Alnylam at 24th Annual Needham Conference: Strategic Growth in Focus

On Tuesday, 08 April 2025, Alnylam Pharmaceuticals (NASDAQ: ALNY) presented at the 24th Annual Needham Virtual Healthcare Conference, showcasing its strategic growth and future plans. The company highlighted its achievements and optimism in the TTR franchise, while acknowledging challenges like modest tariff impacts. Alnylam's stock saw a slight decline recently, reflecting a nuanced market response.

Key Takeaways

• Alnylam projects 2025 TTR franchise revenue between $1.6 billion and $1.725 billion, indicating a growth rate of 36% to 41%.
• Ambutra, approved for ATTR cardiomyopathy, is priced at $477,000 annually, with plans to lower costs as more patients adopt the treatment.
• The cardiomyopathy market presents a significant opportunity with 300,000 patients worldwide, 80% of whom are untreated.
• Alnylam's pipeline includes promising therapies like Nuclisiran, Zalvisiran, and Mibel Suran, aimed at expanding treatment options in various conditions.
• The company has engaged with 90% of payers through value-based agreements to enhance market access.

Financial Results

• TTR Franchise Revenue Guidance:

- 2025 revenue is projected between $1.6 billion and $1.725 billion.

- Growth expectations range from 36% at the midpoint to 41% at the top end.

• Polyneuropathy Business Growth:

- Achieved 35% growth in the last quarter and approximately 34% for the full year.

Operational Updates

• Ambutra Approval:

- Approved for ATTR cardiomyopathy, priced at $477,000 annually.

- Plans to reduce the price gradually as patient adoption increases.

• Value-Based Agreements:

- Active contracts with around 90% of payers, most involving value-based agreements.

Future Outlook

• Cardiomyopathy Market Opportunity:

- Estimated at 300,000 patients worldwide, with 80% currently untreated.

- Anticipates about 18,000 new patients annually.

• Pipeline Programs:

- Focus on advancing Nuclisiran, Zalvisiran, Mibel Suran, and Huntington's program.

• Financial Goals:

- Aiming to grow operating income and invest in organic innovation over the next five years.

Q&A Highlights

• Tariffs and Regulatory Developments:

- Minimal exposure to new tariffs due to U.S.-based manufacturing.

- Addressed uncertainty surrounding HHS and FDA developments.

• Competition and Market Dynamics:

- Continued volume growth despite new competitors, expanding the category.

- Expected monotherapy market dominance, with potential combination therapy growth when generic tafamidis becomes available.

For a deeper dive into Alnylam's strategic insights and detailed discussions, refer to the full transcript below.

Full transcript - 24th Annual Needham Virtual Healthcare Conference:

Joey Stringer, Biotech Analyst, Needham and Company: Good morning, everyone. Thank you for joining the twenty fourth Annual Needham Healthcare Conference. My name is Joey Stringer and I'm one of the biotech analysts at Needham and Company. It's my pleasure to introduce our next presenting company, Alnylam Pharmaceuticals. And joining us today from the company is John Kennedy, who is VP of the TTR franchise global commercial lead, and Sandeep Menon, chief development officer.

For those of you joining on the webcast, if you'd like to ask a question, please do so at any time. You can submit a question using the chat box feature at the bottom of your screen. So with that, we'll get started. John and Sandeep, thank you so much for joining us today.

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah, thank you.

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Thank you.

Joey Stringer, Biotech Analyst, Needham and Company: Great. Well, I guess we'll start high level here. A lot going on lately, but can you give us your high level thoughts on the recent tariffs and Alnylam's exposure here? How big of an impact does this have on your business?

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Thanks, Joe. The majority of our commercial products is manufactured in The US. So our exposure to this new tariffs is very modest. So that's all, you know, we can say as of now. And, you know, as things evolve, you know, we'll see how it goes.

Joey Stringer, Biotech Analyst, Needham and Company: Got it. And what's your take on some of the recent developments and layoffs within HHS and FDA? And what specifically, what impact do you think it could have on some of your programs?

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Yeah. Yeah. You're right. I think there's a lot of, uncertainty right now. Right?

We can't predict where things will land. We have been extremely fortunate, up to now. So happy to have achieved our approval for the sNDA for, the vutrisiran, you know, two weeks ago, as well as the, the the approval. You know, this is for, our, you know, the fitusiran the last week. So we continue to have good engagements, with the rank and the file members of the of the FDA in the review divisions.

And our hope, in that is those individuals will be protected, as they are PDUFA funded roles. And, you know, as far as the experienced leaders at the top leaving, it's a little bit hard to predict the ramifications, Joe, on all of that. However, we remain very confident that the agency will continue to do what it is best for the patients and the science. Right? We understand Doctor.

McCree is very, supportive of innovation. So beyond that, at this time, I I don't know what else we can comment on given all the changes there. Yeah.

Joey Stringer, Biotech Analyst, Needham and Company: Got it. That that's fair enough and, helpful, insight. 2025 revenue guidance for Alnylam, specifically, I wanna focus on the TTR front. 1.6 to 1,725,000.000 just in TTR sales. So I guess, what what are the key areas that if you execute very well, could drive revenue to the high end of that guidance or potentially in a best case, even even exceed it?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. I'll I'll take that. So, yes, we we've provided full year guidance, and specific to TTR. And, you know, I think, you know, that is unique to the the players that are in this category. And I I think, you know, it's a sense that under we understand that this is an important launch.

It's an important launch for us. It's an important launch for for those of us who are watching. And and I the fact that we put out financial guidance for 02/2025, I think, really conveys our our confidence. So the guidance that we provided, as you said, is 1.6 to 1,725,000,000, for the TTR franchise. Now at the the midpoint of that range, that's about a 36% growth.

So it's it's an acceleration of growth on an already robust base where there's been significant growth to date. So it's an acceleration. That was ahead of consensus at the time that we provide that guidance. And if you talk about the the top end of that guidance, it's about a 41% growth. So it's it's a and it's an acceleration of growth.

And, you know, again, we're very confident and we put out that guidance for a reason. In terms of the types of things that have to happen for us to achieve that, you know, I think we have everything that we need to be able to execute the strategy. We've got a tremendous medicine. We had a great data package that has been talked about. And we now have the approval with a label that broadly reflects the data package that we have so we can begin that important work.

We expect that we're going to see utilization as a first line treatment. And we also know in this category, there are some patients that have been treated with a stabilizer and and unfortunately, continue to progress. And so some of the patients will continue to to seek an alternate treatment option. The fact that we are the first and only, silencer in ATTR cardiomyopathy, an alternate treatment option, I think really positions us well for that as well. So that that gives you a sense of what we're thinking about in in the guidance.

But again, that that reflects our understanding that this is important and our confidence to be able to put that up there.

Joey Stringer, Biotech Analyst, Needham and Company: Yeah. And still sticking with polyneuropathy where we get into cardiomyopathy. You mentioned the strong growth. Just referencing your 4Q numbers, three forty three million you mentioned it grew 35% year over year. You're seeing strong growth both in The US and rest of the world.

So, you know, it's impressive given your drug was proven in 2018, and there's been a recent launch of a competitor in this space. So what's been driving the overall growth in the polygraphy market here? And any metrics you can share around that? And I guess as a follow-up to that, what gives you the confidence that you can maintain that majority share?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. A great question. So, yes, in in that last quarter, 35% growth. So for the full year, about 34% growth in that polyneuropathy business. And what's interesting, you said that, you know, we this is the first full year we've had a competitor in the polyneuropathy space.

Now if you were to go back and look at the year over year growth in the last quarter before we had a competitor, it was in the same ballpark. So essentially, our volume growth has continued unabated. And what what that means is essentially more voices in this category have accelerated category expansion.

Joey Stringer, Biotech Analyst, Needham and Company: Interesting. That's

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: not entirely a surprise. So consider, you know, polyneuropathy of ATTR and cardiomyopathy. These are rare diseases. And so the majority of patients worldwide, the majority of patients are still untreated. And, again, more voices help.

We think polyneuropathy will continue to be a growth story. We also think it's a helpful analog to what we expect in ATTR cardiomyopathy where we also think it's a growth story. More voices will continue to help more patients find their way to diagnosis and treatment. Now in polyneuropathy, we really have done a lot of work to establish Ambutra, as a market leader in polyneuropathy. We still continue to be a market leader in polyneuropathy and we continue we expect to maintain that.

But again, it's a it's I think a good analog of what we expect across both of these indications in terms of the growth story.

Joey Stringer, Biotech Analyst, Needham and Company: Got it. And last one on polyneuropathy. Just given the the metrics that you've mentioned and the strong growth market is increasing here, how big of an opportunity is a polyneuropathy alone? Just any quantitative metrics that you can provide there.

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. We have historically estimated the size of the ATTR hereditary ATTR polyneuropathy, segment to be about twenty five to thirty thousand patients worldwide. So it gives you a sense of of the size of that. And and, again, we still think that there's more opportunity to help more patients find their way to diagnosis and treatment. So we expect that you'll see continued growth in polyneuropathy.

Joey Stringer, Biotech Analyst, Needham and Company: Great. Well, the recent approval to cardiomyopathy, Ambutra, touch on the price there. You had announced that you're maintaining the current annual price of around 477,000 per year on average, but that you decrease this price over time as more patients get on the drug. So I guess that said, what are the potential risks in taking this approach given that the oral stabilizers are priced much lower around $2.40 to $270,000 per year.

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: I I think probably the underlying question here is do we expect to face step edits behind tafamidis or somehow have payers run-in us to the second line? And and I would say no. In in majority of cases, I do not expect, that we would be stepped behind to feminist. And and that's that's for a handful of reasons. Number one, we've engaged with payers significantly, done research.

We've been in the ATTR space obviously for polyneuropathy to date. But what is very clear in these conversations, number one, this is a rare and devastating disease that's generally been underserved to date. So that's a component of the consideration set for payers. Number two, many payers are saying they're looking for, treatment choice and optionality. We feel really, really well positioned as the first and only of an alternate mechanism of action that works upstream.

And, again, the first and only in a new class of medicines for ATTR cardiomyopathy. Payers also consider the clinical data package. And with HELIOS b, it's a really rigorous study. It it it essentially set a high bar, in terms of just the study design, and the results were really compelling. And happy to go through those, of course, but really compelling and consistent results from that.

And then we also hear from payers that the dosing regimen matters. So again, with quarterly dosing, ACP administered, that is peace of mind that the patient will actually receive the the medicine as intended. So by and large, we don't expect to be stepped for all these reasons. Now, could there be some examples where there's a step? There may be.

In those cases, number one, it won't be the majority. We think it's more exception. And we do have the tools to help mitigate or manage that. Whether that's engaging in value based agreements with payers to mitigate that that risk and or, you know, continue to provide patient support services so that those patients can find their way to therapy if that's what the physician or patient determine is the best for them.

Joey Stringer, Biotech Analyst, Needham and Company: Got it. How big do you think the total cardiomyopathy market is, just given what we know about tafamidis, twenty twenty four is 5,500,000,000.0, which historically, you kind of use that as a proxy for the cardiomyopathy market. And some of the commentary from Pfizer around, you know, perhaps the drug's only 20% penetrated of the market. So, you know, collectively, what what are your thoughts on how big this market could could be?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. You know, we've estimated that we think the ATTR cardiomyopathy population worldwide is about three hundred thousand patients. And again, I'll go back to to what you said. I I do see this as a growth story. There have been improvements in diagnosis and treatment rates, but we really scratched the surface.

The majority, again worldwide, about eighty percent of these patients are still untreated. And so we do see it's a significant opportunity. So as that manifests on a kind of more acute basis, we expect that there are about 18,000 globally, 18,000 new to treatment patients coming in on an annual basis. And if these diagnosis and treatment rates improve, we'll see potentially an acceleration of that.

Joey Stringer, Biotech Analyst, Needham and Company: And big picture, how do you see the cardiomyopathy market playing out given the competitive dynamics? I mean, obviously, two oral stabilizers on market, a third silencers in phase three development. You know, what percentage of of TTR patients would you anticipate would be on in the buckets of, you know, stabilizer only combo therapy and then maybe silencer only at a quote unquote steady state, if you will?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. I mean, I I don't wanna get in front of ourselves and kinda speculate on, share allocation. But what I will tell you is that, number one, lots of, opportunity to help more patients. Number two, if you look at the segments of of, where we can help patients, again, there's that new to treatment patient population on a global basis about 18,000. So in The US, call it about half of that, new patients coming in on an annual basis.

There are patients in The US about twenty five, stabilizer treated twenty five thousand patients treating with a stabilizer today. We've seen in the literature estimates of how many progress, could be about half of those patients, and we expect that that, is an opportunity again for uniquely for a product that is the first and only of a different mechanism of action. But what I'll tell you is that on the basis of HELIOS b, our priority is to position Ambucha as our first line treatment choice. And HELIOS b does that. If you look at the patient population that was studied, this reflects the patient that is showing up for that first treatment decision today.

Generally, healthier patients in terms of earlier on the disease progression, substantial background treatments, including in the study of Helius b, about half of those patients on a stabilizer, about thirty percent on SGL two inhibitors, and and majority on diuretics. So, on the basis of that, the the effectiveness we've been able to show really positioned us well as a first line treatment option.

Joey Stringer, Biotech Analyst, Needham and Company: What percentage of total patients are on, Invutra are currently on value based agreements? And how do you see this changing following the cardiomyopathy approval?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: I you know, in terms of value based agreements, let me just back up and say, you know, we're we're really pleased that we've been, I would argue, a pioneer in establishing value based agreements. We've had them for many years here within, the ATTR polyneuropathy, and we've done them across our portfolio. So we've we've been in the value based agreement space for for a long time. If we look at, our experience to date, which is in the hereditary ATTR polyneuropathy, we have engagement contracts with the majority of payers, call it about 90%. The majority of those are covered by some form of a value based agreement.

So, you know, that gives you a sense of scale. But, you know, it is it's a tool in our toolbox and something that we've really learned from the experience that we have in this category.

Joey Stringer, Biotech Analyst, Needham and Company: Got it. Makes sense. In terms of the patients on ONPATTRO and Butra, what's the relative split in terms of community setting versus centers of excellence or, I guess, more general non community setting? And with the larger cardiomyopathy indication coming online, how do you see the split evolving?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. It's actually pretty balanced. I mean, there's maybe a little bit of a skew towards concentration in academic or centers of excellence, but it's generally balanced. A part of why we think it's been balanced is, how we've been able to establish this really robust network of buy and bill ready alternate sites of care. The implication of that is the vast majority of physicians, whether they're in a center of excellence or they're out in a community, are either affiliated with and or have access to an alternate site of care that is very, very familiar and accustomed to engaging in BuyBuilt.

And so it that is just as an essentially a network that's been built up over time. And so we see in polyneuropathy, it's generally balanced, and I expect something similar as we move to cardiomyopathy.

Joey Stringer, Biotech Analyst, Needham and Company: You kind of touched on this before, but in terms of monotherapy versus combo therapy use, and combo meaning silencer plus stabilizer, what percentage of patients currently on IMBUCRA are on combo therapy? And how do you think this will change with the cardiomyopathy approval?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. So, for the time when we had hereditary ATTR polyneuropathy indication, we we did see some combination use where there's non overlapping label with a stabilizer. So it was, you know, call it in the the double digits, in terms of, you know, what we saw. Now more generally, how do I see this this playing out in cardiomyopathy? I think for the next several years, we do expect it as predominantly a monotherapy market.

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Yeah.

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Once we have tafamidis, generic, that could be potentially an unlock of more combination treatment. But but in that case, I think we're set up for durability given the the dataset that we have. Again, if you look at HeLis b, about half of its were on stabilizer in the background, and we saw a tremendous consistency of effect with or without. So I think we're we're set up for durability.

Joey Stringer, Biotech Analyst, Needham and Company: Great. Yeah. You mentioned the defamatous LOE, late twenty twenty eight. How do you think this will impact Invutra use? You know, would you anticipate that it would increase slow or stay about the same?

I guess, you could make theoretical arguments for for both sides, but what are your thoughts on that?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Mean, the the first thing I'll say is, you know, I I don't think our fate is necessarily tied to, anybody else's IP, so to speak. But but just to, kind of build on what we were just talking about, I I do think that when, tafamidis is available as a generic, that that could be an unlock of more combination use in in this category. So that that could be kind of the the pivot that you see. But, again, based on the HeLOS b dataset and the label that we have, we're really well positioned for durability if that were to to come to pass.

Joey Stringer, Biotech Analyst, Needham and Company: Okay. Great. Nuclisiran, your next gen TTR therapy, you guys have talked about the advantages here. It's wholly owned, more convenient dosing, potentially better efficacy, and, of course, better economics to Alnylam. So I guess the question is, in terms of the positioning of this drug, what's the goal here?

Would it be that ultimately all patients on ONPATTRO and anbutrin would eventually transition to this drug? And, you know, I know we're a long ways away from, data, but, how realistic would that be in a real world setting, that switching dynamic?

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Sure. I can take that. I'd start with the Nucleusiran Surin benefits. Right? Because we we are seeing ninety five percent TTR knockdown.

Right? So there is a lot of data that is coming that is, you know, durability supporting by and by dosing. Right? So there is in this case and plus we will not have any third party royalties here. And the IP is going to possibly extend to the 20.

So this is the key benefits. And then what we have seen from, both the ONPATTRO and the ambutra data in the in polyneuropathy is that greater TTR knockdown is associated with better clinical outcomes. You know? In this case, you know, MNIS plus seven. Similarly, we know for other amyloidosis diseases in general.

Right? Like, for example, AL amyloidosis that that the more you remove the insulting protein, in this case, the toxic protein, the better the clinical outcomes are. So we have also seen that basically in in our Centimeters study as well for for Helios P, we are starting to see that the patients with a better knockdown has got, you know, better outcome. So for our from our vantage point, we want to bring in something that is going to be even better. You know, Vutri is already a differentiated pro profile.

We want to bring things that is even better in terms of both the efficacy and safety and the patient convenient convenience. You know? From an uptake perspective, you know, having a safe and effective, therapeutic option could be potentially game changing, you know, because this is going to be only twice a year, and could be very highly attractive option for for patients. Now in terms of the switch, and other things, and I'm sure, John, you will agree, it's a little bit far you know, too far for us to sort of make all of these projections. But what we are seeing from a scientific perspective is that we are seeing, based on, you know, a better knockdown, better profile.

That's the bottom line. John, you want to add anything here?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: I think you covered it well. I mean, look, I I think, you know, our goal is to make sure that we continue to drive innovation, for the sake of of patient. And, you know, if we're able to bring forward a a treatment option that delivers that type of profile that Sandeep had talked about, I think that will be compelling.

Joey Stringer, Biotech Analyst, Needham and Company: One more on NUCRISAN. You know, obviously, Alnylam markets ONPATTRO and Buthra, but Sanofi has a significant economic interest in in the revenue stream. So I guess in a scenario where Nucyrann is ultimately proved in TTR, how could you see this commercialization dynamic play out?

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: So I guess I can start and then, you know, John, you can build it. Right? I guess I I I mentioned that we'll definitely don't have any, you know, third party royalties. And and from our perspective, it will be a fully differentiated profile clinically, you know, and and beyond that, you know, I'll I'll let, John comment on the commercial play. You know?

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. I mean, look. I I don't wanna get ahead of ourselves. So we're very excited that we have, approval for Ambutra in ATTR cardiomyopathy. We're very excited about, what we can accomplish in the near term.

In terms of nucreseren, obviously, there's more development work, as Sandeep, explained to be done. When we get to that point, we are able to promote, nucreseren. And so, we'll educate customers on on the profile that we're able to deliver with nucreseren and, create optionality for patients. So, yeah, I think we'll take that in time as we continue to build a long and durable experience here in this ATTR market.

Joey Stringer, Biotech Analyst, Needham and Company: Great. Fair enough. A lot of them, they have an expansive pipeline. We don't have time to cover everything. But I guess if you had to pick one outside of your marketed therapies, which one are you most excited about and you think could be a meaningful value driver for shareholders and why?

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Thank you. You know, from our perspective, I'm going to share a few of them, not just one. Right.

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Have a

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: few of them, which is a fantastic opportunities. Right? So, you know, we have shared in the R and D day that, you know, the current pipeline, the the way we are positioned is, you know, huge unmet need for patients and, and from a commercial perspective and a multibillion dollar opportunity. So, I've already talked about Nucleusiran because and you know what it can do to the TTR franchise. The the next one is Zalvisiran.

So we are almost reimagining the opportunity for treatment of hypertension. Okay. So we have read two data sets now, which has been positive, k, you know, k cardio one and cardio two. We are expecting the data, you know, by the end of this year, for the second half of this year, you know, for cardio three. And then the phase three CVOT is expected to start, you know, in the second half of year for zolvisiran.

The next one is Mibel Suran, which is another differentiated, you know, potentially differentiated profile that should come. It's targeting the amyloid, precursor protein. So this is almost like the mother of all the protein, you know, amyloid proteins that goes. So we are switching off the tab here. We have a differentiated approach both for the cerebral amyloid angiopathy, which is the CAA, and Alzheimer's disease.

And we have shown some data in the phase one ongoing early enzyme early onset Alzheimer's disease patients where we have got encouraging results so far, you know, showing robust target engagement, but also moving the the pathogenic peptides. You know, we are, you know, bringing it down, which is much more closer to the disease. And then finally for the, the CAA, you know, which is the second leading cause of the intracerebral hemorrhage, which is about eighty thousand patients in US alone. So what we are doing is we are running the phase two study, and it's it's going on, you know, so so far, you know, it's it's recruiting well. And then finally, it's the Huntington's program.

And this is we have a very differentiated approach again in terms of how we are targeting the Exon one, which is one of the, you know, differentiation we bring in for the Huntington's disease patients where, you know, this is it will it will help us prevent widespread neurodegeneration and reduce progression of the Huntington's disease. So we have a bunch of programs, exciting in terms of the what it can give to the patient community and, you know, a multibillion dollar opportunity.

Joey Stringer, Biotech Analyst, Needham and Company: Great. Very helpful, Sandeep. And last quest question from us. It's a financial question. So sustainable Don Gap profitability was a big goal for Alnylam, and it looks like you're on track to hit that in in 2025.

So I guess what's the next financial goal here? And as we start to think more about operating margins, deployment of capital, what's the right balance between investment in the pipeline and maximizing profitability?

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Yep. I'll take that. And, John, you can build build if any I missed anything. So we are actually actively thinking about our next five year, you know, set of strategies. Right?

As we are looking at our new exciting chapter for the next five years. So we we definitely want to ensure we can, we can continue to grow the operating income. At the same time, we I've always believed in sustaining the innovative engine and an r and d strategy that is sustainable, that is differentiated, that can yield higher rates, of success, you know, that has already, you know, yielded higher rates of success than the other industry standards, you know, known to date. So, therefore, as we have highlighted in our, recent r and d day in Feb, you know, it makes us, for us, a lot of sense for us to continue to invest in the organic innovation, which we have been very committed to. So, you know, as, you know, months go on, we will share more of our long term strategy, you know, at a later time.

John, you want to add anything? Yeah.

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: I think you covered it. I mean, you know, it starts with a successful launch of, amputer in cardiomyopathy, and we've provided the guidance and, you know, we're confident and we're ready. So I I think that's where it starts, and and Sandeep, finished the story well.

Joey Stringer, Biotech Analyst, Needham and Company: John and Sandeep, thank you so much for the excellent discussion. It was very informative.

John Kennedy, VP of the TTR franchise global commercial lead, Alnylam Pharmaceuticals: Yeah. Thank you.

Sandeep Menon, Chief Development Officer, Alnylam Pharmaceuticals: Thank you, John. Thank you, everyone.

Joey Stringer, Biotech Analyst, Needham and Company: And thank you, everyone, for joining on the webcast.

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