvement of growth platforms expected from 2012 to 2015 178
  • 178. 2012-2015Main Metrics Set to Improve in a Post Patent Cliff Era Sales GROWING Gross margin IMPROVING R&D expenses FLAT to DECLINING SG&A ratio IMPROVING Operating cash flow STRONG 179
  • 179. Agenda Impact of U.S. Plavix® and Avapro® Cost savings Margin trends Capital allocation 180
  • 180. 2012-2015Deploying Capital Effectively Balanced Capital Deployment Free cash flow use(1) 1 2 3 4 CapEx and Debt External Shareholder working capital reimbursement growth returns management (1) After R&D investments 181
  • 181. 2012-2015 1 Strong Control of Investment Policy Keeping Tight Control on CapEx Streamlining Working Capital CapEx excluding product acquisitions ● Strong improvement in working capital management in 2010 Genzyme €1,409m €1,414m and H1 2011 Merial €1,274m ● Further improvement expected Vaccines by 2013 ● Optimizing purchase to pay progress Pharma ● Reduce inventories to CoGS by & Others at least 1 month (except Genzyme) ● Stabilize DSO despite change in business mix 2008 2009 2010 2011e 2013e Targeting CapEx range of €1.5bn to €1.6bn as from 2013 182
  • 182. 2012-2015 2 Optimizing our Capital Structure Net Debt Evolution €13.2bn ● Reasonable leverage ~€10bn(1) ● Strong commitment to retain solid credit ratings ● Current ratings: ● Moody’s: A2- stable outlook €1.6bn ● Standard & Poor’s: AA- stable outlook 2010 End Q2 2012e 2011 (1) At 1.40 $/€ 183
  • 183. 2012-2015 3 Near Term Bolt-on Acquisitions to Strengthen Growth Platforms Business Development Priority Areas ● BD activities to continue ● Consumer Health Care, to strengthen Growth Animal Health Platforms ● Enlarge portfolio and develop global presence ● Potential for bolt-on acquisitions in the near ● Emerging Markets term of €1bn to €2bn ● Seize opportunities to generate sales synergies ● Further R&D partnerships ● R&D partnerships focused on early stage projects 184
  • 184. 2012-2015 4 Sustaining Higher Shareholders Returns Evolution of Dividend by year of payment ● Progressive increase of Payout 50% payout target to 50% in Payout 2014(1) 35% €2.50 ● Opportunistic use of share €2.40 €2.20 repurchasing to tackle dilution over time 2009 2010 2011 2014 (1) Dividend paid in 2014 185
  • 185. 2012-2015 GROWTH OUTLOOKChristopher A. ViehbacherChief Executive Officer
  • 186. 2012-2015Targeting at Least 5% Compounded Annual Growth Ratefor Group Sales Total Group Sales CAGR at least 5% New products(1) Animal Health Animal Health Vaccines Vaccines Consumer €27.6bn Consumer Healthcare Growth Healthcare Platforms & Genzyme(2) Genzyme(2) Genzyme: Growth Platforms Growth >80% of Platforms Diabetes(3) Group sales Diabetes(3) Pharma Other Emerging Pharma Emerging Other Other Key Other Genericized Key Gen. Key Gen. 2008 2011e 2012e 2015e (1) Incl. Jevtana®, Multaq® Lovenox® U.S., Plavix® Western EU, Taxotere® Western EU & U.S., Eloxatin® U.S., Ambien CR® U.S., Allegra® (2) Historical Genzyme perimeter U.S., Aprovel® Western EU, Xyzal® U.S., Xatral® U.S., Nasacort® U.S. - Generic makers of oxaliplatin (Teva, including LemtradaTM Fresenius Kabi (formerly Dabur), Sandoz, Mayne/Hospira, MN/Par, Actavis and Sun) required to cease selling in (3) Incl. BGM, Lyxumia® the U.S. since June 30, 2010 but litigation continues. 187
  • 187. 2012-2015Dynamic Growth From Multiple Growth Platforms 2012e-2015e CAGR Sales Growth >5% Emerging New Markets  Genzyme(1)  Consumer Vaccines  Health Care  Diabetes Animal Solutions  Health   Growth Rate Scale     Double digit High single digit Mid single digit (1) Personalized Genetic Health and Multiple Sclerosis 188
  • 188. 2012-2015Offering a Lower Risk Profile Low exposure Conservative assumptions to small molecule generic entries of R&D contribution in mature markets(1) embedded in 2015 estimates ● Only 6% of post cliff sales come ● 2015e sales projections do not from small molecules facing include significant sales from generic exposure over new product launches over 2012-2015 2012-2015 (5 to 7%) ● Biological portfolio not expected to have significant competition from biosimilars by 2015 (1) 6% of 2012 sales estimates 189
  • 189. Six NME Filings Expected in 9 Months 1 Kynamro™ (mipomersen) – hoFH and severe heFH in Jul 2011 in EU and hoFH in Q4 2011 in the U.S. 2 Aubagio™ (teriflunomide) – RMS in Aug 2011 in the U.S. and Q1 2012 in EU 3 Visamerin® / Mulsevo® (semuloparin) – VTE prevention in chemo-treated patients in Sep 2011 in the U.S. and EU 4 Zaltrap™ (aflibercept) – 2L-mCRC in Sep 2011 in the U.S. and Q4 2011 in EU 5 Lyxumia® (lixisenatide) – Type 2 diabetes in Q4 2011 in EU 6 Lemtrada™ (alemtuzumab) – RMS in Q1 2012 in the U.S. and EU hoFH: Homozygous Familial Hypercholesterolemia RMS: Relapsing Forms of Multiple Sclerosis heFH: Heterozygous Familial Hypercholesterolemia mCRC: Metastatic Colorectal Cancer VTE: Venous Thrombo Embolism NME: New Molecular Entity 190
  • 190. Solid R&D Newsflow Expected in Next 12 Months Key Milestones Timing Lyxumia® in Type 2 diabetes - Further Phase III data presentation Q3 2011 Phase II results of Zaltrap® in 1st line mCRC (AFFIRM) Q4 2011 Expected regulatory submission of Zaltrap® in 2nd line mCRC in EU Q4 2011 Expected regulatory submission of Lyxumia® in EU Q4 2011 Expected regulatory submission of Kynamro™ in U.S. for hoFH Q4 2011 Phase III top-line results of Lemtrada™ in multiple sclerosis (CARE-MS 2) Q4 2011 Phase III top-line results of Aubagio™ in multiple sclerosis (TENERE) Q4 2011 Start of Phase III for Vaxigrip® QIV IM Q4 2011 Expected regulatory submission of Aubagio™ in EU Q1 2012 Expected regulatory submission of Lemtrada™ in MS in U.S. and EU Q1 2012 Start of Phase III for Fluzone® QIV ID Q1 2012 Scientific opinion for Hexaxim® issued by EMA Q2 2012 191
  • 191. 2012-2015Nineteen Potential New Launches Cumulative Number of Projects Pharmaceuticals (excluding LCM) and Vaccines 19 13 9 Vaccines PGH & MS 6 Ophthalmology Quadracel® Diabetes Kynamro™ Oncology (mipomersen) DTP-HepB- Other Pharma Lemtrada™ Polio-Hib (alemtuzumab) FOV1101 Aubagio™ Dengue vaccine (prednisporin) (teriflunomide) Lyxumia® Fluzone® QIV IM eliglustat SAR236553 (lixisenatide) anti-PCSK-9 mAb Zaltrap™ Hexaxim® SAR302503 iniparib (aflibercept) (JAK-2 inhibitor) Visamerin® ombrabulin otamixaban sarilumab (semuloparin) anti IL6R mAb 2012 2013 2014 2015 Note: Scope includes pharmaceuticals NMEs (excluding LCM) and vaccines. Only first launches in a given market are mentioned. 192
  • 192. 2012-2015Targeting Business EPS Growth Superior to Sales Growth Leveraging our P&L from 2012 to 2015 Business EPS CAGR greater than Sales CAGR EPS 2012e EPS 2015e 193
  • 193. 2012-2015Sanofi - A Strong Scorecard for 2012-2015 2012-2015 Sales CAGR At least 5% Diversified sources of growth  Scale in businesses with significant barriers to entry  Low small molecule patent exposure in mature markets(1) ~6% Large Emerging Markets presence(2) 38-40% Potential new product launches(3) 19 Operating margin evolution Rebounding 2012-2015 Business EPS CAGR > Sales CAGR Increased dividend payout ratio 50% by 2014(4) (1) 2012 sales from chemical products exposed to patent expiry in the U.S., Japan and Western Europe over 2012/2015 (2) Based on 2015 internal estimates (3) Over 2012-2015 194 (4) Dividend paid in 2014
  • 194. IN SUMMARYThe New Sanofi Offers An Attractive Profile 1. Consistent and sustainable growth outlook 2. Growth Platforms & Genzyme expected >80% of sales by 2015 3. Unparalleled position in Emerging Markets 4. Emerging R&D pipeline of higher quality assets 5. Track record of successful execution 6. Lower risk profile 195
  • 195. IN SUMMARYSanofi: A Rare Intersection Between Growth, Quality and Value Quality th Va w lu e Gro 196
  • 196. APPENDICESR&D Pipeline
  • 197. Late Stage Pipeline – Pharma & Vaccines Phase III Registration iniparib N otamixaban N Quadracel® Hexaxim® (BSI-201) Direct Xa inhibitor Diphtheria, tetanus, pertussis DTP-HepB-Polio-Hib vaccine mTNBC; squamous LC ACS & polio vaccine; 4-6 y of age aflibercept N semuloparin (AVE5026) N Fluzone® QIV IM Plavix® VEGF-Trap Indirect Xa/IIa inhibitor Quadrivalent inactivated influenza clopidogrel bisulfate 2nd line mCRC; 1st line mHRPC VTE prevention in cancer patients vaccine Pediatric, EU; Stent, Japan ombrabulin (AVE8062) N Plavix® Dengue G mipomersen N Vascular disrupting agent clopidogrel bisulfate Mild-to-severe Apolipoprotein B-100 antisense Sarcoma PAD, Japan dengue fever vaccine hoFH and severe heFH (EU) G Clolar® / Evoltra® Lantus® teriflunomide N DTP-HepB-Polio-Hib Purine analogue insulin glargine Relapsing forms of multiple sclerosis Pediatric hexavalent vaccine Adult acute myeloid leukemia (AML) ORIGIN*; Pediatric, EU (RMS) – monotherapy (U.S.) teriflunomide lixisenatide (AVE0010) N Allegra® Multiple sclerosis GLP-1 agonist fexofenadine (monotherapy, adjunct therapy & CIS) Type 2 diabetes Dry syrup, Japan G alemtuzumab G mipomersen sarilumab (SAR153191) N Anti-CD52 mAb Apolipoprotein B-100 antisense Anti-IL-6R mAb Multiple sclerosis hoFH (U.S.) RA G MACI® eliglustat tartrate N G prochymal N Cell-based treatment Glucosylceramide synthetase inhibitor Mesenchymal stem cell Articular cartilage defects Gaucher disease Graft-versus-host disease G Genzyme Oncology Thrombosis Vaccines Metabolic Disorders Central Nervous System Internal Medicine N New Molecular Entity Genetic diseases Biosurgery * ORIGIN: Evaluation of Lantus® in reducing cardiovascular morbidity & mortality 198
  • 198. Early Stage Pipeline – Pharma & Vaccines Phase II iniparib N N FOV1101 SAR231893 (BSI-201) FDC prednisolone/ cyclosporine Anti-IL4 mAb Ovarian cancer, non-squamous NSCLC, Allergic conjunctivitis Asthma; Atopic dermatitis neoadjuvant breast cancer aflibercept FOV2302 N ferroquine N Plasma kallikrein inhibitor VEGF-Trap Antimalarial Retinal vein occlusion induced 1st line colorectal cancer macular edema Malaria SAR256212 (MM-121) N FOV2304 N G fresolimumab (GC1008) N anti-ErbB3 mAb Bradykinin B1 antagonist TGFβ antagonist Breast cancer Diabetic macular edema Fibrosis SAR245408 (XL147) N SAR164877 N ACAM-Cdiff Anti-NGF mAb Oral PI3K inhibitor Clostridium difficile Pain Endometrial cancer (on clinical hold) Toxoid vaccine SAR245409 (XL765) N SAR110894 N Rabies Oral dual inhibitor of PI3K & mTOR H3 antagonist mAb post exposure prophylaxis Cancer Alzheimers disease ombrabulin (AVE8062) G ataluren N Rabies VRVg Vascular disrupting agent Transcription modulator Purified vero rabies vaccine Ovarian 2nd line, NSCLC 1st line Cystic fibrosis SAR236553 (REGN727) N Multaq® Meninge ACYW conj. Anti-PCSK-9 mAb Antiarrhythmic agent 2nd generation meningococcal Hypercholesterolemia Atrial fibrillation, Japan conjugate Infant vaccine G Recombinant human N TSH Modified (rhTSH-M) Goiter G Genzyme Oncology Ophthalmology Vaccines Metabolic Disorders Central Nervous System Internal Medicine N New Molecular Entity Genetic diseases Cardiovascular 199
  • 199. Early Stage Pipeline – Pharma & Vaccines Phase I SAR153192 N G Genz644282 N G Gene therapy (sFLT-01) N SAR114137 N Anti-DLL4 mAb Topoisomerase-1 inhibitor Age related Macular Degeneration Cathepsin S/K inhibitor Cancer Solid tumors (AMD) OA pain & Peripheral neuropathic pain SAR3419 N G Mozobil® (plerixafor) G N SAR152954 N Gene therapy (AAV-AADC) Maytansin-loaded anti-CD19 mAb CXCR4 Antagonist H3 antagonist Tumor Sensitization Parkinsons disease Sleep disorders non-Hodgkin’s lymphoma SAR256212 (MM-121) G tasidotin N SAR339658 N SAR411298 N anti-ErbB3 mAb (GC1008) Microtubule disrupter VLA 2 antagonist FAAH inhibitor Solid tumors, ovarian cancer Melanoma Inflammatory Bowel disease Cancer pain SAR103168 N G Oral clofaribine SAR113945 N Rotavirus Multikinase inhibitor Purine analogue IKK-β inhibitor Live Attenuated Tetravalent AML Myelodysplastic syndromes Osteoarthritis Rotavirus oral vaccine SAR650984 N SAR407899 N SAR292833 (GRC15300) N Streptococcus pneumonia Anti-CD38 naked mAb Rho kinase inhibitor TRPV3 antagonist Hematological malignancies Meningitis & pneumonia vaccine Diabetic nephropathy Neuropathic pain, osteoarthritic pain SAR302503 (TG101348) N lixisenatide + Lantus® SAR100842 N Pseudomonas aeruginosa Antibody fragment product JAK-2 inhibitor GLP-1 agonist + insulin glargine LPA-1/LPA-3 Prevention of Myelofibrosis, refractory polycythemia Sngle pen device / Type 2 diabetes Internal medicine ventilator-associated pneumonia SAR566658 N SAR101099 N SAR279356 (F598) N Urotensin II receptor antagonist Tuberculosis Maytansin-loaded anti-DS6 Anti-PNAG mAb Recombinant subunit vaccine Solid tumors Diabetic nephropathy Serious infections N N RetinoStat® N SAR307746 (REGN910) New formulation SAR97276 Gene therapy Anti-Ang2 mAb Insulin glargine Antimalarial Cancer Type 1+2 diabetes Wet age-related macular degeneration Malaria (AMD) SAR125844 N G N SAR156597 N N Acid sphingomyelinase SAR104772/SAR126119 Met kinase inhibitor IL4/IL13 Bi-specific mAb TAFIa inhibitor Niemann-Pick type B Acute ischemic stroke Solid tumors Idiopathic Pulmonary Fibrosis G Genzyme Oncology Thrombosis Vaccines Genetic diseases N New Molecular Entity Metabolic Disorders Central Nervous System Internal Medicine Ophthalmology 200
  • 200. R&D Pipeline Summary TableNew Molecular Entities (NMEs) and Vaccines Phase I Phase II Phase III Registration TOTAL Oncology 10 3 3 0 16 Metabolic Disorders 2 2 1 1 6 Thrombosis 1 0 2 0 3 Central Nervous System 3 2 0 1 6 52 Internal Medicine 7 3 2 0 12 Ophthalmology 1 3 0 0 4 Genetic Diseases 3 1 1 0 5 Vaccines 4 4 4 1 13 TOTAL 31 18 13 3 65 49 16 NMEs & Vaccines 201