The value of this combo is already recognized by the US FDA, which granted it the Fast Track Designation in October 2023. If Phase 1/2 results are positive, the Phase 3 trial is planned to start by the end of this year. Overall, I’m thrilled by the phenomenal progress our RSV team has made in the last six months, building foundations for Sanofi to become the leader in the RSV franchise. Let me now hand over the call to Olivier.
Olivier Charmeil: Thank you, Thomas. General Medicine sales in the four quarter showed a slight decrease of 2.4% to EUR3 billion. Our core assets grew by 6.3%, driven by Plavix, Toujeo, Rezurock and Praluent, which was partially offset by lower sales of Mozobil due to generic competition, which started in the US in July 2023. Sales of Rezurock in the US continued to grow strongly, driven by increasing patient numbers as well as improved adherence rates. Toujeo Q4 sales delivered double digit growth driven by China. This largely offset lower sales in the US due to a lower average net price. Sales of non-core assets decreased mainly driven by lower Lantus sales in the US which continued to be affected by a negative channel mix as well as lower inventory and trade-in anticipation of the [2024 list high figures] (ph).
For the full year 2023, GenMed sales decreased by 7.1% due to the exceptional impact from the US launches decline along with the VBP impact on Lantus sales in China. As mentioned, Tzield continued its gradual uptake in Type 1 diabetes. In November, we launched a well-received national screening campaign in the US to increase awareness and encourage screening for at-risk individuals. As a result, screening grew 31% driven by endocrinologists in 2023 and 168 patients were infused by the end of the year. The number of patients infused grew by 25% in Q4 versus Q3 despite the year-end holiday season. The full results of the product studies with newly diagnosed Stage 3 Type 1 diabetes patients We have shared that the ISPAD Congress and interaction with FDA and EMA are ongoing.
With this, I’m handing over to Julie.
Julie van Ongevalle: Thank you, Olivier. Firstly, I’d like to start with an update on the separation of the CHC business, which as previously announced, could happen in Q4 this year at the earliest. We’re making solid progress on our journey to full business autonomy and continue to enhance our own internal talent pool with selective hires in key areas. The service agreements are being put in place and we are establishing our digital infrastructure so that we can hit the ground running on day one. Regarding performance, Q4 marks our 11th consecutive quarter of growth with sales up 8.5%, driven primarily by price. Excluding divestment and acquisitions, Q4 growth was around 5%. The Qunol acquisition closed at the end of September drove growth over 50% in our physical and mental wellness category.
As you may recall, Qunol products focus on healthy aging in the US. I’m very glad that the Qunol is now part of our CHC business, giving us a fast growing platform with which to compete in the important US VMS market. Last quarter, I introduced you to the 15 priority brands, which represent over 60% of our total net sales and over 85% of our growth in the past three years. In Q4 and in full year 2023, these brands were once again our major growth drivers, which resulted in a 6.3% growth for the full year with good growth across all categories. Our largest category, digestive wellness, continues to perform strongly with double digit growth and market share gains. And I would like to give you some more background on one of these brands, in this category, Dulcolax.
Dulcolax is the world’s number one non-prescriptive laxative. Important to note is that one-third of the world’s population suffer from constipation, yet nearly half still don’t seek treatments with laxatives. This makes an attractive and substantial market opportunity. Dulcolax has been growing faster than the market for the past three years, executing on its repeatable model of growth, of which three main drivers are, one, the change in the focus of marketing to consumers. Moving from our positioning from purely medical and functional solution to a more emotional communication, breaking down the taboo of constipation, while educating on how Dulcolax works naturally with your body. Second, launching innovative, more consumer friendly and gentle formats such as chewables that have driven category penetration.
Last but not least, working with healthcare professionals, resulting in strong endorsement. With its simple reputable amount of growth, I’m confident Dulcolax will continue to help consumers and gain market share. With this, I’m handing it over to Jean-Baptiste, our CFO.
Jean-Baptiste de Chatillon: Thank you. Thank you, Julie. As you just heard, we’re up 9.3% in the quarter driven by double digit growth in Specialty Care and Vaccines. Dupixent and rare diseases were key drivers in the Specialty Care, while vaccine sales grew more than 20%. General Medicine sales decline decelerated and CHC reported another quarter of growth of 8.5%. Looking at the Q4 P&L on Slide 31, gross margin expansion was driven by our improved product mix and the strong contribution from COVID-19 vaccines revenues in the last quarter. R&D expenses grew 6.6% at CER mainly reflecting the continued progress of our Vaccines pipeline, mainly driven by the mRNA development programs. This quarter, we also start recording a share of the Phase 3 development costs related to the recently announced collaboration with JNJ on our potential first-in-class ExPEC vaccine.
The BOI margin decreased 1.7 percentage point to 23.7% mainly due to a decrease in capital gains related to product disposals when compared to the same quarter last year. EPS was up 8.2% in Q4. Turning now to the full year group P&L on Slide 32. We recorded an improvement in gross margin, of which almost 1 percentage point was due to COVID-19 vaccine related sales and revenues. The product mix also contributed to gross margin expansion partially offset by lower Aubagio sales due to generic competition on lower net prices of launches in the US. Operating expenses grew roughly in line with sales and our business operating margin remained stable at constant exchange rate. EPS for the year grew 5.4% in line with our full year 2023 guidance. On Slide 33, our Board is proposing an annual dividend of EUR3.76, which represents a 5.6% increase over last year.
Our progressive dividend policy remains an important part of our capital allocation policy. We have launched the different efficiency initiatives presented in Q3 with the objective to reallocate up to EUR2 billion savings. We will focus on the programs with first best-in-class potential, reallocating resources on growth drivers on strategic therapeutic areas. We will also leverage procurement to generate additional savings. Lastly, we will modernize the commercial delivery by optimizing our country setup, expanding the hub strategy to increase centralization, while refocusing R&D on most critical sites on technology platform. On Slide 36, we are providing an outlook for both the full year 2024 and the Q1 2024. Full year 2024 sales, we expect Dupixent to reach EUR13 billion and the Vaccines franchise to grow mid-single-digit driven by the ongoing launch of Beyfortus.
The Aubagio LOE will continue to impact mainly in H1. The planned GenMed divestments will lower the top line by around EUR300 million. On full year 2024 P&L, we expect the gross margin to decrease slightly due to the absence of COVID-19 sales and revenues. OpEx is expected to grow due to roughly EUR700 million step-up in R&D, while SG&A expenses are expected to remain stable. Finally, as announced in Q3, the ETR will increase to 21% due to the implementation of [Dillard] (ph). The dynamics in Q1 will differ from the overall year mainly due to high base effects in Vaccines on GenMed Aubagio, on top of the Dupixent sales annual step-up in US co-pay as already mentioned by Brian. Similarly, on the P&L side, I remind you of a high level of capital gains generated in Q1 2023.
So advancing to my final slide, Slide 37, we expect full year 2024 Business EPS to decline in the low single digits at CER. Excluding the impact of the tax rate change, the full year 2024 business EPS would be roughly stable. On foreign exchange, we see a negative currency impact of minus 3.5% to minus 4.5% based on January 2024 average exchange rate. 2024 is a year where we are resetting the company for long term value creation and we expect a strong EPS rebound in 2025. Let’s open the call now for Q&A.
A – Eva Schaefer-Jansen: [Operator Instructions] The first question comes from Luisa Hector, Berenberg. Luisa?
Luisa Hector: Hi. Can you hear me?
Eva Schaefer-Jansen: Luisa, can you hear us?
Luisa Hector: Yes. Can you hear me?
Paul Hudson: Yeah.
