43
San Francisco – June 16th, 2014 IR Thematic Call on Diabetes

2014/06 - IR - Diabetes

  • Upload
    sanofi

  • View
    2.383

  • Download
    1

Embed Size (px)

Citation preview

Page 1: 2014/06 - IR - Diabetes

San Francisco – June 16th, 2014

IR Thematic Call on Diabetes

Page 2: 2014/06 - IR - Diabetes

2

Sanofi Forward Looking Statements

This presentation contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, as amended. Forward-looking statements are statements that are not historical facts. These statements include projections and estimates and their underlying assumptions, statements regarding plans, objectives, intentions and expectations with respect to future financial results, events, operations, services, product development and potential, and statements regarding future performance. Forward-looking statements are generally identified by the words "expects", "anticipates", "believes", "intends", "estimates", "plans" and similar expressions. Although Sanofi's management believes that the expectations reflected in such forward-looking statements are reasonable, investors are cautioned that forward-looking information and statements are subject to 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 or projected by, the forward-looking information and statements. These risks and uncertainties include among other things, the uncertainties inherent in research and development, future clinical data and analysis, including post marketing, decisions by regulatory authorities, such as the FDA or the EMA, regarding whether and when to approve any drug, device or biological application that may be filed for any such product candidates as well as their decisions regarding labeling and other matters that could affect the availability or commercial potential of such product candidates, the absence of guarantee that the product candidates if approved will be commercially successful, the future approval and commercial success of therapeutic alternatives, the Group's ability to benefit from external growth opportunities, trends in exchange rates and prevailing interest rates, the impact of cost containment policies and subsequent changes thereto, the average number of shares outstanding as well as those discussed or identified in the public filings with the SEC and the AMF made by Sanofi, including those listed under "Risk Factors" and "Cautionary Statement Regarding Forward-Looking Statements" in Sanofi's annual report on Form 20-F for the year ended December 31, 2013. Other than as required by applicable law, Sanofi does not undertake any obligation to update or revise any forward-looking information or statements.

Page 3: 2014/06 - IR - Diabetes

Introduction

3

Pascale Witz Executive Vice President, Global Divisions & Strategic Development

Page 4: 2014/06 - IR - Diabetes

4 4

Agenda

Unmet Needs with Diabetes Treatment ● Riccardo Perfetti, MD – Senior Medical Officer, Diabetes

New Clinical Evidence on Toujeo®

● Matthew C. Riddle, Professor of Medicine – Oregon Health & Science University

Sanofi Leading the Basal Insulin Market ● Pierre Chancel – Senior Vice President, Diabetes

Sanofi Expanding its Diabetes Portfolio ● Pierre Chancel – Senior Vice President, Diabetes

Moving Towards Integrated Care ● Pascale Witz – Executive Vice President, Global Divisions & Strategic Development

Q&A Session

Toujeo® (insulin glargine [rDNA origin] injection, 300 U/mL; “U300”) is new a basal insulin currently in development for the treatment of people with diabetes. Toujeo® is the intended trade name for U300. U300 is not currently approved or licensed anywhere in the world.

Page 5: 2014/06 - IR - Diabetes

Unmet Needs with Diabetes Treatment

5

Riccardo Perfetti, M.D. Senior Medical Officer, Diabetes

Page 6: 2014/06 - IR - Diabetes

Optimal dose often not reached

during initiation or maintenance

phase1–6

Fear of hypoglycemia &

insulin-associated

weight gain are barriers to

effective insulin use7–13

High discontinuation of basal insulins during the first

6 months16

50% of patients on

insulin are still not at target1–6

Significant burden of

intra-patient glucose

variability in patients15

Hypoglycemia is a major

contributor to treatment

discontinuation /transition14

Unmet Needs

(1) Steinberg BA et al. Am Heart J 2008, (2) Chan JCN et al. Diabetes Care 2009, (3) Choi YJ et al. Diabetes Care 2009, (4) Banegas JR et al. Eur Heart J 2011, (5) Vouri SM et al. J Manag Care Pharm 2011, (6) Casagrande SS et al. Diabetes Care 2013, (7) Polonsky WH et al. Diabetes Care 2005, (8) Funnell MM et al. Clinical Diabetes 2007, (9) Karter AJ et al. Diabetes Care 2010, (10) Khunti K et al. Diabetes Care 2013, (11) Russell-Jones D et al. Diabetes Obes Metab 2007, (12) Pontiroli AE et al. Diabetes Obes Metab 2011, (13) DAWN2, Diabetes Attitudes, Wishes, and Needs Study, (14) Bron M et al. Postgrad Med 2012, (15) Skaff M et al. Health Psychol 2009, (16) Quantification of patient adherence to Lantus® treatment initiation, IMS (US, UK & Germany), 2013 [Market Research]

Unmet Medical Needs Remain a Reality in the Insulin Space

6

Page 7: 2014/06 - IR - Diabetes

As for any Chronic Disease, People with Diabetes Struggle to Stay on Treatment

Source: Quantification of Patient Adherence to Treatment Initiation (U.S., 2013), IMS 7

Proportion of Patients who Continue With Initially Prescribed Treatment

% of Patients Continuing Treatment

at Month 6

% of Patients Continuing Treatment

at Month 12

0%

25%

50%

75%

100%

0%

25%

50%

75%

100%

Page 8: 2014/06 - IR - Diabetes

Patients Fear that Insulin Treatment May Be a Source of Hypoglycemia, Complexity and Weight Gain

0% 25% 50% 75% 100%

Meant my disease was worsening

Cause hypoglycemia

Have to be on it forever once you start

Represented failure to care of my health

Difficult to integrate insulin injections into my daily routine

Cause weight gain

Injections would be painful

Add restrictions to my eating/sleeping schedule

My diabetes was NOT “severe enough”

Would limit what I can eat

Percent concerned (1) Source: Insulin glargine satisfaction study, Impact Rx, Dec 2012 (U.S., n=225)

Top 10 Concerns With Insulin Initiation(1)

8

Page 9: 2014/06 - IR - Diabetes

Hypoglycemia is a Significant Contributor to Sub-Optimal Dosing and Discontinuation of Insulin Therapy

9

Patient reluctance to initiate or comply with

insulin treatment

Hard to maintain routine (treatment, eating habits);

triggers hypoglycemia

Reduced insulin dose

Sub-optimal insulin dose lack of efficacy; not achieving A1c goals

Treatment discontinuation or switch

Eventual return to insulin treatment

The drop-off cycle

Source: Uncontrolled insulin drop-off patients and HCPs – insights regarding insulin drop-off Findings from previous S-A research – LOLA assessment of uncontrolled patients

The drop-off cycle

4

5

6 2

3

1

Page 10: 2014/06 - IR - Diabetes

Emotional and Economic Burden Reported events associated with

hypoglycemia in prior 12 months (%)(1)

Substantial Cost Burden to the Healthcare System Associated with Hypoglycemia

10

3% 4%

55%

49%

10%

Hospitalization ED visit Consulted HCP ≥1

Consulted HCP ≤5

Sick leave from work

ED: Emergency department; HCP: Healthcare professional (1) Willis WD et al. Expert Rev Pharmacoecon Outcomes Res. 2013;13:123-130 and European online survey (n=1,848) (2) Ward A et al. J Med Econ, Vol. 17, No. 3, 2014, 176–183

Complication Estimated Costs Per Patient

Hypoglycemia requiring hospitalization

$16,478

Hypoglycemia requiring ED visit $1,331

Cost Impact of Hypoglycemia is High Estimated direct medical costs

per patient per episode(2)

~1/3 of patients very worried

about hypoglycemia

Page 11: 2014/06 - IR - Diabetes

Many People with Diabetes are Still Not at A1c Goal despite Treatment

11

47% 47%

53% 53%

2013(437)

2013(2215)

Controlled (<=7%) Uncontrolled (>7%)

All T1D Patients

All T2D Diabetes

Source: Adelphi Real World Diabetes Disease Specific Programme (DSP) X, 2013 Base: All US diabetic patients where doctor has stated most recent HbA1c (random sample). “All patients” are treated patients and must be on an OAD, GLP-1 or insulin

Page 12: 2014/06 - IR - Diabetes

Diabetes Is Associated with Micro and Macrovascular Complications

12

Microvascular Complications Macrovascular Complications

Diabetic Retinopathy Leading cause of blindness in working-age adults

Diabetic Nephropathy Leading cause of end-stage renal disease

Heart Disease Leading cause of mortality in patients with Type 2 diabetes

Peripheral Vascular Disease Leading cause of non-traumatic lower-extremity amputations

Diabetic Neuropathy Leading cause of diabetic foot syndrome and non-traumatic lower-extremity amputations

Stroke 25% of all ischemic strokes are due to diabetes alone or with hypertension

(1) Endocrinol Metab Clin 1996;25:243 - 254 (DCC Trial) (2) Diabetes Care Publish Ahead of Print, published online March 6, 2013

Risk of complications and HbA1c(1)

HbA1C(%)

Rel

ativ

e R

isk

in %

1

3

5

7

9

11

13

15

6 7 8 9 10 11 12

Retinopathy Nephropathy

Microalbuminuria Neuropathy

25% to 45% of diabetes-attributed medical expenditures spent treating complications of diabetes(2)

Page 13: 2014/06 - IR - Diabetes

New Clinical Evidence on Toujeo®

13

Matthew C. Riddle, Professor of Medicine

Oregon Health & Science University

Toujeo® is the intended trade name for the investigational product insulin glargine 300 U/ml.

Page 14: 2014/06 - IR - Diabetes

Toujeo® Provides More Constant Absorption of Glargine after Subcutaneous Injection

14

Three-fold more concentrated formulation of glargine

Reduced volume (1/3) and reduced surface area (1/2) of subcutaneous depot

Slower and more constant rate of absorption

Schematic illustration

Toujeo®

Page 15: 2014/06 - IR - Diabetes

Toujeo® Has a Flatter and More Prolonged PK/PD Profile than Lantus®

15

Flatter PK Profile More Prolonged PD Profile

Dahmen R et al, 2013 ADA, abstract 113-OR (euglycemic clamp study in T1D in steady state) PK/PD: Pharmacokinetic/Pharmacodynamic

0 6 12 18 24 30 36

0

1

2

3

4

5DOSE 0.4 U.kg-1

U300 U100

GIR

- mg.

kg-1.m

in-1

TIME - hour

Glucose Infusion Rate

0 6 12 18 24 30 36

0

5

10

15

20

25

30

LLOQ 5.02 µU.mL-1

SC INJECTION

INSU

LIN

- µU.

mL-1

TIME - hour

U100 0.4 U.kg-1

U300 0.4 U.kg-1

LOESS 0.15

Toujeo®

Lantus®

Serum Insulin Glargine Concentration

Toujeo®

Lantus®

Page 16: 2014/06 - IR - Diabetes

EDITION: A Comprehensive Phase III Program Testing Toujeo® in Different Diabetes Populations

16

Study Population Intervention Data Released

EDITION 1 Type 2 Basal + mealtime insulin √

EDITION 2 Type 2 Basal + oral therapy √

EDITION 3 Type 2 Insulin naïve √

EDITION 4 Type 1 Basal + mealtime insulin √

EDITION JP 1 Type 1 Basal + bolus insulin √

EDITION JP 2 Type 2 Basal + oral therapy √

Toujeo® vs.

Today’s focus will be on Type 2 Diabetes

Page 17: 2014/06 - IR - Diabetes

Pooled Analysis of EDITION Phase III Trials in Type 2 Diabetes (T2D)(1)

17

Baseline characteristics Toujeo® Lantus®

Age (years) 58.7 58.5

BMI (kg/m2) 34.7 34.8

Duration of diabetes (years) 12.7 12.6

A1c (%) 8.31 8.32

n=1,249

Screening period Up to 2 weeks

Qualifying visit: 7% ≤ A1c ≤10% 7% ≤ A1c ≤10% 7% ≤ A1c ≤11%

Concomitant glucose-lowering therapy R

T2D patient

(≥18 years old) Toujeo®

Lantus®

n=1,247 Evaluation

of endpoints

at 6 months

FPG target: 80-100 mg/dL (4.4-5.6 mmol/L) Basal insulin dose adjusted once weekly

Concomitant glucose-lowering therapy

EDITION 1 + Mealtime insulin + Met

EDITION 2 + Met + OADs(3)

EDITION 3 + Met + OADs(4)

Glucose-lowering therapy at screening: EDITION 1: Basal(2) + mealtime insulin + OADs 2: Basal(2) + OADs

3: Insulin naïve + OADs

Met: metformin OAD: oral antihyperglycemic drug FPG: Fasting plasma glucose (1) Ritzel R et al, 2014 ADA, abstract 90-LB (2) Total daily dose Lantus® ≥42 U (or equivalent dose of NPH) (3) Use of sulfonylureas were prohibited within 2 months prior to screening and during the study (4) Except sulfonylureas, glinides and other OADs not approved for use with insulin

Titration period Maintenance phase

Page 18: 2014/06 - IR - Diabetes

7.00%

7.20%

7.40%

7.60%

7.80%

8.00%

8.20%

8.40%

0 1 2 3 4 5 6 7 8

8.4%

8.2%

8.0%

7.0%

7.2%

7.4%

7.6%

7.8%

Baseline Week 12 Month 6

Toujeo® was as Effective as Lantus® in Improving Glycemic Control(1)

18

Mean A1c (%) from Baseline

A1c

(%) M

ean

± S

E

LS mean difference between groups (95% CI)

0.00 (-0.08 to 0.07)

Lantus®

Toujeo®

(1) Pooled analysis of EDITION 1, 2 & 3 - Ritzel R et al, 2014 ADA, abstract 90-LB LS: Last square

Page 19: 2014/06 - IR - Diabetes

(1) Confirmed: ≤70 mg/dL (≤3.9 mmol/L) (2) Pooled analysis of EDITION 1, 2 & 3 - Ritzel R et al, 2014 ADA, abstract 90-LB

With Toujeo® -- Lower Rates of Confirmed(1) or Severe Hypoglycemic Events(2)

Event Rate Per Patient-Year Across The 6-Month Study Period

Cumulative Mean Number of Events Per Patient

Any Time (24 h)

Nocturnal (00:00-05:59)

19

0

1

2

3

2 4 6 8 10 12 14 16 18 20 22 24 26 28

0

2

4

6

8

10

2 4 6 8 10 12 14 16 18 20 22 24 26 28Week

15.22

3.06

17.73

2.10

= Statistically significant Week

Lantus®

Toujeo®

Lantus®

Toujeo®

Lantus® Toujeo®

-14%

-31%

RR: 0.69 (0.57 to 0.84) p=0.0002

RR: 0.86 ( 077 to 0.97) p=0.0116

Page 20: 2014/06 - IR - Diabetes

With Toujeo® -- Fewer Patients Experienced Confirmed

or Severe Hypoglycemia across Study Periods(1)

20

0%

10%

20%

30%

40%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Nocturnal (00:00-05:59) Any Time of Day (24 h)

Baseline to Week 8

Week 9 to Month 6

Baseline to Month 6

Baseline to Week 8

Week 9 to Month 6

Percentage of Patients Reporting ≥1 Event ≤ 70 mg/dL (3.9 mmol/L)

Baseline to Month 6

RR: 0.91 (0.87 to 0.96)

RR: 0.83 (0.77 to 0.89)

RR: 0.75 (0.68 to 0.83)

RR: 0.69 (0.58 to 0.81)

RR: 0.92 (0.86 to 0.98) RR: 0.80

(0.71 to 0.91)

Lantus®

Toujeo®

(1) Pooled analysis of EDITION 1, 2 & 3 - Ritzel R et al, 2014 ADA, abstract 90-LB

-9% -25%

= Statistically significant

Page 21: 2014/06 - IR - Diabetes

21

0%

5%

10%

15%

20%

25%

0%

10%

20%

30%

40%

50%

Baseline to Week 8

Week 9 to Month 6

Baseline to Month 6

Baseline to Week 8

Week 9 to Month 6

Baseline to Month 6

RR: 0.81 (0.72 to 0.90)

RR: 0.78 (0.66 to 0.93)

RR: 0.73 (0.59 to 0.81)

RR: 0.73 (0.53 to 1.02)

RR: 0.87 (0.76 to 1.01)

RR: 0.76 (0.58 to 0.99)

Lantus®

Toujeo®

Any Time of Day (24 h) Nocturnal (00:00-05:59)

Percentage of Patients Reporting ≥1 Event ≤ 54 mg/dL (3.0 mmol/L)

With Toujeo® -- Fewer Patients Experienced Confirmed

or Severe Hypoglycemia across Study Periods(1)

-19%

-27%

(1) Pooled analysis of EDITION 1, 2 & 3 - Ritzel R et al, 2014 ADA, abstract 90-LB = Statistically significant

Page 22: 2014/06 - IR - Diabetes

Less Weight Gain was Observed with Toujeo®

than with Lantus®(1)

22

Mean Change From Baseline in Weight (kg) by Visit

-0,50

0,00

0,50

1,001.0

0.5

0

-0,5

Mean difference between groups (95% CI)

-0.28kg (−0.55 to 0.01) p=0.039

Wei

ght C

hang

e (k

g) M

ean

± S

E

Adverse Events Both treatments were

generally well tolerated with similar rates of AEs

Lantus®

Toujeo®

Mean dose 0.76 UI/kg/day

Mean dose 0.85UI/kg/day

(1) Pooled analysis of EDITION 1, 2 & 3 - Ritzel R et al, 2014 ADA, abstract 90-LB LOV: last on-treatment value defined as the last measurement made prior to or on the day of the last investigational product intake during the main 6-month on-treatment period.

= Statistically significant

Page 23: 2014/06 - IR - Diabetes

23

0

2

4

6

8

10

12

14

16

0 2 4 6 8 10 12 14 16 18 20 22 24 26

0

1

2

3

4

5

0 2 4 6 8 10 12 14 16 18 20 22 24 26

Cumulative Mean Number of Events Per Patient

Any Time (24 h)

Nocturnal (00:00-05:59)

Week

Week

Lantus®

Toujeo®

Lantus®

Toujeo®

Event Rate Per Patient-Year Across The 6-Month Study Period

10.48

4.98

16.52

2.18

Lantus® Toujeo®

-36%

-55%

RR: 0.45 (0.21 to 0.96)

RR: 0.64 (0.43 to 0.96)

(1) Confirmed: ≤70 mg/dL (≤3.9 mmol/L) (2) Terauchi Y et al. 2014 ADA, abstract 94-LB

= Statistically significant

EDITION JP 2 -- Lower Rates of Confirmed(1) or Severe Hypoglycemic Events(2)

Page 24: 2014/06 - IR - Diabetes

New Clinical Evidence on Toujeo®

24

● A pooled analysis of 6-month data from EDITION 1, 2 and 3(1) demonstrated, compared with Lantus®

● Comparable glycemic control

● Less hypoglycemia, especially at night, and consistently in the first 8 weeks as well as from 8 weeks to 6 months

● Limited weight effect

● EDITION JP 2(2), in T2D Japanese patients uncontrolled on basal insulin, also showed significantly less hypoglycemia with Toujeo®

● Over one year of treatment in EDITION 1(3) and 2(4), Toujeo® provided sustained glycemic control with a lower risk of hypoglycemia compared with Lantus®

● A sub-study(5) of EDITION 1 and 2 demonstrated no untoward effects of occasionally adapting dosing intervals by ±3 hours

(1) Ritzel R et al, 2014 ADA, abstract 90-LB (2) Terauchi Y et al. 2014 ADA, abstract 94-LB (4) Yki-Järvinen H 2014 ADA, abstract 93-LB (3) Riddle MC et al 2014 ADA, abstract 81-LB (5) Riddle MC et al 2014 ADA, abstract 919-P

Summary

Page 25: 2014/06 - IR - Diabetes

Conclusion

25

● Toujeo® is as effective as Lantus® in controlling glucose in T2D

● Lower risk of hypoglycemia with Toujeo® was consistently found both early and late after intensification of treatment, in different populations, and when timing of injections was flexible

● These findings support the potential of Toujeo® to further enhance the clinical value of basal insulin

Toujeo® in T2D

Page 26: 2014/06 - IR - Diabetes

Sanofi Leading the Basal Insulin Market

26

Pierre Chancel Senior Vice President, Diabetes, Sanofi

Page 27: 2014/06 - IR - Diabetes

27

Global Treatment Paradigm Shift Towards Basal Insulin

Breakdown By Insulin Type Market Share (%)

2003 - 2013 Worldwide Insulin Market Development (Value)

47.8%

Source: Market share data from IMS Health MIDAS Q4/2013 – Copyright 2014 – All rights reserved

31.8%

48.9%

36.1%

17.1%

32.1% 34.0%

0%

10%

20%

30%

40%

50%

60%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% of Sales

Basal Premix SAI

Page 28: 2014/06 - IR - Diabetes

Basal Insulin New Gold Standard in All Regions

28

2003 – 2013 Insulin Market by Insulin Type (Value) Market Share (%)

+ 23% + 24%

+ 8%

- 1%

+ 3%

+ 1%

+ 4% + 0%

+ 7%

+ 14% + 15%

35.9%

51.3%

29.6%

11.3%

34.5%

37.4%

0%

10%

20%

30%

40%

50%

60%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% of Sales

Basal Premix SAI

29.9%

47.7%

36.9%

16.3% 33.2%

36.0%

0%

10%

20%

30%

40%

50%

60%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% of Sales

Basal Premix SAI

30.1%

42.7% 48.2%

37.8%

21.7% 19.5%

0%

10%

20%

30%

40%

50%

60%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% of Sales

Basal Premix SAI

25.1%

44.2% 45.1%

23.0% 29.8% 32.8%

0%

10%

20%

30%

40%

50%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% of Sales

Basal Premix SAI

Japan/Can/Aus/NZ Emerging Markets(2)

U.S. Western Europe(1)

(1) France, Germany, UK, Italy, Spain, Greece, Cyprus, Malta, Belgium, Luxembourg, Portugal, Netherlands, Austria, Switzerland, Sweden, Ireland, Finland, Norway, Iceland, Denmark (2) World excluding the U.S. and Canada, Western Europe, Japan, Australia and New Zealand Source: Market share data from Source IMS Health MIDAS Q4/2013 – Copyright 2014 – All rights reserved

Page 29: 2014/06 - IR - Diabetes

29

Sanofi has a Strong Position in the Basal Market, the Fastest Growing Insulin Segment

Breakdown By Insulin Type Market Share (%)

Growth vs. Prior Year (%)

Basal Breakdown By Brand Market Share (%)

Growth vs. Prior Year (%)

2013 Worldwide Insulin Market Breakdown (Value)

47.8%

18.3%

SAI: Short-Acting Insulins NPH: Neutral Protamine Hagedorn Source: Market share data from IMS Health MIDAS Q4/2013 – Copyright 2014 – All rights reserved

Basal 48.9% + 21.5 %

SAI 34.0% +18.0 %

Premix 17.1% + 7.3 %

69.3% + 22.9 %

Levemir® 20.6% +27.4 %

Tresiba® 0.2% NPH

9.9% +1.8%

Lantus®

Page 30: 2014/06 - IR - Diabetes

Basal Insulins Constitute the Leading and Fastest Growing Insulin Segment Across All Geographies

30

2013 Insulin Market Breakdown by Insulin Type (Value) Market Share (%)

Growth vs. Prior Year (%) U.S.

Emerging Markets

17% - 5%

12% + 7%

50% + 24%

47% + 5%

42% + 12%

38% + 10%

Source: Market share data from Source IMS Health MIDAS Q4/2013 – Copyright 2014 – All rights reserved

51.3% +28.8%

37.4% +24.1%

11.3% +12.0%

47.7% +5.0%

36.0% +3.7%

16.3% - 3.7%

42.7% +17.3%

19.5% +17.8%

37.8% +11.7%

44.2% +11.0%

32.8% +4.3%

23% -6.6%

Western Europe

Japan/Can/Aus/NZ Premix

Basal SAI

Page 31: 2014/06 - IR - Diabetes

60.8% +7.4%

24.8% +5.6%

14.1% - 5.9%

0.2%

69.0% +14.7%

17.6% + 2.4%

11.3% -11.0%

2.1%

Lantus® as a Well-established Position on the Basal Market in all Geographies

31

2013 Basal Insulin Market Breakdown by Brand(Value) Market Share (%)

Growth vs. Prior Year (%)

12% + 7%

50% + 24%

Source: Market share data from Source IMS Health MIDAS Q4/2013 – Copyright 2014 – All rights reserved

74.4% +28.9%

20.8% +41.1%

4.9% -6.5%

56.3% +16.1%

16.3 % +17.1%

27.3 % +19.4%

0.1%

U.S.

Emerging Markets

Western Europe

Japan/Can/Aus/NZ NPH

Lantus®

Levemir®

Tresiba®

Page 32: 2014/06 - IR - Diabetes

Patients Initiating or Using Basal Insulin Therapy Represent a Large Pool of Diabetic Patients

32

Existing Basal Insulin users

~14m patients (80% T2D)

>50% uncontrolled

Insulin naïve patients starting

Basal Insulin ~4m patients

START WITH SWITCH TO

STAY ON

Patient numbers: Company estimates based on various sources – 11 main markets (U.S. Top 5 EU, Japan, and BRIC countries) Toujeo is the intended trade name for the investigational product insulin glargine U300/ml

Page 33: 2014/06 - IR - Diabetes

Toujeo®: New Generation Basal Insulin to Improve Patient Care

33

● The basal insulin market is large and growing

● Patients initiating or using basal insulin therapy represent a broad pool of diabetics with unmet needs

● Toujeo® offers a competitive profile

● Sanofi uniquely positioned to sustain a strong foothold in diabetes with Toujeo® and other new product opportunities

● EMA evaluation of application recently started

● NDA submitted in the U.S.

● Submission in Japan planned in H2 2014

● Phase IIIb/IV plan and patient support program

Next Steps Conclusion

Page 34: 2014/06 - IR - Diabetes

Sanofi Expanding its Diabetes Portfolio

34

Pierre Chancel Senior Vice President, Diabetes, Sanofi

Page 35: 2014/06 - IR - Diabetes

® New Data(1) Reinforces That Not All GLP-1 Receptor Agonists Are the Same

35

PPG Levels at Baseline and Week 8(1) ● More pronounced PPG-lowering

effect of lixisenatide vs. liraglutide, as add-on to Lantus®(1)

● Lyxumia® launch status ● Commercially available in UK,

Spain, Italy, Japan and Mexico

● ELIXA CV outcome trial on track ● Results expected in H1 2015 ● U.S. submission planned in

summer 2015

*p<0.0001 for change vs. baseline †p<0.0001 for change with lixisenatide vs liraglutide

(1) PPG (post-prandial glucose) lowering effect evaluated after a test-meal - Meier JJ et al, 2014 ADA, Poster 1017-P

Treatment groups

Day -1 / Before treatment (full lines)

Week 8 (dotted lines)

Page 36: 2014/06 - IR - Diabetes

: Combining Insulin Glargine With Lixisenatide in a Single Daily Injection

36

● Phase III program initiated in Q1 2014 ● LixiLan-O study in patients insufficiently

controlled on OADs (1,125 patients)

● LixiLan-L study in patients not at goal on basal insulin (700 patients)

● >90% of study sites initiated

● Potential to be the first combination of [Basal Insulin + GLP-1] in a single daily injection marketed in the U.S. ● Targeted FDA submission could be as

early as end of 2015

Patients Uncontrolled

with basal therapy

~4m patients

Patients Not at Target

on OAD ~5.5m

patients

Number of patients estimated for the U.S. (2017 projections based on internal model adapted from Adelphi)

1st injectable drug

Basal Intensification

U.S. Target Populations of T2D Patients for

Page 37: 2014/06 - IR - Diabetes

New Insulin Lispro (SAR342434) Progressing to Phase III Development in H2 2014

37

● Complementary to Sanofi Diabetes portfolio aiming at offering patients complete solutions for better outcomes

● Phase I completed ● Similar activity and exposure

demonstrated to Humalog®(1)

● Phase III program to recruit ~1,000 patients

● Leading rapid-acting insulin among U.S. T1D pump users(2)

Phase III study in T1D Patients vs. Humalog®

Phase III study in T2D Patients vs. Humalog®

Insulin lispro is marketed by Eli Lilly and Company as Humalog®

(1) Using the euglycemic clamp technique in subjects with Type 1 Diabetes (data on file) (2) Sourced from www.insulin-pumpers.org (June 2, 2014) T1D: Type 1 Diabetes

Insulin Lispro Structure

LysB28

ProB29

Page 38: 2014/06 - IR - Diabetes

Moving Towards Integrated Care

38

Pascale Witz Executive Vice President, Global Divisions & Strategic Development

Page 39: 2014/06 - IR - Diabetes

No single product or service can satisfy the market demand for simple, complete solutions that provide better outcomes

39

Integrated Care: Tremendous Potential to Improve Patients’ Lives

● Increase adherence to products

● Better patient experience

● Improved outcome

● Cost control

TOMORROW TODAY

Page 40: 2014/06 - IR - Diabetes

Working to Improve the Journey of People with Diabetes

40

®

Integrated Care

BGM Drug Delivery Digital Heath Drugs

Patient Support

MyStar Care®

LixiLan and Toujeo® are under development. These products are not approved or licensed anywhere in the world.

Page 41: 2014/06 - IR - Diabetes

Global Strategic Alliance between Sanofi and Medtronic Supports Broader Strategy(1)

● Leader in insulin pumps and continuous glucose monitoring

● Drug delivery technology ● Miniaturization ● Implantable devices

● Leader in insulin management ● Deep clinical and medical expertise ● Regulatory and market access ● Leading portfolio of

pharmaceuticals

Structured as open innovation model, leveraging complementary strengths of both companies

Initial focus on novel drug-device combinations and care management services

41 (1) Sanofi and Medtronic announced on June 14, 2014 that they have signed a memorandum of understanding to enter into global strategic alliance in diabetes.

Page 42: 2014/06 - IR - Diabetes

42

Taking Care of People with Diabetes

Page 43: 2014/06 - IR - Diabetes

Q&A

43