Vertex at Leerink: Strategic Moves and Growth Prospects

On Monday, 10 March 2025, Vertex Pharmaceuticals Inc. (NASDAQ: VRTX) presented at the Leerink Global Healthcare Conference 2025. The discussion, led by CFO/COO Charlie Wagner and CSO David Altschuler, highlighted Vertex’s recent achievements and future plans. The company celebrated a successful 2024, marked by regulatory approvals and strategic acquisitions, but also acknowledged challenges such as margin pressures from new product launches.

Key Takeaways

• Vertex achieved substantial growth in 2024 with key regulatory approvals and the acquisition of Alpine Immune Sciences.
• The company is focusing on the launches of Aliftrec, KASGEBI, and Jernavix in 2025.
• Vertex is advancing its pipeline with significant developments in pain management and Type 1 Diabetes treatments.
• Financial guidance for 2025 projects revenue between $11.75 billion and $12 billion.
• The company is optimistic about its future, emphasizing transformative therapies and strategic execution.

Financial Results

• Revenue guidance for 2025 is set between $11.75 billion and $12 billion.
• Jernavix is expected to contribute more significantly to revenue in the latter half of the year, despite initial lower revenues due to financial assistance programs.
• Aliftrec offers a favorable margin profile compared to Trikafta, while KASGEBI and Jernavix will initially create margin pressures.

Operational Updates

• Jernavix, approved on January 30th, is focusing its launch efforts on hospitals and Integrated Delivery Networks (IDNs), with positive early discussions in New York and Arkansas.
• Vertex is progressing with NAV 1.7 inhibitors and pivotal trials for VX-880 and VX-264 in Type 1 Diabetes.
• Aliftrec is anticipated to become the leading treatment for cystic fibrosis, with a gradual switch from Trikafta expected.

Future Outlook

• Four programs in Phase III are set to reach major milestones in 2025, potentially broadening Vertex’s therapeutic offerings.
• The company aims to develop manufacturing processes capable of treating a million people with Type 1 Diabetes.
• Vertex plans to engage in reimbursement discussions for Aliftrec outside the U.S. throughout the year.

Q&A Highlights

• Financial assistance programs for Jernavix are temporary, with an expectation of expanded payer coverage over time.
• Updates on VX-880 will be shared at an upcoming ADA meeting, while data for VX-264 is anticipated this year.

For further details, readers are encouraged to refer to the full transcript below.

Full transcript - Leerink Global Healthcare Conference 2025:

Dave Reisinger, Covering Diversified Biopharmaceuticals: All righty. Great. Well, thanks very much, everyone, for joining us for our next session with Vertex. My name is Dave Reisinger. For those of you who don’t know me, I cover Diversified Biopharmaceuticals.

And it’s my pleasure to welcome Charlie Wagner, who is CFO and was recently appointed COO as well and David Altschuler, who is the company’s Chief Scientific Officer to be with us today. So I thought we could start off by turning it over to you, Charlie, to kick us off with some opening comments.

Charlie Wagner, CFO and COO, Vertex: Yes. Thank you, David, and thanks for everyone who’s here. Listen, we’re not that far removed from 2024, a year in which Vertex saw exceptional growth in financial performance, regulatory approvals and the important acquisition of Alpine Immune Sciences. Now squarely in 2025, we continue to extend our leadership in CF, notably with the recent approval and ongoing launch of Aliftrec. We are continuing to build momentum with KASGEBI, our gene editing therapy for sickle cell disease and beta thalassemia, executing that launch.

And then importantly, now kicking off the growth of our franchise in acute pain with the launch of Jernavix. So very, very busy start to the year. We’ve also got four programs in Phase three that will have significant milestones during the year, so something for folks to look forward to there. And I guess I would just say in a period of time when it seems like a lot of people are very feeling very uncertain and focused on turbulence, we continue to execute very consistently and are really excited for the year and happy to take your questions today.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. And could you comment on your sort of key areas of focus in your new role for Vertex in coming years?

Charlie Wagner, CFO and COO, Vertex: Yes. I think, listen, my areas of focus are the same for the entire executive team, and I alluded to it in the opening remarks. We’ve got a business now that is very healthy, very growing, diversifying in many ways. Certainly, a lot of our focus in 2025 is on the launches, the launch of Aliftrec, the launch of KAS Jevi, the launch of Jernavix, sort of all attention on making sure that we are building momentum, that patients and physicians are having a great experience in the early days of these launches. And for those that are in pain, for example, ensuring that we are contracting and pricing in a way that is both responsibly balances access, but also preserving value for Vertex for the long term.

So a lot of attention there. And then as I mentioned with four programs in Phase III, David and our colleagues in clinical and Reshma, our CEO, are very focused on making sure that those are shepherded through the process. Next year. But that really does set us up for a whole another wave of diversification, not in the distant future, but in the next couple

Dave Reisinger, Covering Diversified Biopharmaceuticals: of years, something

Charlie Wagner, CFO and COO, Vertex: that requires a lot of not in the distant future, but in the next couple of years, something that requires a lot of our attention these days.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent, excellent. And how would you paint the picture of where you are with respect to garnering attractive insurance access for Jernavix? For Jernavix, yes.

Charlie Wagner, CFO and COO, Vertex: So keep in mind with Jernavix, the approval was January 30. So we’re just over a month in and I know people expect great things from us. We are moving as fast as we can. Honestly, we had as many sort of appropriate pre approval conversations as we could have with IDNs and payers. Obviously, that’s kicked into high gear since the approval.

We are really encouraged by the conversations. So whether they are currently now conversations with physicians, with hospitals, with IDNs, with payers, with GPOs, there is very, very clearly an unmet need for an alternative to opioids and Genavix fills that need very nicely, and there’s a lot of interest in procuring coverage for this medicine. Now that takes some time. We have said all along that going through P and T committees, going through the contracting process would take some time and it will. But we’ve already seen signs of progress.

There was some news in the press last week about ongoing conversations we have with Optum not complete yet, but I think positive that these are occurring so rapidly. There are two states, New York and Arkansas that have already provided coverage for generics. And so we have a lot to go, but the early signs are really encouraging. And I think in particular, some of the conversations that are going on right now indicate that coverage in many cases will be sooner rather than later. But again, we’re going to balance that responsibly.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. And so yes, I think you actually understated the two states providing coverage. When I say that, my understanding is that, it’s fully open access, no prior authorizations, no step edits, which is quite extraordinary for states that are not in the best of financial health in particular, right. So New York and Arkansas were the ones that provided that access. Could you add a little more color?

Charlie Wagner, CFO and COO, Vertex: Yes, you’re right about that. So obviously, our goal is to provide access for patients without any prior authorization or step edits. That is, in fact, what we’ve achieved in those two states. And again, I think it speaks to the compelling proposition, if you will, including the economic proposition for Jernavix. These are states that have understand the cost of the opioid epidemic, understand the role that an alternative to opioids can provide in this case.

And so the fact that they’ve provided broad coverage quickly, I think, again, is very telling. Excellent.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Well, hopefully, the rest of the states follow.

Charlie Wagner, CFO and COO, Vertex: Hopefully. 48 to go. 49 maybe.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. So maybe we could just then pivot to thinking about how the inpatient setting is quite different from the outpatient setting. So clearly, broad access without constraints by PBMs is important. But also, within IDNs, it’s quite complicated. But how would you paint that picture?

Charlie Wagner, CFO and COO, Vertex: Yes. And I think we’ve talked about the fact that annually in The U. S, about eighty million people a year seek a prescription for moderate to severe acute pain. Importantly, about sixty percent of those of the prescriptions are written or influenced in an institutional setting, so in a hospital or a surgical center. Some of those prescriptions, the medicine is used in the institution.

The majority though of the prescriptions, the medicine is filled at discharge or at retail and administered at home essentially. So the largest part of the market is outside of the institution, but there is a lot of influence around the writing of prescriptions in the institutional setting. And so therefore, our commercial efforts in the early days are concentrated on a couple of thousand hospitals that ladder up into a couple hundred IDNs that represent the majority of prescription writing. Over time, we expect to reach the rest of the market partly through efforts in our virtual or digital sales effort. We have kind of non personal outreach to other aspects of the market, and that will grow over time.

But the greatest commercial leverage for us in the early days is in the institutional setting where the greatest volumes of prescriptions are written.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Got it. Okay. Excellent. Why don’t we pivot to the pipeline a little bit? So it would be helpful, David, for you to talk about the X.

September, your vision for it and you know, just color and perspective on that first follow on agent.

David Altschuler, Chief Scientific Officer, Vertex: Sure. Let me start just with sort of, excuse me, our long term vision, and then I’ll speak to the nearer term. We do believe that a door this is sort of Genomics opening the door to what I think will, in the long run, prove to be a transformation of how pain is treated because, the selective sodium channels to block peripheral nerve signaling, getting the pain basically the signals that take the pain from your tissues to your brain has great potential ahead of us. And the reason for that is NAV one point eight, Genavix approved, and I’ll come to nine nine three in a minute. But also there’s, NAV 1.7, which is another sodium channel selective sodium channel that’s expressed in the same neurons that partners with NAV 1.8 and that, NAV one seven triggers, NAV one eight propagates the signals.

And so there’s really tremendous potential in the future for this. But in the near term, as we do with all of our programs, we continue to out innovate ourselves. And with nine nine three, I’d say there’s three things that are, you know, particularly, a focus with that molecule, which as you know is in phase two, both in acute pain and also in DPN. And so the the three things are, one, the ability to dose higher up the curve. So, we don’t know what will happen when we do that because we’ve never done it before, so no one else has either.

So we don’t know if we’re already at the ceiling or if there’s more efficacy that can be had. But nine nine three has the potential to go higher considerably higher. And the phase two studies will do that, so we’ll be able to answer that question. The second thing is, the potential for IV treatment because just the physical properties are such that it can be formulated for IV, and we’re in the clinic with that, which I think for the, clinical, in hospital treatment to be able to go from to be able to eliminate not only the oral opioids, but also potentially at least some uses of, IV opioids would also be powerful. So we’re working on that.

And the third is the potential for combo therapy, which is why I sort of started by mentioning NAV one seven. NAV one seven NAV one eight NAV one eight obviously works as a monotherapy. NAV one seven hasn’t yet gone to the clinic, but the human genetics is that people who carry knockouts of both copies of NAV one seven have something called congenital insensitivity to pain, which was first discovered in a family of Pakistani fire walkers who could walk on coals. They could feel the sharpness of the coal. They could feel the pressure of the coal.

They could feel the temperature of the coal, and they were otherwise healthy. They just didn’t feel any pain, and that’s lacking NAV one seven. And we we’ve cracked that as well. And although it’s not in the clinic yet, we’re moving forward aggressively on that. So the ability to be able to do combo therapy may be important in the future.

Now I wanna be clear. Jernavix could be used in combo therapy. There’s no reason it couldn’t be. But our team in San Diego who discovered the CF medicines and also is leading this pain program knows a lot about how do you actually design molecules not just to work in a dish, but actually to work in combo therapy in a person. And, so we continue to optimize so that the best chance, not just for the next quarter or two or even the next year or two, but the transformation of the disease in the future.

And, one thing I’ll I’ll close with is, I first became part of Vertex when I joined the board in 2012, and Kalydeco had just been launched. And one of the reasons that I was so compelled I think Jeff Lyden was so compelled by the company was, he became CEO that year, was because you had a target in yeah. The disease in CF that, of course, had serious unmet need and no transformative therapy. You had human genetic target validation in that case of CFTR, in this case of NAV one seven and one eight. You had a human cell model that you used in the case of of CF, it’s, HBEs.

In the case of pain, we use human dorsal root ganglion cells. And then you had multiple mechanisms of action and multiple scaffolds that had already been proven their translatability. In the case of Kalydeco, that was proving you could translate the target and the cells to a human being. In the case of generics, now we’ve done that with pain. And so it’s not like we’re speculating we might have other molecules and scaffolds.

It’s not like we’re speculating there might be another, target and that they might work in combo like they did in CF. It’s all reality. And so the question is just sort of as we thought in 2012, you know, how do you execute that? In that case, it took seven years to get in 2012 to Trikafta. I’m not saying it’ll happen that fast.

But, nonetheless, we did move quickly. And I think in this case, it feels just like 2012 to me.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. Yes. That’s

David Altschuler, Chief Scientific Officer, Vertex: Pain 2012, CF 20 Pain twenty twenty five, CF twenty twelve, in case you wonder what I meant.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. And so then going back to NAV 1.7, could you tell us a little bit about how you’ve cracked the code there and what to watch going forward?

David Altschuler, Chief Scientific Officer, Vertex: Yes. In terms of how we did it, I’ll give some answers. Obviously, especially with the success the approval of Genavix, this is becoming, I’m sure, a more competitive area, so I’m not gonna give any enabling comments. But what I’ll say is that, you know, people have worked on NAV one eight and NAV one seven for two decades, and we’re the first to ever get, you know, to phase three, let alone approval. And the reason for that is selective sodium channel inhibition.

There are nine sodium channels in the human genome, and they have different functions. Nav 1.1, for example, is the gene mutated in Dravet syndrome. If you have 50% less or 50% more, you have inherited epilepsy. So that’s not a target you wanna touch. Nav 1.5 is involved in the heart, etcetera.

And so it’s been known from the human genetics that if you can modulate one eight or one seven, you can have effects on pain without other effects. The question is, could you make a molecule that only did that? And finally, if you wanted before we started clinical evidence, it’s not just Drnavix. It’s lidocaine, novocaine. If everyone who’s had dental work or had, you know, stitches knows that if you put lidocaine or novocaine, which is a nonselective sodium channel blocker, you can block all pain.

You say, why is that used locally and not in the systemically? It’s because it blocks the other sodium channels. So the case of NAV one eight, our New England Journal paper a couple years ago showed 30,000 fold selectivity of one eight over the others as well of having screened hundreds of other targets and seen nothing. With NAV one seven, the whole community was working for twenty years on a particular, target approach. And, we decided a number of years ago, technology had changed so much that people were sort of, like, following a thread that had been laid, you know, decades earlier.

And we said there’s so many new technologies, and we we don’t we’re not a platform company. We use all the technologies. So whether it’s DNA encoded libraries, cryo EM, AI, ten years of of, of structure activity relationships, our in vivo our human assays, and we decided to start again. So we said, let’s pretend no one had ever done anything. Let’s try and discover it fresh.

And in fact, we did discover, something new that’s not in the literature that anyone else knows about that has now moved forward rapidly towards the clinic. It’s not yet ready for the clinic, but I’m confident based on where we are that we’ll get there. So it’s actually something that’s not knowable for others because we decided, let’s start afresh with all the new technology rather than following something that was discovered with technology from twenty fifteen, twenty years ago.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. That’s very impressive. Thank you. So maybe we can pivot to CF. So it seems to me that many CF patients would likely want to switch to a lift track and obviously you’re not providing targets.

But could you talk a little bit about your connectivity to patients both through your specialty pharmacies and Vertex Direct and how you can pretty rapidly educate

Charlie Wagner, CFO and COO, Vertex: the existing users about Aliftrex availability? Sure, absolutely. And I would say the CF community is sort of among the most well educated patient communities, I think, of any disease area. That’s particularly true in The U. S, but increasingly so in countries outside The U.

S. So whether you’re talking about patients or the treating physicians, there’s very little chance that they don’t know about the availability of Aliftrec at this point. And we have said all along that Alift Trikafta is a fantastic medicine. Many patients do extraordinarily well on Trikafta, but there is the opportunity to do better. And we think Aliftrec is the medicine that provides that next level of benefit for patients and a great profile all around, including once a day dosing, which obviously is convenient.

We think that over time, the majority of CF patients who are currently on Trikafta or other medicines will switch to Aliftrec. We are not actively driving switching because we think it’s a very important choice for patients and their physicians to make, but we will support that as it occurs. And again, we do think the majority will switch over time. We’re not that focused on how many per se make the switch in this calendar year, but we will be reporting out in our quarterly revenues. People will have a sense of LifTrec revenues and therefore a sense of uptake.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Got it. And then could you comment on ex U. S. Prospects for LIFTRIC as well?

Charlie Wagner, CFO and COO, Vertex: Yes. Again, I think that there’s a significant opportunity. I think the experience with Trikafta has been one where we secured, I forget the number at this point, something like 50 reimbursement agreements in relatively short order, which I think shows the power of the profile of Trikafta. Again, a lift track with an even better profile, we think is significant. We’ve recently received approvals.

I think we just announced on Friday an approval for a lift truck outside The U. S. So great momentum there. In terms of uptake, it will require reimbursement discussions. So the approval alone isn’t enough.

We’ll have reimbursement discussions that will be ongoing outside The U. S. Throughout the year.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Got it. And then, maybe we could pivot back to the pipeline. David, if you could paint the picture for Type one diabetes, in terms of the opportunity as you see it, the datasets that we should be watching for and also comment on the scalability of the manufacturing.

David Altschuler, Chief Scientific Officer, Vertex: No. Absolutely. And it’s a it’s a super exciting program, I should say. I trained as a diabetes physician. I was a diabetes doctor at Mass General for a number of years before I I focused entirely on science.

And so one of the things I learned clinically a long time ago is there’s no patient I’ve ever met with type one diabetes who doesn’t consider the current state to be, overwhelming life experience and not in a good way. And the reason for that is because you have to monitor your blood sugar, like, every minute of every day. You have to in the old days, you have to inject yourself. Now you have a device that pumps and monitors. You have to think about every meal you eat and, like, what it’s gonna do.

And probably the most concerning thing is that if you have any excess insulin, you can have hypoglycemia and pass away. And in fact, like, I was talking to a young woman the other day who’s in college, and her mother has, like, the her, monitor is tied to her mother’s phone so that if she has hypoglycemia, which she has and doesn’t wake up, her mother’s phone at home rings and she calls the, front desk of the dormitory and they send someone up to try and save her life. That’s what it’s like to have type one diabetes. So the idea that you could have a therapy that’s a one time therapy perhaps where you can be off insulin and have normal blood sugar is like a dream that people had. And, what’s remarkable is we bought, Sema five years ago, Doug Melton, who was one of, 14 university professors at Harvard, moved full time to Vertex a few years ago.

He was so excited about it. He spent twenty five years developing this because his kids both have type one diabetes. The current data for VX eight eighty, as you know, which is in pivotal development, is that approximately three quarters of the patients who we who we described and we’ll be updating, at a meet clinical meeting this year at ADA, were off insulin with normal blood sugars. They all had severe hypoglycemic events, and they hadn’t had any since the treatment. The others all had substantial reductions in insulin use so that they weren’t off insulin.

And that led to the conversion of that phase one, two trial to a pivotal trial, which will have 50 people agreed to with the regulators, 50 people, we will complete dosing this year. And then the, the endpoint has changed from removing hypoglycemic episodes to actually being off insulin and blood sugar than with elimination of hypoglycemic events as secondary. And that’s remarkable sort of progress in the field. So in the in the program. So we really couldn’t be more excited about that.

Now you asked about, what about, you know, how would that be scaled? And I think that it’s obviously the case that manufacturing cell and gene therapies is no trivial thing, but, we’ve been working on it for years. And, you know, there’s sort of three ways that we work on it. You know, the most near term, obviously, is we’ve just been working our manufacturing group to scale the current process, make it more efficient. And, also, we have a a site in New Hampshire with, that’s being developed, a factory, basically, to build it with Lonza.

In addition and we already have an existing site, I should say, in Boston for manufacturing that already exists. And so we’re building all that. But the other thing we’re doing, which I think in the long run will have a lot of value, is Doug and the rest of the science team is actually going through and saying, can we fundamentally improve the process? So the sort of scaling of the existing process is the current focus for the launch of August. But you can imagine by dissecting every aspect of this process, we we believe we’ll be able to substantially, sort of make it more scalable, which will also, of course, be a competitive advantage if we’ve discovered things others don’t know.

And our goal, it’s not gonna happen, you know, in a in a year or two, is to treat, you know, a million people. You know, there’s three million people in The US and Europe with type one. I can’t imagine one of them who, if it was, you know, effective and safe enough, would choose to be, you know, treated with, insulin treatment if they could be cured. Excellent. That’s

Dave Reisinger, Covering Diversified Biopharmaceuticals: a great framework, and we look forward to the progress. So the next data readout?

David Altschuler, Chief Scientific Officer, Vertex: So we’ll be describing data for VX eight eighty. There’ll be an update at ’88. And then we also have VX two six four. One thing we I didn’t mention is, obviously, I focused on the cells and that in the last answer, because the cells are the key. You know, if you can’t make if you can make islets off the shelf and you can manufacture them at scale, there’s lots of ways to figure out how to deliver them to patients.

But, obviously, a critical issue since they’re allogeneic, they’re not the person’s own cells, is how do you modulate the immune system? In the case of VX eight eighty, it’s traditional, transplant immunosuppression. And the reason we did that was we wanted to limit the number of variables in the first clinical trial. That approach to immunosuppression had been used with cadaveric islets. So we knew that if we held that constant, we could see how our islets did, and they’ve done very well.

But there’s three ways we’re working to improve that because that certainly has some properties that you could improve upon. One is the device that is now called VX two six four, where the cells are put inside of a device, and that device is then put inside of the patient. And the device was invented by our team was at Sema and now at Vertex that are still all there as the device has novel material, novel design to try and keep the cells, healthy and alive with the glucose going in, the insulin coming out, and not have the kind of, responses others have had. But there are two other approaches in parallel. So that data, I should say, two six four will be reading out, this year.

We’ll read out some data on that. That’s in, you know, as you know, in in, phase this the part b of the trial. The other thing I should say is there’s two other approaches. One is hypoimmune gene editing. That’s, conceptually, very appealing, and we’re the only company that has a CRISPR medicine approved, so we’re good at gene editing.

But nonetheless, it’s picking the targets you need to edit. And I think it’s gonna be a little bit more. I don’t wanna overpromise. Like, I think anyone who claims you can, like, knock out one thing, press one thing, and evade the entire immune system is oversimplifying the efficacy of the human immune system after a hundred million years of evolution. But we’re working on it, and we, in fact, are investing the time and money to discover those targets, not just sort of moving forward.

And then finally, as as you all know, immunomodulators are now a very hot area of development. So there’s actually improved immunomodulators we might be able to use in place of the standard immunosuppression that might already exist. We don’t have to invent them or develop them, and that’s another way to try and improve, the the profile for patients. So, you know, it’s derisked in terms of the cells, obviously, a huge amount to do. And also there’s multiple ways that we can get to modulate the immune system so even more patients can benefit.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. Thank you. So why don’t we pause for a minute? I just wanted to see if anybody from the audience has, any questions.

David Altschuler, Chief Scientific Officer, Vertex: We haven’t, like, said exact So the question I’m sorry. The question was, how big is the device for type one diabetes? We haven’t said exactly, but it’s of a scale that it could be straightforwardly put in in patients, and they would, live a normal life.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Any other questions from the audience? Okay. Maybe we could hit it back to a few financial questions. So obviously, you’ve described the fact that volumes are going to dramatically outpace revenue initially for Jernavix. Could you just discuss that a little bit more and what we should expect you to comment on with respect to paying that picture when you report quarterly results?

Charlie Wagner, CFO and COO, Vertex: Yes. I think it’s fairly straightforward. So Jurnavix is included within our revenue guidance for the year range of $11,750,000,000 to $12,000,000,000 We have said that we expect the contribution to really show up in the second half of the year. The reason for that is that we don’t have broad coverage right immediately after approval. So while we are working urgently to gain coverage, we would like patients and physicians to have access to the medicine, and we’d like them to have a seamless clean experience.

So we have financial assistance programs in place that will allow patients to access the medicine even ahead of payer coverage. That’s why volumes will ramp ahead of revenues. As payers provide coverage for generics, those assistance programs will fall away. They’re temporary. And as those fall away, then we’ll achieve a kind of a more normalized gross to net revenue run rate in the second half of the year.

And as I mentioned, we will in our quarterly results, when the numbers are big enough, we will report out on Jernavix revenues.

Dave Reisinger, Covering Diversified Biopharmaceuticals: And what about payer coverage? So is that something you’ll be able to speak to?

Charlie Wagner, CFO and COO, Vertex: Yes. I think in the early days of the launch, just so that folks have a sense of progress, we will provide data on prescriptions and we’ll provide data on payer coverage.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Excellent. And then maybe looking beyond this year, and I know that you don’t provide long term financial guidance, how should we think about the company’s margin prospects? So gross margin would seem to have some upward pressure given obviously what’s happening with Lyft Track and that uptake, but also Gaschevy drives some downward pressure, although very modest at this point. Could you just contextualize that for us?

Charlie Wagner, CFO and COO, Vertex: Yes. I mean, the good news is I think the strategy of the company lends itself to a really attractive financial profile both top and bottom line. As we work to transform these disease areas with transformative therapies, that equates to tremendous value for patients, values for health systems, but also values for Vertex if we price responsibly. So each of our disease areas that we select, we think can provide significant top line growth and attractive margins. In the shorter term, it’s I think it’s natural when you are in the early days of a launch of a product, there are fixed costs that you’ve put in place either with a sales organization or manufacturing capacity that have to get absorbed as volume grows.

So to your point, if you look at the dynamics for 2025, the margin profile for Aliftrec is better than the margin profile for Trikafta because of lower royalties. So the amount of the benefit to Vertex will depend on the rate of a LiftTrak growth and switching during the year. Offsetting that is margin pressure from KASGEVY, which is very early in its launch and from Genavix, which is very early in its launch. So we see a balancing, if you will, in 2025. Over time, we think each of these disease areas is going to carry attractive margins that are going to allow us to continue to grow and reinvest in the business.

Excellent.

Dave Reisinger, Covering Diversified Biopharmaceuticals: Well, we are out of time. Thank you so much both for being here with us today. Really appreciate it.

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