Brian Ford: Thank you so much, Houman. Now taking a closer look at Specialty Care, we once again delivered double digit growth in the quarter supported by outstanding performance of Dupixent. As Paul mentioned earlier, strong demand for this exceptional medicine across all approved indications and geographies continues to be a core driver of Specialty Care. Our rare disease business was another important contributor in the quarter. Strong growth across Pompe, Gaucher and Fabry products highlights our unique expertise in identifying patients and our ability to drive demand through new patient approvals. The rollout of Nexvizyme as a new standard of care in Pompe and Zempizyme in ASMD continue to be successful in global markets.
In rare blood disease, we’re very pleased with the continued strong uptake of ALTUVIIIO, another exciting launch in Specialty Care. And I’m going to update you a little bit on the insights of the brand’s recent performance in just a minute. Now we believe the continued double digit growth in Specialty Care is particularly impressive against the backdrop of generic competition for Aubagio, Sanofi’s last meaningful LOE for the rest of the decade. Generic versions of Aubagio have now entered all key markets, including Europe in September. With almost EUR1 billion in sales in 2023, we continue to navigate the impact of generic erosion into 2024, including a particularly high base comparison for Aubagio in the first quarter. Now moving to my next slide, Dupixent sales reached almost EUR3 billion in the fourth quarter alone.
As highlighted on the slide, full year sales were up 34%, driven by continuous robust growth in both US And ex US geographies. Almost seven years into the initial US launch in atopic dermatitis, we have achieved and maintained leadership positions in NBRx’s across all five approved indications and we are confident to deliver around EUR13 billion in sales in 2024 as previously guided. We remain very excited about the outlook for the brand’s outstanding commercial success and expect COPD to become another important growth pillar over time. And as Paul discussed earlier, significant regulatory progress has been achieved with COPD across key markets and we plan for a launch in the US later this year. Now as a quick reminder on the left hand side of the chart, you will notice similar to what we have seen in previous years and it is common for specialty biologics, Q1 growth usually reflects the impact of higher seasonal patient co-pay assistance program utilization associated with the annual resetting of insurance deductibles at the beginning of the year.
We expect a similar effect to weigh on the reported sales in the first quarter of 2024. Now turning to my next slide, we saw strong momentum for ALTUVIIIO in the fourth quarter. ALTUVIIIO has become a top choice for switches in the hemophilia A market, now capturing more than 50% of all switches, and this is really driven by the brand’s differentiated efficacy profile. Importantly, two of every three switches comes from competitive products, including an estimated 10% from non-factor HEMLIBRA. In addition to the gains in a number of US patients, we also saw a geographic expansion with our promising launch in Japan late last year. And launch to date, we’ve seen a broad uptake in the US and many HCPs have even stated that their intent is to increase their depth of prescribing, which provides us with another encouraging indicator for the launch progress into 2024.
And with that, I’ll pass over to Thomas.
Thomas Triomphe: Thank you, Brian. Growing 21% year-on-year, our Q4 vaccine sales reached EUR2 billion, driven by the strong uptake of Beyfortus, an impressive launch I will further elaborate on in my next slide. In Flu, Sanofi continues to be the market leader, driven by our differentiated product portfolio, which represent the majority of our total flu sales. In line with Q3 earnings call comments, approximately 30% of our H2 2023 flu sales were reported in the fourth quarter, generating 4% sales reduction year-on-year, as we saw lower [premiumization] (ph) rate this season and an increased level of competition in the US market. Finally, we are very pleased by the Q4 performance of our [PPH] (ph) franchise, which benefited from a favorable public order pattern in the US despite Vaxelis sales not being recorded in our net sales.
In Q4 2023, Vaxelis has become the US pediatric primary service leader and continues to gain share over the pentavalent vaccine. The next slide is focused on our RSV franchise. Starting with the left. You can see that the launch of Beyfortus in the US set a new record in terms of routine pediatric immunization uptake when compared to similar pediatric vaccine launches, such as Rotavirus and Meningococcal conjugate vaccines. With an average adoption rate of 38% in only six months after launch, Beyfortus performance illustrates the successful implementation of its first broad infant recommendation in the US, in France and in Spain. We’re very encouraged by the strong real world clinical data generated in Spain, and we now look forward to rolling out Beyfortus more broadly in 2024.
But beyond the infant segment, the respiratory syncytial virus is also a significant burden for toddlers and older adults. We are developing vaccines specifically targeted to these two groups, and I’m glad to report that our vaccine candidates are making good progress. For toddlers, our live [indiscernible] candidate received EU PRIME designation in December, Following US Fast Track Designation in 2023. These designations do recognize the potential of our vaccine candidate to address a significant unmet medical need. As communicated at our Vaccines Day, Phase 3 will start this quarter. For older adults, we initiated last November the Phase 1/2 clinical trial of our mRNA, RSV and hMPV vaccine. As highlighted then, we believe that our combo vaccine has a real potential to be first in class, and that its medical value compared to RSV standalone vaccines, will provide a more compelling case to recommending bodies.
